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https://www.readbyqxmd.com/read/28320201/analysis-of-never-events-following-adult-cardiac-surgical-procedures-in-the-united-states
#1
Michael P Robich, Brianna M Krafcik, Nishant K Shah, Alik Farber, Denis Rybin, Jeffrey J Siracuse
BACKGROUND: This study was conducted to determine the risk factors, nature, and outcomes of "never events" following open adult cardiac surgical procedures. Understanding of these events can reduce their occurrence, and thereby improve patient care, quality metrics, and cost reduction. METHODS: "Never events" for patients included in the Nationwide Inpatient Sample who underwent coronary artery bypass graft, heart valve repair/replacement, or thoracic aneurysm repair between 2003-2011 were documented...
March 16, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28319514/do-not-resuscitate-status-is-associated-with-increased-mortality-but-not-morbidity
#2
Elisa C Walsh, Ethan Y Brovman, Angela M Bader, Richard D Urman
BACKGROUND: Do-not-resuscitate (DNR) orders instruct medical personnel to forego cardiopulmonary resuscitation in the event of cardiopulmonary arrest, but they do not preclude surgical management. Several studies have reported that DNR status is an independent predictor of 30-day mortality; however, the etiology of increased mortality remains unclear. We hypothesized that DNR patients would demonstrate increased postoperative mortality, but not morbidity, relative to non-DNR patients undergoing the same procedures...
March 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28306417/the-management-and-outcome-for-patients-with-chronic-subdural-hematoma-a-prospective-multicenter-observational-cohort-study-in-the-united-kingdom
#3
Paul M Brennan, Angelos G Kolias, Alexis J Joannides, Jonathan Shapey, Hani J Marcus, Barbara A Gregson, Patrick J Grover, Peter J Hutchinson, Ian C Coulter
OBJECTIVE Symptomatic chronic subdural hematoma (CSDH) will become an increasingly common presentation in neurosurgical practice as the population ages, but quality evidence is still lacking to guide the optimal management for these patients. The British Neurosurgical Trainee Research Collaborative (BNTRC) was established by neurosurgical trainees in 2012 to improve research by combining the efforts of trainees in each of the United Kingdom (UK) and Ireland's neurosurgical units (NSUs). The authors present the first study by the BNTRC that describes current management and outcomes for patients with CSDH throughout the UK and Ireland...
March 17, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28302461/data-quality-in-institutional-arthroplasty-registries-description-of-a-model-of-validation-and-report-of-preliminary-results
#4
Maria P Bautista, Guillermo A Bonilla, Klaus W Mieth, Adolfo M Llinás, Fernanda Rodríguez, Laura L Cárdenas
BACKGROUND: Arthroplasty registries are a relevant source of information for research and quality improvement in patient care and its value depends on the quality of the recorded data. The purpose of this study is to describe a model of validation and present the findings of validation of an Institutional Arthroplasty Registry (IAR). METHODS: Information from 209 primary arthroplasties and revision surgeries of the hip, knee, and shoulder recorded in the IAR between March and September 2015 were analyzed in the following domains...
February 20, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28293315/quality-of-life-in-patients-following-vertebroplasty
#5
Sasa Rapan, Jasna Batrnek, Vjeran Rapan, Egon Biuk, Domagoj Rapan
AIM: To examine the quality of life in patients who underwent vertebroplasty treatment and compare it to the preoperative quality of life. STUDY DESIGN: The Cross-sectional study conducted at the Department of Orthopaedics, Clinical Hospital Centre Osijek. PATIENTS AND METHODS: The research included 50 patients under stationary treatment in hospital at the Department of Orthopaedics. The research instruments include a questionnaire containing demographic data and the standardised EuroQuol Research Foundation Questionnaire (EQ-5D-5L) consisting of five dimensions which include mobility, self-care, usual activities, pain level and anxiety...
