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https://www.readbyqxmd.com/read/27914232/resuscitation-attempts-and-duration-in-traumatic-out-of-hospital-cardiac-arrest
#1
Ben Beck, Janet E Bray, Peter Cameron, Lahn Straney, Emily Andrew, Stephen Bernard, Karen Smith
BACKGROUND: This study aimed to understand factors associated with paramedics' decision to attempt resuscitation in traumatic out-of-hospital cardiac arrest (OHCA) and to characterise resuscitation attempts ≤10min in patients who die at the scene. METHODS: The Victorian Ambulance Cardiac Arrest Registry (VACAR) was used to identify all cases of traumatic OHCA between July 2008 and June 2014. We excluded cases <16 years of age or with a mechanism of hanging or drowning...
November 30, 2016: Resuscitation
https://www.readbyqxmd.com/read/27910090/spinal-fractures-in-older-adult-patients-admitted-after-low-level-falls-10-year-incidence-and-outcomes
#2
Randeep S Jawa, Adam J Singer, Daniel N Rutigliano, Jane E McCormack, Emily C Huang, Marc J Shapiro, Suzanne D Fields, Brian N Morelli, James A Vosswinkel
OBJECTIVES: To evaluate the incidence of spinal fractures and their outcomes in the elderly who fall from low-levels in a suburban county. DESIGN: Retrospective county-wide trauma registry review from 2004 to 2013. SETTING: Suburban county with regionalized trauma care consisting of 11 hospitals. PARTICIPANTS: Adult trauma patients aged ≥65 years who were admitted after falling from <3 feet. MEASUREMENTS: Demographic characteristics, comorbidities, and outcomes...
December 2, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27908347/prognostic-implications-of-changes-in-n-terminal-pro-b-type-natriuretic-peptide-in-patients-with-heart-failure
#3
Michael R Zile, Brian L Claggett, Margaret F Prescott, John J V McMurray, Milton Packer, Jean L Rouleau, Karl Swedberg, Akshay S Desai, Jianjian Gong, Victor C Shi, Scott D Solomon
BACKGROUND: Natriuretic peptides (NP) have prognostic value in heart failure (HF), although the clinical importance of changes in NP from baseline is unclear. OBJECTIVES: The authors assessed whether a reduction in N-terminal pro-B-type NP (NT-proBNP) was associated with a decrease in HF hospitalization and cardiovascular mortality (primary endpoint) in patients with HF and reduced ejection fraction, whether treatment with sacubitril/valsartan reduced NT-proBNP below specific partition values more than enalapril, and whether the relationship between changes in NT-proBNP and changes in the primary endpoint were dependent on assigned treatment...
December 6, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27906924/reducing-harm-from-falls
#4
Shelley Jones, Sandy Blake, Richard Hamblin, Carmela Petagna, Carl Shuker, Alan F Merry
Serious adverse event reporting from district health boards (DHBs) brought in-hospital falls to the attention of the Health Quality & Safety Commission (the Commission) when it was incepted in 2010. In 2012, responding to the large numbers reported, the Commission began planning for a three-year programme to reduce harm from falls, initially to run 2013-2015. In this article we discuss the serious consequences of falls, and the challenges and practical considerations involved in reducing the risk of falling and the rate of falls...
December 2, 2016: New Zealand Medical Journal
https://www.readbyqxmd.com/read/27905249/guide-to-ensure-older-people-avoid-trips-and-falls-in-hospital
#5
(no author information available yet)
The Royal College of Physicians has developed a guide for patients and carers to help prevent trips and falls among older people in hospital, and thereby reduce serious injuries and unnecessary cost to the NHS.
