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Charlson Comorbidity Index

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https://www.readbyqxmd.com/read/28652813/charlson-comorbidity-index-derived-from-chart-review-or-administrative-data-agreement-and-prediction-of-mortality-in-intensive-care-patients
#1
Knut Stavem, Henrik Hoel, Stein Arve Skjaker, Rolf Haagensen
PURPOSE: This study compared the Charlson comorbidity index (CCI) information derived from chart review and administrative systems to assess the completeness and agreement between scores, evaluate the capacity to predict 30-day and 1-year mortality in intensive care unit (ICU) patients, and compare the predictive capacity with that of the Simplified Acute Physiology Score (SAPS) II model. PATIENTS AND METHODS: Using data from 959 patients admitted to a general ICU in a Norwegian university hospital from 2007 to 2009, we compared the CCI score derived from chart review and administrative systems...
2017: Clinical Epidemiology
https://www.readbyqxmd.com/read/28650921/effect-of-continuity-of-care-on-drug-drug-interactions
#2
Jiun-Yu Guo, Yiing-Jenq Chou, Christy Pu
BACKGROUND: Drug-drug interaction (DDI) is a critical concern in health care systems because it is directly associated with patient outcomes and is generally preventable. However, few studies have been conducted on whether poor continuity of care (COC) is a determinant of DDIs and whether this effect varies by level of comorbidity. Patients with higher comorbidity normally require more complex treatment regimens than other patients, and hence their COC is more critical for ensuring the accuracy of their medication information...
June 23, 2017: Medical Care
https://www.readbyqxmd.com/read/28650248/health-services-utilization-among-fee-for-service-medicare-and-medicaid-patients-under-age-65-with-behavioral-health-illness-at-an-urban-safety-net-hospital
#3
Ramon S Cancino, Brian W Jack, John Jarvis, Alice Kate Cummings, Ellie Cooper, Pierre-Yves Cremieux, James F Burgess
BACKGROUND: In 2011, fee-for-service patients with both Medicare and Medicaid (dual eligible) sustained $319.5 billion in health care costs. OBJECTIVE: To describe the emergency department (ED) use and hospital admissions of adult dual eligible patients aged under 65 years who used an urban safety net hospital. METHODS: This was a retrospective database analysis of patients aged between 18 and 65 years with Medicare and Medicaid, who used an urban safety net academic health center between January 1, 2011, and December 31, 2011...
July 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28650247/burden-of-alcohol-abuse-or-dependence-among-long-term-opioid-users-with-chronic-noncancer-pain
#4
Pamela B Landsman-Blumberg, Nathaniel Katz, Kavita Gajria, Anna D Coutinho, Paul P Yeung, Richard White
BACKGROUND: Substance abuse disorders among chronic noncancer pain (CNCP) patients add to the clinical challenges and economic burden of caring for such patients. Despite potential risks, some CNCP patients with a history of alcohol abuse or dependence (AAD) and pain that is refractory to nonopioid treatment options may still need opioids for pain management. However, there is a lack of data on adverse outcomes in long-term opioid users with CNCP and a history of substance abuse or AAD disorders...
July 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28648393/etiologies-trends-and-predictors-of-30-day-readmissions-in-patients-with-diastolic-heart-failure
#5
Shilpkumar Arora, Sopan Lahewala, Hafeez Ul Hassan Virk, Saman Setareh-Shenas, Prashant Patel, Varun Kumar, Byomesh Tripathi, Harshil Shah, Viralkumar Patel, Umesh Gidwani, Abhishek Deshmukh, Apurva Badheka, Radha Gopalan
An estimated half of all heart failure (HF) populations has been categorized to have diastolic HF (DHF), but sparse data are available describing etiologies and predictors of 30-day readmission in DHF population. The study cohort was derived from the National Readmission Database 2013 to 2014, a subset of the Healthcare Cost and Utilization Project sponsored by the Agency for Healthcare Research and Quality. DHF was identified using International Classification of Diseases, 9th Revision code 428.3x in primary diagnosis field...
