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volume outcome relationship

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https://www.readbyqxmd.com/read/28433333/effects-of-hospital-safety-net-burden-and-hospital-volume-on-failure-to-rescue-after-open-abdominal-aortic-surgery
#1
Eric B Rosero, Girish P Joshi, Abu Minhajuddin, Carlos H Timaran, J Gregory Modrall
OBJECTIVE: Failure to rescue (FTR) is defined as the inability to rescue a patient from major perioperative complications, resulting in operative mortality. FTR is a known contributor to operative mortality after open abdominal aortic surgery. Understanding the causes of FTR is essential to designing interventions to improve perioperative outcomes. The objective of this study was to determine the relative contributions of hospital volume and safety-net burden (the proportion of uninsured and Medicaid-insured patients) to FTR...
April 19, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28424612/an-examination-of-brain-abnormalities-and-mobility-in-individuals-with-mild-cognitive-impairment-and-alzheimer-s-disease
#2
Barbara L Fischer, Rhonda Bacher, Barbara B Bendlin, Alex C Birdsill, Martina Ly, Siobhan M Hoscheidt, Richard J Chappell, Jane E Mahoney, Carey E Gleason
Background: Mobility changes are concerning for elderly patients with cognitive decline. Given frail older individuals' vulnerability to injury, it is critical to identify contributors to limited mobility. Objective: To examine whether structural brain abnormalities, including reduced gray matter volume and white matter hyperintensities, would be associated with limited mobility among individuals with cognitive impairment, and to determine whether cognitive impairment would mediate this relationship. Methods: Thirty-four elderly individuals with mild cognitive impairment (MCI) and Alzheimer's disease underwent neuropsychological evaluation, mobility assessment, and structural brain neuroimaging...
2017: Frontiers in Aging Neuroscience
https://www.readbyqxmd.com/read/28420565/analysis-of-prognostic-factors-for-acute-kidney-injury-with-continuous-renal-replacement-therapy-in-severely-burned-patients
#3
Jaechul Yoon, Youngmin Kim, Haejun Yim, Yong Suk Cho, Dohern Kym, Jun Hur, Wook Chun, Hyeong Tae Yang
BACKGROUND: Acute kidney injury (AKI) is a critical complications in severely burned patients associated with high morbidity and mortality. The purpose of this study was to investigate the impact of severity of AKI at the time of continuous renal replacement therapy (CRRT) start on patient outcome and to identify the prognostic factors in severely burned patients with CRRT application. METHODS: From January 2007 to June 2010, 84 burn patients with more than 40% of total body surface area (TBSA) burned who treated with continuous renal replacement therapy for acute kidney injury were analyzed retrospectively...
April 15, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28419506/neuronal-loss-demyelination-and-volume-change-in-the-multiple-sclerosis-neocortex
#4
D Carassiti, D R Altmann, N Petrova, B Pakkenberg, F Scaravilli, K Schmierer
AIMS: Indices of brain volume (grey matter, white matter, lesions) are being used as outcomes in clinical trials of patients with multiple sclerosis (MS). We investigated the relationship between cortical volume, the number of neocortical neurons estimated using stereology, and demyelination. METHODS: Nine MS and seven control hemispheres were dissected into coronal slices. On sections stained for Giemsa, the cortex was outlined and optical disectors applied using systematic uniform random sampling...
April 18, 2017: Neuropathology and Applied Neurobiology
https://www.readbyqxmd.com/read/28419060/relationship-of-hospital-costs-with-mortality-in-pediatric-critical-care-a-multi-institutional-analysis
#5
Punkaj Gupta, Mallikarjuna Rettiganti
OBJECTIVE: With increasing emphasis on high "value" care, we designed this study to evaluate the relationship between hospital costs and patient outcomes in pediatric critical care. DESIGN: Post hoc analysis of data from an existing administrative national database, Pediatric Health Information Systems. Multivariable mixed effects logistic regression models were fitted to evaluate association of hospital cost tertiles with odds of mortality after adjusting for patient and center characteristics...
