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https://www.readbyqxmd.com/read/28002203/differences-in-hospital-risk-standardized-mortality-rates-for-acute-myocardial-infarction-when-assessed-using-transferred-and-nontransferred-patients
#1
Ian J Barbash, Hongwei Zhang, Derek C Angus, Steven E Reis, Chung-Chou H Chang, Francis R Pike, Jeremy M Kahn
BACKGROUND: One in 5 patients with acute myocardial infarction (AMI) are transferred between hospitals. However, current hospital performance measures based on AMI mortality exclude these patients from the evaluation of referral hospitals. OBJECTIVE: To determine the relationship between risk-standardized mortality for transferred and nontransferred patients at referral hospitals. RESEARCH DESIGN: This is a retrospective cohort study. SUBJECTS: Fee-for-service Medicare claims from 2011 for patients hospitalized with a primary diagnosis of AMI, at hospitals admitting at least 15 patients in transfer...
December 20, 2016: Medical Care
https://www.readbyqxmd.com/read/27993698/lead-time-bias-and-interhospital-transfer-after-injury-trauma-center-admission-vital-signs-underpredict-mortality-in-transferred-trauma-patients
#2
Daniel N Holena, Douglas J Wiebe, Brendan G Carr, Jesse Y Hsu, Jason L Sperry, Andrew B Peitzman, Patrick M Reilly
BACKGROUND: Admission physiology predicts mortality after injury but may be improved by resuscitation prior to transfer. This phenomenon, which has been termed lead-time bias, may lead to underprediction of mortality in transferred patients and inaccurate benchmarking in centers receiving large numbers of transfer patients. We sought determine the impact of using vital signs on arrival at the referring center vs. on arrival at the trauma center in mortality prediction models for transferred trauma patients...
December 16, 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/27979421/a-comparison-between-evacuation-from-the-scene-and-interhospital-transportation-using-a-helicopter-for-subarachnoid-hemorrhage
#3
Kouhei Ishikawa, Kazuhiko Omori, Ikuto Takeuchi, Kei Jitsuiki, Toshihiko Yoshizawa, Hiromichi Ohsaka, Yasuaki Nakao, Takuji Yamamoto, Youichi Yanagawa
PURPOSE: We investigated the changes in the vital signs and the final outcomes subarachnoid hemorrhage (SAH) patients who were evacuated from the scene using the doctor-helicopter (Dr. Heli) service and those who only underwent interhospital transportation using the doctor-helicopter Dr. Heli service to investigate safety of this system METHODS: We retrospectively investigated all of the patients with non-traumatic SAH who were transported by a Dr. Heli between January 2010 and March 2016...
December 10, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27942727/quantifying-the-burden-of-interhospital-cost-variation-in-pediatric-surgery-implications-for-the-prioritization-of-comparative-effectiveness-research
#4
Danielle B Cameron, Dionne A Graham, Carly E Milliren, Charity C Glass, Christina Feng, Feroze Sidhwa, Hariharan Thangarajah, Matthew Hall, Shawn J Rangel
Importance: Practice variation is believed to be a driver of excess health care spending, although few objective data exist to guide the prioritization of comparative effectiveness research (CER) in pediatric surgery. Objective: To identify high-priority general pediatric surgical procedures for CER on the basis of the following 2 complementary measures: the magnitude of interhospital cost variation as a surrogate for the need for and potential effect of CER at the patient level and the cumulative fiscal burden of this cost variation when considering the case volume from all hospitals as a surrogate for public health relevance...
December 12, 2016: JAMA Pediatrics
https://www.readbyqxmd.com/read/27923247/patterns-of-empiric-antibiotic-administration-for-presumed-early-onset-neonatal-sepsis-in-neonatal-intensive-care-units-in-the-united-states
#5
Emily A Oliver, Patricia B Reagan, Jonathan L Slaughter, Catalin S Buhimschi, Irina A Buhimschi
Objective To evaluate current patterns in empiric antibiotic use for early-onset neonatal sepsis (EONS). Study Design Retrospective population-based cohort study of newborns admitted on postnatal day 0 to 1 and discharged from NICUs participating in the Pediatric Health Information System (PHIS 2006-2013). Analyses included frequency of antibiotic initiation within 3 days of birth, duration of first course, and variation among hospitals. Results Of 158,907 newborns, 118,624 (74.7%) received antibiotics on or before postnatal day 3...
