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Charlson Comorbidity Index

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https://www.readbyqxmd.com/read/28346311/latissimus-dorsi-flap-breast-reconstruction-a-nationwide-inpatient-sample-review
#1
Michael R DeLong, Vickram J Tandon, George H Rudkin, Andrew L Da Lio
INTRODUCTION: The latissimus dorsi (LD) myocutaneous flap has been a long term standard for breast reconstruction. The variable indications for the LD flap have not been statistically examined because of the relative infrequency of its use by any single surgeon or institution. METHODS: The Nationwide Inpatient Sample data set was queried for all patient encounters involving a LD myocutaneous flap procedure. The study population was further restricted to female patients with a history of breast cancer or previous mastectomy...
March 24, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28345439/primary-nonadherence-to-overactive-bladder-medications-in-an-integrated-managed-care-health-care-system
#2
Nazia Rashid, Maria Vassilakis, Kathy J Lin, Rita Kristy, Daniel B Ng
BACKGROUND: Treatment for overactive bladder (OAB) remains suboptimal, in part because of patient nonadherence to medications. Primary nonadherence is when patients fail to pick up their initial prescriptions. OBJECTIVE: To measure primary nonadherence to OAB medications within 30 days of a first OAB prescription order using electronic medical records from a U.S. managed care health care system METHODS: A retrospective cohort study was conducted using electronic medical records from the Kaiser Permanente Southern California (KPSC) database to identify patients with new OAB prescriptions between January 1, 2007, and December 31, 2013...
April 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28345436/characterizing-health-care-utilization-direct-costs-and-comorbidities-associated-with-interstitial-cystitis-a-retrospective-claims-analysis
#3
Amy Tung, Zsolt Hepp, Aasthaa Bansal, Emily Beth Devine
BACKGROUND: Interstitial cystitis (IC) is a debilitating condition that affects up to 5% of the U.S. POPULATION: This condition is characterized by bladder pain, urinary urgency and frequency, nocturia, and, in some patients, bladder lesions called Hunner's lesions (HL). IC patients who have HL experience a clinical course that is distinct from those without HL and, as a result, respond differently to existing treatments. Without effective and lasting therapeutic options, IC patients are expected to experience a reduced quality of life and be a significant economic burden...
April 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28342121/can-comprehensive-imaging-analysis-with-analytic-morphomics-and-geriatric-assessment-predict-serious-complications-in-patients-undergoing-pancreatic-surgery
#4
Andrew J Benjamin, Mary M Buschmann, Andrew Schneider, Brian A Derstine, Jeffrey F Friedman, Stewart C Wang, William Dale, Kevin K Roggin
We aimed to determine whether comprehensive imaging analysis with analytic morphomics (AM) enhances or replaces geriatric assessment (GA) in risk-stratifying pancreatic surgery patients. One hundred thirty-four pancreatic surgery patients were identified from a prospective cohort. Sixty-three patients in the cohort had preoperative CT scans in addition to comprehensive geriatric assessments. CT scans were processed using AM. Associations with National Surgical Quality Improvement Program (NSQIP) serious complications were evaluated using univariate analysis and robust elastic net modeling to obtain AUROC curves by adding AM and GA measures to our previously defined clinical base risk model (age, body mass index, American Society of Anesthesiologists classification, and Charlson comorbidity index)...
March 24, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28341194/outcomes-of-open-staged-corrective-surgery-in-the-setting-of-adult-spinal-deformity
#5
Peter G Passias, Gregory W Poorman, Cyrus M Jalai, Breton Line, Bassel Diebo, Paul Park, Robert Hart, Douglas Burton, Frank Schwab, Virginie Lafage, Shay Bess, Thomas Errico
BACKGROUND CONTEXT: Adult spinal deformity (ASD) represents a constellation of complex mal-alignments affecting the spinal column. Corrective surgical procedures aimed at improving ASD can be equally challenging, and commonly require multiple index procedures and potential revisions prior to definitive management. There is a paucity of data comparing the outcomes of same-day (simultaneous) and two-day (staged) procedures for long spinal-fusions for ASD. Utilizing a large patient cohort with surgeon and patient-reported outcomes will be particularly useful in determining the utility and effect of staging long spine fusions for ASD...