April 17, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28414114/why-do-long-distance-travelers-have-improved-pancreatectomy-outcomes
#6
Manila Jindal, Chaoyi Zheng, Humair S Quadri, Chukwuemeka U Ihemelandu, Young K Hong, Andrew K Smith, Vikas Dudeja, Nawar M Shara, Lynt B Johnson, Waddah B Al-Refaie
BACKGROUND: Centralization of complex surgical care has led patients to travel longer distances. Emerging evidence suggested a negative association between increased travel distance and mortality after pancreatectomy. However, the reason behind this association remains largely unknown. We sought to unravel the relationships among travel distance, receiving pancreatectomy at high volume hospitals (HVH), delayed surgery, and operative outcomes. STUDY DESIGN: We identified 44,476 patients who underwent pancreatectomy for neoplasms between 2004 and 2013 at the reporting facility from the National Cancer Data Base...
April 13, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28408154/outcomes-for-critical-limb-ischemia-are-driven-by-lower-extremity-revascularization-volume-not-distance-to-hospital
#7
Ankit N Medhekar, Doran S Mix, Christopher T Aquina, Lauren E Trakimas, Katia Noyes, Fergal J Fleming, Roan J Glocker, Michael C Stoner
OBJECTIVE: The objective of this study was to identify relationships among geographic access to care, vascular procedure volume, limb preservation, and survival in patients diagnosed with critical limb ischemia (CLI). METHODS: Using New York State administrative data from 2000 to 2013, we identified a patient's first presentation with CLI defined by International Classification of Diseases, Ninth Revision diagnosis and procedure codes. Distance from the patient's home to the index hospital was calculated using the centroids of the respective ZIP codes...
April 10, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28400697/the-impact-of-individual-surgeon-volume-on-hysterectomy-costs
#8
Jonathan P Shepherd, Charelle M Carter-Brooks, Kelly L Kantartzis, Ted Lee, Michael J Bonidie
BACKGROUND AND OBJECTIVE: Hysterectomy is one of the most common surgical procedures women will undergo in their lifetime. Several factors affect surgical outcomes. It has been suggested that high-volume surgeons favorably affect outcomes and hospital cost. The objective is to determine the impact of individual surgeon volume on total hospital costs for hysterectomy. METHODS: This is a retrospective cohort of women undergoing hysterectomy for benign indications from 2011 to 2013 at 10 hospitals within the University of Pittsburgh Medical Center System...
January 2017: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/28400188/devascularized-parenchymal-mass-associated-with-partial-nephrectomy-predictive-factors-and-impact-on-functional-recovery
#9
Wen Dong, Jitao Wu, Chalairat Suk-Ouichai, Elvis Caraballo Antonio, Erick Remer, Jianbo Li, Joseph Zabell, Sudhir Isharwal, Steven C Campbell
PURPOSE: Parenchymal mass loss is the predominant factor associated with functional outcomes after partial nephrectomy (PN), and is primarily due to excised parenchymal mass (EPM) and/or devascularized parenchymal mass (DPM). We evaluate the importance of EPM and DPM relative to functional recovery after PN. MATERIALS AND METHODS: 168 PN patients had necessary studies to determine EPM and DPM and evaluate parenchymal mass changes and functional loss within the operated kidney...
April 8, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28394065/patients-of-doctors-further-from-medical-school-graduation-have-poorer-outcomes
#10
John J Norcini, John R Boulet, Amy Opalek, W Dale Dauphinee
CONTEXT: There is an apparent contradiction between the findings of studies indicating that patient outcomes are better when physicians have a greater volume of practice and those that find outcomes to be worse with increased time since training, which implies greater volume. OBJECTIVES: This study was designed to estimate the adjusted relationships between physicians' characteristics, including recent practice volume and time since medical school graduation, and patient outcomes...