June 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28648390/clinical-and-microbiological-characteristics-of-unusual-manifestations-of-invasive-pneumococcal-disease
#6
Adrian Sousa, Maria Teresa Pérez-Rodríguez, Andrés Nodar, Lucía Martínez-Lamas, Francisco Jose Vasallo, Maximiliano Álvarez-Fernández, Manuel Crespo
INTRODUCTION: Invasive pneumococcal disease (IPD) typically presents as bacterial pneumonia, meningitis or primary bacteraemia. However, Streptococcus pneumoniae can produce infection at any level of the body (endocarditis, arthritis, spontaneous bacterial peritonitis, etc.), which is also known as unusual IPD (uIPD). There are very limited data available about the clinical and microbiological profile of these uncommon manifestations of pneumococcal disease. Our aim was to analyse clinical forms, microbiological profile, epidemiology and prognosis of a cohort of patients with unusual invasive pneumococcal disease (uIPD)...
June 22, 2017: Enfermedades Infecciosas y Microbiología Clínica
https://www.readbyqxmd.com/read/28647579/frailty-is-associated-with-lower-expression-of-genes-involved-in-cellular-response-to-stress-results-from-the-toledo-study-for-healthy-aging
#7
Mariam El Assar, Javier Angulo, José Antonio Carnicero, Stefan Walter, Francisco José García-García, Eva López-Hernández, José-María Sánchez-Puelles, Leocadio Rodríguez-Mañas
BACKGROUND: Specific mechanisms underlying frailty syndrome are not well known. Frailty can be viewed as a loss of functional reserve resulting in increased vulnerability to stressors. We hypothesize that pathways regulating cellular response to stress are potential players in the development of frailty. The aim of this study was to evaluate the association of the expression of certain genes related to cellular response to stress with the presence of frailty in older patients. METHODS: A sample of 350 individuals aged 65 years or older (22% frail) was selected from the Toledo Study of Healthy Aging...
June 21, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28646726/trends-in-admission-rates-and-in-hospital-stay-for-venous-thromboembolism
#8
Sola Mansour, Ghazi Alotaibi, Cynthia Wu, Michael Sean McMurtry
BACKGROUND: Acute venous thromboembolism leads to significant morbidity and mortality. Advances in pharmacotherapy facilitate outpatient care in low-risk acute venous thromboembolism. The proportion of hospitalized acute venous thromboembolism cases and the average length of stay are not known. We sought to identify predictors of hospitalization, changes in hospitalization rates and length of stay of acute venous thromboembolism over a decade in Alberta, Canada. METHODS: Using linked administrative health databases, we identified adult patients diagnosed primarily with acute venous thromboembolism between April 2002 and March 2012...
June 8, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28646645/comorbidity-assessment-in-patients-with-oral-squamous-cell-carcinoma-can-imaging-techniques-fludeoxyglucose-positron-emission-tomographic-computed-tomography-and-contrast-enhanced-computed-tomography-provide-additional-information
#9
Matthias Troeltzsch, Florian Andreas Probst, Axel Rominger, Ulrich Müller-Lisse, Monika Probst, Katharina Obermeier, Michael Ehrenfeld, Sven Otto
PURPOSE: This study evaluated the role of imaging staging examinations (positron-emission tomographic computed tomography [PET/CT] and contrast-enhanced computed tomography [ceCT]) for the assessment of the comorbidity status of patients with oral squamous cell carcinoma (OSCC). A binary null hypothesis was drafted: 1) imaging staging examinations do not augment knowledge about the comorbidity status of patients with OSCC and 2) there is no difference between PET/CT and ceCT in this regard...
May 31, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28645598/efficacy-of-early-surgery-for-neurological-improvement-in-spinal-cord-injury-without-radiographic-evidence-of-trauma-in-the-elderly
#10
Tomoo Inoue, Shinsuke Suzuki, Toshiki Endo, Hiroshi Uenohara, Teiji Tominaga
OBJECT: The optimal timing for surgery for patients with spinal cord injury without radiographic evidence of trauma (SCIWORET) remains unclear. This is especially true in the elderly, because most studies are done with younger patients to avoid age-related comorbidities. We therefore aimed to compare the efficacy of early (less than 24 hours post-injury) versus late (more than 24 hours post-injury) surgery in patients with SCIWORET aged 65 years or older. METHODS: We identified patients aged 65 years or older who underwent surgery for SCIWORET between January 1995 and February 2016...
