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https://www.readbyqxmd.com/read/29149478/hospital-quality-patient-risk-and-medicare-expenditures-for-cancer-surgery
#1
Sarah P Shubeck, Jyothi R Thumma, Justin B Dimick, Hari Nathan
BACKGROUND: Surgical resection is a cornerstone of curative-intent therapy for patients with solid organ malignancies. With increasing attention paid to the costs of surgical care, there is a new focus on variations in the costs of cancer surgery. This study evaluated the potential interactive effect of hospital quality and patient risk on expenditures for cancer resections. METHODS: With 100% Medicare claim data for 2010-2013, patients aged 65 to 99 years who had undergone cancer resection were identified...
November 17, 2017: Cancer
https://www.readbyqxmd.com/read/29148904/randomized-controlled-study-comparing-2-surgical-techniques-for-decompressive-craniectomy-with-watertight-duraplasty-and-without-watertight-duraplasty
#2
Eduardo Vieira, Thiago C Guimarães, Igor V Faquini, Jose L Silva, Tammy Saboia, Rodrigo V C L Andrade, Thaís L Gemir, Valesca C Neri, Nivaldo S Almeida, Hildo R C Azevedo-Filho
OBJECTIVE Decompressive craniectomy (DC) is a widely used procedure in neurosurgery; however, few studies focus on the best surgical technique for the procedure. The authors' objective was to conduct a prospective randomized controlled trial comparing 2 techniques for performing DC: with watertight duraplasty and without watertight duraplasty (rapid-closure DC). METHODS The study population comprised patients ranging in age from 18 to 60 years who were admitted to the Neurotrauma Service of the Hospital da Restauração with a clinical indication for unilateral decompressive craniectomy...
November 17, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29148356/specialization-as-an-organizing-principle-the-case-of-ambulatory-surgery-centers
#3
Kathleen Carey, Jean M Mitchell
Ambulatory surgery centers (ASCs) recently have grown to become the dominant provider of specific surgical procedures in the United States. While the majority of ASCs focus primarily on a single specialty, many have diversified to offer a wide range of surgical specialties. We exploited a unique data set from Pennsylvania for the years 2004 to 2014 to conduct an empirical investigation of the relative cost of production in ASCs over varying degrees of specialization. We found that for the majority of ASCs, focus on a specialty was associated with lower facility costs...
August 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29148349/hospital-supply-expenses-an-important-ingredient-in-health-services-research
#4
Yousef Abdulsalam, Eugene Schneller
The purpose of this article is to shed light on hospital supply expenses, which form the second largest expense category after payroll and hold more promise for improving cost-efficiency compared to payroll. However, limited research has rigorously scrutinized this cost category, and it is rarely given specific consideration across cost-focused studies in health services publications. After reviewing previously cited estimates, we examine and independently validate supply expense data (collected by the American Hospital Association) for over 3,500 U...
July 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29148021/routine-adoption-of-timp2-and-igfbp7-biomarkers-in-cardiac-surgery-for-early-identification-of-acute-kidney-injury
#5
Chiara Levante, Fiorenza Ferrari, Chiara Manenti, Faeq Husain-Syed, Marta Scarpa, Tommaso Hinna Danesi, Massimo De Cal, Valentina Corradi, Grazia M Virzì, Alessandra Brendolan, Federico Nalesso, Pércia Bezerra, Salvador Lopez-Giacoman, Sara Samoni, Mara Senzolo, Davide Giavarina, Loris Salvador, Raffaele Bonato, Silvia De Rosa, Enrico Rettore, Claudio Ronco
BACKGROUND AND PURPOSE: Acute Kidney Injury (AKI) is a severe complication affecting many hospitalized patients after cardiac surgery, with negative impacts on short- and long-term clinical outcomes and on healthcare costs. Recently, clinical interest has been aimed at defining and classifying AKI, identifying risk factors and developing diagnostic strategies to identify patients at risk early on. Achieving an early and accurate diagnosis of AKI is a crucial issue, because prevention and timely detection may help to prevent negative clinical outcomes and avoid AKI-associated costs...
