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Surgical readmission

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https://www.readbyqxmd.com/read/29791482/impact-of-high-versus-low-dose-neuromuscular-blocking-agent-administration-on-unplanned-30-day-readmission-rates-in-retroperitoneal-laparoscopic-surgery
#1
Martijn Boon, Chris Martini, H Keri Yang, Shuvayu S Sen, Rob Bevers, Michiel Warlé, Leon Aarts, Marieke Niesters, Albert Dahan
Recent data shows that a neuromuscular block (NMB) induced by administration of high doses of rocuronium improves surgical conditions in certain procedures. However, there are limited data on the effect such practices on postoperative outcomes. We performed a retrospective analysis to compare unplanned 30-day readmissions in patients that received high-dose versus low-dose rocuronium administration during general anesthesia for laparoscopic retroperitoneal surgery. This retrospective cohort study was performed in the Netherlands in an academic hospital where routine high-dose rocuronium NMB has been practiced since July 2015...
2018: PloS One
https://www.readbyqxmd.com/read/29787368/contemporary-surgical-outcomes-of-venous-tumour-thrombectomy-managed-with-intraoperative-doppler-ultrasound-for-kidney-cancer
#2
Deepak K Pruthi, Hanzhang Wang, Arpan Satsangi, Miguel Cajipe, Kevan Iffrig, Georges M Haidar, Taylor Hicks, Edward Y Sako, Michael A Liss, Wasim H Chowdhury, Ronald Rodriguez, Dharam Kaushik
INTRODUCTION: Radical nephrectomy (RN) with venous tumour thrombectomy (VTT) carries a significant morbidity and mortality risk. Examination of a contemporary single-institution series permits the development of a management algorithm and an audit its results. We report outcomes following the use of intraoperative colour Doppler ultrasound and our surgical pathway. METHODS: We retrospectively reviewed the records of all patients who underwent RN with VTT for kidney cancer between January 1, 2013 and October 1, 2016...
May 14, 2018: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/29787349/head-and-neck-cancer-patients-rates-reasons-and-risk-factors-for-30-day-unplanned-readmission
#3
Michael K Ghiam, Alexander Langerman, Zoukaa Sargi, Sarah Rohde
Objective To analyze rates, risk factors, and complications for 30-day readmission among head and neck cancer (HNC) patients. Methods Retrospective review of administrative records from Vizient (Irving, Texas) Clinical Data Base/Resource Manager on HNC patients who underwent a head and neck surgical procedure from January 2013 through September 2015 at 176 academic and community medical centers. Results Of the 18,121 patients included in the study, 2502 patients were readmitted within 30 days (13.8%). Mean time to readmission was 11 ± 8...
May 1, 2018: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29783911/can-predictive-modeling-identify-head-and-neck-oncology-patients-at-risk-for-readmission
#4
Amy M Manning, Keith A Casper, Kay St Peter, Keith M Wilson, Jonathan R Mark, Ryan M Collar
Objective Unplanned readmission within 30 days is a contributor to health care costs in the United States. The use of predictive modeling during hospitalization to identify patients at risk for readmission offers a novel approach to quality improvement and cost reduction. Study Design Two-phase study including retrospective analysis of prospectively collected data followed by prospective longitudinal study. Setting Tertiary academic medical center. Subjects and Methods Prospectively collected data for patients undergoing surgical treatment for head and neck cancer from January 2013 to January 2015 were used to build predictive models for readmission within 30 days of discharge using logistic regression, classification and regression tree (CART) analysis, and random forests...
May 1, 2018: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29779783/readmission-to-the-intensive-care-unit-following-cardiac-surgery-a-derived-and-validated-risk-prediction-model-in-4-869-patients
#5
Rebekah Thomson, Nick Fletcher, Oswaldo Valencia, Vivek Sharma
OBJECTIVE: To derive and validate a clinical risk index that can predict readmission to the intensive care unit (ICU) after cardiac surgery. DESIGN: Retrospective nonrandomized study to determine the perioperative variables associated with risk of readmission to the ICU after cardiac surgery. SETTING: The study was carried out in a single university hospital. PARTICIPANTS: This was an analysis of 4,869 consecutive adult patients...
