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https://www.readbyqxmd.com/read/29672398/evaluating-quality-metrics-and-cost-after-discharge-a-population-based-cohort-study-of-value-in-health-care-following-elective-major-vascular-surgery
#1
Charles de Mestral, Konrad Salata, Mohamad A Hussain, Ahmed Kayssi, Mohammed Al-Omran, Graham Roche-Nagle
BACKGROUND: Early readmission to hospital after surgery is an omnipresent quality metric across surgical fields. We sought to understand the relative importance of hospital readmission among all health services received after hospital discharge. OBJECTIVE: The aim of this study was to characterize 30-day postdischarge cost and risk of an emergency department (ED) visit, readmission, or death after hospitalization for elective major vascular surgery. METHODS: This is a population-based retrospective cohort study of patients who underwent elective major vascular surgery - carotid endarterectomy, EVAR, open AAA repair, bypass for lower extremity peripheral arterial disease - in Ontario, Canada, between 2004 and 2015...
April 18, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29661050/healthcare-resource-use-and-costs-associated-with-chronic-kidney-disease-in-us-private-insurance-patients-with-multiple-myeloma
#2
Debajyoti Bhowmik, Xue Song, Michele Intorcia, Shia T Kent, Nianwen Shi
Objectives Within a median 1.2 years after patients have an initial diagnosis with multiple myeloma, up to 61% were diagnosed with renal impairment and 50% were diagnosed with chronic kidney disease. This study estimated economic burden associated with chronic kidney disease in multiple myeloma patients in the US. Methods In this retrospective cohort study, patients ≥18 years old with ≥1 inpatient or ≥ 2 outpatient multiple myeloma diagnoses between 1 January 2008 and 31 March 2015 were identified from MarketScan® Commercial and Medicare Supplemental Databases...
January 1, 2018: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/29656265/classification-of-attempted-suicide-by-cluster-analysis-a-study-of-888-suicide-attempters-presenting-to-the-emergency-department
#3
Hyeyoung Kim, Bora Kim, Se Hyun Kim, C Hyung Keun Park, Eun Young Kim, Yong Min Ahn
BACKGROUND: It is essential to understand the latent structure of the population of suicide attempters for effective suicide prevention. The aim of this study was to identify subgroups among Korean suicide attempters in terms of the details of the suicide attempt. METHODS: A total of 888 people who attempted suicide and were subsequently treated in the emergency rooms of 17 medical centers between May and November of 2013 were included in the analysis. The variables assessed included demographic characteristics, clinical information, and details of the suicide attempt assessed by the Suicide Intent Scale (SIS) and Columbia-Suicide Severity Rating Scale (C-SSRS)...
April 4, 2018: Journal of Affective Disorders
https://www.readbyqxmd.com/read/29652166/ambulance-use-distance-and-outcomes-in-patients-with-suspected-cardiovascular-disease-a-registry-based-geographic-information-system-study
#4
Nariman Sepehrvand, Wendimagegn Alemayehu, Padma Kaul, Rick Pelletier, Aminu K Bello, Robert C Welsh, Paul W Armstrong, Justin A Ezekowitz
BACKGROUND: Despite guideline recommendations, the majority of patients with symptoms suggestive of acute coronary syndrome do not use emergency medical services to reach the emergency department (ED). The aim of this study was to investigate the factors associated with EMS utilisation and subsequent patient outcomes. METHODS: Using administrative data, all patients who presented to an ED in the metropolitan areas of Edmonton and Calgary in the years of 2007-2013 with main ED diagnosis of acute coronary syndrome, stable angina or chest pain were included...
April 1, 2018: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/29650872/-examination-of-patients-that-died-within-48-hours-after-urgent-hospitalization
#5
Kazuhiro Kawada, Ryota Yanaizumi, Osamu Takahashi
We offer inpatient support for end-stage cancer patients, not only in palliative care units, but also in general medical and long-term care units. We also provide outpatient palliative care and offer emergent backup for the regional home care clinics. From January 2014 to December 2016, 1,832 patients were hospitalized, and among them, 983 patients visited our hospital on an emergency basis. Among the urgent hospitalized patients, 378 patients returned home after adequate palliative care. But 605 patients had to stay admitted in the hospital until their time of death...
