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S Renshaw, I L Silva, A Hotouras, S D Wexner, J Murphy, C Bhan
The purpose of this study was to assess outcome measures and cost-effectiveness of robotic colorectal resections in adult patients with inflammatory bowel disease. The Cochrane Library, PubMed/Medline and Embase databases were reviewed, using the text "robotic(s)" AND ("inflammatory bowel disease" OR "Crohn's" OR "Ulcerative Colitis"). Two investigators screened abstracts for eligibility. All English language full-text articles were reviewed for specified outcomes. Data were presented in a summarised and aggregate form, since the lack of higher-level evidence studies precluded meta-analysis...
March 15, 2018: Techniques in Coloproctology
John A Brockman, Joel Vetter, Vicky Peck, Seth A Strope
OBJECTIVES: To determine whether an enhance recovery protocol for radical cystectomy patient affected the length of stay or the number and type of readmissions that occurred after hospital discharge. METHODS: We prospectively assessed 152 cystectomy patients after initiation of the pathway. These patients were compared to the previous 147 patient operated on prior to the pathway initiation. Eligible patients were those undergoing radical cystectomy with any diversion at our institution...
March 12, 2018: Urology
Anna Therese Bjerkreim, Andrej Netland Khanevski, Solveig Bergliot Glad, Lars Thomassen, Halvor Naess, Nicola Logallo
Background: Intracerebral hemorrhage (ICH) is the most severe form of stroke, but data on readmission after ICH are sparse. We aimed to determine frequency, causes, and predictors of 30-day readmission after ICH. Materials and Methods: This retrospective cohort study includes all spontaneous ICH survivors admitted to the stroke unit at Haukeland University Hospital in Bergen in Norway from July 2007 to December 2013. Patients were followed by review of electronic medical charts, and the first unplanned readmission within 30 days after discharge was used as final outcome...
March 2018: Brain and Behavior
Yi Zuo, Elizabeth C Pino, Mrithyunjay Vyliparambil, Bindu Kalesan
The majority of the burden of firearm injury in the United States is on men as compared to women. There is limited evidence regarding sex differences in short-term hospitalization outcomes after surviving firearm injury. The risk of cardiovascular and all-cause hospital readmission, length of stay (LOS), and costs within 180 days after surviving an index firearm injury was compared between males and females. A claims-based, retrospective, cohort study was performed using Nationwide Readmission Database (2013-2014) to obtain a cohort of patients who survived an index hospitalization of firearm injury...
March 1, 2018: American Journal of Men's Health
Kerry A Morrison, James C Lee, Mark M Souweidane, Neil A Feldstein, Jeffrey A Ascherman
BACKGROUND: Surgical intervention during infancy for both syndromic and nonsyndromic patients with craniosynostosis remains the criterion standard of treatment with the 2 main options being open vault remodeling versus minimally invasive surgery. Although open cranial vault remodeling was initially considered a high-risk procedure, many advances have improved its safety. Despite this, there is a paucity of literature on the long-term outcomes of contemporary open craniosynostosis repair...
March 13, 2018: Annals of Plastic Surgery
David W Morris, Subroto Ghose, Ella Williams, Kevin Brown, Fuad Khan
Introduction: Hospital emergency departments (EDs) around the country are being challenged by an ever-increasing volume of patients seeking psychiatric services. This manuscript describes a study performed to identify internal and external factors contributing to repeated psychiatric patient admissions to the hospital main ED. Methods: Data from ED visits of patients who were admitted to the Parkland Memorial Hospital ED (the community hospital for Dallas County, TX, USA) with a psychiatric complaint more than once within a 30-day period were evaluated (n=202)...
2018: Neuropsychiatric Disease and Treatment
Zachary Hodosevich, Krista K Wheeler, Junxin Shi, Rebecca Coffey, J Kevin Bailey, Larry M Jones, Rajan K Thakkar, Renata B Fabia, Jonathan I Groner, Henry Xiang
Introduction: This study characterizes adult burn readmissions in the United States using a nationally representative hospital inpatient sample. Readmission rates, diagnoses, and risk factors are discussed. Methods: We analyzed the 2013 and 2014 Nationwide Readmission Database (NRD) for adult burn patients. The data were weighted to estimate national 30-day readmission rates. Principal readmission diagnoses were sorted into burn-specific or other readmission categories...
