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volume outcome relationship

A M M Boers, R Sales Barros, I G H Jansen, O A Berkhemer, L F M Beenen, B K Menon, D W J Dippel, A van der Lugt, W H van Zwam, Y B W E M Roos, R J van Oostenbrugge, C H Slump, C B L M Majoie, H A Marquering
BACKGROUND AND PURPOSE: Many studies have emphasized the relevance of collateral flow in patients presenting with acute ischemic stroke. Our aim was to evaluate the relationship of the quantitative collateral score on baseline CTA with the outcome of patients with acute ischemic stroke and test whether the timing of the CTA acquisition influences this relationship. MATERIALS AND METHODS: From the Multicenter Randomized Clinical Trial of Endovascular Treatment of Acute Ischemic Stroke in the Netherlands (MR CLEAN) data base, all baseline thin-slice CTA images of patients with acute ischemic stroke with intracranial large-vessel occlusion were retrospectively collected...
April 19, 2018: AJNR. American Journal of Neuroradiology
Osama Sabri, Philipp M Meyer, Susanne Gräf, Swen Hesse, Stephan Wilke, Georg-Alexander Becker, Michael Rullmann, Marianne Patt, Julia Luthardt, Gudrun Wagenknecht, Alexander Hoepping, Rene Smits, Annegret Franke, Bernhard Sattler, Solveig Tiepolt, Steffen Fischer, Winnie Deuther-Conrad, Ulrich Hegerl, Henryk Barthel, Peter Schönknecht, Peter Brust
In early Alzheimer's dementia, there is a need for PET biomarkers of disease progression with close associations to cognitive dysfunction that may aid to predict further cognitive decline and neurodegeneration. Amyloid biomarkers are not suitable for that purpose. The α4β2 nicotinic acetylcholine receptors (α4β2-nAChRs) are widely abundant in the human brain. As neuromodulators they play an important role in cognitive functions such as attention, learning and memory. Post-mortem studies reported lower expression of α4β2-nAChRs in more advanced Alzheimer's dementia...
April 17, 2018: Brain: a Journal of Neurology
Ryan P Dumas, Mark J Seamon, Brian P Smith, Wei Yang, Jeremy W Cannon, C William Schwab, Patrick M Reilly, Daniel N Holena
INTRODUCTION: The relationship between high volume and improved outcomes has been described for a host of elective high-impact, low-frequency procedures, but there are little data to support such a relationship in high-impact low-frequency procedures in trauma. Using emergency department thoracotomy (EDT) as a model, we hypothesized that patients presenting to centers with higher institutional volumes of EDT would have improved survival referent to those presenting to lower volume institutions...
April 17, 2018: Journal of Trauma and Acute Care Surgery
Alexandra Bucknor, Anmol Chattha, Winona Wu, Sabine Egeler, Klaas Ultee, Salim Afshar, Samuel J Lin
BACKGROUND: Centralization of specialist services, including cleft service delivery, is occurring worldwide with the aim of improving the outcomes. This study examines the relationship between hospital surgical volume in cleft palate repair and outcomes. METHODS: A retrospective analysis of the Kids' Inpatient Database was undertaken. Children 3 years or younger undergoing cleft palate repair in 2012 were identified. Hospital volume was categorized by cases per year as low volume (LV; 0-14), intermediate volume (IV; 15-46), or high volume (HV; 47-99); differences in complications, hospital costs, and length of stay (LOS) were determined by hospital volume...
April 2018: Annals of Plastic Surgery
Heather S Haeberle, Sergio M Navarro, William C Frankel, Michael A Mont, Prem N Ramkumar
BACKGROUND: High-volume surgeons and hospital systems have been shown to deliver higher-value care in several studies. However, no evidence-based volume thresholds for cost currently exist in total hip arthroplasty (THA). The objective of this study was to establish meaningful thresholds in cost for surgeons and hospitals performing THA. A secondary objective was to analyze the market share of THAs for each surgeon and hospital stratifications. METHODS: Using a database of 136,501 patients undergoing THA, we used stratum-specific likelihood ratio analysis of a receiver operating characteristic curve to generate volume thresholds based on costs for surgeons and hospitals...
