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https://www.readbyqxmd.com/read/29343987/performance-of-the-lace-index-to-predict-30-day-hospital-readmissions-in-patients-with-chronic-obstructive-pulmonary-disease
#1
Maryam A Hakim, Frances L Garden, Matthew D Jennings, Claudia C Dobler
Background and objective: Patients hospitalized for acute exacerbation of chronic obstructive pulmonary disease (COPD) have a high 30-day hospital readmission rate, which has a large impact on the health care system and patients' quality of life. The use of a prediction model to quantify a patient's risk of readmission may assist in directing interventions to patients who will benefit most. The objective of this study was to calculate the rate of 30-day readmissions and evaluate the accuracy of the LACE index (length of stay, acuity of admission, co-morbidities, and emergency department visits within the last 6 months) for 30-day readmissions in a general hospital population of COPD patients...
2018: Clinical Epidemiology
https://www.readbyqxmd.com/read/29343950/examining-30-day-copd-readmissions-through-the-emergency-department
#2
Michael E Rezaee, Charlotte E Ward, Bonita Nuanez, Daniel A Rezaee, Jeffrey Ditkoff, Alexandra Halalau
Background: Thirty-day readmission in COPD is common and costly, but potentially preventable. The emergency department (ED) may be a setting for COPD readmission reduction efforts. Objective: To better understand COPD readmission through the ED, ascertain factors associated with 30-day readmission through the ED, and identify subgroups of patients with COPD for readmission reduction interventions. Patients and methods: A retrospective cohort study was conducted from January 2009 to September 2015 in patients with COPD of age ≥18 years...
2018: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29323987/care-bundles-in-the-management-of-a-copd-exacerbation
#3
Charlotte Lloyd, Joanne Garside
Chronic obstructive pulmonary disease (COPD), the umbrella term used to describe chronic lung diseases that cause limitations in lung airflow, is predicted to be the third leading cause of death by 2030. COPD is said to affect 3 million people in the UK, resulting in approximately 30 000 deaths each year. Related healthcare costs continue to escalate, not least because of increasing readmission rates associated with COPD emergencies. The use of care bundles to streamline care is becoming more popular in an attempt to tackle this issue...
January 11, 2018: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/29278993/adherence-to-gold-guidelines-in-the-inpatient-copd-population
#4
Melissa Lipari, Amber Lanae Smith, Pramodini B Kale-Pradhan, Sheila M Wilhelm
PURPOSE: The Global Initiative for Chronic Obstructive Lung Disease guidelines provide recommendations to manage chronic obstructive lung disease (COPD) exacerbations. This study assessed the management of inpatient COPD exacerbations at an urban teaching hospital. METHODS: A retrospective cohort analysis of adults admitted between December 2010 and August 2012 with a COPD exacerbation was conducted. Patient demographics, length of stay (LOS), Charlson comorbidity score, inpatient pulmonary medications, and 30-day readmission were collected...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29261675/the-limited-prognostic-role-of-echocardiograms-in-short-term-follow-up-after-acute-decompensated-heart-failure-an-analysis-of-the-korean-heart-failure-korhf-registry
#5
Sung Hea Kim, Hyun-Joong Kim, Seongwoo Han, Byung-Su Yoo, Dong-Ju Choi, Jae-Joong Kim, Eun-Seok Jeon, Myeong-Chan Cho, Shung Chull Chae, Kyu-Hyung Ryu
BACKGROUND: The prognostic values of the left ventricular ejection fraction (LVEF) and end-diastolic dimension (LVEDD) have primarily been shown among patients with chronic heart failure (HF), with little representation of patients with acute HF (AHF). Therefore, we investigated the value of these echocardiographic parameters in predicting clinical outcomes among patients in the Korean Heart Failure (KorHF) Registry. METHODS: The KorHF Registry consists of 3,200 patients who were hospitalized with AHF from 2005 to 2009...