May 2017: Medical Education
https://www.readbyqxmd.com/read/28392994/medical-big-data-promise-and-challenges
#11
Choong Ho Lee, Hyung-Jin Yoon
The concept of big data, commonly characterized by volume, variety, velocity, and veracity, goes far beyond the data type and includes the aspects of data analysis, such as hypothesis-generating, rather than hypothesis-testing. Big data focuses on temporal stability of the association, rather than on causal relationship and underlying probability distribution assumptions are frequently not required. Medical big data as material to be analyzed has various features that are not only distinct from big data of other disciplines, but also distinct from traditional clinical epidemiology...
March 2017: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/28392777/efficacy-of-cerebral-autoregulation-in-early-ischemic-stroke-predicts-smaller-infarcts-and-better-outcome
#12
Pedro Castro, Jorge Manuel Serrador, Isabel Rocha, Farzaneh Sorond, Elsa Azevedo
BACKGROUND AND PURPOSE: Effective cerebral autoregulation (CA) may protect the vulnerable ischemic penumbra from blood pressure fluctuations and minimize neurological injury. We aimed to measure dynamic CA within 6 h of ischemic stroke (IS) symptoms onset and to evaluate the relationship between CA, stroke volume, and neurological outcome. METHODS: We enrolled 30 patients with acute middle cerebral artery IS. Within 6 h of IS, we measured for 10 min arterial blood pressure (Finometer), cerebral blood flow velocity (transcranial Doppler), and end-tidal-CO2...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28392326/preliminary-investigation-of-pain-related-changes-in-cerebral-blood-volume-in-patients-with-phantom-limb-pain
#13
Cheong Hoon Seo, Chang-Hyun Park, Myung Hun Jung, Soyeon Jang, So Young Joo, Yoonkyeong Kang, Suk Hoon Ohn
OBJECTIVE: We utilized MRI to measure CBV in patients who had undergone unilateral arm amputation following electrical injury to investigate changes in the pain network associated with phantom limb pain. DESIGN: Case-controlled exploratory MRI study of cerebral blood volume (CBV) via magnetic resonance imaging (MRI) SETTING: University hospital PARTICIPANTS: Ten patients with phantom limb pain following unilateral arm amputation and 16 healthy, age-matched participants...
April 6, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28388274/six-minute-stepper-test-to-set-pulmonary-rehabilitation-intensity-in-patients-with-copd-a-retrospective-study
#14
Tristan Bonnevie, Francis-Edouard Gravier, Marie Leboullenger, Clément Médrinal, Catherine Viacroze, Antoine Cuvelier, Jean-François Muir, Catherine Tardif, David Debeaumont
Pulmonary rehabilitation (PR) improves outcomes in patients with chronic obstructive pulmonary disease (COPD). Optimal assessment includes cardiopulmonary exercise testing (CPET), but consultations are limited. Field tests could be used to individualize PR instead of CPET. The six-minute stepper test (6MST) is easy to set up and its sensitivity and reproducibility have previously been reported in patients with COPD. The aim of this study was to develop a prediction equation to set intensity in patients attending PR, based on the 6MST...
April 7, 2017: COPD
https://www.readbyqxmd.com/read/28382100/patient-satisfaction-with-implant-based-breast-reconstruction-associated-with-implant-volume-and-mastectomy-specimen-weight-ratio
#15
Woo Yeol Baek, Il Hwan Byun, Young Seok Kim, Dae Hyun Lew, Joon Jeong, Tai Suk Roh
PURPOSE: Breast volume assessment is one of the most important steps during implant-based breast reconstruction because it is critical in selecting implant size. According to previous studies, there is a close relationship between the mastectomy specimen weight and resected breast volume. The aim of this study was to evaluate long-term patient satisfaction with implant-based breast reconstruction guided by the ratio of implant volume to mastectomy specimen weight. In doing so, we describe the ideal ratio for patient satisfaction...
