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Surgical readmission

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https://www.readbyqxmd.com/read/28329352/costs-and-consequences-of-early-hospital-discharge-after-major-inpatient-surgery-in-older-adults
#1
Scott E Regenbogen, Anne H Cain-Nielsen, Edward C Norton, Lena M Chen, John D Birkmeyer, Jonathan S Skinner
Importance: As prospective payment transitions to bundled reimbursement, many US hospitals are implementing protocols to shorten hospitalization after major surgery. These efforts could have unintended consequences and increase overall surgical episode spending if they induce more frequent postdischarge care use or readmissions. Objective: To evaluate the association between early postoperative discharge practices and overall surgical episode spending and expenditures for postdischarge care use and readmissions...
March 22, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28327899/thirty-day-readmission-rates-following-deep-brain-stimulation-surgery
#2
Ashwin G Ramayya, Kalil G Abdullah, Arka N Mallela, John T Pierce, Jayesh Thawani, Dmitry Petrov, Gordon H Baltuch
BACKGROUND: Deep brain stimulation (DBS) has emerged as a safe and efficacious surgical intervention for several movement disorders; however, the 30-day all-cause readmission rate associated with this procedure has not previously been documented. OBJECT: To perform a retrospective cohort study to estimate the 30-day all-cause readmission rate associated with DBS. METHODS: We reviewed medical records of patients over the age of 18 who underwent DBS surgery at Pennsylvania Hospital of the University of Pennsylvania between 2009 and 2014...
March 15, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28327274/physician-extenders-on-surgical-services-a%C3%A2-systematic-review
#3
Jagdeep Johal, Andrew Dodd
BACKGROUND: With the introduction of resident duty hour restrictions and the resulting in-house trainee shortages, a long-term solution to ensure safe and efficient patient care is needed. One solution is the integration of nurse practitioners (NPs) and physician assistants (PAs) in a variety of health care settings. We sought to examine the use of NPs and PAs on surgical/trauma services and their effect on patient outcomes and resident workload. METHODS: We performed a systematic review of EMBASE, Medline, CINAHL, and the Cochrane Central Register of Controlled Trials...
April 1, 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28327122/midodrine-as-adjunctive-support-for-treatment-of-refractory-hypotension-in-the-intensive-care-unit-a-multicenter-randomized-placebo-controlled-trial-the-midas-trial
#4
Matthew H Anstey, Bradley Wibrow, Tharusan Thevathasan, Brigit Roberts, Khushi Chhangani, Pauline Yeung Ng, Alexander Levine, Alan DiBiasio, Todd Sarge, Matthias Eikermann
BACKGROUND: Patients admitted to intensive care units (ICU) are often treated with intravenous (IV) vasopressors. Persistent hypotension and dependence on IV vasopressors in otherwise resuscitated patients lead to delay in discharge from ICU. Midodrine is an oral alpha-1 adrenergic agonist approved for treatment of symptomatic orthostatic hypotension. This trial aims to evaluate whether oral administration of midodrine is an effective adjunct to standard therapy to reduce the duration of IV vasopressor treatment, and allow earlier discharge from ICU and hospital...
March 21, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28325504/buttressing-of-the-eea-stapler-during-gastrojejunal-anastomosis-decreases-rate-of-bleeding-related-complications-for-laparoscopic-gastric-bypass
#5
Zachary A Ichter, Lindsay Voeller, Homero Rivas, Habib Khoury, Dan Azagury, John M Morton
BACKGROUND: Bariatric surgery is a well-tolerated and effective treatment for severe obesity. Newer surgical techniques and equipment have improved safety standards surrounding bariatric surgery. In particular, buttressing of the staple line in sleeve gastrectomy has decreased rates of clinically significant postoperative bleeding. The present study investigates the effectiveness of buttressing the circular stapled anastomosis during laparoscopic Roux-en-Y gastric bypass (LRYGB). SETTING: Academic, accredited hospital...