December 6, 2016: American Journal of Perinatology
https://www.readbyqxmd.com/read/27884027/-transfer-of-critically-ill-patients-between-hospitals-fundamentals-and-requirements
#6
Gregor Lichy, Jörg Braun
Due to the increasingly changed clinical landscape, which leads to a reduction of clinical facilities in rural regions. This also leads to a centralized clinical care, in addition to limited care options in the periphery. Therefore the interhospital transfer is becoming increasingly important. Specialized centers have become more and more important through this centralization of clinical care. Not only the number of transports, but also the transport distances have steadily increased in recent years. It is necessary to differentiate centripetal transports into the centers of the maximum and centrifugal transports back to peripheral clinics, weaning devices or rehabilitation facilities...
November 2016: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/27850978/1342-interhospital-transfer-of-patients-with-sepsis-across-the-united-states
#7
Patrick Tyler, Leo Anthony Celi, Barret Rush
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27811599/physician-perspectives-on-interhospital-transfers
#8
Stephanie K Mueller, Jeffrey L Schnipper
OBJECTIVE: The transfer of patients between acute care hospitals (interhospital transfer [IHT]) is a common but nonstandardized process leading to variable quality and safety. The goal of this study was to survey accepting physicians regarding problems encountered in the transfer process. METHODS: A cross-sectional survey of residents and inpatient attendings from internal medicine, neurology, and surgery services at a large tertiary care referral hospital was undertaken to identify problematic aspects of the IHT process as perceived by accepting frontline providers...
November 2, 2016: Journal of Patient Safety
https://www.readbyqxmd.com/read/27809958/exploring-interhospital-transfers-and-partnerships-in-the-hospital-sector-in-new-south-wales-australia
#9
Hassan Assareh, Helen M Achat, Jean-Frederic Levesque, Stephen R Leeder
Objective The aim of the present study was to explore characteristics of interhospital transfers (IHT) and sharing of care among hospitals in New South Wales (NSW), Australia.Methods Data were extracted from patient-level linked hospital administrative datasets for separations from all NSW acute care hospitals from 1 July 2013 to 30 June 2015. Patient discharge and arrival information was used to identify IHTs. Characteristics of patients and related hospitals were then analysed.Results Transfer-in patients accounted for 3...
November 4, 2016: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/27806171/intensive-care-unit-utilization-and-mortality-among-medicare-patients-hospitalized-with-non-st-segment-elevation-myocardial-infarction
#10
Alexander C Fanaroff, Eric D Peterson, Anita Y Chen, Laine Thomas, Jacob A Doll, Christopher B Fordyce, L Kristin Newby, Ezra A Amsterdam, Mikhail N Kosiborod, James A de Lemos, Tracy Y Wang
Importance: Intensive care unit (ICU) utilization may have important implications for the care and outcomes of patients with non-ST-segment elevation myocardial infarction (NSTEMI). Objectives: To examine interhospital variation in ICU utilization in the United States for older adults with hemodynamically stable NSTEMI and outcomes associated with ICU utilization among patients with low, moderate, or high mortality risk. Design, Setting, and Participants: This study was a retrospective analysis of 28 018 Medicare patients 65 years or older admitted with NSTEMI to 346 hospitals participating in the Acute Coronary Treatment and Intervention Outcomes Network (ACTION)-Get With the Guidelines from April 1, 2011, through December 31, 2012...