March 21, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28340494/postoperative-care-of-patients-with-high-grade-glioma-is-there-a-real-need-for-the-neurocritical-icu-and-early-ct-scan
#6
Roberto Altieri, Fabio Cofano, Alessandro Agnoletti, Riccardo Fornaro, Marco Ajello, Francesco Zenga, Alessandro Ducati, Diego Garbossa
Background Pressure on economic resources now requires a careful rationalization of services. For adult patients with supratentorial gliomas, there is no consensus on the real need for care in a postoperative neurocritical intensive care unit (NICU) and on the timing of a postsurgical computed tomography (CT) scan. In this retrospective nonrandomized study, we assessed if and when there is a real need for NICU and if an early CT scan could be justified in the absence of neurologic worsening. Methods Of 264 patients, 21 were admitted to the NICU after the procedure as planned before the surgery for their clinical features (Karnofsky performance status < 70, American Society of Anesthesiologists score > 2, or Charlson Comorbidity Index > 5)...
March 24, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28338851/do-not-resuscitate-orders-and-early-mortality-in-hip-fracture-patients
#7
Anouk E Simons, Julian Karres, Leontien M G Nijland, Jan M Ultee, Gino M M J Kerkhoffs, Bart C Vrouenraets
Background: factors affecting mortality after hip fracture surgery have been studied extensively. It has been suggested that do-not-resuscitate (DNR) orders are associated with higher mortality in surgical patients due to less aggressive treatment. However, the effect of DNR orders on mortality in hip fracture patients is unknown. The objective of this study was to investigate the effect of DNR orders on early mortality after hip fracture surgery. Methods: all patients undergoing hip fracture surgery between 2004 and 2015 were included in this retrospective study...
February 25, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28338449/development-of-a-preoperative-predictive-model-for-major-complications-following-adult-spinal-deformity-surgery
#8
Justin K Scheer, Justin S Smith, Frank Schwab, Virginie Lafage, Christopher I Shaffrey, Shay Bess, Alan H Daniels, Robert A Hart, Themistocles S Protopsaltis, Gregory M Mundis, Daniel M Sciubba, Tamir Ailon, Douglas C Burton, Eric Klineberg, Christopher P Ames
OBJECTIVE The operative management of patients with adult spinal deformity (ASD) has a high complication rate and it remains unknown whether baseline patient characteristics and surgical variables can predict early complications (intraoperative and perioperative [within 6 weeks]). The development of an accurate preoperative predictive model can aid in patient counseling, shared decision making, and improved surgical planning. The purpose of this study was to develop a model based on baseline demographic, radiographic, and surgical factors that can predict if patients will sustain an intraoperative or perioperative major complication...
March 24, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28337579/comorbidity-and-the-risk-of-anastomotic-leak-in-chinese-patients-with-colorectal-cancer-undergoing-colorectal-surgery
#9
Yaohua Tian, Beibei Xu, Guopei Yu, Yan Li, Hui Liu
PURPOSE: Comorbidities had considerable effects on the prognosis in patients with colorectal cancer (CRC). The primary aim of the present study was to examine the influence of comorbidity on the risk of anastomotic leak (AL) in patients with CRC who underwent surgical resection. METHODS: Using the electronic Hospitalization Summary Reports in the top-ranked public hospitals in China, we identified 11,397 patients with CRC undergoing resection surgery from 2013 through 2015...
March 23, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28330822/long-term-survival-of-patients-aged-80-years-or-older-treated-with-radical-prostatectomy-for-prostate-cancer
#10
P Dell'Oglio, E Zaffuto, K Boehm, V Trudeau, A Larcher, Z Tian, M Moschini, S F Shariat, M Graefen, F Saad, U Capitanio, A Briganti, F Montorsi, P I Karakiewicz
BACKGROUND: Radical prostatectomy (RP) is the gold standard for clinically localized prostate cancer (PCa) patients with life expectancy (LE) of at least 10 years. We examined long-term survival of men aged 80 years or older treated with RP and we attempted to identify criteria based on age and comorbidities that could predict survival of at least 10 years after RP, to identify those that might be considered for RP. PATIENTS AND METHODS: In Surveillance Epidemiology and End Results (SEER)-Medicare-linked database, we identified 234 octo- and nonagenarians with clinical T1, T2 or T3 PCa treated with RP between 1991 and 2009...