December 1, 2016: Nursing Management (Harrow)
https://www.readbyqxmd.com/read/27899124/outcomes-after-helicopter-versus-ground-emergency-medical-services-for-major-trauma-propensity-score-and-instrumental-variable-analyses-a-retrospective-nationwide-cohort-study
#6
Asuka Tsuchiya, Yusuke Tsutsumi, Hideo Yasunaga
BACKGROUND: Because of a lack of randomized controlled trials and the methodological weakness of currently available observational studies, the benefits of helicopter emergency medical services (HEMS) over ground emergency medical services (GEMS) for major trauma patients remain uncertain. The aim of this retrospective nationwide cohort study was to compare the mortality of adults with serious traumatic injuries who were transported by HEMS and GEMS, and to analyze the effects of HEMS in various subpopulations...
November 29, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27896468/evaluation-of-major-trauma-in-elderly-patients-a%C3%A2-single-trauma-center-analysis
#7
Samo Kocuvan, Drago Brilej, Domen Stropnik, Rolf Lefering, Radko Komadina
BACKGROUND: The objective of the study was to gather information about elderly major trauma patients admitted to one particular Slovenian trauma centre in Celje and examine this group of polytrauma patients, specifically with respect to mechanisms of injury, injury severity and distribution of injuries. Further on, to identify morbidity and mortality rates and compare these to the younger population and, finally, to determine the factors that have the most impact on treatment results...
November 28, 2016: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/27895235/benzodiazepine-initiation-and-dose-escalation-a-risk-factor-for-inpatient-falls
#8
Brian W Skinner, Elizabeth V Johnston, Lindsay M Saum
BACKGROUND: Benzodiazepines (BZDs) place patients at a significant risk of falling. The current literature does not address if this risk is increased during initiation or dose escalations of BZDs. OBJECTIVE: To determine if initiation or dose escalations of BZD regimens are associated with an increased risk of falls in hospitalized patients compared with patients maintained on their home dose or who had their dose decreased from baseline. METHODS: This retrospective case-control study evaluated hospitalized patients aged 45 years or older who received a BZD...
November 27, 2016: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/27895200/demographics-mechanisms-of-injury-and-concurrent-injuries-associated-with-calcaneus-fractures-a-study-of-14-516-patients-in-the-american-college-of-surgeons-national-trauma-data-bank
#9
Daniel D Bohl, Nathaniel T Ondeck, Andre M Samuel, Pablo J Diaz-Collado, Stephen J Nelson, Bryce A Basques, Michael P Leslie, Jonathan N Grauer
: Background This study uses the American College of Surgeons National Trauma Data Bank (NTDB) to update the field on the demographics, injury mechanisms, and concurrent injuries among a national sample of patients admitted to the hospital department with calcaneus fractures. Methods Patients with calcaneus fractures in the NTDB during 2011-2012 were identified and assessed. Results A total of 14 516 patients with calcaneus fractures were included. The most common comorbidity was hypertension (18%), and more than 90% of fractures occurred via traffic accident (49%) or fall (43%)...
November 28, 2016: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/27894887/ultrasound-tissue-pulsatility-imaging-suggests-impairment-in-global-brain-pulsatility-and-small-vessels-in-elderly-patients-with-orthostatic-hypotension
#10
Julie Biogeau, Thomas Desmidt, Paul-Armand Dujardin, Redouane Ternifi, Charlotte Eudo, Emilie Vierron, Jean-Pierre Remenieras, Frédéric Patat, Vincent Camus, Thierry Constans
BACKGROUND: Orthostatic hypotension (OH) is highly prevalent in the elderly, and this population can be exposed to serious complications, including falls and cognitive disorders, as well as overall mortality. However, the pathophysiology of OH is still poorly understood, and innovative methods of cerebral blood flow (CBF) assessment have been required to accurately investigate cerebrovascular reactivity in OH. OBJECTIVES: We want to compare brain tissue pulsatility (BTP) changes during an orthostatic challenge in elderly patients over 80 with and without OH...