January 11, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28325053/-iatrogenic-biliary-tract-lesions-requiring-surgical-reconstruction-presentation-and-classification-of-the-lesions-their-reconstruction-and-evaluation-of-the-results
#6
M Straka, E Holášková, L Burda, M Vávrová, P Fojtík, M Škrovina
INTRODUCTION: The incidence of biliary duct injuries requiring surgical reconstruction has stabilised between 0.30.7%. Biliary reconstruction in the hands of a trained hepatobiliary surgeon may lead to better short- and long-term outcomes in patients with this infrequent, but serious complication. METHODS: This study presents a retrospective analysis of single surgeon experience with biliary injury repair during the period of 20072016. Extramucosal hepaticojejunostomy on the excluded segment of the jejunal loop was performed without the use of any transanastomotic drain...
2017: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/28323788/traumatic-colon-injury-in-damage-control-laparotomy-a-multicenter-trial-is-it-safe-to-do-a-delayed-anastomosis
#7
Leah Carey Tatebe, Andrew Jennings, Ken Tatebe, Alexandra Handy, Purvi Prajapati, Michael Smith, Tai Do, Gerald O Ogola, Rajesh R Gandhi, Therese M Duane, Stephen Luk, Laura Bruce Petrey
BACKGROUND: Delayed colonic anastomosis after damage control laparotomy (DCL) is an alternative to colostomies during a single laparotomy (SL) in high-risk patients. However, literature suggests increased colonic leak rates up to 27% with DCL, and various reported risk factors. We evaluated our regional experience to determine if delayed colonic anastomosis was associated with worse outcomes. METHODS: A multicenter retrospective cohort study was performed across three Level I trauma centers encompassing traumatic colon injuries from January 2006 through June 2014...
April 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28322488/surgical-glue-in-laparoscopic-sleeve-gastrectomy-an-initial-experience-and-cost-effectiveness-analysis
#8
Gregoire Mercier, Marcelo Loureiro, Vera Georgescu, El Mehdi Skalli, Marius Nedelcu, Mohamed Ramadan, Jean Michel Fabre, Patrick Lefebvre, David Nocca
RATIONALE, AIMS, AND OBJECTIVES: Laparoscopic sleeve gastrectomy (LSG) is one of the most common bariatric procedures. Gastric leaks and bleeding are the most frequent complications, associated with a high clinical and economic burden. The best method of staple line reinforcement in LSG is debated. Surgical glue is one of the options available. The aim of this study was to assess the safety, efficiency, and relative cost-effectiveness of surgical glue used to perform LSG in morbid obese adults as compared with standard stapling...
March 21, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28321533/perioperative-antibiotic-use-in-vagus-nerve-stimulator-implantation-a-clinical-series
#9
Jeffrey S Raskin, Daniel Hansen, Arvind Mohan, I-Wen Pan, Daniel J Curry, Sandi Lam
PURPOSE: Preoperative antibiosis contributes up to one third of total antibiotic use in major hospitals. Choice of antibiotic is not uniformly standardized, and polypharmacy regimens may be used without knowing the effect on rates of surgical site infection, nonsurgical infections, or antibiotic resistance. Careful examination of trends in surgical prophylaxis is warranted. In this study, we aimed to examine our institution's experience with vagus nerve stimulator (VNS) implantation, focusing on association between perioperative antibiotic practices and postoperative infectious outcomes...
March 20, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28317227/trends-in-the-surgical-treatment-of-benign-prostatic-hyperplasia-in-a-tertiary-hospital
#10
Darren Ow, Nathan Papa, Marlon Perera, Peter Liodakis, Shomik Sengupta, Stephen Clarke, Damien M Bolton, Nathan Lawrentschuk
BACKGROUND: To assess current treatment trends and perioperative outcomes of transurethral resection of the prostate (TURP) and photoselective vaporization of the prostate (PVP) in a tertiary institution. METHODS: We prospectively collected a database of all patients undergoing TURP and PVP for benign prostatic hyperplasia (BPH) at a tertiary hospital between January 2011 and December 2013. Patient characteristics such as length of stay, readmission, anticoagulation status, American Society of Anesthesiologists (ASA) score and need for blood transfusion were recorded and analysed...