April 18, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29779588/meta-analysis-comparing-transcatheter-and-surgical-treatments-of-paravalvular-leaks
#6
Tatiana Busu, Fahad Alqahtani, Vinay Badhwar, Chris C Cook, Charanjit S Rihal, Mohamad Alkhouli
Percutaneous paravalvular leak (PVL) closure has emerged as a feasible alternative to redo valve surgery. However, comparative data on percutaneous and surgical treatment of PVL are scarce. We performed a systematic review and a meta-analysis of studies on percutaneous and surgical treatments of PVL. Of the 2,267 studies screened, 22 eligible studies were analyzed. Primary end points were technical success, 30-day mortality, stroke, and length of stay. Secondary end points were 1-year mortality, readmission for heart failure, reoperation, and symptomatic improvement at follow-up...
April 20, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29779575/thirty-day-readmissions-in-surgical-and-transcatheter-aortic-valve-replacement-a-systematic-review-and-meta-analysis
#7
Stein Ove Danielsen, Philip Moons, Irene Sandven, Marit Leegaard, Svein Solheim, Theis Tønnessen, Irene Lie
BACKGROUND: The 30-day all-cause readmission rate after surgical aortic valve replacement (SAVR) and transcatheter aortic valve replacement (TAVR) vary substantially. We conducted a systematic review and meta-analysis to examine the overall incidence, causes, and risk factors of 30-day all-cause readmission rate after SAVR and TAVR. METHODS: Eight medical research databases were searched; Cochrane, Medline, Embase, UpToDate, PROSPERO, National Guideline Clearinghouse, SweMed and Oria...
May 17, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29779180/the-impact-of-an-adolescent-depressive-disorders-clinical-pathway-on-healthcare-utilization
#8
Brooke Lifland, Davene R Wright, Rita Mangione-Smith, Arti D Desai
Clinical pathways are known to improve the value of health care in medical and surgical settings but have been rarely studied in the psychiatric setting. This study examined the association between level of adherence to an adolescent depressive disorders inpatient clinical pathway and length of stay (LOS), cost, and readmissions. Patients in the high adherence category had significantly longer LOS and higher costs compared to the low adherence category. There was no difference in the odds of 30-day emergency department return visits or readmissions...
May 19, 2018: Administration and Policy in Mental Health
https://www.readbyqxmd.com/read/29778596/anterior-vs-posterior-approach-for-thoracic-corpectomy-an-analysis-of-risk-factors-outcomes-and-complications
#9
Ryan G Chiu, Jonathan Hobbs, Darian R Esfahani, Saavan Patel, David Rosenberg, Clayton L Rosinski, Akash S Patel, Anisse N Chaker, Ankit I Mehta
BACKGROUND: Thoracic corpectomies are performed for various reasons including spinal deformity, trauma, neoplasms, and infection. Regardless of indication, both anterior and posterior approaches are surgical options, selected based on pathology, anatomy, patient characteristics, and surgical experience. Risk profiles and outcomes for these procedures are poorly characterized, however, and the choice between the two approaches remains inconclusive. OBJECTIVE: To compare risk factors and complications for adult patients undergoing anterior and posterior thoracic corpectomies...
May 17, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29778507/factors-associated-with-outcomes-and-inpatient-90-day-cost-of-care-in-endometrial-cancer-patients-undergoing-hysterectomy-implications-for-bundled-care-payments
#10
Aimee Rolston, Ryan J Spencer, R Kevin Reynolds, Laurel W Rice, Shitanshu Uppal
OBJECTIVE: To investigate the association of obesity and other comorbidities as well as route of surgery with postoperative outcomes, as well as 30- and 90-day inpatient cost of care after hysterectomy for endometrial cancer. METHODS: From the 2013 National Readmission Database release, patients who underwent hysterectomy for endometrial cancer were included. Obesity was classified as non-obese (body mass index [BMI] < 35 kg/m2 ); class I/II obesity (BMI ≥ 35 but <40 kg/m2 and without obesity related medical condition qualifying it as morbid obesity), class III obesity (BMI ≥ 40 kg/m2 OR BMI ≥ 35 kg/m2 with an obesity-related medical condition)...