November 16, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/29148019/a-prospective-randomised-comparison-of-2-skin-closure-techniques-in-primary-total-hip-arthroplasty-surgery
#6
Min Rui, Xin Zheng, Shao-Song Sun, Cheng-Yu Li, Xing-Chen Zhang, Kai-Jin Guo, Feng-Chao Zhao, Yong Pang
INTRODUCTION: As an essential step of total hip arthroplasty (THA), an effective and secure skin closure technique after primary THA is important. Metallic staples closure and subcuticular suture are the 2 common techniques for skin closure. However, which closure technique is the optimal skin-closure method remains unclear. The purpose of this prospective randomised clinical study was to compare the clinical outcomes and costs between staples and subcuticular suture techniques. METHODS: In this clinical study, 165 patients who underwent primary unilateral THA through a posterolateral approach from August 2014 to May 2015 were included...
November 13, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/29147166/a-cost-utility-analysis-of-endovascular-aneurysm-repair-for-abdominal-aortic-aneurysm
#7
Yutaka Takayama
Objective: To assess medical economic adequacy of endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA). Methods: Cost-utility analysis. A total of 21 patients with AAA treated at Ibaraki Prefectural Central Hospital in 2014 were divided into non-ruptured EVAR (Group E) and open surgery (OS) (Group O), and ruptured OS (Group R) groups, and hospital costs were aggregated with a medical accounting system. Mid-level hospital costs were estimated by a diagnosis-procedure-combination analysis system...
September 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29146657/a-randomised-controlled-trial-of-a-duodenal-jejunal-bypass-sleeve-device-endobarrier-compared-with-standard-medical-therapy-for-the-management-of-obese-subjects-with-type-2-diabetes-mellitus
#8
Michael Alan Glaysher, Aruchuna Mohanaruban, Christina Gabriele Prechtl, Anthony P Goldstone, Alexander Dimitri Miras, Joanne Lord, Navpreet Chhina, Emanuela Falaschetti, Nicholas Andrew Johnson, Werd Al-Najim, Claire Smith, Jia V Li, Mayank Patel, Ahmed R Ahmed, Michael Moore, Neil Poulter, Stephen Bloom, Ara Darzi, Carel Le Roux, James P Byrne, Julian P Teare
INTRODUCTION: The prevalence of obesity and obesity-related diseases, including type 2 diabetes mellitus (T2DM), is increasing. Exclusion of the foregut, as occurs in Roux-en-Y gastric bypass, has a key role in the metabolic improvements that occur following bariatric surgery, which are independent of weight loss. Endoscopically placed duodenal-jejunal bypass sleeve devices, such as the EndoBarrier (GI Dynamics, Lexington, Massachusetts, USA), have been designed to create an impermeable barrier between chyme exiting the stomach and the mucosa of the duodenum and proximal jejunum...
November 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/29146646/cross-sectional-study-of-the-financial-cost-of-training-to-the-surgical-trainee-in-the-uk-and-ireland
#9
John O'Callaghan, Helen M Mohan, Anna Sharrock, Vimal Gokani, J Edward Fitzgerald, Adam P Williams, Rhiannon L Harries
OBJECTIVES: Applications for surgical training have declined over the last decade, and anecdotally the costs of training at the expense of the surgical trainee are rising. We aimed to quantify the costs surgical trainees are expected to cover for postgraduate training. DESIGN: Prospective, cross-sectional, questionnaire-based study. SETTING/PARTICIPANTS: A non-mandatory online questionnaire for UK-based trainees was distributed nationally...
November 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/29146229/evaluating-the-projected-surgical-impact-of-reclassifying-noninvasive-encapsulated-follicular-variant-of-papillary-thyroid-cancer-as-noninvasive-follicular-thyroid-neoplasm-with-papillary-like-nuclear-features
#10
Rajshri Mainthia, Heather Wachtel, Yufei Chen, Elizabeth Mort, Sareh Parangi, Peter M Sadow, Carrie C Lubitz
BACKGROUND: The reclassification of noninvasive encapsulated follicular variant of papillary thyroid cancer to noninvasive follicular thyroid neoplasm with papillary-like nuclear features will reduce nonefficacious and potentially harmful care. Reclassification is estimated in 18.6% of patients with papillary thyroid carcinoma; we aimed to quantify the implications of this change. METHODS: Pathology reports from April 2006 to April 2016 were reviewed to isolate cases that would have been designated as neoplasm with papillary-like nuclear features...