June 20, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28643075/a-standardized-comparison-of-peri-operative-complications-after-minimally-invasive-esophagectomy-ivor-lewis-versus-mckeown
#11
Andrew M Brown, Michael J Pucci, Adam C Berger, Talar Tatarian, Nathaniel R Evans, Ernest L Rosato, Francesco Palazzo
BACKGROUND: While our institutional approach to esophageal resection for cancer has traditionally favored a minimally invasive (MI) 3-hole, McKeown esophagectomy (MIE 3-hole) during the last five years several factors has determined a shift in our practice with an increasing number of minimally invasive Ivor Lewis (MIE IL) resections being performed. We compared peri-operative outcomes of the two procedures, hypothesizing that MIE IL would be less morbid in the peri-operative setting compared to MIE 3-hole...
June 22, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28641971/comorbidities-have-a-greater-impact-than-age-alone-in-the-outcomes-of-octogenarian-total-knee-arthroplasty
#12
Kae Sian Tay, Eric W L Cher, Karen Zhang, Seang Beng Tan, Tet Sen Howe, Joyce S B Koh
BACKGROUND: Increasing age and various comorbidities are known risk factors for complications after total knee arthroplasty (TKA), but data on the impact of total comorbidity burden is scarce. We investigated the effect of age and total comorbidity burden on outcomes after primary TKA in octogenarians (OGs). METHODS: A matched-pair comparison study was conducted using prospectively collected TKA registry data in a large tertiary institution. Between 2006 and 2011, consecutive OGs undergoing primary unilateral TKA, with minimum 2-year follow-up, were matched 1:1 with younger controls based on demographic and surgical variables...
May 31, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28641871/the-patient-s-comorbidity-burden-correlates-with-the-erectile-dysfunction-severity
#13
E García-Cruz, A Carrión, T Ajami, M Álvarez, M Á Correas, B García, J V García, C González, J A Portillo, J Romero-Otero, C Simón, J Torremadé, F Vigués, A Alcaraz
OBJECTIVE: To explore the potential relationship between erectile dysfunction (ED), low testosterone levels, and the Charlson Comorbidity Index (CCI). MATERIAL AND METHODS: Cross-sectional study on patients referred to the andrology unit in 7 Spanish centers. The ED was diagnosed and graded using the International Index of Erectile Function (IIEF-5) score. Total testosterone, the prevalence of each comorbidity, and the CCI were compared between patients with different grades of ED...
June 19, 2017: Actas Urologicas Españolas
https://www.readbyqxmd.com/read/28639163/agr-functionality-affects-clinical-outcomes-in-patients-with-persistent-methicillin-resistant-staphylococcus-aureus-bacteraemia
#14
C K Kang, Y K Kim, S-I Jung, W B Park, K-H Song, K-H Park, P G Choe, H-C Jang, S Lee, Y-S Kim, Y G Kwak, K T Kwon, S Kiem, C-J Kim, E S Kim, H B Kim
Methicillin-resistant Staphylococcus aureus bacteremia (MRSAB) often persists despite appropriate antibiotic therapy. It is unclear what microbiological factors contribute to poor clinical outcomes in persistent MRSAB (pMRSAB). We aimed to identify clinical and microbiological risk factors for in-hospital mortality in pMRSAB. We analysed MRSAB cases prospectively collected between 2009 and 2016 at 11 hospitals in Korea, defining cases of pMRSAB as MRSAB lasting ≥5 days despite administration of effective antibiotics...
June 21, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28638605/effect-of-ethnicity-and-socioeconomic-status-on-vascular-access-provision-and-performance-in-an-urban-nhs-hospital
#15
Teun Wilmink, Anika Wijewardane, Kathryn Lee, Alexander Murley, Lee Hollingworth, Sarah Powers, Jyoti Baharani
BACKGROUND: The aim of this study was to examine the effect of ethnicity, socioeconomic group (SEG) and comorbidities on provision of vascular access for haemodialysis (HD). METHODS: This was a retrospective review of two databases of HD sessions and access operations from 2003-11. Access modality of first HD session and details of transplanted patients were derived from the renal database. Follow-up was until 1 January 2015. Primary failure (PF) was defined as an arteriovenous fistula (AVF) used for fewer than six consecutive dialysis sessions...