May 16, 2018: Gynecologic Oncology
https://www.readbyqxmd.com/read/29778455/planning-post-discharge-destination-for-gastrointestinal-surgery-patients-room-for-improvement
#11
Courtney J Balentine, Kelly Kenzik, Daniel I Chu, Melanie S Morris, Sara J Knight, Cynthia J Brown, Smita Bhatia
BACKGROUND: We compared short-term recovery for patients discharged to inpatient rehabilitation versus skilled nursing facilities after gastrointestinal surgery. MATERIALS & METHODS: We conducted a propensity-matched cohort study of 12,939 adults discharged to inpatient rehabilitation or skilled nursing facilities after colectomy, pancreatectomy or hepatectomy at hospitals participating in the American College of Surgeons National Surgical Quality Improvement Program from 2011 to 2014...
May 16, 2018: American Journal of Surgery
https://www.readbyqxmd.com/read/29777672/valvectomy-versus-replacement-for-the-surgical-treatment-of-tricuspid-endocarditis
#12
Adam N Protos, Jaimin R Trivedi, William M Whited, Michael P Rogers, Ugochukwu Owolabi, Kendra J Grubb, Kristen Sell-Dottin, Mark S Slaughter
BACKGROUND: Optimal surgical treatment of infective tricuspid endocarditis is debatable, especially in the setting of inherent social and pathologic concerns. This study seeks to compare tricuspid valve repair, replacement, and excision for the treatment of infective endocarditis METHODS: A single center cardiac surgery database was queried between 2012 and 2016 to identify patients >18 years who underwent tricuspid valve surgery for infective endocarditis. Patients were divided into 3 groups based on the type of tricuspid valve surgery: valvectomy, repair, or replacement and evaluated to identify differences between the pre-op factors and outcomes including mortality, length of stay, and complications...
May 16, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29776436/rates-and-causes-of-30-day-readmission-and-emergency-room-utilization-following-head-and-neck-surgery
#13
Vincent Wu, Stephen F Hall
BACKGROUND: Unplanned returns to hospital are common, costly, and potentially avoidable. We aimed to investigate and characterize reasons for all-cause readmissions to hospital as in-patients (IPs) and visits to the Emergency Department (ED) within 30-days following patient discharge post head and neck surgery (HNS). METHODS: Retrospective case series with chart review. All patients within the Department of Otolaryngology - Head and Neck Surgery who underwent HNS for benign and malignant disease from January 1, 2010 to May 31, 2015 were identified...
May 18, 2018: Journal of Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/29775546/leakage-rate-after-laparoscopic-ileocolic-intracorporeal-anastomosis
#14
Jesper Nors, Thorbjørn Sommer, Pål Wara
BACKGROUND AND AIMS: The prevailing technique in laparoscopic resection of the right colon has been laparoscopic-assisted procedure with externalization of the bowel for extracorporeal creation of the ileocolic anastomosis. The total laparoscopic technique performing all steps intracorporeally, however, has gained increasing interest. The purpose of this study was to describe our experience with creation of an ileocolic intracorporeal anastomosis (IIA) and to determine anastomotic leakage (AL) rate and short-term outcome of performing IIA...
May 18, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29771807/administration-of-an-oral-hydration-solution-prevents-electrolyte-and-fluid-disturbances-and-reduces-readmissions-in-patients-with-a-diverting-ileostomy-after-colorectal-surgery-a-prospective-randomized-controlled-trial
#15
Athanasios Migdanis, Georgios Koukoulis, Ioannis Mamaloudis, Ioannis Baloyiannis, Ioannis Migdanis, Maria Kanaki, Eleni Malissiova, Georgios Tzovaras
BACKGROUND: Patients with a newly formed ileostomy often develop electrolyte abnormalities and dehydration. OBJECTIVE: The study assessed the prophylactic effect of an isotonic hydration solution on dehydration and electrolyte abnormalities in patients with a newly formed ileostomy. DESIGN: This was a prospective, randomized, controlled trial (NCT02036346). SETTINGS: The study was conducted at a single surgical unit of a public university hospital...