March 19, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28315721/current-outcomes-and-predictors-of-treatment-failure-in-patients-with-surgical-site-infection-after-elective-colorectal-surgery-a-multicentre-prospective-cohort-study
#11
Aina Gomila, Josep Ma Badia, Jordi Carratalà, Xavier Serra-Aracil, Evelyn Shaw, Vicens Diaz-Brito, Antoni Castro, Elena Espejo, Carmen Nicolás, Marta Piriz, Montserrat Brugués, Josefina Obradors, Ana Lérida, Jordi Cuquet, Enric Limón, Francesc Gudiol, Miquel Pujol
OBJECTIVE: To determine current outcomes and predictors of treatment failure among patients with surgical site infection (SSI) after colorectal surgery. METHODS: A multicentre observational prospective cohort study of adults undergoing elective colorectal surgery in 10 Spanish hospitals (2011-2014). Treatment failure was defined as persistence of signs/symptoms of SSI or death at 30 days post-surgery. RESULTS: Of 3,701 patients, 669 (18.1%) developed SSI; 336 (9...
March 15, 2017: Journal of Infection
https://www.readbyqxmd.com/read/28306648/site-specific-approach-to-reducing-emergency-department-visits-following-surgery
#12
Hassaan Abdel Khalik, Haley Stevens, Arthur M Carlin, Amanda Stricklen, Rachel Ross, Carl Pesta, Jonathan F Finks, Andrew Ibrahim, Amir A Ghaferi
OBJECTIVE: The aim of this study was to explore the efficacy of current bariatric perioperative measures at reducing emergency department (ED) visits following bariatric surgery in the state of Michigan. SUMMARY OF BACKGROUND DATA: Many ED visits following bariatric surgery do not result in readmission and may be preventable. Little research exists evaluating the efficacy of perioperative measures aimed at reducing ED visits in this population. Therefore, understanding the driving factors behind these preventable ED visits may be a fruitful approach to prevention...
March 16, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28304095/postoperative-complications-of-total-laryngectomy-in-diabetic-patients
#13
Andrey Filimonov, Jacob S Brady, Aparna Govindan, Aziz Merchant, Jean Anderson Eloy, Soly Baredes, Richard Chan Woo Park
OBJECTIVES/HYPOTHESIS: Analyze postoperative complications of total laryngectomies (TL) in patients with diabetes mellitus and apply these data toward preoperative management of diabetic patients undergoing TL. STUDY DESIGN: Retrospective analysis of surgical outcomes database METHODS: The American College of Surgeons National Surgical Quality Improvement Program database was queried for TL performed between 2005 and 2013. Comparison of demographics, preoperative comorbidities, and postoperative outcomes in a diabetic versus a nondiabetic cohort was conducted using SPSS software...
March 17, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28299203/outcomes-of-bariatric-surgery-in-morbidly-obese-patients-with-multiple-sclerosis
#14
Kalman Bencsath, Adham Jammoul, Ali Aminian, Hideharu Shimizu, Carolyn J Fisher, Philip R Schauer, Alexander Rae-Grant, Stacy A Brethauer
Obesity is common in patients with multiple sclerosis (MS); however, safety and efficacy of bariatric surgery in this population remain unclear. A database of 2,918 was retrospectively reviewed, yielding 22 (0.75%) severely obese patients with MS who underwent bariatric surgery. Sixteen surgical patients with complete follow-up data were matched to a nonsurgical control group of MS patients, based on age, BMI, MS subtype, and length of follow-up. MS relapse rates and trends in the timed twenty-five foot walk test (T25FW) were compared...
2017: Journal of Obesity
https://www.readbyqxmd.com/read/28296288/effect-of-diabetes-mellitus-on-postoperative-endoscopic-sinus-surgery-outcomes
#15
Andrey Filimonov, Sei Yeon Chung, Anni Wong, Jacob S Brady, Soly Baredes, Jean Anderson Eloy
BACKGROUND: Endoscopic sinus surgery (ESS) has become the treatment of choice for a variety of nasal conditions. The purpose of this study was to analyze the effect of diabetes mellitus (DM) on postoperative outcomes in ESS. METHODS: Data on endoscopic sinus surgery performed from 2005 to 2013 were collected from the American College of Surgeons National Surgical Quality Improvement (ACS-NSQIP) database. Two groups were created, based on the presence of a DM diagnosis, and were analyzed for preoperative variables, comorbidities, and postoperative complications using SPSS statistical software...
