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https://www.readbyqxmd.com/read/29148332/medicare-advantage-and-traditional-medicare-hospitalization-intensity-and-readmissions
#1
Rachel Mosher Henke, Zeynal Karaca, Teresa B Gibson, Eli Cutler, Marguerite L Barrett, Katharine Levit, Jayne Johann, Lauren Hersch Nicholas, Herbert S Wong
Medicare Advantage plans have incentives and tools to optimize patient care. Therefore, Medicare Advantage hospitalizations may have lower cost and higher quality than similar traditional Medicare hospitalizations. We applied a coarsened matching approach to 2013 Healthcare Cost and Utilization Project hospital discharge data from 22 states to compare hospital cost, length of stay, and readmissions for Traditional Medicare and Medicare Advantage. We found that Medicare Advantage hospitalizations were substantially less expensive and shorter for mental health stays but costlier and longer for injury and surgical stays...
March 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29146432/predictors-of-hospital-length-of-stay-and-30-day-readmission-in-cervical-spondylotic-myelopathy-patients-an-analysis-of-3057-patients-using-the-acs-nsqip-database
#2
Peter G Passias, Cyrus M Jalai, Nancy Worley, Shaleen Vira, Saqib Hasan, Samantha R Horn, Frank A Segreto, Cole A Bortz, Andrew P White, Michael Gerling, Virginie LaFage, Thomas Errico
BACKGROUND: Hospital length of stay (LOS), 30-day readmission rate, and other metrics are increasingly being used to evaluate quality of surgical care. The factors most relevant to cervical spondylotic myelopathy (CSM) are not yet established. OBJECTIVE: To identify peri-operative factors associated with extended LOS and/or 30-day readmission following elective surgery for CSM. METHODS: Surgical CSM patients at institutions represented by the American-College-of-Surgeons-National-Surgical-Quality-Improvement-Program (ACS-NSQIP) from 2010-2012 were included...
November 13, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29145982/impact-of-outpatient-total-joint-replacement-on-postoperative-outcomes
#3
REVIEW
Danielle Lovett-Carter, Zain Sayeed, Leila Abaab, Vinay Pallekonda, William Mihalko, Khaled J Saleh
Total joint arthroplasty (TJA) has demonstrated tremendous benefits to patients with osteoarthritis. Health care reform has influenced surgeons to optimize TJA care pathways as well as playing a role in the formation of outpatient TJA protocols. Understanding the outcomes of outpatient TJA is imperative to surgical predicate decision making. The aim of this review is to compare outcomes of outpatient TJA patients to standard-stay inpatients. Postoperative outcomes assessed include pain, complications, readmissions, reoperation, patient satisfaction, and cost...
January 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29139194/advantages-of-care-for-patients-with-hip-fractures-in-the-acute-geriatric-unit-hip-study-anoia
#4
Enric Duaso, Francesc Formiga, Patrícia Marimón, Montserrat Sandiumenge, Maria Teresa Salgado, Victor Murga, Andrés Gamboa, Carlos Rodriguez, Jaume Castellà, Enrique Escalante, Célia Lumbreras, Anna Tarrida, Ramón Sellarès
AIM: Hip fracture as a result of bone fragility is characterized by poor health outcomes in the medium and long term. Our goal was to compare a new orthogeriatric model with the old trauma model and evaluate improvements in clinical management. METHODS: We carried out a comparative unicentric study, a historical sample (trauma model) collected from 1 June 2007 to 31 May 2010, versus a prospective sample (orthogeriatric model) collected from 1 June 2010 until 31 May 2013...
November 15, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/29137576/perioperative-assessment-of-older-surgical-patients-using-a-frailty-index-feasibility-and-association-with-adverse-post-operative-outcomes
#5
H Lin, N M Peel, I A Scott, D L Vardesh, P Sivalingam, R L McBride, J J Morong, M J Nelson, R E Hubbard
This study aimed to examine the feasibility of using a frailty index (FI) based on comprehensive geriatric assessment (CGA), to assess the level of frailty in older surgical patients preoperatively and to evaluate the association of FI-CGA with poorer postoperative outcomes. Two hundred and forty-six patients aged ≥70 years undergoing intermediate- to high-risk surgery in a tertiary hospital were recruited. Frailty was assessed using a 57-item FI-CGA form, with fit, intermediate frail, and frail patients defined as FI ≤0...