March 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29626743/examining-racial-ethnic-differences-in-patterns-of-benzodiazepine-prescription-and-misuse
#6
Benjamin Cook, Timothy Creedon, Ye Wang, Chunling Lu, Nicholas Carson, Piter Jules, Esther Lee, Margarita Alegría
BACKGROUND: Benzodiazepines (BZDs) are widely prescribed during psychiatric treatment. Unfortunately, their misuse has led to recent surges in overdose emergency visits and drug-related deaths. METHODS: Electronic health record data from a large healthcare system were used to describe racial/ethnic, sex, and age differences in BZD use and dependence. Among patients with a BZD prescription, we assessed differences in the likelihood of subsequently receiving a BZD dependence diagnosis, number of BZD prescriptions, receiving only one BZD prescription, and receiving 18 or more BZD prescriptions...
March 26, 2018: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/29610668/hcfc-123-induced-toxic-hepatitis-and-death-at-a-korean-fire-extinguisher-manufacturing-facility-a-case-series
#7
Mu Young Shin, Jong Soo Park, Hae Dong Park, Jihye Lee
Background: Exposure to sustained high concentrations of HCFC-123 is known to be hepatotoxic. We report two simultaneous cases of toxic hepatitis related to exposure to 2,2-dichloro-1,1,1-trifluoroethane (HCFC-123), a common refrigerant, at a Korean fire extinguisher manufacturing facility. Case presentation: Patients A and B were men aged 21 and 22 years, respectively, with no notable medical histories. They had recently started working for a manufacturer of fire extinguishers...
2018: Annals of Occupational and Environmental Medicine
https://www.readbyqxmd.com/read/29603724/multimorbidity-and-functional-limitation-in-individuals-with-heart-failure-a-prospective-community-study
#8
Sheila M Manemann, Alanna M Chamberlain, Véronique L Roger, Cynthia Boyd, Andrea Cheville, Shannon M Dunlay, Susan A Weston, Ruoxiang Jiang, Lila J Finney Rutten
OBJECTIVES: To characterize the individual and combined effects of multimorbidity and functional limitation on healthcare use and mortality in a large, community cohort of individuals with heart failure (HF). DESIGN: Prospective cohort study. SETTING: Eleven southeastern Minnesota counties. PARTICIPANTS: Individuals (mean age 74, 54% male) with a first-ever HF code (International Classification of Diseases, Ninth Revision code 428 or Tenth Revision code I50) between January 1, 2013 and March 31, 2016 (N=2,692)...
March 30, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29588312/clustered-emergency-room-visits-following-an-acute-heart-failure-admission-a-population-based-study
#9
Juan G Duero Posada, Yasbanoo Moayedi, Limei Zhou, Michael McDonald, Heather J Ross, Douglas S Lee, R Sacha Bhatia
BACKGROUND: While it is well known that heart failure patients presenting to the emergency room (ER) have high short-term mortality after discharge, the outcomes of patients with heart failure with repeated ER visits within a short time are not known. In this study, we aimed to determine whether clustering is associated with an increased risk of death. METHODS AND RESULTS: This is a retrospective, population-based cohort study with an accrual window between 2003 and 2014 and maximal follow-up up to and including March 31, 2015...
March 27, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29575248/a-high-yield-fall-risk-and-adverse-events-screening-questions-from-the-stopping-elderly-accidents-death-and-injuries-steadi-guideline-for-older-emergency-department-fall-patients
#10
Jiraporn Sri-On, Gregory Philip Tirrell, Anucha Kamsom, Keith A Marill, Kalpana Narayan Shankar, Shan W Liu
OBJECTIVES: The objectives were to examine whether responses to the Stopping Elderly Accidents, Death, and Injuries (STEADI) questions responses predicted adverse events after an older adult emergency department (ED) fall visits and to identify factors associated with such recurrent fall. METHODS: We conducted a prospective study at 2 urban, teaching hospitals. We included patients aged ≥ 65 who presented to the ED for an accidental fall. Data were gathered for fall relevant co-morbidities, high-risk medications for falls and the responses to 12 questions from the STEADI guideline recommendation...