March 2017: Journal of Breast Cancer
https://www.readbyqxmd.com/read/28379871/effect-of-hospital-volume-on-in-hospital-morbidity-and-mortality-following-pancreatic-surgery-in-germany
#16
Christian Krautz, Ulrike Nimptsch, Georg F Weber, Thomas Mansky, Robert Grützmann
OBJECTIVE: We aimed to determine the effect of hospital volume on in-hospital mortality, and failure to rescue following major pancreatic resections using hospital discharge data of every inpatient case in Germany. SUMMARY BACKGROUND DATA: Several studies have found strong volume-outcome relationships in pancreatic surgery, with high mortality in low-volume facilities. However, their datasets were only based on portions of national populations. In addition, these studies did not assess the effect of hospital volume according to other crucial variables such as medical indications, postoperative complications, and failure to rescue...
April 4, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28375720/child-maltreatment-and-risk-for-psychopathology-in-childhood-and-adulthood
#17
Sara R Jaffee
Although rates of child maltreatment are declining, more than 600,000 children in the United States are substantiated victims of abuse or neglect. The focus of this review is on the relationship between maltreatment and mental health problems in childhood and adulthood. Children and adults who are exposed to abuse or neglect in childhood are at risk for a range of poor mental health outcomes, including internalizing and externalizing psychopathology, posttraumatic stress disorder, psychotic symptoms, and personality disorders...
March 30, 2017: Annual Review of Clinical Psychology
https://www.readbyqxmd.com/read/28372162/on-the-assessments-of-arabinoxylan-localization-and-enzymatic-modifications-for-enhanced-protein-networking-and-its-structural-impact-on-rye-dough-and-bread
#18
Clemens Döring, Mohamed A Hussein, Mario Jekle, Thomas Becker
For rye dough structure, it is hypothesised that the presence of arabinoxylan hinders the proteins from forming a coherent network. This hypothesis was investigated using fluorescent-stained antibodies that bind to the arabinoxylan chains. Image analysis proves that the arabinoxylan surrounds the proteins, negatively affecting protein networking. Further, it is hypothesised that the dosing of xylanase and transglutaminase has a positive impact on rye dough and bread characteristics; the findings in this study evidenced that this increases the protein network by up to 38% accompanied by a higher volume rise of 10...
August 15, 2017: Food Chemistry
https://www.readbyqxmd.com/read/28364382/hypersensitivity-to-orthopedic-implants-a-review-of-the-literature
#19
REVIEW
Joseph Wawrzynski, Joseph A Gil, Avi D Goodman, Gregory R Waryasz
Awareness of rare etiologies for implant failure is becoming increasingly important. In addition to the overall increase in joint arthroplasties, revision surgeries are projected to increase dramatically in the coming years, with volume increasing up to seven-fold between 2005 and 2030. The literature regarding the relationship between metal allergy and implant failure is controversial. It has proven difficult to determine whether sensitization is a cause or a consequence of implant failure. Testing patients with functional implants is not a clinically useful approach, as the rate of hypersensitivity is higher in implant recipients than in the general population, regardless of the status of the implant...
March 31, 2017: Rheumatology and Therapy
https://www.readbyqxmd.com/read/28362914/understanding-hospital-volume-outcome-relationship-in-severe-traumatic-brain-injury
#20
Aziz S Alali, David Gomez, Victoria McCredie, Todd G Mainprize, Avery B Nathens
BACKGROUND: The hospital volume-outcome relationship in severe traumatic brain injury (TBI) population remains unclear. OBJECTIVE: To examine the relationship between volume of patients with severe TBI per hospital and in-hospital mortality, major complications, and mortality following a major complication (ie, failure to rescue). METHODS: In a multicenter cohort study, data on 9255 adults with severe TBI were derived from 111 hospitals participating in the American College of Surgeons Trauma Quality Improvement Program over 2009-2011...
April 1, 2017: Neurosurgery
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