November 25, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27894709/external-validation-in-an-intermediate-unit-of-a-respiratory-decompensation-model-trained-in-an-intensive-care-unit
#11
Holly N Blackburn, Matthew T Clark, Travis J Moss, Jeffrey S Young, J Randall Moorman, Douglas E Lake, J Forrest Calland
BACKGROUND: Preventing urgent intubation and upgrade in level of care in patients with subclinical deterioration could be of great utility in hospitalized patients. Early detection should result in decreased mortality, duration of stay, and/or resource use. The goal of this study was to externally validate a previously developed, vital sign-based, intensive care unit, respiratory instability model on a separate population, intermediate care patients. METHODS: From May 2014 to May 2016, the model calculated relative risk of adverse events every 15 minutes (n = 373,271 observations) for 2,050 patients in a surgical intermediate care unit...
November 25, 2016: Surgery
https://www.readbyqxmd.com/read/27893655/a-retrospective-observational-study-of-length-of-stay-in-hospital-after-colorectal-cancer-surgery-in-england-1998-2010
#12
Ariadni Aravani, Elizabeth F Samy, James D Thomas, Phil Quirke, Eva J A Morris, Paul J Finan
The National Health Service (NHS) is facing financial constraints and thus there is considerable interest in ensuring the shortest but optimal hospital stays possible. The aim of this study was to investigate patterns of postoperative length of stay (LOS) stay across the English NHS and to identify factors that significantly influence both optimal and prolonged LOS.Data were obtained from the National Cancer Data Repository (NCDR). National patterns of LOS were examined and multilevel mixed effects logistic regression was used to study factors associated with an "ideal" (≤5 days) or a prolonged (≥21 days) LOS in hospital after major resection...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27892909/managing-patient-falls-in-psychiatric-inpatient-units-part-1
#13
Sam Abraham
The problem addressed in the current quantitative, descriptive study was the significantly higher number of patient falls in hospital inpatient psychiatric units than in medical-surgical areas, resulting in patient-safety issues. The purpose of this study was to explore psychiatric unit directors' perceptions of the factors that contribute to patient falls in the State of Michigan. Two research questions guided the study: (a) What are psychiatric unit directors' perceptions of the possible intrinsic factors that contribute to patient falls in the psychiatric inpatient units, and (b) what are psychiatric unit directors' perceptions of the possible extrinsic factors that contribute to patient falls in the psychiatric inpatient units? An online survey was the tool used to gather data from the State of Michigan psychiatric unit directors...
January 2016: Health Care Manager
https://www.readbyqxmd.com/read/27891727/rehospitalization-after-pediatric-heart-transplantation-incidence-indications-and-outcomes
#14
Seth A Hollander, Doff B McElhinney, Christopher S Almond, Nancy McDonald, Sharon Chen, Beth D Kaufman, Daniel Bernstein, David N Rosenthal
We report the patterns of rehospitalization after pediatric heart transplant (Htx) at a single center. Retrospective review of 107 consecutive pediatric Htx recipients between January 22, 2007, and August 28, 2014, who survived their initial transplant hospitalization. The frequency, duration, and indications for all hospitalizations between transplant hospitalization discharge and September 30, 2015, were analyzed. A total of 444 hospitalization episodes occurred in 90 of 107 (84%) patients. The median time to first rehospitalization was 59...
November 27, 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/27889266/the-effect-anticoagulation-status-on-geriatric-fall-trauma-patients
#15
Julia Coleman, Mustafa Baldawi, David Heidt
BACKGROUND: This research study aims to identify the effect of anticoagulation status on hospital course, complications, and outcomes among geriatric fall trauma patients. METHODS: The study design is a retrospective cohort study, looking at fall trauma among patients aged 60 to 80 years from 2009 to 2013 at a university hospital in the United States. The statistical analysis, conducted with SPSS software with a threshold for statistical significance of P < ...