March 25, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29573007/patients-readiness-for-discharge-predictors-and-effects-on-unplanned-readmissions-emergency-department-visits-and-death
#11
Sıdıka Kaya, Gulay Sain Guven, Seda Aydan, Ahmet Kar, Mesut Teleş, Ahmet Yıldız, Gülsüm Ş Koca, Nazan Kartal, Cahit Korku, Duygu Ürek, İpek Bilgin Demir, Onur Toka
AIM: To determine the variables that affect patients' perceptions about their readiness for discharge and to elucidate the effects of these perceptions on patient outcomes such as unplanned readmission to the hospital, emergency department visits and death within 30 days after discharge. BACKGROUND: In recent years, it has become even more important to assess patients' readiness for discharge as patients tend to be discharged more quickly. METHODS: For the determination of patients' self-assessment, the Readiness for Hospital Discharge Scale/Short Form was utilized...
March 23, 2018: Journal of Nursing Management
https://www.readbyqxmd.com/read/29560060/reduced-computed-tomography-use-in-the-emergency-department-evaluation-of-headache-was-not-followed-by-increased-death-or-missed-diagnosis
#12
Daniel G Miller, Priyanka Vakkalanka, Mark L Moubarek, Sangil Lee, Nicholas M Mohr
Introduction: This study investigated whether a 9.6% decrease in the use of head computed tomography (HCT) for patients presenting to the emergency department (ED) with a chief complaint of headache was followed by an increase in proportions of death or missed intracranial diagnosis during the 22.5-month period following each index ED visit. Methods: We reviewed the electronic medical records of all patients sampled during a quality improvement effort in which the aforementioned decrease in HCT use had been observed...
March 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29558508/impact-of-comorbidities-on-the-prognoses-of-trauma-patients-analysis-of-a-hospital-based-trauma-registry-database
#13
Chih-Yuan Wang, Yi-Chan Chen, Ti-Hsuan Chien, Hao-Yu Chang, Yu-Hsien Chen, Chih-Ying Chien, Ting-Shuo Huang
Here we conducted a retrospective analysis of hospital-based trauma registry database for evaluating the impacts of comorbidities on the prognosis for traumatized patients using Index of Coexistent Comorbidity Disease (ICED) scores. We analyzed the data of patients with blunt trauma who visited emergency department between January 1, 2011, and December 31, 2015 in Chang-Gung Memorial Hospital, Keelung branch, a single level I trauma center in the Northern Taiwan. All consecutive patients with blunt trauma who admitted to the intensive care unit or ordinary ward after initial managements in the emergency department were included...
2018: PloS One
https://www.readbyqxmd.com/read/29550195/post-licensure-safety-surveillance-study-of-routine-use-of-quadrivalent-meningococcal-diphtheria-toxoid-conjugate-vaccine-menacwy-d-in-infants-and-children
#14
J Hansen, L Zhang, A Eaton, R Baxter, C A Robertson, M D Decker, D P Greenberg, E Bassily, N P Klein
BACKGROUND: Menactra® vaccine (MenACWY-D) was licensed in the United States in 2005 for persons 11-55 years of age, in 2007 for children 2-10 years of age, and in 2011 for infants/toddlers 9-23 months of age. We conducted two studies at Kaiser Permanente Northern California (KPNC), an integrated health care organization, to assess the safety of MenACWY-D in 2-10-year-olds and 9-23-month-olds receiving the vaccine during routine clinical care. METHODS: We conducted observational, retrospective studies of MenACWY-D in 2-10-year-olds (October 2007-October 2010) and in 9-23-month-olds (June 2011-June 2014)...
March 14, 2018: Vaccine
https://www.readbyqxmd.com/read/29525968/informing-prehospital-care-planning-using-pilot-trauma-registry-data-in-yaound%C3%A3-cameroon
#15
Obieze Chiemeka Nwanna-Nzewunwa, Marquise Kouo Ngamby, Elinor Shetter, Georges Alain Etoundi Mballa, Isabelle Feldhaus, Martin Ekeke Monono, Adnan A Hyder, Rochelle Dicker, Kent A Stevens, Catherine Juillard
INTRODUCTION: About 54% of deaths in low- and middle-income countries (LMICs) are attributable to lack of prehospital care. The single largest contributor to the disability-adjusted life years due to poor prehospital care is injury. Despite having disproportionately high injury burdens, most LMIC trauma systems have little prehospital organization. An understanding of existing prehospital care patterns in LMICs is warranted as a precursor to strengthening prehospital systems. METHODS: In this retrospective pilot study, we collected demographic and injury characteristics, therapeutic itinerary, and transport data of patients that were captured by the trauma registry at the Central Hospital of Yaoundé (CHY) from April 15, 2009 to October 15, 2009...
