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https://www.readbyqxmd.com/read/28196696/patients-hospitalized-abroad-as-importers-of-multiresistant-bacteria-a-cross-sectional-study
#1
Tamim Khawaja, Juha Kirveskari, Sara Johansson, Juuso Väisänen, Aurora Djupsjöbacka, Annika Nevalainen, Anu 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
#2
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
#3
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
#4
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
#5
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
#6
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...
February 1, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28137325/interhospital-comparison-of-surgical-site-infection-rates-in-orthopedic-surgery
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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...
February 6, 2017: 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
#15
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
#16
REVIEW
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
#17
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
#18
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
#19
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
#20
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
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