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https://www.readbyqxmd.com/read/28283485/quit-emr-trial-a-prospective-observational-multicentre-study-to-evaluate-quality-and-24%C3%A2-hours-post-transport-morbidity-of-interhospital-transportation-of-critically-ill-patients-study-protocol
#1
Ulrich Strauch, Dennis C J J Bergmans, Joachim Habers, Jochen Jansen, Bjorn Winkens, Dirk J Veldman, Paul M H J Roekaerts, Stefan K Beckers
INTRODUCTION: It is widely accepted that transportation of critically ill patients is high risk. Unfortunately, however, there are currently no evidence-based criteria with which to determine the quality of various interhospital transport systems and their impact on the outcomes for patients. We aim to rectify this by assessing 2 scores which were developed in our hospital in a prospective, observational study. Primarily, we will be examining the Quality of interhospital critical care transportation in the Euregion Meuse-Rhine (QUIT EMR) score, which focuses on the quality of the transport system, and secondarily the SEMROS (Simplified EMR outcome score) which detects changes in the patient's clinical condition in the 24 hours following their transportation...
March 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28280094/hirschsprung-s-disease-in-the-uk-and-ireland-incidence-and-anomalies
#2
T J Bradnock, M Knight, S Kenny, M Nair, G M Walker
OBJECTIVES: To describe clinical characteristics and preoperative management of a national cohort of infants with Hirschsprung's disease (HD). DESIGN: Population-based cohort study of all live-born infants with HD born in the UK and Ireland from October 2010 to September 2012. SETTING: All 28 paediatric surgical centres in the UK and Ireland. PARTICIPANTS: 305 infants presenting before 6 months of age with histologically proven HD...
March 9, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28274969/cohort-analysis-of-outcomes-in-69%C3%A2-490-emergency-general-surgical-admissions-across-an-international-benchmarking-collaborative
#3
Prem Chana, Mark Joy, Neil Casey, David Chang, Elaine M Burns, Sonal Arora, Ara W Darzi, Omar D Faiz, Carol J Peden
OBJECTIVE: This study aims to use the Dr Foster Global Comparators Network (GC) database to examine differences in outcomes following high-risk emergency general surgery (EGS) admissions in participating centres across 3 countries and to determine whether hospital infrastructure factors can be linked to the delivery of high-quality care. DESIGN: A retrospective cohort analysis of high-risk EGS admissions using GC's international administrative data set. SETTING: 23 large hospitals in Australia, England and the USA...
March 8, 2017: BMJ Open
https://www.readbyqxmd.com/read/28272069/does-prehospital-time-affect-survival-of-major-trauma-patients-where-there-is-no-prehospital-care
#4
S B Dharap, S Kamath, V Kumar
BACKGROUND: Survival after major trauma is considered to be time dependent. Efficient prehospital care with rapid transport is the norm in developed countries, which is not available in many lower middle and low-income countries. The aim of this study was to assess the effect of prehospital time and primary treatment given on survival of major trauma patients in a setting without prehospital care. MATERIALS AND METHODS: This prospective observational study was carried out in a university hospital in Mumbai, from January to December 2014...
March 3, 2017: Journal of Postgraduate Medicine
https://www.readbyqxmd.com/read/28262279/major-influence-of-interobserver-reliability-on-polytrauma-identification-with-the-injury-severity-score-iss-time-for-a-centralised-coding-in-trauma-registries
#5
Roman Maduz, Patrick Kugelmeier, Severin Meili, Robert Döring, Christoph Meier, Peter Wahl
OBJECTIVE: The Abbreviated Injury Scale (AIS) and the Injury Severity Score (ISS) find increasingly widespread use to assess trauma burden and to perform interhospital benchmarking through trauma registries. Since 2015, public resource allocation in Switzerland shall even be derived from such data. As every trauma centre is responsible for its own coding and data input, this study aims at evaluating interobserver reliability of AIS and ISS coding. METHODS: Interobserver reliability of the AIS and ISS is analysed from a cohort of 50 consecutive severely injured patients treated in 2012 at our institution, coded retrospectively by 3 independent and specifically trained observers...