March 10, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29525480/safety-of-reassessment-and-release-practice-for-mental-health-patients-boarded-in-the-emergency-department
#16
Sangil Lee, Karisa K Harland, Morgan Bobb Swanson, Sara Lawson, Elijah Dahlstrom, Lance Clemson, Elaine Himadi
OBJECTIVES: Among emergency department (ED) mental health and substance abuse (MHSA) patients, we sought to compare mortality and healthcare utilization by ED discharge disposition and inpatient bed request status. METHODS: A retrospective cohort study of 492 patients was conducted at a single University ED. We reviewed three groups of MHSA patients including ED patients that were admitted, ED patients with a bed request that were discharged from the ED, and ED patients with no bed request that were discharged from the ED...
February 27, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29503828/using-intra-aortic-balloon-pump-for-management-of-cardiogenic-shock-following-aluminum-phosphide-poisoning-report-of-3-cases
#17
Ahmad Bagheri-Moghaddam, Hasan Abbaspour, Shahrad Tajoddini, Vahideh Mohammadzadeh, Ali Moinipour, Bita Dadpour
Introduction: Aluminium phosphide (Alp) poisoning mortality rate has been reported as high as 70-100%, and refractory hypotension and cardiogenic shock are the two most common presentations leading to death. Due to lack of specific antidote, all treatments are focused on supportive care and recently, intra-aortic balloon pump (IABP) has been suggested to treat cardiogenic shock resulting from toxic myocarditis. In the current paper, we introduce three Alp poisoned patients for whom IABP was applied to manage their refractory shock...
2018: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/29488459/case-report-delayed-or-recurrent-plasmodium-falciparum-malaria-in-migrants-a-report-of-three-cases-with-a-literature-review
#18
Nicolas Dauby, Mariana Figueiredo Ferreira, Deborah Konopnicki, Vo Thanh Phuong Nguyen, Brigitte Cantinieaux, Charlotte Martin
Emerging evidence indicates that migrants from Plasmodium falciparum endemic regions are at risk of delayed presentation of P. falciparum malaria. We report three cases of P. falciparum malaria occurring years after arrival in Europe. All patients were originally from Sub-Saharan Africa. Two subjects had controlled HIV infection and one was a pregnant woman. We performed a literature review of all published cases of delayed presentation of P. falciparum in migrants and identified 32 additional cases. All cases but one originate from sub-Saharan Africa...
February 26, 2018: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/29485954/differences-in-all-cause-health-care-utilization-and-costs-in-a-type-2-diabetes-mellitus-population-with-and-without-a-history-of-cardiovascular-disease
#19
Sandhya Mehta, Sabyasachi Ghosh, Stephen Sander, Effie Kuti, William K Mountford
BACKGROUND: Multiple studies have reported that type 2 diabetes mellitus (T2DM) is a major risk factor for cardiovascular diseases (CVD), and presence of T2DM and CVD increases risk of death. There is growing interest in examining the effects of antidiabetic treatments on the reduction of cardiovascular events in T2DM adults with a history of CVD and thus at higher risk of cardiovascular events. OBJECTIVE: To estimate the incremental all-cause health care utilization and costs among adults with T2DM and a history of CVD compared with adults without a history of CVD, using a national linked electronic medical records (EMR) and claims database...
March 2018: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29460217/maternal-sociodemographic-characteristics-experiences-and-health-behaviors-associated-with-postpartum-care-utilization-evidence-from-maryland-prams-dataset-2012-2013
#20
Isabel Morgan, Mary Elizabeth Hughes, Harolyn Belcher, Laurens Holmes
Objectives Postpartum visits are increasingly recognized as a window of opportunity for health care providers to counsel new mothers and promote healthy behaviors, including increasing contraceptive use and screening for postpartum depression. In Maryland, there is a lack of research on postpartum visit (PPV) attendance and the specific risk factors associated with not receiving postpartum care. In this study, we estimated the proportion of mothers in Maryland who attended a PPV and assessed maternal sociodemographic characteristics and health behaviors associated with PPV non-attendance...
February 19, 2018: Maternal and Child Health Journal
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