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Charlson Comorbidity Index

Ahmed Siddiqi, Nicole E George, Peter B White, Bartlomiej W Szczech, John V Thompson, Jennifer I Etcheson, Chukwuweike U Gwam, Alexander T Caughran, Ronald E Delanois, James Nace
INTRODUCTION: Periprosthetic joint infection (PJI) following primary total knee arthroplasty (TKA) is a challenging complication for surgeons and patients alike. Although two-stage revision arthroplasty remains the gold standard PJI management in the United States, one-stage revision has had success in many parts of Europe. The aim of this study was to retrospectively review: 1) ultimate treatment success; 2) necessary antibiotic duration; 3) change in knee range of motion (ROM); and 4) final Knee Society Scores (KSS) in a case series of patients managed with retention of articulating antibiotic spacers following PJI...
March 12, 2018: Surgical Technology International
Pablo A Slullitel, Martín Estefan, Wilber M Ramírez-Serrudo, Fernando M Comba, Gerardo Zanotti, Francisco Piccaluga, Martín A Buttaro
BACKGROUND: Following a total hip arthroplasty (THA), early hospital re-admission rates of 3-11% are considered as 'acceptable' in terms of medical care cost policies. Surprisingly, the impact of re-admissions on mortality has not been priorly portrayed. Therefore, we sought to determine the mortality rate after 90-day re-admissions following a THA in a series of patients from a captive medical care program. PATIENTS AND METHODS: We prospectively analysed 90-day readmissions of 815 unilateral, elective THA patients operated upon between 2010 and 2014 whose medical care was the one offered by our institution...
March 10, 2018: International Orthopaedics
Kim I Cao, Flore Salviat, Fatima Laki, Marie-Christine Falcou, Matthieu Carton, Philip Poortmans, Alain Fourquet, Youlia M Kirova
OBJECTIVES: The aim of this study was to assess efficacy, tolerability, and the impact of comorbidities on outcomes in older women treated by radiation therapy (RT) for non-metastatic breast cancer. MATERIALS AND METHODS: Women aged ≥70 years at diagnosis who received postoperative RT for primary non-metastatic BC between 2003 and 2009 were retrieved from the Institut Curie registry. We calculated the Charlson Comorbidity Index (CCI) for each patient. We analyzed overall survival (OS), progression free survival (PFS), and acute and late toxicities according to the Common Terminology Criteria for Adverse Events (CTCAE) v3...
March 7, 2018: Journal of Geriatric Oncology
Ruiyang Jiang, Steven Wolf, Muhammad H Alkazemi, Gina-Maria Pomann, J Todd Purves, John S Wiener, Jonathan C Routh
INTRODUCTION: The surgical comorbidity assessment is important for patient risk stratification, counseling, and research. In adults, risk assessment indices, such as the Charlson Co-morbidity Score (CCS) or Van Walraven Index (VWI), are well established. In pediatrics, however, risk assessment indices are scarce. Recently, a pediatric-specific risk assessment index, the Rhee index, was developed to discriminate mortality for pediatric general surgery patients. Currently, there is no validated risk assessment tool in pediatric urology...
February 26, 2018: Journal of Pediatric Urology
Ana Agudo Tabuenca, Jara Altemir Trallero, José Antonio Gimeno Orna, María Julia Ocón Bretón
BACKGROUND: The percutaneous gastrostomy tube (PG) is an effective and safe way for the delivery of enteral nutrition. The aim of this study was to identify predictive factors for mortality after PG placement. MATERIAL AND METHODS: An observational and analytical cohort study was conducted. All endoscopic or radiological percutaneous gastrostomy tubes placed between January 2009 and July 2016 were evaluated. Mortality was the dependent variable. Initial clinical and analytical patient features and the development of complications during follow-up were recorded...
February 21, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Francisco Jesús Represas Carrera, Álvaro Carrera García, Ana Clavería Fontán
OBJECTIVE: Type 2 Diabetes Mellitus is a chronic disease that represent an important problem of public health. The objective of this study was to describe the sociodemographic, anthropometric, metabolic control, comorbidity and cardiovascular risk characteristics of patients diagnosed with Diabetes Mellitus type 2 in the health area of Vigo. METHODS: Retrospective observational descriptive study. Between March and September 2016, it did telephone interview and an audit of electronic medical records to 195 patients ≥ 18 years old from the health area of Vigo diagnosed with type 2 Diabetes Mellitus...