March 9, 2018: Journal of Burn Care & Research: Official Publication of the American Burn Association
Anuj K Dalal, Adam Schaffer, Esteban F Gershanik, Ranganath Papanna, Katyuska Eibensteiner, Nyryan V Nolido, Cathy S Yoon, Deborah Williams, Stuart R Lipsitz, Christopher L Roy, Jeffrey L Schnipper
BACKGROUND: Follow-up of tests pending at discharge (TPADs) is poor. We previously demonstrated a twofold increase in awareness of any TPAD by attendings and primary care physicians (PCPs) using an automated email intervention OBJECTIVE: To determine whether automated notification improves documented follow-up for actionable TPADs DESIGN: Cluster-randomized controlled trial SUBJECTS: Attendings and PCPs caring for adult patients discharged from general medicine and cardiology services with at least one actionable TPAD between June 2011 and May 2012 INTERVENTION: An automated system that notifies discharging attendings and network PCPs of finalized TPADs by email MAIN MEASURES: The primary outcome was the proportion of actionable TPADs with documented action determined by independent physician review of the electronic health record (EHR)...
March 12, 2018: Journal of General Internal Medicine
A J Perez, I N Haskins, A S Prabhu, D M Krpata, C Tu, S Rosenblatt, K Hashimoto, T Diago, B Eghtesad, M L J Rosen
Background: Umbilical hernias are common in patients with end-stage liver disease undergoing liver transplantation. Management of those persisting at the time of liver transplantation is important to define. Objective: To evaluate the long-term results of patients undergoing simultaneous primary umbilical hernia repair (UHR) at the time of liver transplantation at a single institution. Methods: Retrospective chart review was performed on patients undergoing simultaneous UHR and liver transplantation from 2010 through 2016...
2018: International Journal of Organ Transplantation Medicine
Lelwala Guruge Thushani Shanika, Shaluka Jayamanne, Chandrani Nirmala Wijekoon, Judith Coombes, Dhineli Perera, Fahim Mohamed, Ian Coombes, Hithanadura Asita De Silva, Andrew Hamilton Dawson
Objective: To assess if a ward-based clinical pharmacy service resolving drug-related problems improved medication appropriateness at discharge and prevented drug-related hospital readmissions. Method: Between March and September 2013, we recruited patients with noncommunicable diseases in a Sri Lankan tertiary-care hospital, for a non-randomized controlled clinical trial. The intervention group received usual care and clinical pharmacy service. The intervention pharmacist made prospective medication reviews, identified drug-related problems and discussed recommendations with the health-care team and patients...
March 1, 2018: Bulletin of the World Health Organization
Rocco Friebel, Katharina Hauck, Paul Aylin, Adam Steventon
OBJECTIVE: To assess trends in 30-day emergency readmission rates across England over one decade. DESIGN: Retrospective study design. SETTING: 150 non-specialist hospital trusts in England. PARTICIPANTS: 23 069 134 patients above 18 years of age who were readmitted following an initial admission (n=62 584 297) between April 2006 and February 2016. PRIMARY AND SECONDARY OUTCOMES: We examined emergency admissions that occurred within 30 days of discharge from hospital ('emergency readmissions') as a measure of healthcare quality...
March 12, 2018: BMJ Open
Megan K Luther, Diane M Parente, Aisling R Caffrey, Katie Daffinee, Vrishali V Lopes, Emily T Martin, Kerry L LaPlante
Background. Molecular and clinical factors associated with biofilm-forming methicillin-resistant Staphylococcus aureus (MRSA) are incompletely understood. Methods. Biofilm production was quantified in 182 MRSA isolates from clinical culture sites (2004-2013). Microbiologic toxins, pigmentation, and genotypes were evaluated, and patient demographics were collected. Logistic regression was used to quantify the effect of strong biofilm production (versus weak) on clinical outcomes and independent predictors of strong biofilm...
March 12, 2018: Antimicrobial Agents and Chemotherapy
Louise S van Galen, Daisy Vedder, Tom Boeije, Wilma Jansen, Nieke E Mullaart-Jansen, Donald L van der Peet, Ralph K L So, Prabath W B Nanayakkara
BACKGROUND: Although unscheduled readmissions are increasingly being used as a quality indicator, only few readmission studies have focused on surgical patient populations. METHODS: An observational study "CURIOS@" was performed at three centers in the Netherlands. Readmitted patients and treating doctors were surveyed to assess the discharge process during index admission and their opinion on predictability and preventability of the readmission. Risk factors associated with predictability and preventability as judged by patients and their doctor were identified...