October 1, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27887896/comorbid-parkinson-s-disease-falls-and-fractures-in-the-2010-national-emergency-department-sample
#16
Hind A Beydoun, May A Beydoun, Nishant K Mishra, Ola S Rostant, Alan B Zonderman, Shaker M Eid
INTRODUCTION: Parkinson's disease (PD) is a progressive, neurodegenerative disorder of multifactorial etiology affecting ∼1% of older adults. Research focused on linking PD to falls and bone fractures has been limited in Emergency Department (ED) settings, where most injuries are identified. We assessed whether injured U.S. ED admissions with PD diagnoses were more likely to exhibit comorbid fall- or non-fall related bone fractures and whether a PD diagnosis with a concomitant fall or bone fracture is linked to worse prognosis...
November 19, 2016: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/27886565/investigating-the-relationship-between-reduced-self-awareness-of-falls-risk-rehabilitation-engagement-and-falls-in-older-adults
#17
Tijana Mihaljcic, Terry P Haines, Jennie L Ponsford, Renerus J Stolwyk
The present study aimed to investigate whether self-awareness of falls risk is associated with rehabilitation engagement, motivation for rehabilitation, and number of falls after hospital discharge. The sample comprised 91 older adults (Mage=77.97, SD=8.04) undergoing inpatient rehabilitation. The Self-Awareness of Falls Risk Measure (SAFRM) was used to measure different aspects of self-awareness. The treating physiotherapist and occupational therapist rated the patient's engagement in rehabilitation and the patient reported his/her motivation for treatment...
November 16, 2016: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/27884843/traumatic-brain-injury-in-england-and-wales-prospective-audit-of-epidemiology-complications-and-standardised-mortality
#18
T Lawrence, A Helmy, O Bouamra, M Woodford, F Lecky, P J Hutchinson
OBJECTIVES: To provide a comprehensive assessment of the management of traumatic brain injury (TBI) relating to epidemiology, complications and standardised mortality across specialist units. DESIGN: The Trauma Audit and Research Network collects data prospectively on patients suffering trauma across England and Wales. We analysed all data collected on patients with TBI between April 2014 and June 2015. SETTING: Data were collected on patients presenting to emergency departments across 187 hospitals including 26 with specialist neurosurgical services, incorporating factors previously identified in the Ps14 multivariate logistic regression (Ps14(n)) model multivariate TBI outcome prediction model...
November 24, 2016: BMJ Open
https://www.readbyqxmd.com/read/27881629/risk-of-fractures-after-stroke-results-from-the-ontario-stroke-registry
#19
Moira K Kapral, Jiming Fang, Shabbir M H Alibhai, Peter Cram, Angela M Cheung, Leanne K Casaubon, Marla Prager, Melissa Stamplecoski, Brennan Rashkovan, Peter C Austin
OBJECTIVE: To determine the risk of fractures after stroke. METHODS: Using the Ontario Stroke Registry, we identified a population-based sample of consecutive patients seen in the emergency department or hospitalized with stroke (n = 23,751) or TIA (n = 11,240) at any of 11 stroke centers in Ontario, Canada, and discharged alive between July 1, 2003, and March 31, 2012. We compared the risk of low-trauma fractures in patients with stroke vs those with TIA using propensity score methods to adjust for differences in baseline factors...
November 23, 2016: Neurology
https://www.readbyqxmd.com/read/27881180/polypharmacy-and-adverse-outcomes-after-hip-fracture-surgery
#20
Maria Härstedt, Cecilia Rogmark, Richard Sutton, Olle Melander, Artur Fedorowski
BACKGROUND: We aimed to explore the effects of polypharmacy and specific drug classes on readmissions and mortality after hip surgery. METHODS: We analyzed data on 272 consecutive hip fracture patients (72.1% females; age 82 ± 9 years) who underwent acute hip replacement. We collected detailed data on the pharmacological treatment upon admission and discharge. Patients were followed up over a period of 6 months after discharge using the Swedish National Hospital Discharge Register and the Swedish National Cause of Death Register...
November 24, 2016: Journal of Orthopaedic Surgery and Research
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