March 15, 2017: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28288889/cardiac-stress-testing-during-workup-for-abdominal-aortic-aneurysm-repair-is-not-associated-with-improved-patient-outcomes
#6
Benjamin S Brooke, Mark R Sarfati, Yingying Zhang, Yue Zhang, Angela P Presson, Tom H Greene, Larry W Kraiss
BACKGROUND: Cardiac stress testing (CST) is commonly used to help determine whether patients with abdominal aortic aneurysms (AAA) are better candidates for open vs. endovascular repair, although it is unknown whether use of CST achieves its goal of optimizing patient selection and postoperative outcomes. METHODS: We retrospectively identified 3,635 patients in the Vascular Quality Initiative (VQI) database (2010- 2012) with an AAA ≥ 5.0cm who were candidates for either open or endovascular AAA repair...
March 10, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28285902/continued-inpatient-care-after-primary-total-knee-arthroplasty-increases-30-day-post-discharge-complications-a-propensity-score-adjusted-analysis
#7
Alexander S McLawhorn, Michael C Fu, William W Schairer, Peter K Sculco, Catherine H MacLean, Douglas E Padgett
BACKGROUND: Discharge destination, either home or skilled care facility, after total knee arthroplasty (TKA) may be associated with significant variation in postacute care outcomes. The purpose of this study was to characterize the 30-day postdischarge outcomes after primary TKA relative to discharge destination. METHODS: All primary unilateral TKAs performed for osteoarthritis from 2011-2014 were identified in the National Surgical Quality Improvement Program database...
February 1, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28279729/access-to-post-hospitalization-acute-care-facilities-is-associated-with-payer-status-for-open-abdominal-aortic-repair-and-open-lower-extremity-revascularization-in-the-vascular-quality-initiative
#8
Jesus G Ulloa, Karen Woo, Chi-Hong Tseng, Melinda Maggard-Gibbons, David Rigberg
OBJECTIVE: Uninsured patients may not have access to post-acute care facilities that play an important role in clinical recovery and functional outcomes after vascular surgery. We sought to determine whether discharge disposition is associated with insurance status. METHODS: We retrospectively reviewed data from the Vascular Quality Initiative(®) for patients who underwent open abdominal aortic repair (OAR), infra-inguinal bypass (IB) or supra-inguinal bypass (SB) between January 2012 and July 2015...
March 6, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28277408/hospital-standards-to-promote-optimal-surgical-care-of-the-older-adult-a-report-from-the-coalition-for-quality-in-geriatric-surgery
#9
Julia R Berian, Ronnie A Rosenthal, Tracey L Baker, JoAnn Coleman, Emily Finlayson, Mark R Katlic, Sandhya A Lagoo-Deenadayalan, Victoria L Tang, Thomas N Robinson, Clifford Y Ko, Marcia M Russell
OBJECTIVE: The aim of this study was to establish high-quality, valid standards to improve surgical care of the older adult. BACKGROUND: The aging population increases demand for high-quality surgical care. Building upon prior guidelines, quality indicators, and pilot projects, the Coalition for Quality in Geriatric Surgery (CQGS) includes 58 diverse stakeholder organizations committed to improving geriatric surgery. METHODS: Using a modified RAND-UCLA Appropriateness Methodology, 44 of 58 CQGS Stakeholders twice rated validity (primary outcome) and feasibility for 308 standards, ranging from goals and decision-making, pre-operative assessment and optimization, perioperative and postoperative care, to transitions of care beyond the acute care hospital...
March 8, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28262923/outcomes-after-scoliosis-surgery-for-children-with-cerebral-palsy-a-systematic-review
#10
REVIEW
Rachel Toovey, Adrienne Harvey, Michael Johnson, Louise Baker, Katrina Williams
AIM: This study aims (1) to evaluate and synthesize the evidence for the postoperative outcomes after scoliosis surgery for children with cerebral palsy (CP), and (2) to identify preoperative risk factors for adverse outcomes after surgery. METHOD: Medline, EMBASE, CINAHL, and PubMed were searched for relevant literature. Included studies were assessed for risk of bias using the Cochrane Effective Practice and Organisation of Care tool. Quality of evidence for overall function, quality of life (QoL), gross motor function, caregiver outcomes, deformity correction, and postoperative complications were assessed using GRADE (Grades of Recommendation, Assessment, Development and Evaluation)...