March 8, 2018: Journal of Surgical Research
Pablo A Slullitel, Martín Estefan, Wilber M Ramírez-Serrudo, Fernando M Comba, Gerardo Zanotti, Francisco Piccaluga, Martín A Buttaro
BACKGROUND: Following a total hip arthroplasty (THA), early hospital re-admission rates of 3-11% are considered as 'acceptable' in terms of medical care cost policies. Surprisingly, the impact of re-admissions on mortality has not been priorly portrayed. Therefore, we sought to determine the mortality rate after 90-day re-admissions following a THA in a series of patients from a captive medical care program. PATIENTS AND METHODS: We prospectively analysed 90-day readmissions of 815 unilateral, elective THA patients operated upon between 2010 and 2014 whose medical care was the one offered by our institution...
March 10, 2018: International Orthopaedics
Nathaniel R Smilowitz, Joshua A Beckman, Scott E Sherman, Jeffrey S Berger
BACKGROUND : Acute myocardial infarction (AMI) is a major cardiovascular complication of noncardiac surgery. We aimed to evaluate the frequency, causes, and outcomes of 30-day hospital readmission after perioperative AMI. METHODS : Patients who were diagnosed with AMI during hospitalization for major noncardiac surgery were identified using the 2014 US Nationwide Readmission Database. Rates, causes, and costs of 30-day readmissions after noncardiac surgery with and without perioperative AMI were identified...
March 10, 2018: Circulation
Jessica L Markham, Matt Hall, James C Gay, Jessica L Bettenhausen, Jay G Berry
BACKGROUND AND OBJECTIVES: Readmissions burden the health care system. Despite increasing attention to readmission rates, little is known about the duration and cost of readmissions. The objective of this study was to assess, nationally, the length of stay (LOS) and costs for 30-day readmissions in children. METHODS: We performed a retrospective analysis of 30-day readmissions by using the 2013 Nationwide Readmissions Database. We used generalized linear mixed effects models adjusted for important clinical and demographic factors to assess LOS and cost for index admissions, readmissions, and the episode of care (index admission plus readmission)...
March 9, 2018: Pediatrics
N Koyuncu, O Karcioglu, S Sener
Introduction: Little data have been published on the outcome of patients discharged from the emergency department (ED) after being diagnosed with nonspecific abdominal pain (NSAP). This study aimed to investigate short-term follow-up of patients discharged with a diagnosis of NSAP from the ED. Materials and Methods: This prospective, observational study was conducted in the University-based ED and enrolled all consecutive adult patients who were diagnosed as NSAP out of patients presented with abdominal pain (AP)...
March 2018: Nigerian Journal of Clinical Practice
Sahil Agrawal, Lohit Garg, Mahek Shah, Manyoo Agarwal, Brijesh Patel, Amitoj Singh, Aakash Garg, Ulrich P Jorde, Navin K Kapur
BACKGROUND: Early readmissions contribute significantly to heart failure-related morbidity and negatively affect quality of life. Data on left ventricular assist device (LVAD)-related 30-day readmissions are scarce and limited to small studies. METHODS AND RESULTS: Patients undergoing LVAD implantation between January 2013 and November 2014 who survived the index hospitalization were identified in the Nationwide Readmissions Database. We analyzed the incidence, predictors, causes, and costs of 30-day readmissions...
March 2018: Circulation. Heart Failure
Helle Molter Duriaud, Niels Kroman, Henrik Kehlet
INTRODUCTION: Improvement in perioperative care programmes has facilitated post-operative recovery and use of short-term or outpatient procedures. The aim of this study was to assess the feasibility and safety of an outpatient breast cancer programme in patients referred to a large breast cancer unit. METHODS: After an introduction period involving 554 consecutive patients, all patients operated from 1 November 2015 to 30 June 2016 (a total 483 patients) were treated with multimodal oral analgesia, preoperative high-dose glucocorticoids and no routine use of drains...
March 2018: Danish Medical Journal
Tetsu Ohnuma, Daisuke Shinjo, Alan M Brookhart, Kiyohide Fushimi
Background: Reducing the 30-day unplanned hospital readmission rate is a goal for physicians and policymakers in order to improve quality of care. However, data on the readmission rate of critically ill patients in Japan and knowledge of the predictors associated with readmission are lacking. We investigated predictors associated with 30-day rehospitalization for medical and surgical adult patients separately. Methods: Patient data from 502 acute care hospitals with intensive care unit (ICU) facilities in Japan were retrospectively extracted from the Japanese Diagnosis Procedure Combination (DPC) database between April 2012 and February 2014...
2018: Journal of Intensive Care
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