2017: PloS One
https://www.readbyqxmd.com/read/29215657/-the-patient-and-the-crossing-between-primary-and-hospital-care-systematic-review-of-trials-for-the-implementation-of-tools-for-integration-in-spain
#6
REVIEW
L Corral Gudino, M Borao Cengotita-Bengoa, R J Jorge Sánchez, J García Aparicio
BACKGROUND: Health services are moving towards a complete integration to try and reduce fragmentation, increase efficiencies and improve health outcomes. Estimates the effectiveness in of different tools for integrated care in Spain. METHODS: We performed a systematic review of articles using MEDLINE (last search July31st, 2017). Randomized clinical trials reporting health outcomes of tools for integrated care used in Spain were included. Studies were appraised for quality using the Cochrane Risk of Bias assessment...
December 7, 2017: Anales del Sistema Sanitario de Navarra
https://www.readbyqxmd.com/read/29210750/insights-about-the-economic-impact-of-chronic-obstructive-pulmonary-disease-readmissions-post-implementation-of-the-hospital-readmission-reduction-program
#7
Valerie G Press, R Tamara Konetzka, Steven R White
PURPOSE OF REVIEW: Chronic obstructive pulmonary disease (COPD) affects over 12 million adults in the United States and is the third leading cause of 30-day readmissions. COPD is costly with almost $50 billion in direct costs annually. Total COPD costs can be up to double the identified direct costs because of comorbid disease and numerous indirect costs such as absenteeism. Acute exacerbations of COPD (AECOPD) are responsible for up to 70% of COPD-related healthcare costs; hospital readmissions alone account for over $15 billion annually...
November 27, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/29206640/trends-in-30-day-readmission-rates-after-copd-hospitalization-2006-2012
#8
Tadahiro Goto, Mohammad Kamal Faridi, Koichiro Gibo, Sengwee Toh, Nicola A Hanania, Carlos A Camargo, Kohei Hasegawa
BACKGROUND: Reduction in 30-day readmission rate after chronic obstructive pulmonary disease (COPD)-related hospitalization is a national objective. However, little is known about trends in readmission rates in recent years, particularly in priority populations defined by the Agency for Healthcare Research and Quality (AHRQ)(e.g., the elderly, women, racial/ethnic minorities, low-income and rural populations, and populations with chronic illnesses). METHODS: We conducted a retrospective cohort study using data from the State Inpatient Database of eight geographically-dispersed US states (Arkansas, California, Florida, Iowa, Nebraska, New York, Utah, and Washington) from 2006 through 2012...
September 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/29206052/risk-trajectories-of-readmission-and-death-in-the-first-year-following-hospitalization-for-copd
#9
Peter K Lindenauer, Kumar Dharmarajan, Li Qin, Zhenqui Lin, Andrea S Gershon, Harlan M Krumholz
Rationale Characterizing the dynamic nature of post-hospital risk in COPD is needed to provide counseling and plan clinical services. Objectives To analyze risk of readmission and death among Medicare beneficiaries >=65 years following discharge for COPD, and to determine the association between ventilator support and risk trajectory. Methods We computed daily absolute risks of hospital readmission and death for one year after discharge for COPD, stratified by ventilator support. We determined the time required for risks to decline 50% from maximum daily values after discharge; and for daily risks to plateau...
December 5, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29183318/the-development-implementation-and-evaluation-of-clinical-pathways-for-chronic-obstructive-pulmonary-disease-copd-in-saskatchewan-protocol-for-an-interrupted-times-series-evaluation
#10
Thomas Rotter, Christopher Plishka, Mohammed Rashaad Hansia, Donna Goodridge, Erika Penz, Leigh Kinsman, Adegboyega Lawal, Sheryl O'Quinn, Nancy Buchan, Patricia Comfort, Prakesh Patel, Sheila Anderson, Tanya Winkel, Rae Lynn Lang, Darcy D Marciniuk
BACKGROUND: Chronic obstructive pulmonary disease (COPD) has substantial economic and human costs; it is expected to be the third leading cause of death worldwide by 2030. To minimize these costs high quality guidelines have been developed. However, guidelines alone rarely result in meaningful change. One method of integrating guidelines into practice is the use of clinical pathways (CPWs). CPWs bring available evidence to a range of healthcare professionals by detailing the essential steps in care and adapting guidelines to the local context...