March 15, 2018: Journal of Arthroplasty
Bernardo Sanchez-Dalmau, Elena H Martinez-Lapiscina, Irene Pulido-Valdeolivas, Irati Zubizarreta, Sara Llufriu, Yolanda Blanco, Nuria Sola-Valls, Maria Sepulveda, Ana Guerrero, Salut Alba, Magi Andorra, Anna Camos, Laura Sanchez-Vela, Veronica Alfonso, Albert Saiz, Pablo Villoslada
Visual impairment significantly alters the quality of life of people with Multiple Sclerosis (MS). The objective of this study was to identify predictors (independent variables) of visual outcomes, and to define their relationship with neurological disability and retinal atrophy when assessed by optical coherence tomography (OCT). We performed a cross-sectional analysis of 119 consecutive patients with MS, assessing vision using high contrast visual acuity (LogMar), 2.5% and 1.25% low contrast visual acuity (Sloan charts), and color vision (Hardy-Rand-Rittler plates)...
2018: PloS One
Ji-Bin Yin, Xin Wang, Xin Zhang, Li Liu, Rui-Tao Wang
Most pancreatic cancer (PC) patients manifest multiple liver metastases at the time of diagnosis. Activated platelets play a key role in tumor growth and tumor metastases. Mean platelet volume (MPV) is a platelet index and is altered in patients with malignancies. This study aimed to evaluate whether MPV can effectively predict death in PC patients with synchronous liver metastases. The clinical data of 411 PC patients with synchronous liver metastases between January 1, 2006 and December 31, 2013 were retrospectively analyzed...
April 16, 2018: Scientific Reports
Eva Giralt-Steinhauer, Santiago Medrano, Carolina Soriano-Tárraga, Marina Mola-Caminal, Raquel Rasal, Elisa Cuadrado-Godia, Ana Rodríguez-Campello, Angel Ois, J Capellades, Jordi Jimenez-Conde, Jaume Roquer
BACKGROUND: Increased supratentorial white matter hyperintensities volume (S-WMHV) has been reported as a predictor of worse outcome in acute ischemic stroke (AIS) patients. However, few studies focus on less common locations such as brainstem-white matter hyperintensities (B-WMH), and their relationship with S-WMHV. This study aimed to examine whether B-WMH affects clinical outcome after AIS or transient ischemic attack (TIA). METHODS: Based on MRI evidence, B-WMH was evaluated in 313 prospectively identified patients with AIS/TIA and registered as absent or present...
April 16, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
Rishi K Wadhera, Karen E Joynt Maddox, Yun Wang, Changyu Shen, Robert W Yeh
OBJECTIVES: The purpose of this study was to examine the association of 30-day payments for an episode of heart failure (HF) care at the hospital level with patient outcomes. BACKGROUND: There is increased focus among policymakers on improving value for HF care, given its rising prevalence and associated financial burden in the United States; however, little is known about the relationship between payments and mortality for a 30-day episode of HF care. METHODS: Using Medicare claims data for all fee-for-service beneficiaries hospitalized for HF between July 1, 2011, and June 30, 2014, we examined the association between 30-day Medicare payments at the hospital level (beginning with a hospital admission for HF and across multiple settings following discharge) and patient 30-day mortality using mixed-effect logistic regression models...
April 5, 2018: JACC. Heart Failure
Virginia C Huynh, Desi P Fuhr, Bradley W Byers, Anne-Marie Selzler, Linn E Moore, Michael K Stickland
PURPOSE: Some patients with chronic obstructive pulmonary disease (COPD) fail to achieve health benefits with pulmonary rehabilitation (PR). Exercise intensity and load represent stimulus for adaptation but it is unclear whether inappropriate exercise intensity and/or load are affected by severity of COPD, which may affect health benefits. The purpose was to determine whether COPD severity and/or the severity of pulmonary limitation to exercise (PLE) impacted exercising intensity or load and whether resultant intensity/load affected health outcomes derived from PR...
