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Heart failure readmission

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https://www.readbyqxmd.com/read/29154427/design-of-a-multicentre-randomized-controlled-trial-to-assess-the-safety-and-efficacy-of-dose-titration-by-specialized-nurses-in-patients-with-heart-failure-etific-study-protocol
#1
Juana Oyanguren, LLuisa García-Garrido, Magdalena Nebot Margalef, Iñaki Lekuona, Josep Comin-Colet, Nicolás Manito, Julia Roure, Pilar Ruiz Rodriguez, Cristina Enjuanes, Pedro Latorre, Jesús Torcal Laguna, Susana García-Gutiérrez
AIMS: Heart failure (HF) is associated with many hospital admissions and relatively high mortality, rates decreasing with administration of beta-blockers (BBs), angiotensin-converting-enzyme inhibitors, angiotensin II receptor blockers, and mineralocorticoid receptor antagonists. The effect is dose dependent, suboptimal doses being common in clinical practice. The 2012 European guidelines recommend close monitoring and dose titration by HF nurses. Our main aim is to compare BB doses achieved by patients after 4 months in intervention (HF nurse-managed) and control (cardiologist-managed) groups...
November 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/29154415/persistent-high-blood-urea-nitrogen-level-is-associated-with-increased-risk-of-cardiovascular-events-in-patients-with-acute-heart-failure
#2
Kentaro Jujo, Yuichiro Minami, Shintaro Haruki, Yuya Matsue, Kensuke Shimazaki, Hiromu Kadowaki, Issei Ishida, Keigo Kambayashi, Hiroyuki Arashi, Haruki Sekiguchi, Nobuhisa Hagiwara
AIMS: The association between kinetics of blood urea nitrogen (BUN) levels in hospital and cardiovascular outcomes in patients with acutely decompensated congestive heart failure (HF) is unclear. We aimed to estimate the impact of changes in BUN level during hospitalization on clinical prognosis in patients with acute HF. METHODS AND RESULTS: A total of 353 consecutive patients that were urgently hospitalized due to acutely decompensated HF and discharged alive were divided into four subgroups depending on their BUN level at admission and discharge, using a cut-off level of 21...
November 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/29152829/procedural-trends-outcomes-and-readmission-rates-pre-and-post-fda-approval-for-mitraclip-from-the-national-readmission-database-2013-14
#3
Sidakpal S Panaich, Shilpkumar Arora, Apurva Badheka, Varun Kumar, Elad Maor, Claire Raphael, Abhishek Deshmukh, Guy Reeder, Mackram Eleid, Charanjit S Rihal
BACKGROUND: There are sparse clinical data on the procedural trends, outcomes and readmission rates following FDA approval and expansion of Transcatheter mitral valve repair/MitraClip(®) . Whether a complex new technology can be disseminated safely and quickly is controversial. METHODS: The study cohort was derived from the National Readmission Data (NRD) 2013-14. MitraClip(®) was identified using appropriate International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes...
November 20, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29148301/provider-connectedness-to-other-providers-reduces-risk-of-readmission-after-hospitalization-for-heart-failure
#4
Alon Geva, Karen L Olson, Chunfu Liu, Kenneth D Mandl
Provider interactions other than explicit care coordination, which is challenging to measure, may influence practice and outcomes. We performed a network analysis using claims data from a commercial payor. Networks were identified based on provider pairs billing outpatient care for the same patient. We compared network variables among patients who had and did not have a 30-day readmission after hospitalization for heart failure. After adjusting for comorbidities, high median provider connectedness-normalized degree, which for each provider is the number of connections to other providers normalized to the number of providers in the region-was the network variable associated with reduced odds of readmission after heart failure hospitalization (odds ratio = 0...
July 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29148231/employment-status-at-time-of-first-hospitalization-for-heart-failure-is-associated-with-a-higher-risk-of-death-and-rehospitalization-for-heart-failure
#5
Rasmus Rørth, Emil L Fosbøl, Ulrik M Mogensen, Kristian Kragholm, Anna-Karin Numé, Gunnar H Gislason, Pardeep S Jhund, Mark C Petrie, John J V McMurray, Christian Torp-Pedersen, Lars Køber, Søren L Kristensen
AIMS: Employment status at time of first heart failure (HF) hospitalization may be an indicator of both self-perceived and objective health status. In this study, we examined the association between employment status and the risk of all-cause mortality and recurrent HF hospitalization in a nationwide cohort of patients with HF. METHODS AND RESULTS: We identified all patients of working age (18-60 years) with a first HF hospitalization in the period 1997-2015 in Denmark, categorized according to whether or not they were part of the workforce at time of the index admission...