March 9, 2018: Revista Española de Salud Pública
Ahmed I Ghanem, Ankit Modh, Charlotte Burmeister, Adnan R Munkarah, Mohamed A Elshaikh
OBJECTIVES: We sought to evaluate the impact of age-adjusted Charlson comorbidity index (AACCI) score on survival endpoints for women with advanced stage endometrial carcinoma (EC). METHODS AND MATERIALS: We identified 238 women with stage III EC. AACCI score was calculated and 3 groups were created accordingly; group 1 with a score of 0-2, group 2 with score 3-4, and group 3 with score ≥5. Significant predictors of recurrence-free (RFS), disease-specific (DSS) and overall survival (OS) were analyzed...
March 8, 2018: Gynecologic and Obstetric Investigation
Anand A Dalal, Annie Guerin, Alex Mutebi, Kenneth W Culver
AIMS: To assess the time to BRAF testing, compare the characteristics of tested versus not-tested patients, and describe the costs for sequential versus next-generation sequencing (NGS) BRAF testing. METHODS: Patients diagnosed with lung cancer after 12/1/2013 were identified from two US claims databases; their characteristics were assessed during the 12 months before diagnosis (index date). Testing modalities were analyzed from the index date to end of continuous health plan enrollment or data availability (12/2015) based on combinations of Current Procedural Terminology (CPT) procedure codes...
March 8, 2018: Journal of Medical Economics
J A van Erven, L S van Galen, A A Hettinga-Roest, E P J Claessens, J C Roos, M H H Kramer, P W B Nanayakkara
BACKGROUND: This study investigates (1) whether the hospital standardised mortality ratio (HSMR) model underestimates or overestimates disease severity and (2) the completeness of the data collected by administrators to calculate HSMR in a cohort of deceased patients with the diagnosis of pneumonia. METHODS: In this retrospective cohort study Pneumonia Severity Index (PSI) and Abbreviated Mortality in Emergency Department Sepsis (abbMEDS) scores and associated mortality probabilities were obtained from 32 deceased pneumonia patients over the year 2014 in the VU University Medical Centre...
March 2018: Netherlands Journal of Medicine
M E Ogunsanya, S O Nduaguba, C M Brown
Objectives The objective of this paper is to describe the annual direct medical expenditures for cutaneous lupus erythematosus (CLE) patients, and to estimate the incremental health care expenditures and utilization associated with depression among adults with CLE, while controlling for covariates. Methods Using the 2014 Medical Expenditure Panel Survey (MEPS), we compared CLE patients with and without depression to determine differences in: (a) health care utilization-inpatient, outpatient, office-based and emergency room (ER) visits, and prescriptions filled; and (b) expenditures-total costs, inpatient, outpatient, office-based, ER, and prescription medication costs, and other costs using demography-adjusted and comorbidity-adjusted multivariate models (age, gender, race/ethnicity, marital status, education, perception of health status, poverty category, smoking status, and Charlson Comorbidity Index)...
January 1, 2018: Lupus
Kali S Thomas, Jessica A Ogarek, Joan M Teno, Pedro L Gozalo, Vincent Mor
Purpose: To develop a score to predict mortality using the Minimum Data Set 3.0 (MDS 3.0) that can be readily calculated from items collected during nursing home (NH) residents' admission assessments. Participants: We developed a training cohort of Medicare beneficiaries newly admitted to U.S. NHs during 2012 (N=1,426,815) and a testing cohort from 2013 (N=1,160,964). Methods: Data came from the MDS 3.0 assessments linked to the Medicare Beneficiary Summary File...
March 5, 2018: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
Thomas Partridge, Simon Jameson, Paul Baker, David Deehan, James Mason, Mike R Reed
BACKGROUND: More than 75,000 total hip replacements were performed in England and Wales in 2014, and this figure is predicted to increase. Trends in mortality and complications following total hip replacement from 2005 to 2014 were evaluated to quantify risk and to identify "at-risk" groups to better inform recommendations for patient care. METHODS: Our primary analysis estimated 90-day inpatient mortality following total hip replacement using Hospital Episode Statistics data from 2005 to 2014...
March 7, 2018: Journal of Bone and Joint Surgery. American Volume
Tetsu Ohnuma, Daisuke Shinjo, Alan M Brookhart, Kiyohide Fushimi
Background: Reducing the 30-day unplanned hospital readmission rate is a goal for physicians and policymakers in order to improve quality of care. However, data on the readmission rate of critically ill patients in Japan and knowledge of the predictors associated with readmission are lacking. We investigated predictors associated with 30-day rehospitalization for medical and surgical adult patients separately. Methods: Patient data from 502 acute care hospitals with intensive care unit (ICU) facilities in Japan were retrospectively extracted from the Japanese Diagnosis Procedure Combination (DPC) database between April 2012 and February 2014...