March 10, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/28291408/clinical-outcomes-following-spinal-fusion-using-an-intraoperative-computed-tomographic-3d-imaging-system
#16
Roy Xiao, Jacob A Miller, Navin C Sabharwal, Daniel Lubelski, Vincent J Alentado, Andrew T Healy, Thomas E Mroz, Edward C Benzel
OBJECTIVE Improvements in imaging technology have steadily advanced surgical approaches. Within the field of spine surgery, assistance from the O-arm Multidimensional Surgical Imaging System has been established to yield superior accuracy of pedicle screw insertion compared with freehand and fluoroscopic approaches. Despite this evidence, no studies have investigated the clinical relevance associated with increased accuracy. Accordingly, the objective of this study was to investigate the clinical outcomes following thoracolumbar spinal fusion associated with O-arm-assisted navigation...
March 3, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28290954/improving-surgical-complications-and-patient-safety-at-the-nation-s-largest-military-hospital-an-analysis-of-national-surgical-quality-improvement-program-data
#17
Steve Maturo, Charlotte Hughes, George Kallingal, Stephen Silvey, A J Johnson, Douglas Soderdahl, Evan Renz, Joseph Brennan
INTRODUCTION: The U.S. Military Health System cares for over 9 million patients and encompasses 63 hospitals and 413 clinics worldwide. Military medicine balances the simultaneous tasks of caring for those patients wounded in military engagements, treating large numbers of families of service men and women, and training the next generation of health care providers and ancillary staff. Similar to civilian health care delivery in the United States, military medicine has also seen increased scrutiny in the areas of cost and quality...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28288777/outcomes-after-pediatric-open-laparoscopic-and-robotic-pyeloplasty-at-academic-institutions
#18
Yvonne Y Chan, Blythe Durbin-Johnson, Renea M Sturm, Eric A Kurzrock
INTRODUCTION: Patient age and hospital volume have been shown to affect perioperative outcomes after pediatric pyeloplasty. However, there are few multicenter studies that focus on outcomes at teaching hospitals, where many of the operations are performed. OBJECTIVE: The goal was to determine if surgical approach, age, case volume, or other factors influence perioperative outcomes in a large contemporary cohort. STUDY DESIGN: Using the clinical database/resource manager (CDB/RM) of the University Health-System Consortium (UHC), children who underwent open, laparoscopic, or robotic pyeloplasty from 2011 to 2014 were identified at 102 academic institutions...
February 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28288681/a-study-to-reduce-readmissions-after-surgery-in-the-veterans-health-administration-design-and-methodology
#19
Laurel A Copeland, Laura A Graham, Joshua S Richman, Amy K Rosen, Hillary J Mull, Edith A Burns, Jeff Whittle, Kamal M F Itani, Mary T Hawn
BACKGROUND: Hospital readmissions are associated with higher resource utilization and worse patient outcomes. Causes of unplanned readmission to the hospital are multiple with some being better targets for intervention than others. To understand risk factors for surgical readmission and their incremental contribution to current Veterans Health Administration (VA) surgical quality assessment, the study, Improving Surgical Quality: Readmission (ISQ-R), is being conducted to develop a readmission risk prediction tool, explore predisposing and enabling factors, and identify and rank reasons for readmission in terms of salience and mutability...
March 14, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28288068/emergency-surgery-for-medicare-beneficiaries-admitted-to-critical-access-hospitals
#20
Andrew M Ibrahim, Scott E Regenbogen, Jyothi R Thumma, Justin B Dimick
OBJECTIVE: The aim of this study was to compare the surgical outcomes of emergency operations performed at critical access and non-critical access hospitals. BACKGROUND: Critical access hospitals are often the only source of surgical care for rural populations. Previous studies have demonstrated that patients undergoing common, elective operations at these rural hospitals have similar outcomes to their urban counterparts. Little is known, however, about the quality of care these hospitals provide for emergency operations for which they are most essential...
March 10, 2017: Annals of Surgery
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