February 21, 2017: Injury
https://www.readbyqxmd.com/read/28235958/prehospital-emergency-care-in-childhood-arterial-ischemic-stroke
#6
Belinda Stojanovski, Paul T Monagle, Ian Mosley, Leonid Churilov, Fiona Newall, Grant Hocking, Mark T Mackay
BACKGROUND AND PURPOSE: Immediately calling an ambulance is the key factor in reducing time to hospital presentation for adult stroke. Little is known about prehospital care in childhood arterial ischemic stroke (AIS). We aimed to determine emergency medical services call-taker and paramedic diagnostic sensitivity and to describe timelines of care in childhood AIS. METHODS: This is a retrospective study of ambulance-transported children aged <18 years with first radiologically confirmed AIS, from 2008 to 2015...
February 24, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28216215/direct-admission-versus-interhospital-transfer-for-primary-percutaneous-coronary-intervention-in-st-segment-elevation-myocardial-infarction
#7
Damian Kawecki, Marek Gierlotka, Beata Morawiec, Michał Hawranek, Mateusz Tajstra, Michał Skrzypek, Wojciech Wojakowski, Lech Poloński, Ewa Nowalany-Kozielska, Mariusz Gąsior
OBJECTIVES: This study sought to assess the influence of direct admission versus transfer via regional hospital to a percutaneous coronary intervention (PCI) center on time delays and 12-month mortality in ST-segment elevation myocardial infarction (STEMI) patients from a real-life perspective. BACKGROUND: Reduction of delays to reperfusion is crucial in a STEMI system of care. However, it is still debated whether direct admission to a PCI center is superior to interhospital transfer in terms of long-term prognosis...
February 9, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28196696/patients-hospitalized-abroad-as-importers-of-multiresistant-bacteria-a-cross-sectional-study
#8
T Khawaja, J Kirveskari, S Johansson, J Väisänen, A Djupsjöbacka, A Nevalainen, A Kantele
OBJECTIVES: The pandemic spread of multidrug-resistant (MDR) bacteria poses a threat to healthcare worldwide, with highest prevalence in indigent regions of the (sub)tropics. As hospitalization constitutes a major risk factor for colonization, infection control management in low-prevalence countries urgently needs background data on patients hospitalized abroad. METHODS: We collected data on 1122 patients who, after hospitalization abroad, were treated at the Helsinki University Hospital between 2010 and 2013...
February 11, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28187248/emergency-department-telemedicine-is-used-for-more-severely-injured-rural-trauma-patients-but-does-not-decrease-transfer-a-cohort-study
#9
Nicholas M Mohr, Karisa K Harland, Elizabeth A Chrischilles, Amanda Bell, Dan M Shane, Marcia M Ward
OBJECTIVES: Traumatic injury is a leading cause of death in the United States, and rural populations are at increased risk of injury and death. Rural residents have limited access to trauma care, and telemedicine has been proposed as one strategy to improve the provision of trauma care locally. The objective of this study was to describe patient-level factors associated with telemedicine consultation in North Dakota critical-access hospital (CAH) emergency departments (EDs) and to measure the association between telemedicine consultation and interhospital transfer...
February 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28186453/effects-of-distance-and-transport-method-on-intervention-and-mortality-in-aneurysmal-subarachnoid-hemorrhage
#10
Jonathan Weyhenmeyer, Cristian F Guandique, Adam Leibold, Stephen Lehnert, Jonathan Parish, Woody Han, Chad Tuchek, Janit Pandya, Thomas Leipzig, Troy Payner, Andrew DeNardo, John Scott, Aaron A Cohen-Gadol
OBJECTIVE Most patients suffering from aneurysmal subarachnoid hemorrhage (aSAH) initially present to a hospital that lacks a neurosurgical unit. These patients require interhospital transfer (IHT) to tertiary facilities capable of multidisciplinary neurosurgical intervention. Yet, little is known about the effects of IHT on the outcomes of patients suffering from aSAH. In this study, the authors examined the effects of IHT and transport method on the timing of treatment, rebleed rates, and overall outcomes of patients who have experienced aSAH...
February 10, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28180097/interhospital-transport-system-for-critically-ill-patients-mobile-extracorporeal-membrane-oxygenation-without-a-ventilator
#11
Hye Ju Yeo, Woo Hyun Cho, Jong Myung Park, Dohyung Kim
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) has been successfully used as a method for the interhospital transportation of critically ill patients. In South Korea, a well-established ECMO interhospital transport system is lacking due to limited resources. We developed a simplified ECMO transport system without mechanical ventilation for use by public emergency medical services. METHODS: Eighteen patients utilized our ECMO transport system from December 2011 to September 2015...