November 28, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29177758/reducing-copd-readmissions-through-predictive-modeling-and-incentive-based-interventions
#11
Xiang Zhong, Sujee Lee, Cong Zhao, Hyo Kyung Lee, Philip A Bain, Tammy Kundinger, Craig Sommers, Christine Baker, Jingshan Li
This paper introduces a case study at a community hospital to develop a predictive model to quantify readmission risks for patients with chronic obstructive pulmonary disease (COPD), and use it to support decision making for appropriate incentive-based interventions. Data collected from the community hospital's database are analyzed to identify risk factors and a logistic regression model is developed to predict the readmission risk within 30 days post-discharge of an individual COPD patient. By targeting on the high-risk patients, we investigate the implementability of the incentive policy which encourages patients to take interventions and helps them to overcome the compliance barrier...
November 25, 2017: Health Care Management Science
https://www.readbyqxmd.com/read/29155116/the-effect-of-steroids-on-complications-readmission-and-reoperation-after-posterior-lumbar-fusion
#12
Michael B Cloney, Roxanna M Garcia, Zachary A Smith, Nader S Dahdaleh
BACKGROUND DATA: The effects of chronic corticosteroid therapy on complications, readmission, and reoperation after posterior lumbar fusion (PLF) remains under-investigated and was examined to determine differences in outcomes. METHODS: We analyzed patients from 2006 to 2013 using the National Surgery Quality Improvement Program database (NSQIP) undergoing PLF. Patients taking steroids for a chronic condition were compared to those not taking steroids. Multivariable regression identified factors independently associated with complications, readmission, and reoperation...
November 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29123431/comparative-quality-measures-of-emergency-care-an-outcome-cockpit-proposal-to-survey-clinical-processes-in-real-life
#13
Susanne Burgemeister, Alexander Kutz, Antoinette Conca, Thomas Holler, Sebastian Haubitz, Andreas Huber, Ulrich Buergi, Beat Mueller, Philipp Schuetz
Background: Benchmarking of real-life quality of care may improve evaluation and comparability of emergency department (ED) care. We investigated process management variables for important medical diagnoses in a large, well-defined cohort of ED patients and studied predictors for low quality of care. Methods: We prospectively included consecutive medical patients with main diagnoses of community-acquired pneumonia, urinary tract infection (UTI), myocardial infarction (MI), acute heart failure, deep vein thrombosis, and COPD exacerbation and followed them for 30 days...
2017: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/29064260/deterioration-of-limb-muscle-function-during-acute-exacerbation-of-chronic-obstructive-pulmonary-disease
#14
Raolat M Abdulai, Tina Jellesmark Jensen, Naimish R Patel, Michael I Polkey, Paul Jansson, Bartolomé R Celli, Stephen I Rennard
Important features of both stable and acute exacerbation of COPD are skeletal muscle weakness and wasting. Limb muscle dysfunction during an exacerbation has been linked to various adverse outcomes, including prolonged hospitalization, readmission, and mortality. The contributing factors leading to muscle dysfunction are similar to those seen in stable COPD: disuse, nutrition/energy balance, hypercapnia, hypoxemia, electrolyte derangements, inflammation, and drugs (i.e., glucocorticoids). These factors may be the trigger for a downstream cascade of local inflammatory changes, pathway process alterations, and structural degradation...
October 24, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29062616/association-of-internal-mammary-artery-flow-with-different-comorbidities-and-post-coronary-artery-bypass-graft-complications
#15
Mudassir Iqbal Dar, Asim Hassan Dar, Muhammad Bilal, Mansoor Ahmad, Abdul Haseeb
Objective The internal mammary artery (IMA) is commonly used arterial graft for coronary artery bypass surgery (CABG). The IMA has a better patency and survival. This study considers different comorbidities and conditions where IMA flow may be low. Therefore, the main objective is to determine the flow of IMA in different diseases, its relation to gender, age, and in different blood groups in order to prevent possible complications. Methods A prospective study was conducted at the Cardiac Surgery Unit, Civil Hospital Karachi from January 2013 to December 2015...