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29135663/serum-fructosamine-a-simple-and-inexpensive-test-for-assessing-preoperative-glycemic-control
#6
Noam Shohat, Majd Tarabichi, Eric H Tischler, Serge Jabbour, Javad Parvizi
BACKGROUND: Although the medical community acknowledges the importance of preoperative glycemic control, the literature is inconclusive and the proper metric for assessment of glycemic control remains unclear. Serum fructosamine reflects the mean glycemic control in a shorter time period compared with glycated hemoglobin (HbA1c). Our aim was to examine its role in predicting adverse outcomes following total joint arthroplasty. METHODS: Between 2012 and 2013, we screened all patients undergoing total joint arthroplasty preoperatively using serum HbA1c, fructosamine, and blood glucose levels...
November 15, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29131450/potential-for-health-care-cost-savings-with-preoperative-gastrostomy-tube-placement-in-the-head-and-neck-cancer-population
#7
Ashley C Mays, Harrison G Bartels, Paul R Wistermayer, Matt L Rohlfing, Christopher M Gentile, Ralph D'Agostino, Joshua D Waltonen
BACKGROUND: The purpose of this study was to examine the cost differences between preoperative and postoperative placement of gastrostomy tubes (G-tubes) in patients with head and neck cancer. METHODS: We conducted a retrospective chart review of patients with aerodigestive tract cancers from 2010 to 2015. Data included inpatient and postdischarge costs, demographics, tumor characteristics, surgical treatment, length of stay (LOS), time spent in the intensive care unit (ICU), and readmissions...
November 13, 2017: Head & Neck
https://www.readbyqxmd.com/read/29130989/preoperative-nutritional-optimization-for-crohn-s-disease-patients-can-improve-surgical-outcome
#8
Yael Dreznik, Nir Horesh, Mordechai Gutman, Aviad Gravetz, Imri Amiel, Harel Jacobi, Oded Zmora, Danny Rosin
BACKGROUND: Preoperative preparation of patients with Crohn's disease is challenging and there are no specific guidelines regarding nutritional support. The aim of this study was to assess whether preoperative nutritional support influenced the postoperative outcome. METHODS: A retrospective, cohort study including all Crohn's disease patients who underwent abdominal surgery between 2008 and 2014 was conducted. Patients' characteristics and clinical and surgical data were recorded and analyzed...
November 1, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/29129470/risk-stratification-for-surgical-outcomes-in-older-colorectal-cancer-patients-using-isar-hp-and-g8-screening-tools
#9
Esteban T D Souwer, Norbert M Verweij, Frederiek van den Bos, Esther Bastiaannet, Rob M E Slangen, Willem H Steup, Marije E Hamaker, Johanna E A Portielje
BACKGROUND: Older patients are at risk for adverse outcomes after surgical treatment of cancer. Identifying patients at risk could affect treatment decisions and prevent functional decline. Screening tools are available to select patients for Geriatric Assessment. Until now their predictive value for adverse outcomes in older colorectal cancer patients has not been investigated. OBJECTIVE: To study the predictive value of the Geriatric 8 (G8) and Identification of Seniors at Risk for Hospitalized Patients (ISAR-HP) screening tools for adverse outcomes after elective colorectal surgery in patients older than 70years...
November 9, 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/29125442/long-term-outcomes-after-surgical-treatment-of-pediatric-neurogenic-thoracic-outlet-syndrome
#10
Jennifer Hong, Jared M Pisapia, Zarina S Ali, Austin J Heuer, Erin Alexander, Gregory G Heuer, Eric L Zager
OBJECTIVE Neurogenic thoracic outlet syndrome (nTOS) is an uncommon compression syndrome of the brachial plexus that presents with pain, sensory changes, and motor weakness in the affected limb. The authors reviewed the clinical presentations and outcomes in their series of pediatric patients with surgically treated nTOS over a 6-year period. METHODS Cases of nTOS in patients age 18 years or younger were extracted for analysis from a prospective database of peripheral nerve operations. Baseline patient characteristics, imaging and neurophysiological data, operative findings, and outcomes and complications were assessed...