January 1, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/27800658/interhospital-transfer-delays-emergency-abdominal-surgery-and-prolongs-stay
#11
Alexandra M Limmer, Michael B Edye
BACKGROUND: Interhospital transfer of patients requiring emergency surgery is common practice. It has the potential to delay surgical intervention, increase rate of complications and thus length of hospital stay. METHODS: A retrospective cohort study was conducted of adult patients who underwent emergency surgery for abdominal pain at a large metropolitan hospital in New South Wales (Hospital A) in 2013. The impact of interhospital transfer on time to surgical intervention, post-operative length of stay and overall length of stay was assessed...
November 1, 2016: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/27771225/the-impact-of-recommended-percutaneous-coronary-intervention-care-on-hospital-outcomes-for-interhospital-transferred-stemi-patients
#12
YeongHo Choi, Yu Jin Lee, Sang Do Shin, Kyoung Jun Song, KyungWon Lee, Eui Jung Lee, Yu Jin Kim, Ki Ok Ahn, Ki Jeong Hong, Young Sun Ro
BACKGROUND: Timely transfer and percutaneous coronary intervention (PCI) with or without thrombolysis are recommended by the American Heart Association (AHA) to care for ST-segment elevation myocardial infarction (STEMI) patients who present first to a non-PCI-capable hospital. This study was to evaluate the impact on in-hospital mortality of the compliance with guidelines regarding to the time of PCI for patients with STEMI who were transferred to a capable PCI hospital. METHODS: We used the CArdioVAscular disease Surveillance data from November 2007 to December 2012 for this study...
January 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27771032/complications-and-surgical-outcomes-after-interhospital-transfer-vs-direct-admission-in-colorectal-surgery-a-national-surgical-quality-improvement-program-analysis
#13
Stephen P Sharp, Ashar Ata, Brian T Valerian, Jonathan J Canete, A David Chismark, Edward C Lee
BACKGROUND: Interhospital transfer is common among patients undergoing colorectal surgery. The purpose of this study was to determine surgical outcomes after transfer vs direct admission in patients undergoing colorectal surgery. METHODS: The American College of Surgeons National Surgical Quality Improvement Program database from 2010 to 2012 was used. Colorectal operations were selected, including both emergency and nonemergency cases. Transfers were compared with direct admissions using a complex comorbidity analysis model...
September 2, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27750191/interhospital-transfer-of-children-in-respiratory-failure-a-clinician-interview-qualitative-study
#14
Folafoluwa O Odetola, Renee R Anspach, Yong Y Han, Sarah J Clark
PURPOSE: To investigate the decision making underlying transfer of children with respiratory failure from level II to level I pediatric intensive care unit care. METHODS: Interviews with 19 eligible level II pediatric intensive care unit physicians about a hypothetical scenario of a 2-year-old girl in respiratory failure: RESULTS: At baseline, indices critical to management were as follows: OI (53%), partial pressure of oxygen in arterial blood (Pao2)/Fio2 (32%), and inflation pressure (16%)...
February 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/27735821/hospital-and-intensive-care-unit-length-of-stay-for-injury-admissions-a-pan-canadian-cohort-study
#15
Lynne Moore, Henry Thomas Stelfox, David Evans, Sayed Morad Hameed, Natalie L Yanchar, Richard Simons, John Kortbeek, Gilles Bourgeois, Julien Clément, François Lauzier, Alexis F Turgeon
OBJECTIVE: To assess the variation in hospital and intensive care unit (ICU) length of stay (LOS) for injury admissions across Canadian provinces and to evaluate the relative contribution of patient case mix and treatment-related factors (intensity of care, complications, and discharge delays) to explaining observed variations. BACKGROUND: Identifying unjustified interprovider variations in resource use and the determinants of such variations is an important step towards optimizing health care...
October 4, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27733674/interhospital-transfer-neurological-deterioration-in-patients-with-spontaneous-intracerebral-haemorrhage-incidence-and-risk-factors
#16
Ju-Sing Fan, Yen-Chia Chen, Hsien-Hao Huang, David Hung-Tsang Yen, Chorng-Kuang How, Mu-Shuan Huang
OBJECTIVE: To explore the incidence and risk factors for interhospital transfer neurological deterioration (IHTND) in patients with spontaneous intracerebral haemorrhage (SICH). METHODS: Consecutive adult patients with first-ever SICH referred to our emergency department (ED) and transported by ambulance from July 2011 through June 2015 were eligible for this prospective observational study. Enrolled patients had SICH with elapsed time <12 hours and a nearly normal Glasgow Coma Scale (GCS) score (≥13) at presentation...