March 10, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28329322/utilization-and-in-hospital-complications-of-cardiac-resynchronization-therapy-trends-in-the-united-states-from-2003-to-2013
#11
Seyed Mohammadreza Hosseini, Kasra Moazzami, Guy Rozen, Jeena Vaid, Ahmed Saleh, E Kevin Heist, Mark Vangel, Jeremy N Ruskin
Aims: Cardiac resynchronization therapy (CRT) device implantation has been shown to reduce morbidity and mortality in selected patients with heart failure. We sought to investigate the utilization and in-hospital complications of cardiac resynchronization therapy defibrillator (CRT-D) and pacemaker (CRT-P) implantations in the United States from 2003 to 2013. Methods and results: Patients receiving CRT-D or CRT-P were identified in the National Inpatient Sample database (NIS), using the International Classification of Diseases-Ninth Revision-Clinical Modification procedure codes...
March 13, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28329149/prediction-of-long-term-cognitive-decline-following-postoperative-delirium-in-older-adults
#12
Elizabeth E Devore, Tamara G Fong, Edward R Marcantonio, Eva M Schmitt, Thomas G Travison, Richard N Jones, Sharon K Inouye
Background: Increasing evidence suggests that postoperative delirium may result in long-term cognitive decline among older adults. Risk factors for such cognitive decline are unknown. Methods: We studied 126 older participants without delirium or dementia upon entering the Successful AGing After Elective Surgery (SAGES) study, who developed postoperative delirium and completed repeated cognitive assessments (up to 36 months of follow-up). Pre-surgical factors were assessed preoperatively and divided into nine groupings of related factors ("domains")...
March 15, 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/28329125/outcomes-in-patients-with-cardiovascular-implantable-electronic-device-infection-managed-with-chronic-antibiotic-suppression
#13
Eugene M Tan, Daniel C DeSimone, M Rizwan Sohail, Larry M Baddour, Walter R Wilson, James M Steckelberg, Abinash Virk
Background: Most cardiovascular implantable electronic device (CIED) recipients are elderly, have multiple comorbid conditions, and are at increased risk of CIED infection (CIEDI). Current guidelines recommend complete device removal in patients with CIEDI to prevent relapse and mortality. However, comorbidities or other factors may preclude device removal, thus prompting a non-surgical approach that includes chronic antibiotic suppression (CAS). There are limited data on outcomes of patients receiving CAS for CIEDI...
February 24, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28323674/emergency-presentation-of-esophagogastric-cancer-predictors-and-long-term-prognosis
#14
Sheraz R Markar, Hugh Mackenzie, Sara Jemal, Omar Faiz, David Cunningham, George B Hanna
OBJECTIVE: To identify patient factors that are associated with emergency presentation of esophageal and gastric cancer, and further to evaluate long-term prognosis in this cohort. BACKGROUND: The incidence of emergency presentation is variable, with the prognosis of patients stabilized and discharged to return for elective surgery unknown. METHODS: The primary admission of patients with esophageal or gastric cancer within the Hospital Episode Statistics database (1997-2012) was used to classify as emergency or elective diagnosis...
March 20, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28321833/depression-risk-in-patients-with-rheumatoid-arthritis-in-the-united-kingdom
#15
Louis Jacob, Timo Rockel, Karel Kostev
INTRODUCTION: Rheumatoid arthritis (RA) is one of the most common chronic inflammatory diseases. The goal of this study was to analyze the risk of depression in patients diagnosed with RA and treated by general practitioners in the UK. METHODS: The present study included patients first diagnosed with RA between 2000 and 2014 (index date). Individuals were excluded if they had also been diagnosed with depression or if they had received therapy for depression at or prior to the index date...