November 16, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/29141781/heart-failure-with-preserved-borderline-and-reduced-ejection-fraction-5-year-outcomes
#6
Kevin S Shah, Haolin Xu, Roland A Matsouaka, Deepak L Bhatt, Paul A Heidenreich, Adrian F Hernandez, Adam D Devore, Clyde W Yancy, Gregg C Fonarow
BACKGROUND: Patients with heart failure (HF) have a poor prognosis and are categorized by ejection fraction (EF). OBJECTIVES: This study sought to characterize differences in outcomes in patients hospitalized with heart failure with preserved ejection fraction (HFpEF) (EF ≥50%), heart failure with borderline ejection fraction (HFbEF) (EF 41% to 49%), and heart failure with reduced ejection fraction (HFrEF) (EF ≤40%). METHODS: Data from GWTG-HF (Get With The Guidelines-Heart Failure) were linked to Medicare data for longitudinal follow-up...
October 31, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29128869/association-of-the-hospital-readmissions-reduction-program-implementation-with-readmission-and-mortality-outcomes-in-heart-failure
#7
Ankur Gupta, Larry A Allen, Deepak L Bhatt, Margueritte Cox, Adam D DeVore, Paul A Heidenreich, Adrian F Hernandez, Eric D Peterson, Roland A Matsouaka, Clyde W Yancy, Gregg C Fonarow
Importance: Public reporting of hospitals' 30-day risk-standardized readmission rates following heart failure hospitalization and the financial penalization of hospitals with higher rates have been associated with a reduction in 30-day readmissions but have raised concerns regarding the potential for unintended consequences. Objective: To examine the association of the Hospital Readmissions Reduction Program (HRRP) with readmission and mortality outcomes among patients hospitalized with heart failure within a prospective clinical registry that allows for detailed risk adjustment...
November 12, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/29123431/comparative-quality-measures-of-emergency-care-an-outcome-cockpit-proposal-to-survey-clinical-processes-in-real-life
#8
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/29114926/measures-of-clustering-and-heterogeneity-in-multilevel-poisson-regression-analyses-of-rates-count-data
#9
Peter C Austin, Henrik Stryhn, George Leckie, Juan Merlo
Multilevel data occur frequently in many research areas like health services research and epidemiology. A suitable way to analyze such data is through the use of multilevel regression models. These models incorporate cluster-specific random effects that allow one to partition the total variation in the outcome into between-cluster variation and between-individual variation. The magnitude of the effect of clustering provides a measure of the general contextual effect. When outcomes are binary or time-to-event in nature, the general contextual effect can be quantified by measures of heterogeneity like the median odds ratio or the median hazard ratio, respectively, which can be calculated from a multilevel regression model...
November 8, 2017: Statistics in Medicine
https://www.readbyqxmd.com/read/29114106/designing-and-implementation-of-a-heart-failure-telemonitoring-system
#10
Reza Safdari, Maryam Jafarpour, Mehrshad Mokhtaran, Nasim Naderi
Introduction: The aim of this study was to identify patients at-risk, enhancing self-care management of HF patients at home and reduce the disease exacerbations and readmissions. Method: In this research according to standard heart failure guidelines and Semi-structured interviews with 10 heart failure Specialists, a draft heart failure rule set for alerts and patient instructions was developed. Eventually, the clinical champion of the project vetted the rule set...
September 2017: Acta Informatica Medica: AIM
https://www.readbyqxmd.com/read/29111110/impact-of-injectable-furosemide-hospital-shortage-on-congestive-heart-failure-outcomes-a-time-series-analysis
#11
MULTICENTER STUDY
Vivian S Tan, Danielle M Nash, Eric McArthur, Arsh K Jain, Amit X Garg, David N Juurlink, Matthew A Weir
BACKGROUND: Beginning in February 2012, there was a shortage of injectable furosemide in the province of Ontario, Canada. The objective of this study was to assess the effects of the furosemide shortage on heart failure outcomes in Ontario, Canada. METHODS: We determined which hospitals experienced a shortage of injectable furosemide using an online survey. We then used health administrative data to identify all patients who presented to those hospitals with congestive heart failure...
