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Copd readmission

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https://www.readbyqxmd.com/read/29155116/the-effect-of-steroids-on-complications-readmission-and-reoperation-after-posterior-lumbar-fusion
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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...
October 3, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28974126/identifiable-risk-factors-for-thirty-day-complications-following-arthroscopic-rotator-cuff-repair
#9
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
https://www.readbyqxmd.com/read/28949430/effectiveness-and-safety-of-outpatient-parenteral-antimicrobial-therapy-in-acute-exacerbation-of-chronic-obstructive-pulmonary-disease
#10
Miguel A Ponce González, Manuel Mirón Rubio, Abel Mujal Martinez, Oriol Estrada Cuxart, Dolores Fiuza Perez, Liliana Salas Reinoso, Estrella Fernández Fabrellas, Eusebi Chiner Vives
AIM: We analysed the effectiveness and safety of outpatient parenteral antibiotic therapy (OPAT) in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in patients admitted to home hospitalisation units (HHU). METHODS: Retrospective multicentre study of patients with AECOPD included in the Spanish OPAT Registry during 2 years period. RESULTS: Twenty-seven hospitals included 562 episodes in 361 patients diagnosed COPD GOLD III-IV...
September 26, 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28947044/sex-and-racial-ethnic-differences-in-the-reason-for-30-day-readmission-after-copd-hospitalization
#11
Tadahiro Goto, Mohammad Kamal Faridi, Koichiro Gibo, Carlos A Camargo, Kohei Hasegawa
BACKGROUND: Reduction of 30-day readmissions in patients hospitalized for chronic obstructive pulmonary disease (COPD) is a national objective. However, there is a dearth of research on sex and racial/ethnic differences in the reason for 30-day readmission. METHODS: We conducted a retrospective cohort study using 2006-2012 data from the State Inpatient Database of eight geographically-diverse US states (Arkansas, California, Florida, Iowa, Nebraska, New York, Utah, and Washington)...
October 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28933581/peak-inspiratory-flow-rate-in-chronic-obstructive-pulmonary-disease-implications-for-dry-powder-inhalers
#12
Sohini Ghosh, Jill A Ohar, M Bradley Drummond
Chronic obstructive pulmonary disease (COPD) is the third leading cause of death in the United States with a significant economic burden related to hospital admissions for exacerbations. One of the primary treatment modalities for COPD is medications delivered through breath-actuated dry powdered inhalers (DPIs). For users to successfully receive inhaled medication, they must inhale with enough flow to overcome the internal resistance of the device, leading to deaggregation of the medication powder. Peak inspiratory flow rate (PIFR) is the maximal flow rate obtained during an inspiratory maneuver...
September 21, 2017: Journal of Aerosol Medicine and Pulmonary Drug Delivery
https://www.readbyqxmd.com/read/28883720/effect-of-a-rehabilitation-based-chronic-disease-management-program-targeting-severe-copd-exacerbations-on-readmission-patterns
#13
C Lalmolda, R Coll-Fernández, N Martínez, M Baré, M Teixidó Colet, F Epelde, E Monsó
BACKGROUND: Pulmonary rehabilitation (PR) is recommended after a severe COPD exacerbation, but its short- and long-term effects on health care utilization have not been fully established. AIMS: The aims of this study were to evaluate patient compliance with a chronic disease management (CDM) program incorporating home-based exercise training as the main component after a severe COPD exacerbation and to determine its effects on health care utilization in the following year...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28882909/effect-of-time-and-day-of-admission-on-hospital-care-quality-for-patients-with-chronic-obstructive-pulmonary-disease-exacerbation-in-england-and-wales-single-cohort-study
#14
Christopher Michael Roberts, Derek Lowe, Emma Skipper, Michael C Steiner, Rupert Jones, Colin Gelder, John R Hurst, Gillian E Lowrey, Catherine Thompson, Robert A Stone
OBJECTIVE: To evaluate if observed increased weekend mortality was associated with poorer quality of care for patients admitted to hospital with chronic obstructive pulmonary disease (COPD) exacerbation. DESIGN: Prospective case ascertainment cohort study. SETTING: 199 acute hospitals in England and Wales, UK. PARTICIPANTS: Consecutive COPD admissions, excluding subsequent readmissions, from 1 February to 30 April 2014 of whom 13 414 cases were entered into the study...