March 20, 2017: Rheumatology and Therapy
https://www.readbyqxmd.com/read/28318337/the-association-of-timing-of-disease-modifying-drug-initiation-and-relapse-in-patients-with-multiple-sclerosis-using-electronic-health-records
#16
Frank A Corvino, David Oliveri, Amy L Phillips
OBJECTIVE: A large, US de-identified electronic health record (EHR) database (Optum-Humedica de-identified Electronic Health Record dataset) was used to evaluate whether earlier disease-modifying drug (DMD) treatment initiation was associated with improved outcomes in MS. METHODS: Newly diagnosed patients from 1/1/2008-8/30/2014 (International Classification of Diseases, Ninth Revision, Clinical Modification code: 340.xx; first MS diagnosis = index date) with healthcare activity 1 year pre- and 2-years post-index, and who initiated DMD treatment during the 2-year follow-up period, were included...
March 20, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28315007/central-obesity-and-risks-of-cardiovascular-events-and-mortality-in-prevalent-hemodialysis-patients
#17
Heba Wahid El Said, Osama Mahmoud Mohamed, Tamer Wahid El Said, Ahmed Bahaa El Serwi
BACKGROUND: To date, no attempt has been made to assess the best anthropometric method for defining abdominal adiposity in hemodialysis (HD) patients or to determine whether the quantity of intra-abdominal fat relates to morbidity and mortality in that population. We aimed to describe the prevalence of central obesity in HD patients and to investigate the relationship between central obesity assessed by anthropometric variables, and composite outcomes, cardiovascular morbidity and mortality among HD patients and whether this parameter correlates with intra-abdominal fat assessed by computed tomography scan (CT scan)...
March 17, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28303419/esophagectomy-for-cancer-in-octogenarians-should-we-do-it
#18
Elizabeth Paulus, Caroline Ripat, Vadim Koshenkov, Angela T Prescott, Kiran Sethi, Heather Stuart, Gregory Tiesi, Alan S Livingstone, Danny Yakoub
PURPOSE: Inconsistent data exists regarding esophagectomy outcomes in octogenarians undergoing transhiatal esophagectomy for esophageal cancer. METHODS: A retrospective review was performed for esophagectomy cancer patients between 2000 and 2012 at our tertiary referral center. Outcome data for octogenarians was compared to younger patients aged 20 to 79 years. A case-matched group of patients younger than 80 years old (n = 33) was included based on the Charlson comorbidity index with the octogenarian group (n = 33)...
March 16, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28300435/long-term-outcomes-of-lercanidipine-versus-other-calcium-channel-blockers-in-newly-diagnosed-hypertension-a-nationwide-cohort-study
#19
Kai-Hung Cheng, Kai-Chun Cheng, Kai-Yuan Cheng, Yi-Hsin Yang, Chung-Wei Lee, Wen-Ter Lai
OBJECTIVE: Calcium channel blockers (CCBs) have been proved to have beneficial effects on cardiovascular (CV) outcomes, especially in stroke. Lercanidipine, a highly lipophilic CCB, lacks data regarding long-term outcomes including: CV, stroke, renal and all-cause mortality which are aimed to be clarified in this retrospective cohort study. PATIENTS AND METHODS: A total of 144630 newly diagnosed hypertension (HTN) (age: 18 - 65 y/o) patients in 2005 from the Taiwan's National Health Insurance Research Database were enrolled in this observational study...
March 16, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28298561/charlson-comorbidity-index-is-related-to-organ-damage-in-systemic-lupus-erythematosus-data-from-korean-lupus-network-kornet-registry
#20
Seong-Kyu Kim, Jung-Yoon Choe, Shin-Seok Lee
OBJECTIVE: The aim of this study was to identify whether comorbidity status is associated with organ damage in patients with systemic lupus erythematosus (SLE). METHODS: A total of 502 patients with SLE enrolled in the KORean lupus Network were consecutively recruited. Data included demographics, age-adjusted Charlson Comorbidity Index (CCIa), disease activity indexes, the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI), the Medical Outcomes Study Short Form-36 health survey (SF-36) score, and the Beck Depression Inventory (BDI) score...
March 15, 2017: Journal of Rheumatology
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