November 13, 2017: Surgery
https://www.readbyqxmd.com/read/29145986/hand-surgery-in-the-ambulatory-surgery-center
#11
REVIEW
Norfleet B Thompson, James H Calandruccio
Outpatient surgery, especially in free-standing ambulatory surgery centers (ASC), provides a safe, cost-effective option for a variety of surgical procedures and has become the preferred choice over inpatient and hospital-based outpatient surgery for most hand and wrist procedures. Complication rates after ASC hand surgery are low (0.2%-2.5%). Patient dissatisfaction with ASC surgery is primarily associated with postoperative nausea and vomiting and inadequate pain control.
January 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29145978/outpatient-management-of-ankle-fractures
#12
REVIEW
Charles Qin, Robert G Dekker, Mia M Helfrich, Anish R Kadakia
Interest in outpatient orthopedic surgery has been fueled by provider desire to control costs and development of rapid recovery protocols. Open reduction and internal fixation (ORIF) is a commonly elected treatment strategy for ankle fracture that may be performed in an outpatient setting. Lessons on cost-savings of the outpatient model in orthopedics can be learned in total joint replacement and spine surgery. Moreover, in properly selected patients, outpatient ORIF has been shown to be comparably safe. Reasons for admission of the surgically managed patient with ankle fractures, including concern for surgical delay and additional social factors, warrant further investigation...
January 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29145010/the-use-of-hardened-bone-cement-as-an-impaction-grafting-extender-for-revision-hip-arthroplasty
#13
Mark Ruddy, David P FitzPatrick, Kenneth T Stanton
Impaction bone grafting is a method of restoring bone stock to patients who have suffered significant bone loss due to revision total hip surgery. The procedure requires morsellised cancellous bone (MCB) to be impacted into the site of bone loss in order to stabilise the prosthesis with the aim of long term resorption and reintegration of the impacted bone graft. Due to financial cost and the potential to transmit disease, the use of supplementary material, known as an extender, is frequently used to increase the graft material volume...
November 13, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/29143091/risk-of-catastrophic-health-expenditure-in-rwandan-surgical-patients-with-peritonitis
#14
J L Rickard, C Ngarambe, L Ndayizeye, B Smart, J P Majyambere, R Riviello
BACKGROUND: Surgical procedures are cost-effective compared with various medical and public health interventions. While peritonitis often requires surgery, little is known regarding the associated costs, particularly in low- and middle-income countries. The aim of this study was to determine in-hospital charges for patients with peritonitis and if patients are at risk of catastrophic health expenditure. METHODS: As part of a larger study examining the epidemiology and outcomes of patients with peritonitis at a referral hospital in Rwanda, patients undergoing operation for peritonitis were enrolled and hospital charges were examined...
November 15, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29142864/count-of-platelet-and-mean-platelet-volume-score-serologic-prognostic-factor-in-patients-with-oral-squamous-cell-carcinoma
#15
Jae Woo Park, Chul-Hwan Kim, Yong Chan Ha, Moon Young Kim, Sung Min Park
Objectives: TNM staging, especially for lymph node metastasis, is the scoring system most widely used among prognostic factors for cancer survival. Several biomarkers have been studied as serologic markers, but their specificity is low and clinical applications are difficult. This study aimed to establish a scoring system for patients with oral squamous cell carcinoma (OSCC) using platelet (PLT) and mean platelet volume (MPV) levels measured postoperatively and to evaluate their significance as prognostic factors...