2018: Journal of Intensive Care
Paolo Capogrosso, Eugenio Ventimiglia, Luca Boeri, Walter Cazzaniga, Francesco Chierigo, Filippo Pederzoli, Nicola Frego, Costantino Abbate, Federico Dehò, Francesco Montorsi, Andrea Salonia
BACKGROUND: The awareness regarding erectile dysfunction (ED) may have increased over the past decade due to the widespread availability of phosphodiesterase type 5 inhibitors and the growing knowledge of a link between ED and men's overall health. OBJECTIVE: We examined whether the increased awareness of ED has led to observable changes in patient characteristics among first-time assessments for ED. DESIGN, SETTING, AND PARTICIPANTS: Data was collected from 1586 men seeking their first medical attention for ED at a single academic center during 2005-2017...
March 2, 2018: European Urology Focus
Belma Kalaycı, Yunus Turgay Erten, Tunahan Akgün, Turgut Karabag, Furuzan Kokturk
BACKGROUNDS: Charlson Comorbidity index (CCI) is a scoring system to predict prognosis and mortality. It exhibits better utility when combined with age, age-adjusted Charlson Comorbidity Index (ACCI). The aim of this study was to evaluate the relationship between ACCI and diurnal variation of blood pressure parameters in hypertensive patients and normotensive patients. METHODS: We enrolled 236 patients. All patients underwent a 24-h ambulatory blood pressure monitoring (ABPM) for evaluation of dipper or non-dipper pattern...
March 5, 2018: Clinical and Experimental Hypertension: CHE
Fawad Aslam, Nasim Ahmed Khan
Introduction: Comorbidities influence the prognosis, clinical outcomes, disease activity, and treatment response in rheumatoid arthritis (RA). RA patients have a high-comorbidity burden necessitating their study. Comorbidity indices are used to measure comorbidities and to study their impacts on different outcomes. A large number of such indices are used in clinical research. Some indices have been specifically developed in RA patients. Aim: This review aims to provide an overview of generic and specific comorbidity indices commonly used in RA research...
2018: Frontiers in Medicine
A C Rogers, N McCawley, A M Hanly, J Deasy, D A McNamara, J P Burke
PURPOSE: Rectal prolapse is a common condition, with conflicting opinions on optimal surgical management. Existing literature is predominantly composed of case series, with a dearth of evidence demonstrating current, real-world practice. This study investigated recent national trends in management of rectal prolapse in the Republic of Ireland (ROI). METHODS: This population analysis used a national database to identify patients admitted in the ROI primarily for the management of rectal prolapse, as defined by the International Classification of Diseases, 10th Revision (ICD-10)...
March 3, 2018: International Journal of Colorectal Disease
Robert E Burke, Edward Hess, Anna E Barón, Cari Levy, Jacques D Donzé
OBJECTIVES: To derive a risk prediction score for potential adverse outcomes in older adults transitioning to a skilled nursing facility (SNF) from the hospital. DESIGN: Retrospective analysis. SETTING: Medicare Current Beneficiary Survey (2003-11). PARTICIPANTS: Previously community-dwelling Medicare beneficiaries who were hospitalized and discharged to SNF for postacute care (N=2,043). MEASUREMENTS: Risk factors included demographic characteristics, comorbidities, health status, hospital length of stay, prior SNF stays, SNF size and ownership, treatments received, physical function, and active signs or symptoms at time of SNF admission...
March 2, 2018: Journal of the American Geriatrics Society
Joshua D Palmer, Charles J Schneider, Neil Hockstein, Alexandra L Hanlon, Jordan Silberg, Jon Strasser, Elizabeth A Mauer, Michael Dzeda, Robert Witt, Adam Raben
OBJECTIVES: The objective of this study was to investigate the safety, tolerability and preliminary efficacy of radiotherapy plus cetuximab in high risk CSCC patients. MATERIALS AND METHODS: Patients with high-risk CSCC diagnosed between 2006 and 2013 were analyzed. Patients were divided into two groups: radiotherapy alone versus radiotherapy plus cetuximab. Among 68 patients meeting study criteria, we identified 29 treated with cetuximab plus RT and 39 with RT alone...
March 2018: Oral Oncology
Tara Nikonow Morgan, Mohammed Shahait, Avinash Maganty, Michael C Ost, Stephen V Jackman, Timothy D Averch, Michelle Jo Semins
BACKGROUND: To describe the clinical characteristics, infectious and kidney function patterns, and overall outcomes in a cohort of patients with staghorn calculi treated conservatively. METHODS: Staghorn calculi treated non-operatively between January 2009 and January 2017 were identified. A retrospective analysis was completed. RESULTS: Twenty-nine patients were identified with median age of 74 (IQR 61-81). Mean follow-up was 24 months. Fifty nine percent (17/29) had complete staghorn calculi with 6/29 (21%) bilateral...
March 1, 2018: Journal of Endourology
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