November 10, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29122528/safety-of-open-ventral-hernia-repair-in-high-risk-patients-with-metabolic-syndrome-a-multi-institutional-analysis-of-39-118-cases
#11
Dmitry Zavlin, Kevin T Jubbal, Jeffrey L Van Eps, Barbara L Bass, Warren A Ellsworth, Anthony Echo, Jeffrey D Friedman, Brian J Dunkin
BACKGROUND: Metabolic syndrome (MetS) entails the simultaneous presence of a constellation of dangerous risk factors including obesity, diabetes, hypertension, and dyslipidemia. The prevalence of MetS in Western society continues to rise and implies an elevated risk for surgical complications and/or poor surgical outcomes within the affected population. OBJECTIVE: To assess the risks and outcomes of multi-morbid patients with MetS undergoing open ventral hernia repair...
September 22, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29122274/frequency-and-significance-of-intravascular-hemolysis-before-and-after-transcatheter-aortic-valve-implantation-in-patients-with-severe-aortic-stenosis
#12
Tsung-Yu Ko, Mao-Shin Lin, Lung-Chun Lin, Ying-Ju Liu, Chih-Fan Yeh, Ching-Chang Huang, Ying-Hsien Chen, Yih-Sharng Chen, Hsien-Li Kao
Intravascular hemolysis (IVH) has been identified in patients with surgical prosthetic valves, but few have been reported after transcatheter aortic valve implantation (TAVI). We conducted a prospective analysis of 64 TAVI patients. The hemolysis profiles were collected at baseline and 6 months after TAVI. The echocardiography was performed at baseline and 6 months after TAVI. There are 14 patients (21.9%) with IVH before and 24(37.5%) after TAVI. The serum haptoglobin values before and 6 months after TAVI are 126...
October 10, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29121786/perioperative-morbidity-of-open-versus-minimally-invasive-partial-nephrectomy-a-contemporary-analysis-of-the-national-surgical-quality-improvement-program-nsqip
#13
Jorge Francisco Pereira, Joseph Renzulli, Gyan Pareek, Daniel Moreira, Ruiting Guo, Zheng Zhang, Ali Amin, Anthony Mega, Dragan Golijanin, Boris Gershman
INTRODUCTION AND OBJECTIVES: In recent years, there has been a shift to minimally invasive partial nephrectomy (MIPN) with the dissemination of robotic-assisted technology. However, contemporary data on the comparative morbidity of open PN and MIPN are lacking. We therefore evaluated the perioperative morbidity of MIPN and OPN using a contemporary national cohort. METHODS: We identified 13,658 patients aged 18-89 who underwent PN from 2010-2015 in the National Surgical Quality Improvement Program (NSQIP) database, of whom 9,018 (66...
November 9, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/29121289/association-between-intraoperative-non-depolarising-neuromuscular-blocking-agent-dose-and-30-day-readmission-after-abdominal-surgery
#14
T Thevathasan, S L Shih, K C Safavi, D L Berger, S M Burns, S D Grabitz, R S Glidden, R D Zafonte, M Eikermann, J C Schneider
Background: We hypothesised that intraoperative non-depolarising neuromuscular blocking agent (NMBA) dose is associated with 30-day hospital readmission. Methods: Data from 13,122 adult patients who underwent abdominal surgery under general anaesthesia at a tertiary care hospital were analysed by multivariable regression, to examine the effects of intraoperatively administered NMBA dose on 30-day readmission (primary endpoint), hospital length of stay, and hospital costs...
October 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29118565/is-complete-mesocolic-excision-oncologically-superior-to-conventional-surgery-for-colon-cancer-a-retrospective-comparative-study
#15
Christos Agalianos, Nikolaos Gouvas, Christos Dervenis, John Tsiaoussis, George Theodoropoulos, Demetrios Theodorou, George Zografos, Evaghelos Xynos
Background: During the last decade, many efforts have been made in order to improve the oncologic outcomes following colonic resection. Complete mesocolic excision (CME) has proved to provide high rates of disease-free and overall survival rates in patients undergoing resection for colonic malignancies. The aim of our study was to further investigate the role of CME in colonic surgery through comparison with a series of conventional resections. Methods: All data regarding resections for colonic cancer since 2006 were obtained prospectively from two surgical departments...