February 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28175366/153%C3%A2-significant-interhospital-variation-in-cranial-surgery-costs-using-the-nationwide-inpatient-sample-database
#12
Corinna Clio Zygourakis, Caterina Liu, Philip V Theodosopoulos, Michael T Lawton, Adams Dudley, Ralph Gonzales
No abstract text is available yet for this article.
August 1, 2016: Neurosurgery
https://www.readbyqxmd.com/read/28151758/case-volume-outcomes-associations-among-patients-with-severe-sepsis-who-underwent-interhospital-transfer
#13
Uchenna R Ofoma, John Dahdah, Shravan Kethireddy, Daniel Maeng, Allan J Walkey
OBJECTIVES: Case volume-outcome associations bolster arguments to regionalize severe sepsis care, an approach that may necessitate interhospital patient transfers. Although transferred patients may most closely reflect care processes involved with regionalization, associations between sepsis case volume and outcomes among transferred patients are unclear. We investigated case volume-outcome associations among patients with severe sepsis transferred from another hospital. DESIGN: Serial cross-sectional study using the Nationwide Inpatient Sample...
April 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28137325/interhospital-comparison-of-surgical-site-infection-rates-in-orthopedic-surgery
#14
Jozica Skufca, Jukka Ollgren, Mikko J Virtanen, Kaisa Huotari, Outi Lyytikäinen
OBJECTIVE To investigate whether comparison by deep or adjusted deep surgical site infection (SSI) rates in orthopedic surgeries are a better basis for feedback to Finnish hospitals than overall SSI rates DESIGN Retrospective cohort study SETTING Hospitals conducting surveillance of hip arthroplasties (HPROs) and knee arthroplasties (KPROs) in the Finnish Hospital Infection Program METHODS We analyzed surveillance data for 73,227 HPROs and 56,860 KPROs performed in 18 hospitals during 1999-2014. For each hospital, the overall, deep, and adjusted deep SSI rates with 95% confidence intervals (CIs) were calculated, and the hospital ranks were simulated in the Bayesian framework...
January 31, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28129917/patient-characteristics-outcomes-and-costs-following-interhospital-transfer-to-a-tertiary-facility-for-appendectomy-versus-patients-who-present-directly
#15
Daniel Leberer, John O Elliott, Edward Dominguez
BACKGROUND: Recent healthcare policy changes have emphasized pay-for-performance. Previous studies have not examined outcome differences between primary presenting appendicitis patients and transferred patients. METHODS: A retrospective cohort design examined appendicitis patients between March 2011 and 2013. Patients < age 18, were scheduled for an elective appendectomy, who were pregnant or had an interval appendectomy were excluded. RESULTS: The transfer cohort (n = 59) had more comorbidities, more severe American Society of Anesthesiologists status, a higher rate of pre-operative abscess/rupture as well as higher rates of perforation, gangrene, intra-operative drain placement and open conversion versus primary presenting patients (n = 622)...
January 10, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28125823/effect-of-a-handover-tool-on-efficiency-of-care-and-mortality-for-interhospital-transfers
#16
Cecelia N Theobald, Neesha N Choma, Jesse M Ehrenfeld, Stephan Russ, Sunil Kripalani
BACKGROUND: Interhospital transfer is frequent, and transferred patients experience delays in the provision of care and higher mortality rates when compared to patients directly admitted. The interhospital handover is a key opportunity to improve care but has not been evaluated. OBJECTIVE: To determine the effect of a universal handover tool on timeliness of care, length of stay (LOS), and mortality among interhospital transfer patients. DESIGN, SETTING, AND PATIENTS: Retrospective cohort of patients transferred to an academic medical center between July 1, 2009 and December 31, 2010 with interrupted time-series design...
January 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28114435/undertriage-of-firearm-related-injuries-in-a-major-metropolitan-area
#17
Allison Lale, Allison Krajewski, Lee S Friedman
Importance: National anatomic triage criteria prescribe specific transport rules for injured patients. However, there is limited information about patients with firearm-related injuries undertriaged to nondesignated facilities (ie, hospitals without specialized trauma teams or units), including what clinical outcomes are achieved and how many are transferred to a higher level of care. Without these data, it is difficult to make informed regional or national policy decisions about triage practices...
January 18, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28002203/differences-in-hospital-risk-standardized-mortality-rates-for-acute-myocardial-infarction-when-assessed-using-transferred-and-nontransferred-patients
#18
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
#19
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 before 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 to 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...
March 2017: 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
#20
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
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