October 12, 2016: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/27727069/cumulative-effective-radiation-dose-received-by-blunt-trauma-patients-arriving-to-a-military-level-i-trauma-center-from-point-of-injury-and-interhospital-transfers
#17
Kerri A Van Arnem, David P Supinski, Jonathan E Tucker, Shawn Varney
BACKGROUND: Trauma patients sustaining blunt injuries are exposed to multiple radiologic studies. Evidence indicates that the risk of cancer from exposure to ionizing radiation rises in direct proportion to the cumulative effective dose (CED) received. The purpose of this study is to quantify the amount of ionizing radiation accumulated when arriving directly from point of injury to San Antonio Military Medical Center (SAMMC), a level I trauma center, compared with those transferred from other facilities...
December 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27692683/the-effect-of-combined-out-of-hospital-hypotension-and-hypoxia-on-mortality-in-major-traumatic-brain-injury
#18
Daniel W Spaite, Chengcheng Hu, Bentley J Bobrow, Vatsal Chikani, Bruce Barnhart, Joshua B Gaither, Kurt R Denninghoff, P David Adelson, Samuel M Keim, Chad Viscusi, Terry Mullins, Duane Sherrill
STUDY OBJECTIVE: Survival is significantly reduced by either hypotension or hypoxia during the out-of-hospital management of major traumatic brain injury. However, only a handful of small studies have investigated the influence of the combination of both hypotension and hypoxia occurring together. In patients with major traumatic brain injury, we evaluate the associations between mortality and out-of-hospital hypotension and hypoxia separately and in combination. METHODS: All moderate or severe traumatic brain injury cases in the preimplementation cohort of the Excellence in Prehospital Injury Care study (a statewide, before/after, controlled study of the effect of implementing the out-of-hospital traumatic brain injury treatment guidelines) from January 1, 2007, to March 31, 2014, were evaluated (exclusions: <10 years, out-of-hospital oxygen saturation ≤10%, and out-of-hospital systolic blood pressure <40 or >200 mm Hg)...
January 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27686513/mobile-extracorporeal-membrane-oxygenation-teams-the-north-american-versus-the-european-experience
#19
Adambeke Nwozuzu, Manuel L Fontes, Robert B Schonberger
OBJECTIVE: To evaluate differences in the inclusion of anesthesiologists in mobile extracorporeal membrane oxygenation (ECMO) teams between North American and European centers. DESIGN: A retrospective review of North American versus European mobile ECMO teams. The search terms used to identify relevant articles were the following: "extracorporeal membrane transport," "mobile ECMO," and "interhospital transport." SETTING: MEDLINE review of articles...
December 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27663414/factors-associated-with-initial-prasugrel-versus-clopidogrel-selection-for-patients-with-acute-myocardial-infarction-undergoing-percutaneous-coronary-intervention-insights-from-the-treatment-with-adp-receptor-inhibitors-longitudinal-assessment-of-treatment
#20
Amit N Vora, Eric D Peterson, Lisa A McCoy, Mark B Effron, Kevin J Anstrom, Douglas E Faries, Marjorie E Zettler, Gregg C Fonarow, Brian A Baker, Gregg W Stone, Tracy Y Wang
BACKGROUND: Few studies have examined how antiplatelet therapies are selected during the routine care of acute myocardial infarction patients, particularly relative to the patient's estimated mortality and bleeding risks. METHODS AND RESULTS: We examined patients presenting with acute myocardial infarction treated with percutaneous coronary intervention at 233 US hospitals in the TRANSLATE-ACS observational study from April 2010 to October 2012. We developed a multivariable logistic regression model to identify factors associated with prasugrel selection...
September 23, 2016: Journal of the American Heart Association
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