2017: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/29114698/efficacy-of-emergency-laparoscopic-appendectomy-in-treating-complicated-appendicitis-for-elderly-patients
#16
Tian-Chong Wu, Qiao Lu, Zhi-Yong Huang, Xio-Hui Liang
To assess the therapeutic effects of emergency laparoscopic appendectomy (LA) in treating complicated appendicitis (CA) for elderly patients (defined as age 65 years and above). Methods: We conducted a retrospective study of 115 elderly patients with CA who underwent surgical therapy in the Affiliated Huizhou Hospital of Sun Yat-Sun University, Huizhou, Guangdong Province, China between September 2014 and August 2016. Of these, 59 patients consented to open appendectomy (OA), and LA was performed in the other 56 patients...
November 2017: Saudi Medical Journal
https://www.readbyqxmd.com/read/29113851/impact-of-academic-facility-type-and-volume-on-post-surgical-outcomes-following-diagnosis-of-glioblastoma
#17
Alan Hauser, Sunil W Dutta, Timothy N Showalter, Jason P Sheehan, Surbhi Grover, Daniel M Trifiletti
OBJECTIVE: To identify if facility type and/or facility volume impact overall survival (OS) following diagnosis of glioblastoma (GBM). We also sought to compare early post-surgical outcomes based on these factors. METHODS: The National Cancer Database was queried for patients with GBM diagnosed from 2004 to 2013 with known survival. Patients were grouped based on facility type and facility volume. Multivariable analyses were performed to investigate factors associated OS following diagnosis and Chi-square tests were used to compare early post-surgical outcomes...
November 4, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29112565/a-randomized-control-trial-of-preoperative-oral-antibiotics-as-adjunct-therapy-to-systemic-antibiotics-for-preventing-surgical-site-infection-in-clean-contaminated-contaminated-and-dirty-type-of-colorectal-surgeries
#18
RANDOMIZED CONTROLLED TRIAL
Nadeem Anjum, Jianan Ren, Gefei Wang, Guanwei Li, Xiuwen Wu, Hu Dong, Qin Wu, Jieshou Li
BACKGROUND: Preoperative bowel preparation with or without oral antibiotics is controversial in terms of postoperative surgical site infections. OBJECTIVE: This study aimed to evaluate the efficacy of oral antibiotics as adjunct therapy to systemic antibiotics with mechanical bowel preparation for preventing surgical site infections in clean contaminated, contaminated, and dirty colorectal procedures. DESIGN: This was a single-center, prospective randomized study...
December 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29112560/is-the-distance-worth-it-patients-with-rectal-cancer-traveling-to-high-volume-centers-experience-improved-outcomes
#19
Zhaomin Xu, Adan Z Becerra, Carla F Justiniano, Courtney I Boodry, Christopher T Aquina, Alex A Swanger, Larissa K Temple, Fergal J Fleming
BACKGROUND: It is unclear whether traveling long distances to high-volume centers would compensate for travel burden among patients undergoing rectal cancer resection. OBJECTIVE: The purpose of this study was to determine whether operative volume outweighs the advantages of being treated locally by comparing the outcomes of patients with rectal cancer treated at local, low-volume centers versus far, high-volume centers. DESIGN: This was a population-based study...
December 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29111887/use-of-short-message-service-and-smartphone-applications-in-the-management-of-surgical-patients-a-systematic-review
#20
Keyin Lu, Nikolas E Marino, David Russell, Aashray Singareddy, Donald Zhang, Angela Hardi, Scott Kaar, Varun Puri
BACKGROUND: Mobile health and telemedicine are rapidly evolving fields used to provide healthcare remotely to patients. For surgical patients, telemedicine can improve patient education and remote monitoring of postoperative symptoms. We performed a systematic review of studies involving the use of short message service (SMS) and mobile application-based interventions in surgical patients to evaluate the advantages and disadvantages of each system, as well as of mobile interventions as a whole...
November 7, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
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