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https://www.readbyqxmd.com/read/29670391/determining-30-day-readmission-risk-for-heart-failure-patients-the-readmission-after-heart-failure-scale
#1
Ronald S Chamberlain, Jaswinder Sond, Krishnaraj Mahendraraj, Christine Sm Lau, Brianna L Siracuse
Background: Chronic heart failure (CHF), which affects >5 million Americans, accounts for >1 million hospitalizations annually. As a part of the Hospital Readmission Reduction Program, the Affordable Care Act requires that the Centers for Medicare and Medicaid Services reduce payments to hospitals with excess readmissions. This study sought to develop a scale that reliably predicts readmission rates among patients with CHF. Methods: The State Inpatient Database (2006-2011) was utilized, and discharge data including demographic and clinical characteristics on 642,448 patients with CHF from California and New York (derivation cohort) and 365,359 patients with CHF from Florida and Washington (validation cohort) were extracted...
2018: International Journal of General Medicine
https://www.readbyqxmd.com/read/29623222/the-role-of-minimally-invasive-techniques-in-scoliosis-correction-surgery
#2
Michael B Cloney, Jack A Goergen, Angela M Bohnen, Zachary A Smith, Tyler Koski, Nader Dahdaleh
Objective: Recently, minimally invasive surgery (MIS) has been included among the treatment modalities for scoliosis. However, literature comparing MIS to open surgery for scoliosis correction is limited. The objective of this study was to compare outcomes for scoliosis correction patients undergoing MIS versus open approach. Methods: We retrospectively collected data on demographics, procedure characteristics, and outcomes for 207 consecutive scoliosis correction surgeries at our institution between 2009 and 2015...
2018: Minimally Invasive Surgery
https://www.readbyqxmd.com/read/29620543/outcomes-of-common-general-surgery-procedures-for-patients-discharged-over-weekends-at-a-tertiary-care-hospital-in-saudi-arabia
#3
Ibrahim T Albabtain, Roaa S Alsuhaibani, Sami A Almalki, Hassan A Arishi, Hatim A Alsulaim
BACKGROUND: Hospitals usually reduce staffing levels and services over weekends. This raises the question of whether patients discharged over a weekend may be inadequately prepared and possibly at higher risk of adverse events post-discharge. OBJECTIVES: To assess the outcomes of common general surgery procedures for patients discharged over weekends, and to identify the key predictors of early readmission. DESIGN: Retrospective cohort study...
March 2018: Annals of Saudi Medicine
https://www.readbyqxmd.com/read/29578549/patient-perceptions-of-readmission-risk-an-exploratory-survey
#4
Daniel J Brotman, Hasan M Shihab, Amanda Bertram, Alan Tieu, Henry G Cheng, Erik H Hoyer, Nowella Durkin, Amy Deutschendorf
Interventions to prevent readmissions often rely upon patient participation to be successful. We surveyed 895 general medicine patients slated for hospital discharge to (1) assess patient attitudes surrounding readmission, (2) ascertain whether these attitudes were associated with actual readmission, and (3) determine whether patients can estimate their own readmission risk. Actual readmissions and other clinical variables were captured from administrative data and linked to individual survey responses. We found that actual readmissions were not correlated with patients' interest in preventing readmission, sense of control over readmission, or intent to follow discharge instructions...
March 26, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29569750/predicting-readmission-risk-shortly-after-admission-for-cabg-surgery
#5
Jose Benuzillo, William Caine, R Scott Evans, Colleen Roberts, Donald Lappe, John Doty
BACKGROUND: Reducing preventable hospital readmissions after coronary artery bypass graft (CABG) surgery has become a national priority. Predictive models can be used to identify patients at high risk for readmission. However, the majority of the existing models are based on data available at discharge. We sought to develop a model to predict hospital readmission using data available soon after admission for isolated CABG surgery. METHODS: Fifty risk factors were included in a bivariate analysis, 16 of which were significantly associated (P < 0...
March 23, 2018: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/29565018/impact-of-frailty-on-outcomes-after-discharge-in-older-surgical-patients-a-prospective-cohort-study
#6
Yibo Li, Jenelle L Pederson, Thomas A Churchill, Adrian S Wagg, Jayna M Holroyd-Leduc, Kannayiram Alagiakrishnan, Raj S Padwal, Rachel G Khadaroo
BACKGROUND: Frailty is a state of vulnerability to diverse stressors. We assessed the impact of frailty on outcomes after discharge in older surgical patients. METHODS: We prospectively followed patients 65 years of age or older who underwent emergency abdominal surgery at either of 2 tertiary care centres and who needed assistance with fewer than 3 activities of daily living. Preadmission frailty was defined according to the Canadian Study of Health and Aging Clinical Frailty Scale as "well" (score 1 or 2), "vulnerable" (score 3 or 4) or "frail" (score 5 or 6)...
February 20, 2018: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://www.readbyqxmd.com/read/29501287/nationwide-readmissions-after-tonsillectomy-among-pediatric-patients-united-states
#7
Romaine F Johnson, Andrew Chang, Ron B Mitchell
OBJECTIVES: 1) Investigate incidence and predictors of readmissions after tonsillectomy with or without adenoidectomy (T&A) in children. 2) Identify factors that may predict readmission. SETTINGS: Nationwide cross-sectional survey of US hospital admissions. SUBJECTS: and Methods: The 2013 Nationwide Readmission Database (NRD) was used to examine all-cause readmissions within 30 days of T&A in children (age <18 years). Logistic regression was used to analyze the associations of demographics, diagnosis, insurance status, length of index stay, and median household income with readmission...