November 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29110087/outcomes-of-open-versus-laparoscopic-surgery-in-patients-with-rectal-cancer
#12
José M Quintana, Ane Anton-Ladislao, Santiago Lázaro, Nerea Gonzalez, Marisa Bare, Nerea Fernandez de Larrea, Maximino Redondo, Eduardo Briones, Antonio Escobar, Cristina Sarasqueta, Susana Garcia-Gutierrez
PURPOSE: The goal of this study was to compare the effectiveness of laparoscopic with that of open surgery up to 2 years after intervention in patients with rectal cancer. METHODS: This is a prospective cohort study of patients with rectal cancer who underwent surgery (laparoscopic or open) between June 2010 and December 2012 in 22 acute hospitals. Main outcomes were mortality, complications, reoperation, readmission, and patient-reported outcome measures (PROMs), as measured using the EuroQol-5D (EQ-5D), European Organisation for Research and Treatment of Cancer (EORTC) QLQ-Q30 and Q29, the Barthel Index (BI), and the Duke-UNC Functional Social Support Questionnaire at baseline, 1 year, and 2 years after surgery...
November 6, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/29108668/the-prognostic-value-of-high-sensitivity-cardiac-troponin-t-in-patients-with-congenital-heart-disease
#13
Masayuki Abiko, Kei Inai, Eriko Shimada, Seiji Asagai, Toshio Nakanishi
BACKGROUND: Cardiac troponin T (cTnT) is a specific marker of myocardial injury that is elevated in patients with coronary artery disease or heart failure; it has been investigated as a prognostic marker. A highly sensitive, commercially available assay has been developed to detect cardiac troponin T (hs-cTnT). This study aimed to evaluate the clinical implications and prognostic value of hs-cTnT in patients with congenital heart disease (CHD). METHODS: We evaluated 122 consecutive patients hospitalized at our institution because of heart failure or scheduled cardiac catheterization...
November 3, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/29108365/a-3-year-observation-of-testosterone-deficiency-in-chinese-patients-with-chronic-heart-failure
#14
Ying Han, Weiju Sun, Guizhi Sun, Xiaolu Hou, Zhaowei Gong, Jing Xu, Xiuping Bai, Lu Fu
Testosterone deficiency is present in a certain proportion men with chronic heart failure (CHF). Low testosterone levels in American and European patients with CHF lead to the high mortality and readmission rates. Interestingly, this relationship has not been studied in Chinese patients. To this end, 167 Chinese men with CHF underwent clinical and laboratory evaluations associated with determinations of testosterone levels. Total testosterone (TT) levels and sex hormone-binding globulin were measured by chemiluminescence or immunoassays assays and free testosterone (FT) levels were calculated, Based upon results from these assays, patients were divided into either a low testosterone (LT; n = 93) or normal testosterone (NT; n = 74) group...
October 3, 2017: Oncotarget
https://www.readbyqxmd.com/read/29102442/the-effect-of-nurse-led-education-on-hospitalisation-readmission-quality-of-life-and-cost-in-adults-with-heart-failure-a-systematic-review
#15
REVIEW
Helena Rice, Richard Say, Vasiliki Betihavas
OBJECTIVE: The purpose of this systematic review was to highlight the effect of nurse-led 1:1 patient education sessions on Quality of Life (QoL), readmission rates and healthcare costs for adults with heart failure (HF) living independently in the community. METHOD: A systematic review of randomised control trials was undertaken. Using the search terms nurse, education, heart failure, hospitalisation, readmission, rehospitalisation, economic burden, cost, expenditure and quality of life in PubMed, CINAHL and Google Scholar databases were searched...