April 11, 2018: Journal of Cardiopulmonary Rehabilitation and Prevention
Kristbjörg Sveinsdóttir, David Ley, Holger Hövel, Vineta Fellman, Petra S Hüppi, Lois E H Smith, Ann Hellström, Ingrid Hansen Pupp
BACKGROUND: Retinopathy of prematurity (ROP) is a major complication of preterm birth and has been associated with later visual and nonvisual impairments. OBJECTIVES: To evaluate relationships between any stage of ROP, brain volumes, and developmental outcomes. METHODS: This study included 52 very preterm infants (gestational age [mean ± SD]: 26.4 ± 1.9 weeks). Total brain, gray matter, unmyelinated white matter (UWMV), and cerebellar volumes were estimated in 51 out of 52 infants by magnetic resonance imaging at term-equivalent age...
April 12, 2018: Neonatology
Melvin J Kilsdonk, Sabine Siesling, Boukje A C van Dijk, Michel W Wouters, Wim H van Harten
BACKGROUND: To improve quality of care, centralisation of cancer services in high-volume centres has been stimulated. Studies linking specialisation and high (surgical) volumes to better outcomes already appeared in the 1990's. However, actual centralisation was a difficult process in many countries. In this study, factors influencing the centralisation of cancer services in the Netherlands were determined. MATERIAL AND METHODS: Centralisation patterns were studied for three types of cancer that are known to benefit from high surgical caseloads: oesophagus-, pancreas- and bladder cancer...
2018: PloS One
Kyle Scarberry, Nicholas G Berger, Kelly B Scarberry, Shree Agrawal, John J Francis, Jessica M Yih, Christopher M Gonzalez, Robert Abouassaly
OBJECTIVES: Positive surgical margins (PSM) and lymph node yield (LNY) following radical cystectomy (RC) for urothelial carcinoma of the bladder affect survival. Variations in PSM or LNY at different care facilities are poorly described. We evaluated the relationship between hospital surgical volume and academic hospital status with these surgical outcomes and overall survival (OS). METHODS AND MATERIALS: Patients with nonmetastatic urothelial carcinoma of the bladder who underwent RC were identified from the National Cancer Database (2004-2013)...
April 5, 2018: Urologic Oncology
Larissa Botelho Gaça, Maria Teresa Fernandes Castilho Garcia, Gabriel Barbosa Sandim, Idaiane Batista Assumption Leme, Maria Helena Silva Noffs, Henrique Carrete, Ricardo Silva Centeno, João Ricardo Sato, Elza Márcia Targas Yacubian
OBJECTIVE: The objectives of this study were to verify in a series of patients with mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS) if those with low intellectual quotient (IQ) levels have more extended areas of atrophy compared with those with higher IQ levels and to analyze whether IQ could be a variable implicated on a surgical outcome. MATERIAL AND METHODS: Patients (n=106) with refractory MTLE-HS submitted to corticoamygdalohippocampectomy (CAH) (57 left mesial temporal lobe epilepsy (MTLE); 45 males) were enrolled...
April 3, 2018: Epilepsy & Behavior: E&B
Khaled Elsayad, Laith Samhouri, Sergiu Scobioala, Uwe Haverkamp, Hans Theodor Eich
PURPOSE/OBJECTIVE(S): Lung cancer tumor volume reduction is common during radiation treatment (RT). The purpose of this study was to investigate tumor volume reduction ratio (VRR) and its correlation with outcomes in a cohort of patients with stage III non-small cell lung cancer (NSCLC) who underwent image-guided radiochemotherapy (RCTx). MATERIALS/METHODS: Fifty patients with NSCLC treated with fractionated RT at our institution between 2013 and 2017 were included...