March 6, 2017: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/28262296/duration-of-mechanical-ventilation-and-perioperative-care-quality-after-neonatal-cardiac-operations
#11
Joshua J Blinder, Ravi Thiagarajan, Kathryn Williams, Meena Nathan, John Mayer, Thomas J Kulik
BACKGROUND: This study was conducted to determine whether the duration of mechanical ventilation (DOMV) could be used to benchmark the overall quality of care after neonatal congenital heart operations. METHODS: Children aged younger than 30 days undergoing cardiac operations were reviewed. Technical adequacy was assessed using the Technical Performance Score (TPS), a previously validated tool for determining the adequacy of a palliative or corrective surgical procedure that uses echocardiography criteria and need for unplanned reintervention to determine technical adequacy...
March 2, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28259573/functional-status-predicts-major-complications-and-death-after-endovascular-repair-of-abdominal-aortic-aneurysms
#12
Donald G Harris, Ilynn Bulatao, Connor P Oates, Richa Kalsi, Charles B Drucker, Nandakumar Menon, Tanya R Flohr, Robert S Crawford
OBJECTIVE: Endovascular aneurysm repair (EVAR) is considered a lower risk option for treating abdominal aortic aneurysms and is of particular utility in patients with poor functional status who may be poor candidates for open repair. However, the specific contribution of preoperative functional status to EVAR outcomes remains poorly defined. We hypothesized that impaired functional status, based simply on the ability of patients to perform activities of daily living, is associated with worse outcomes after EVAR...
March 1, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28254734/telerehabilitation-versus-traditional-care-following-total-hip-replacement-a-randomized-controlled-trial-protocol
#13
Mark Nelson, Michael Bourke, Kay Crossley, Trevor Russell
BACKGROUND: Total hip replacement (THR) is the gold standard treatment for severe hip osteoarthritis. Effectiveness of physical rehabilitation for THR patients following discharge from hospital is supported by evidence; however, barriers such as geographical location and transport can limit access to appropriate health care. One solution to this issue is using an alternative model of care using telerehabilitation technology to deliver rehabilitation programs directly into patients' homes...
March 2, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28252588/-transethmoidal-decompressive-orbitotomy-in-the-patients-presenting-with-endocrine-ophthalmopathy-at-the-stage-of-remission-peculiarities-of-the-surgical-intervention-and-the-results-of-exophthalmos-correction
#14
P A Kochetkov
The objective of the present study was to analyze the original results of the transethmoidal decompressive surgical interventions on the eye orbits of the patients presenting with endocrine ophthalmopathy (EOP) including the evaluation of regress of exophthalmos during the post-operative period. The study included 51 patients with endocrine ophthalmopathy at the stage of remission or pharmacotherapeutic compensation of the underlying process. A total of 80 eye-socket were treated in 29 patients with unilateral exophthalmos and 22 ones having bilateral exophthalmos...
2017: Vestnik Otorinolaringologii
https://www.readbyqxmd.com/read/28248612/health-related-quality-of-life-outcomes-following-adult-cochlear-implantation-a-prospective-cohort-study
#15
Douglas P Sladen, Ann Peterson, Matt Schmitt, Amy Olund, Katherine Teece, Brittany Dowling, Melissa DeJong, Alyce Breneman, Charles W Beatty, Matthew L Carlson, Brian A Neff, Becky Hughes-Borst, Colin L Driscoll
INTRODUCTION: The benefits of cochlear implantation extend beyond improved speech recognition and into overall health-related quality of life (HRQoL). Several measures of HRQoL, categorized as generic or disease specific, have been used in the cochlear implant literature. The clinical utility of generic HRQoL measures have been reported to be variable by previous investigators. The degree to which HRQoL correlates to speech perception is largely unknown. METHODS: A prospective single-subject design at a large tertiary care center...
March 1, 2017: Cochlear Implants International
https://www.readbyqxmd.com/read/28247628/-choosing-a-method-of-draining-the-upper-urinary-tract-following-percutaneous-nephrolithotripsy
#16
Ju G Alyaev, N A Grigoriev, N I Sorokin, I V Diakonov, S H Ali
PURPOSE: to compare various methods of upper urinary tract drainage in patients with urolithiasis. PATIENTS AND METHODS: 60 patients were included into a prospective study which ran from March 2013 through December 2014. All patients underwent PCNL with a nephrostomy tract diameter of (28-30 Ch.) at the I.M. Sechenov First Moscow State Medical University urology clinic. Patients were divided into 2 groups. Group 1 30 (patients) underwent nephrostomy after PCNL with nephrostomy tract placement, in group 2 (29 patients) internal drainage was performed...