October 2017: Journal of the Korean Association of Oral and Maxillofacial Surgeons
https://www.readbyqxmd.com/read/29142842/prevention-and-management-of-bleeding-in-thyroid-surgery
#16
REVIEW
Gabriele Materazzi, Carlo Enrico Ambrosini, Lorenzo Fregoli, Luigi De Napoli, Gianluca Frustaci, Valeria Matteucci, Piermarco Papini, Sohail Bakkar, Paolo Miccoli
Post-thyroidectomy neck hematoma represents a major concern for surgeons because it can result in severe and even life-threatening complications. In fact, postoperative hemorrhage may result in airway compression and respiratory distress, and therefore, effective hemostasis is an important goal in thyroid surgery. Postoperative hematoma occurs at a rate of approximately 0.1% to 1.1%. Almost all cases occur in the first 6 h after surgery and can be the result of several surgeon or patient factors. For many years the clamp-and-tie technique has been the most common way to divide the main vascular pedicles of the thyroid gland...
October 2017: Gland Surgery
https://www.readbyqxmd.com/read/29142601/application-of-spontaneously-closing-cannula-ileostomy-in-laparoscopic-anterior-resection-of-rectal-cancer
#17
Dong Chen, Huiying Zhao, Qiang Huang, Xiangming Xu, Xiaofei Cheng, Bingxin Ke, Danyang Wang, Hanju Hua, Jiahe Xu, Jianjiang Lin, Feng Ye
An anastomotic leak (AL) is the most serious complication observed in laparoscopic anterior resection of rectal cancer (LARRC). In order to protect anastomosis from AL and avoid stoma reversal surgery in patients with ileostomy, spontaneously closing cannula ileostomy (SCCI) was used in LARRC and its safety and feasibility were assessed in the present study. To the best of our knowledge, this is the first time that SCCI has been used in such a case. A total of 41 patients who underwent LARRC with SCCI or ileostomy procedures between November 2013 and August 2014 were retrospectively analyzed...
November 2017: Oncology Letters
https://www.readbyqxmd.com/read/29141456/increased-serum-levels-of-mbdnf-in-women-with-minimal-and-mild-endometriosis-have-no-predictive-power-for-the-disease
#18
Alexandra Perricos, Kazem Ashjaei, Heinrich Husslein, Katharina Proestling, Lorenz Kuessel, Reinhard Obwegeser, Rene Wenzl, Iveta Yotova
The objective of our pilot clinical, prospective study was to determine the serum levels of mature brain-derived neurotrophic factor, in of women with endometriosis and controls and explore whether mature brain-derived neurotrophic factor is a potential biomarker for the disease. The patients were selected from the Endometriosis Marker Austria prospective cohort study conducted at the tertiary referral certified Endometriosis Center of the Medical University of Vienna. All women underwent laparoscopic surgery because there was a suspicion of endometriosis, or the women had pelvic pain, adnexal cysts, unexplained infertility, or uterine fibroids...
January 1, 2017: Experimental Biology and Medicine
https://www.readbyqxmd.com/read/29140816/the-role-of-small-incision-suture-less-cataract-surgery-in-the-developed-world
#19
Sanduk Ruit, Reeta Gurung, Shyam Vyas
PURPOSE OF REVIEW: Manual small incision cataract surgery (MSICS) has recently gone through much refinement and fine tuning. It is often taken as an alternate option for phacoemulsification, especially in developing country. This review will present some insight on its applications especially for developed nations. The role of MSCIS in tackling complex cataracts with stony hard nucleus is fairly established. The role of training residents with MSCIS has certain advantages though debatable...
November 14, 2017: Current Opinion in Ophthalmology
https://www.readbyqxmd.com/read/29139105/preoperative-medical-therapy-before-surgery-for-uterine-fibroids
#20
REVIEW
Anne Lethaby, Lucian Puscasiu, Beverley Vollenhoven
BACKGROUND: Uterine fibroids occur in up to 40% of women aged over 35 years. Some are asymptomatic, but up to 50% cause symptoms that warrant therapy. Symptoms include anaemia caused by heavy menstrual bleeding, pelvic pain, dysmenorrhoea, infertility and low quality of life. Surgery is the first choice of treatment. In recent years, medical therapies have been used before surgery to improve intraoperative and postoperative outcomes. However, such therapies tend to be expensive.Fibroid growth is stimulated by oestrogen...
November 15, 2017: Cochrane Database of Systematic Reviews
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