February 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28635566/stone-size-is-a-predictor-for-residual-stone-and-multiple-procedures-of-endoscopic-combined-intrarenal-surgery
#16
Shimpei Yamashita, Yasuo Kohjimoto, Akinori Iba, Kazuro Kikkawa, Isao Hara
OBJECTIVES: The aim of this study was to identify the predictors of treatment results after endoscopic combined intrarenal surgery (ECIRS). MATERIALS AND METHODS: A retrospective analysis was conducted of 75 patients with renal stones who underwent ECIRS and a preoperative non-contrast computed tomography (NCCT) examination. The stone-free rate (SFR), number of primary procedures and perioperative complications were investigated, and the predictors contributing to these three outcomes were analyzed...
February 13, 2017: Scandinavian Journal of Urology
https://www.readbyqxmd.com/read/28634824/association-of-parkinsonism-or-parkinson-disease-with-polypharmacy-in-the-year-preceding-diagnosis-a-nested-case-control-study-in-south-korea
#17
Hae-Young Park, Ji-Won Park, Hyun Soon Sohn, Jin-Won Kwon
INTRODUCTION: Published studies on the association between polypharmacy and parkinsonism or Parkinson disease are very limited. OBJECTIVE: The objective of this study was to investigate whether polypharmacy is associated with parkinsonism or Parkinson disease in elderly patients. METHODS: From a South Korean national health insurance sample cohort database for 2002-2013, we matched parkinsonism cases (defined by diagnosis codes for parkinsonism/Parkinson disease) and Parkinson disease cases (patients who had records for both Parkinson disease diagnosis and anti-Parkinson disease drug prescriptions) with controls...
June 20, 2017: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/28629904/perioperative-morbidity-of-same-day-and-staged-bilateral-total-hip-arthroplasty
#18
Lazaros A Poultsides, Georgios K Triantafyllopoulos, Stavros G Memtsoudis, Huong T Do, Michael M Alexiades, Thomas P Sculco
BACKGROUND: Management strategies for bilateral hip degenerative disease include same-day or staged bilateral total hip arthroplasty (THA), but information on outcomes remains sparse. We sought to describe in-hospital complications and blood transfusion rates after same-day and staged bilateral THAs at different time intervals and to assess risk factors for these events. METHODS: We retrospectively reviewed administrative data for 3785 patients treated with same-day bilateral (n = 1946; group A) and staged bilateral THA within (1) 0-3 months apart (n = 328; group B); (2) 3-6 months apart (n = 703; group C); and (3) 6-12 months apart (n = 808; group D), between 1999 and 2014...
May 23, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28628663/survival-and-medical-utilization-of-children-and-adolescents-with-prolonged-ventilator-dependent-and-associated-factors
#19
Szu-Chi Pai, Pei-Tseng Kung, Wen-Yu Chou, Tsunghuai Kuo, Wen-Chen Tsai
Over the course of a year, more than 20,000 patients in Taiwan require prolonged mechanical ventilation (PMV). Data from the National Health Insurance Research Database for patients between 2005 and 2011 were used to conduct a retrospective analysis on ventilator dependence. The study subjects were PMV patients aged <17 years in Taiwan. A multiple regression model employing general estimating equations was applied to investigate the factors affecting the use of medical resources by children and adolescent PMV patients...
2017: PloS One
https://www.readbyqxmd.com/read/28628498/earlier-physical-therapy-input-is-associated-with-a-reduced-length-of-hospital-stay-and-reduced-care-needs-on-discharge-in-frail-older-inpatients-an-observational-study
#20
Peter J Hartley, Victoria L Keevil, Ledia Alushi, Rebecca L Charles, Eimear B Conroy, Patricia M Costello, Becki Dixon, Aida M Dolinska-Grzybek, Diana Vajda, Roman Romero-Ortuno
BACKGROUND AND PURPOSE: Pressures on hospital bed occupancy in the English National Health Service have focused attention on enhanced service delivery models and methods by which physical therapists might contribute to effective cost savings, while retaining a patient-centered approach. Earlier access to physical therapy may lead to better outcomes in frail older inpatients, but this has not been well studied in acute National Health Service hospitals. Our aim was to retrospectively study the associations between early physical therapy input and length of hospital stay (LOS), functional outcomes, and care needs on discharge...
June 16, 2017: Journal of Geriatric Physical Therapy
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