October 5, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/29101146/effect-of-cardiologist-care-on-6-month-outcomes-in-patients-discharged-with-heart-failure-results-from-an-observational-study-based-on-administrative-data
#16
Vera Maria Avaldi, Jacopo Lenzi, Stefano Urbinati, Dario Molinazzi, Carlo Descovich, Anselmo Campagna, Martina Taglioni, Angelo Fioritti, Maria Pia Fantini
OBJECTIVES: To evaluate the effect of cardiologist care on adherence to evidence-based secondary prevention medications, mortality and readmission within 6 months of discharge in patients with heart failure (HF). DESIGN: Retrospective observational study based on administrative data. SETTING: Local Healthcare Authority (LHA) of Bologna, one of the largest LHAs of Italy with ~870 000 inhabitants. PARTICIPANTS: All patients residing in the LHA of Bologna discharged from hospital with a diagnosis of HF between 1 January 2015 and 31 December 2015...
November 3, 2017: BMJ Open
https://www.readbyqxmd.com/read/29099540/depression-and-anxiety-in-patients-undergoing-left-ventricular-assist-device-implantation
#17
Scott Lundgren, Cecilia Y M Poon, Ahmed Selim, Brian D Lowes, Ronald Zolty, Adam Burdorf, Yael Potashnik-Peled, Michael J Moulton, John Y Um, Eugenia Raichlin
BACKGROUND: Depression and anxiety are associated with a worse prognosis in heart failure patients. The aim of this study was to identify the prevalence of depression and anxiety in left ventricular assist device (LVAD) candidates and assess their effect on post-LVAD outcomes. METHODS: Based on the pre-LVAD psychological assessment, the total cohort of 246 patients were divided into 4 groups: 1) no depression or anxiety (NDep&Anx group, n = 138); 2) isolated depression (Dep group, n = 42); 3) isolated anxiety (Anx group, n = 32), and 4) combined depression and anxiety (Dep&Anx group, n = 34)...
November 1, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/29082676/lessons-learned-in-acute-heart-failure
#18
REVIEW
Baljash Cheema, Andrew P Ambrosy, Rachel M Kaplan, Michele Senni, Gregg C Fonarow, Ovidiu Chioncel, Javed Butler, Mihai Gheorghiade
Acute heart failure (HF) is a global pandemic with more than one million admissions to hospital annually in the US and millions more worldwide. Post-discharge mortality and readmission rates remain unchanged and unacceptably high. Although recent drug development programmes have failed to deliver novel therapies capable of reducing cardiovascular morbidity and mortality in patients hospitalized for worsening chronic HF, hospitalized HF registries and clinical trial databases have generated a wealth of information improving our collective understanding of the HF syndrome...
October 29, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/29082629/aetiology-timing-and-clinical-predictors-of-early-vs-late-readmission-following-index-hospitalization-for-acute-heart-failure-insights-from-ascend-hf
#19
EDITORIAL
Marat Fudim, Christopher M O'Connor, Allison Dunning, Andrew P Ambrosy, Paul W Armstrong, Adrian Coles, Justin A Ezekowitz, Stephen J Greene, Marco Metra, Randall C Starling, Adriaan A Voors, Adrian F Hernandez, G Michael Felker, Robert J Mentz
AIMS: Patients hospitalized for heart failure (HF) are at high risk for 30-day readmission. This study sought to examine the timings and causes of readmission within 30 days of an HF hospitalization. METHODS AND RESULTS: Timing and cause of readmission in the ASCEND-HF (Acute Study of Clinical Effectiveness of Nesiritide and Decompensated Heart Failure) trial were assessed. Early and late readmissions were defined as admissions occurring within 0-7 days and 8-30 days post-discharge, respectively...
October 29, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/29079501/beyond-discrimination-a-comparison-of-calibration-methods-and-clinical-usefulness-of-predictive-models-of-readmission-risk
#20
Colin G Walsh, Kavya Sharman, George Hripcsak
BACKGROUND: Prior to implementing predictive models in novel settings, analyses of calibration and clinical usefulness remain as important as discrimination, but they are not frequently discussed. Calibration is a model's reflection of actual outcome prevalence in its predictions. Clinical usefulness refers to the utilities, costs, and harms of using a predictive model in practice. A decision analytic approach to calibrating and selecting an optimal intervention threshold may help maximize the impact of readmission risk and other preventive interventions...
October 24, 2017: Journal of Biomedical Informatics
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