May 15, 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29771724/early-impact-of-medicare-accountable-care-organizations-on-inpatient-surgical-spending
#16
Hari Nathan, Jyothi R Thumma, Andrew M Ryan, Justin B Dimick
OBJECTIVE: To evaluate whether hospital participation in accountable care organizations (ACOs) is associated with reduced Medicare spending for inpatient surgery. BACKGROUND: ACOs have proliferated rapidly and now cover more than 32 million Americans. Medicare Shared Savings Program (MSSP) ACOs have shown modest success in reducing medical spending. Whether they have reduced surgical spending remains unknown. METHODS: We used 100% Medicare claims from 2010 to 2014 for patients aged 65 to 99 years undergoing 6 common elective surgical procedures [abdominal aortic aneurysm (AAA) repair, colectomy, coronary artery bypass grafting (CABG), hip or knee replacement, or lung resection]...
May 16, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29771723/comparing-short-term-and-oncologic-outcomes-of-minimally-invasive-versus-open-pancreaticoduodenectomy-across-low-and-high-volume-centers
#17
Robert J Torphy, Chloe Friedman, Alison Halpern, Brandon C Chapman, Steven S Ahrendt, Martin M McCarter, Barish H Edil, Richard D Schulick, Ana Gleisner
OBJECTIVE: To compare short-term and oncologic outcomes of patients with cancer who underwent open pancreaticoduodenectomy (OPD) versus minimally invasive pancreaticoduodenectomy (MIPD) using the National Cancer Database. SUMMARY BACKGROUND DATA: MIPD, including laparoscopic and robotic approaches, has continued to gain acceptance despite prior reports of increased short-term mortality when compared with OPD. METHODS: Patients with pancreatic cancer diagnosed from 2010 to 2015 undergoing curative intent resection were selected from the National Cancer Database...
May 16, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29766655/pre-surgical-surgical-and-post-surgical-experiences-of-weight-loss-surgery-patients-a-closer-look-at-social-determinants-of-health
#18
L P Johnson, F M Asigbee, R Crowell, A Negrini
Using a novel qualitative approach, Photovoice, researchers assessed social, psychological, physical and economic barriers encountered by patients of weight loss surgery. Applying the Photovoice approach and Williams' theory of narrative reconstruction for qualitative interviewing, the research team set out to investigate the bariatric patient experience from pre-surgery to hospitalization to post-surgery. Fifteen participants were given digital cameras and asked to take photographs that represented their weight loss journeys...
May 15, 2018: Clinical Obesity
https://www.readbyqxmd.com/read/29766132/red-cell-distribution-width-predicts-out-of-hospital-outcomes-in-critically-ill-emergency-general-surgery-patients
#19
Joaquim Michael Havens, Anupamaa J Seshadri, Ali Salim, Kenneth B Christopher
Introduction: Red cell distribution width (RDW) is associated with mortality and bloodstream infection risk in critically ill patients. We hypothesized that an increase in RDW at hospital discharge in critically ill patients who received emergency general surgery (EGS) would be associated with increased mortality after hospital discharge. Methods: We performed a two-center observational study of patients treated in medical and surgical intensive care units. We studied 1567 patients, who received critical care between 1998 and 2012 who underwent EGS and survived hospitalization...
2018: Trauma surgery & acute care open
https://www.readbyqxmd.com/read/29761322/concurrent-risk-reduction-surgery-in-patients-with-increased-lifetime-risk-for-breast-and-ovarian-cancer-an-analysis-of-the-national-surgical-quality-improvement-program-nsqip-database
#20
Maryam Elmi, Arash Azin, Ahmad Elnahas, David R McCready, Tulin D Cil
BACKGROUND: Patients with genetic susceptibility to breast and ovarian cancer are eligible for risk-reduction surgery. Surgical morbidity of risk-reduction mastectomy (RRM) with concurrent bilateral salpingo-oophorectomy (BSO) is unknown. Outcomes in these patients were compared to patients undergoing RRM without BSO using a large multi-institutional database. METHODS: A retrospective cohort analysis was conducted using the American College of Surgeon's National Surgical Quality Improvement Program (NSQIP) 2007-2016 datasets, comparing postoperative morbidity between patients undergoing RRM with patients undergoing RRM with concurrent BSO...
May 14, 2018: Breast Cancer Research and Treatment
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