September 6, 2017: BMJ Open
https://www.readbyqxmd.com/read/28876432/hospitalization-due-to-exacerbation-of-copd-real-life-outcomes
#15
Lilia Azzi Collet da Rocha Camargo, Maria Vera Oliveira Castellano, Fábio Checchia Ferreira, Flávio Vieira de Faria, Nelson Carvas
Introduction: Hospitalization due to chronic obstructive pulmonary disease exacerbation (eCOPD) may indicate worse prognosis. It is important to know the profile of hospitalized patients and their outcome of hospitalization to customize and optimize treatment. Method: Evaluation of patients hospitalized for eCOPD, with ≥ 10 pack/years and ≥ 1 previous spirometry with airway obstruction over the course of one year at the pulmonology service of a general hospital, applying: COPD assessment test (CAT); mMRc and Visual Analogue Scale (VAS) for dyspnea; hospitalized anxiety and depression questionnaire (HAD); Divo's comorbidities and Cote index; spirometry; and laboratory tests including number of eosinophils, C-reactive protein (CRP), brain natriuretic protein (BNP)...
June 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/28865758/high-doses-of-systemic-corticosteroids-in-patients-hospitalised-for-exacerbation-of-chronic-obstructive-pulmonary-disease-a-cohort-study
#16
J A Rueda-Camino, D Bernal-Bello, J Canora-Lebrato, L Velázquez-Ríos, V García de Viedma-García, M Guerrero-Santillán, M A Duarte-Millán, R Cristóbal-Bilbao, A Zapatero-Gaviria
OBJECTIVES: To assess the effect of high doses of corticosteroids in patients hospitalised for exacerbation of chronic obstructive pulmonary disease (COPD). PATIENTS AND METHODS: A prospective cohort study was conducted on patients hospitalized with COPD between January and March 2015, grouped according to the glucocorticoid dosage administered (cutoff, 40mg of prednisone/day). We compared the results of hospital stay, readmission and mortality at 3 months of discharge...
August 30, 2017: Revista Clínica Española
https://www.readbyqxmd.com/read/28812150/respiratory-complications-after-colonic-procedures-in-chronic-obstructive-pulmonary-disease-does-laparoscopy-offer-a-benefit
#17
Sarath Sujatha-Bhaskar, Reza Fazl Alizadeh, Colette S Inaba, Christina Y Koh, Mehraneh D Jafari, Steven D Mills, Joseph C Carmichael, Michael J Stamos, Alessio Pigazzi
BACKGROUND: Patients with severe chronic obstructive pulmonary disease (COPD) are at a higher risk for postoperative respiratory complications. Despite the benefits of a minimally invasive approach, laparoscopic pneumoperitoneum can substantially reduce functional residual capacity and raise alveolar dead space, potentially increasing the risk of respiratory failure which may be poorly tolerated by COPD patients. This raises controversy as to whether open techniques should be preferentially employed in this population...
August 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28800056/effectiveness-of-structured-planned-post-discharge-support-to-patients-with-chronic-obstructive-pulmonary-disease-for-reducing-readmission-rates-a-systematic-review
#18
Preben Ulrich Pedersen, Karen Bagger Ersgard, Tina Brandt Soerensen, Palle Larsen
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a preventable and treatable disease, characterized by airflow limitation. The disease has a significant impact on the lives of patients and is a challenge for the health care due to readmissions to hospitals. OBJECTIVES: This review aimed to identify, appraise and synthesize the best available evidence on the effectiveness of discharge interventions that can reduce readmission of patients with COPD. TYPES OF PARTICIPANTS: Hospitalized patients, aged 18 years or over, who had been diagnosed with COPD and were admitted to hospital due to acute exacerbation...
August 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28765496/impact-of-a-post-discharge-integrated-disease-management-program-on-copd-hospital-readmissions
#19
Ashlee N Russo, Gayathri Sathiyamoorthy, Chris Lau, Didem Saygin, Xiaozhen Han, Xiao-Feng Wang, Richard Rice, Loutfi S Aboussouan, James K Stoller, Umur Hatipoğlu
BACKGROUND: Readmission following a hospitalization for COPD is associated with significant health-care expenditure. METHODS: A multicomponent COPD post-discharge integrated disease management program was implemented at the Cleveland Clinic to improve the care of patients with COPD and reduce readmissions. This retrospective study reports our experience with the program. Groups of subjects who were exposed to different components of the program were compared regarding their readmission rates...
August 1, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28733370/reliable-adherence-to-a-copd-care-bundle-mitigates-system-level-failures-and-reduces-copd-readmissions-a-system-redesign-using-improvement-science
#20
Muhammad Ahsan Zafar, Ralph J Panos, Jonathan Ko, Lisa C Otten, Anthony Gentene, Maria Guido, Katherine Clark, Caroline Lee, Jamie Robertson, Evaline A Alessandrini
BACKGROUND: Readmissions of chronic obstructive pulmonary disease (COPD) have devastating effects on patient quality-of-life, disease progression and healthcare cost. Effective interventions to reduce COPD readmissions are needed. OBJECTIVES: Reduce 30-day all-cause readmissions by (1) creating a COPD care bundle that addresses care delivery failures, (2) using improvement science to achieve 90% bundle adherence. SETTING: An 800-bed academic hospital in Ohio, USA...
July 21, 2017: BMJ Quality & Safety
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