August 2016: Urologii︠a︡
https://www.readbyqxmd.com/read/28236918/morbidity-and-mortality-after-emergency-lower-extremity-embolectomy
#17
Sergio Casillas-Berumen, Lili Sadri, Alik Farber, Mohammad H Eslami, Jeffrey A Kalish, Denis Rybin, Gheorghe Doros, Jeffrey J Siracuse
OBJECTIVE: Emergency lower extremity embolectomy is a common vascular surgical procedure that has poorly defined outcomes. Our goal was to define the perioperative morbidity for emergency embolectomy and develop a risk prediction model for perioperative mortality. METHODS: The American College of Surgeons National Surgical Quality Improvement database was queried to identify patients undergoing emergency unilateral and lower extremity embolectomy. Patients with previous critical limb ischemia, bilateral embolectomy, nonemergency indication, and those undergoing concurrent bypass were excluded...
March 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28228452/does-the-use-of-a-decision-aid-improve-decision-making-in-prosthetic-heart-valve-selection-a-multicenter-randomized-trial
#18
Nelleke M Korteland, Yunus Ahmed, David R Koolbergen, Marjan Brouwer, Frederiek de Heer, Jolanda Kluin, Eline F Bruggemans, Robert J M Klautz, Anne M Stiggelbout, Jeroen J J Bucx, Jolien W Roos-Hesselink, Peter Polak, Thanasie Markou, Inge van den Broek, Rene Ligthart, Ad J J C Bogers, Johanna J M Takkenberg
BACKGROUND: A Dutch online patient decision aid to support prosthetic heart valve selection was recently developed. A multicenter randomized controlled trial was conducted to assess whether use of the patient decision aid results in optimization of shared decision making in prosthetic heart valve selection. METHODS AND RESULTS: In a 5-center randomized controlled trial, patients were allocated to receive either standard preoperative care (control group) or additional access to the patient decision aid (intervention group)...
February 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28224443/report-of-the-clinical-and-functional-primary-outcomes-in-men-of-the-acl-sports-trial-similar-outcomes-in-men-receiving-secondary-prevention-with-and-without-perturbation-training-1-and-2-years-after-acl-reconstruction
#19
Amelia J H Arundale, Kathleen Cummer, Jacob J Capin, Ryan Zarzycki, Lynn Snyder-Mackler
BACKGROUND: Athletes often are cleared to return to activities 6 months after anterior cruciate ligament (ACL) reconstruction; however, knee function measures continue to improve up to 2 years after surgery. Interventions beyond standard care may facilitate successful return to preinjury activities and improve functional outcomes. Perturbation training has been used in nonoperative ACL injury and preoperative ACL reconstruction rehabilitation, but has not been examined in postoperative ACL reconstruction rehabilitation, specifically return to sport rehabilitation...
February 21, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28222805/use-of-activity-tracking-in-major-visceral-surgery-the-enhanced-perioperative-mobilization-epm-trial-study-protocol-for-a-randomized-controlled-trial
#20
Steffen Wolk, Theresa Meißner, Sebastian Linke, Benjamin Müssle, Ann Wierick, Andreas Bogner, Dorothée Sturm, Nuh N Rahbari, Marius Distler, Jürgen Weitz, Thilo Welsch
BACKGROUND: Enhanced recovery after surgery (ERAS) programs are aimed at minimizing postoperative stress and accelerating postoperative recovery by implementing multiple perioperative principles. "Early mobilization" is one such principle, but the quality of assessment and monitoring is poor, and evidence of improved outcome is lacking. Activity trackers allow precise monitoring and automatic feedback to the patients to enhance their motivation for early mobilization. The aim of the study is to monitor and increase the postoperative mobilization of patients by giving them continuous automatic feedback in the form of a step count using activity-tracking wristbands...
February 21, 2017: Trials
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