April 5, 2018: Journal of Cancer Research and Clinical Oncology
N Bahrami, D Piccioni, R Karunamuni, Y-H Chang, N White, R Delfanti, T M Seibert, J A Hattangadi-Gluth, A Dale, N Farid, C R McDonald
BACKGROUND AND PURPOSE: Treatment with bevacizumab is standard of care for recurrent high-grade gliomas; however, monitoring response to treatment following bevacizumab remains a challenge. The purpose of this study was to determine whether quantifying the sharpness of the fluid-attenuated inversion recovery hyperintense border using a measure derived from texture analysis-edge contrast-improves the evaluation of response to bevacizumab in patients with high-grade gliomas. MATERIALS AND METHODS: MRIs were evaluated in 33 patients with high-grade gliomas before and after the initiation of bevacizumab...
April 5, 2018: AJNR. American Journal of Neuroradiology
Sarah E Deery, Thomas F X O'Donnell, Sara L Zettervall, Jeremy D Darling, Katie E Shean, A James O'Malley, Bruce E Landon, Marc L Schermerhorn
OBJECTIVE/BACKGROUND: While higher lead surgeon volume has been associated with lower mortality following open abdominal aortic aneurysm (AAA) repair, little is known about the impact of using an attending surgeon as assistant surgeon. The aim of this study was to determine whether the presence of an assistant surgeon, particularly a high volume assistant, mitigates the relationship between lead surgeon volume and outcomes. METHODS: All Medicare beneficiaries who underwent intact, open AAA repair between 2003 and 2008 were evaluated and nested regression models were constructed to evaluate the relationship between surgeon and assistant volume and peri-operative mortality, adjusting for comorbid conditions and hospital volume...
March 30, 2018: European Journal of Vascular and Endovascular Surgery
Ming Chao, Jie Wei, Ganesh Narayanasamy, Yading Yuan, Yeh-Chi Lo, José A Peñagarícano
PURPOSE: To investigate three-dimensional cluster structure and its correlation to clinical endpoint in heterogeneous dose distributions from intensity modulated radiation therapy. METHODS: Twenty-five clinical plans from twenty-one head and neck (HN) patients were used for a phenomenological study of the cluster structure formed from the dose distributions of organs at risks (OARs) close to the planning target volumes (PTVs). Initially, OAR clusters were searched to examine the pattern consistence among ten HN patients and five clinically similar plans from another HN patient...
March 30, 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Yue Suo, Weiqi Chen, Yuesong Pan, Yujing Peng, Hongyi Yan, Wei Li, Gaifen Liu, Yongjun Wang
BACKGROUND: Hematoma expansion is an independent risk factor of unfavorable outcome after intracerebral hemorrhage (ICH), which always occurs in the early phase after symptoms onset. The relationship between underlying small vessel disease (SVD) and hematoma expansion was inconsistent in patients with ICH. We aimed to investigate the relationship between magnetic resonance (MR) characteristics of SVD and hematoma expansion in patients with ICH within 72 hours after symptoms onset. METHODS: Data were derived from a cohort of biological sample collection from April 2014 to April 2016...
March 28, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Sehra Birgül Batmaz, Tuğba Arıkoğlu, Lülüfer Tamer, Gülçin Eskandari, Semanur Kuyucu
Introduction: There are scarce data about the role of vitamin D (vitD) in asthma control related to seasons and other confounders. Aim: To investigate the seasonal relationship between vitD levels and asthma control, lung function tests (LFTs) and cytokines during a 1-year period, among 7-17-year-old asthmatic children. Material and methods: Thirty patients with asthma with house dust mite monosensitization were evaluated 3 monthly about the previous month's health and vitD related lifestyle factors and asthma control test (ACT), spirometry and bronchial provocation test for a year...
February 2018: Postȩpy Dermatologii i Alergologii
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