August 20, 2017: Curēus
https://www.readbyqxmd.com/read/29062228/impact-and-prevention-of-severe-exacerbations-of-copd-a-review-of-the-evidence
#16
REVIEW
David Mg Halpin, Marc Miravitlles, Norbert Metzdorf, Bartolomé Celli
Severe exacerbations of COPD, ie, those leading to hospitalization, have profound clinical implications for patients and significant economic consequences for society. The prevalence and burden of severe COPD exacerbations remain high, despite recognition of the importance of exacerbation prevention and the availability of new treatment options. Severe COPD exacerbations are associated with high mortality, have negative impact on quality of life, are linked to cardiovascular complications, and are a significant burden on the health-care system...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29061910/health-coaching-in-severe-copd-after-a-hospitalization-a-qualitative-analysis-of-a-large-randomized-study
#17
Roberto P Benzo, Janae L Kirsch, Julie C Hathaway, Charlene E McEvoy, Kristin S Vickers
BACKGROUND: We recently demonstrated in a randomized study the feasibility and effectiveness of telephone-based health coaching using motivational interviewing on decreasing hospital readmissions and improving quality of life at 6 and 12 months after hospital discharge. In this qualitative study, we sought to explore the health-coaching intervention as seen from the perspective of the participants who received the intervention and the coaches who delivered it. METHODS: Semistructured participant interviews (n = 24) and a focus group of all health coaches (n = 3) who participated in this study were conducted...
November 2017: Respiratory Care
https://www.readbyqxmd.com/read/29033560/proactive-palliative-care-for-patients-with-copd-prolong-a-pragmatic-cluster-controlled-trial
#18
R G Duenk, C Verhagen, E M Bronkhorst, Pjwb van Mierlo, Meac Broeders, S M Collard, Pnr Dekhuijzen, Kcp Vissers, Y Heijdra, Y Engels
BACKGROUND AND AIM: Patients with advanced chronic obstructive pulmonary disease (COPD) have poor quality of life. The aim of this study was to assess the effects of proactive palliative care on the well-being of these patients. TRIAL REGISTRATION: This trial is registered with the Netherlands Trial Register, NTR4037. PATIENTS AND METHODS: A pragmatic cluster controlled trial (quasi-experimental design) was performed with hospitals as cluster (three intervention and three control) and a pretrial assessment was performed...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28974646/factors-associated-with-re-intubation-within-14-days-after-ventilator-liberation
#19
Chia-Chen Chu, Chin-Jung Liu, Suh-May Yen, Wen-Yu Chou, Pei-Tseng Kung, Yuh-Show Tsai, Wen-Chen Tsai
BACKGROUND: According to Taiwan's integrated delivery system policy, ventilator-dependent patients are successfully liberated from mechanical ventilation in accordance with step-down care. However, premature discharge affects the 14-d readmission quality index. Therefore, we explored the risk and related factors of subjects liberated from mechanical ventilation who were re-intubated within 14 d. METHODS: This retrospective study analyzed a cohort of ventilator-dependent subjects 17 y of age and older using a population-based database from the Taiwan National Health Research Institutes Database from 2006 to 2010...
December 2017: Respiratory Care
https://www.readbyqxmd.com/read/28974126/identifiable-risk-factors-for-thirty-day-complications-following-arthroscopic-rotator-cuff-repair
#20
Jessica H Heyer, Xiangyu Kuang, Richard L Amdur, Rajeev Pandarinath
OBJECTIVES: Shoulder arthroscopy has increased in frequency over the past decade, with rotator cuff repair comprising the majority of cases performed. Prior studies have detailed risk factors for 30-day complications and readmission rates after arthroscopic shoulder surgery using the National Surgical Quality Improvement Program (NSQIP) database, but no study has specifically looked at arthroscopic rotator cuff repair. The purpose of the study is to evaluate the risk factors for 30-day complications following arthroscopic rotator cuff repair using the NSQIP database...
October 11, 2017: Physician and Sportsmedicine
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