April 2018: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29450742/focused-cardiac-ultrasound-as-a-predictor-of-readmission-in-acute-decompensated-heart-failure
#8
Luke J Laffin, Amit V Patel, Narayan Saha, Julian Barbat, James K Hall, Matthew Cain, Kishan Parikh, Jay Shah, Kirk T Spencer
Acute decompensated heart failure (ADHF) is a common reason for admission to the hospital, and readmission is frequent. Multiple factors contribute to rehospitalizations, but inadequate assessment of volume status leading to persistent congestion is an important factor. We sought to determine if focused cardiac ultrasound (FCU) of the inferior vena cava (IVC), as a surrogate of volume status, would predict readmission of ADHF patients after index hospitalization. Patients admitted with a primary diagnosis of ADHF were prospectively enrolled...
February 15, 2018: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/29433853/identifying-the-low-risk-patient-in-surgical-intensive-and-intermediate-care-units-using-continuous-monitoring
#9
Holly N Blackburn, Matthew T Clark, J Randall Moorman, Douglas E Lake, J Forrest Calland
BACKGROUND: Continuous predictive monitoring has been employed successfully to predict subclinical adverse events. Should low values on these models, however, reassure us that a patient will not have an adverse outcome? Negative predictive values of such models could help predict safe patient discharge. The goal of this study was to validate the negative predictive value of an ensemble model for critical illness (using previously developed models for respiratory instability, hemorrhage, and sepsis) based on bedside monitoring data in the intensive care units and intermediate care unit...
February 9, 2018: Surgery
https://www.readbyqxmd.com/read/29357864/clinicians-can-independently-predict-30-day-hospital-readmissions-as-well-as-the-lace-index
#10
William Dwight Miller, Kimngan Nguyen, Sitaram Vangala, Erin Dowling
BACKGROUND: Significant effort has been directed at developing prediction tools to identify patients at high risk of unplanned hospital readmission, but it is unclear what these tools add to clinicians' judgment. In our study, we assess clinicians' abilities to independently predict 30-day hospital readmissions, and we compare their abilities with a common prediction tool, the LACE index. METHODS: Over a period of 50 days, we asked attendings, residents, and nurses to predict the likelihood of 30-day hospital readmission on a scale of 0-100% for 359 patients discharged from a General Medicine Service...
January 22, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29357679/area-deprivation-index-predicts-readmission-risk-at-an-urban-teaching-hospital
#11
Jianhui Hu, Amy J H Kind, David Nerenz
A growing body of evidence has shown that neighborhood characteristics have significant effects on quality metrics that evaluate health plans or health care providers. Using a data set of an urban teaching hospital patient discharges, this study aimed to determine whether a significant effect of neighborhood characteristics, measured by the Area Deprivation Index, could be observed on patients' readmission risk, independent of patient-level clinical and demographic factors. This study found that patients residing in more disadvantaged neighborhoods had significantly higher 30-day readmission risks compared to those living in less disadvantaged neighborhoods, even after accounting for individual-level factors...
January 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29338277/assessment-of-inpatient-psychiatric-readmission-risk-among-patients-discharged-on-an-antipsychotic-polypharmacy-regimen-a-retrospective-cohort-study
#12
Esad Boskailo, Aldin Malkoc, Dustin B McCurry, Jacob Venter, David Drachman, Gilbert M Ramos
OBJECTIVE: Patients are frequently prescribed multiple antipsychotic medications, leading to higher healthcare costs and increased risk for side effects. The efficacy of multiple versus single antipsychotics to prevent acute relapse, measured by incidence of inpatient readmission, is investigated in Arizona, USA. METHOD: A retrospective chart review compared socio-demographic and clinical data from 1,010 patients discharged on a single and 377 discharged on multiple antipsychotic medications...
November 2017: Acta Medica Academica
https://www.readbyqxmd.com/read/29303869/functional-capacity-but-not-early-uptake-of-cardiac-rehabilitation-predicts-readmission-in-patients-with-metabolic-syndrome
#13
Lee Anne Siegmund, Nancy M Albert, Mark S McClelland, James F Bena, Shannon L Morrison
BACKGROUND: Phase II cardiac rehabilitation reduces hospital readmissions and cardiovascular disease risk factors and improves functional capacity. Cardiovascular disease risk factors double with patients with metabolic syndrome, a population less likely to adhere to cardiac rehabilitation. PURPOSE: The aim of this study was to determine relationships between cardiac rehabilitation uptake timing, demographic variables and functional capacity, and readmission in patients with metabolic syndrome...
January 5, 2018: Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/29288658/preoperative-scale-to-determine-all-cause-readmission-after-coronary-artery-bypass-operations
#14
Aleksander Zywot, Christine S M Lau, Nina Glass, Stephanie Bonne, Franchesca Hwang, Koren Goodman, Anne Mosenthal, Subroto Paul
BACKGROUND: Coronary artery bypass graft (CABG) operations are associated with all-cause readmission rates of approximately 15%. In attempts to reduce readmission rates, the Hospital Readmission Reduction Program expanded to include CABG operations in 2015. The aim of this study was therefore to develop a predictive readmission scale that would identify patients at higher risk of readmission after CABG using commonly available administrative data. METHODS: Data of 126,519 patients from California and New York (derivation cohort) and 94,318 patients from Florida and Washington (validation cohort) were abstracted from the State Inpatient Database (2006 to 2011)...
April 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29261248/investigating-the-impact-of-intervention-refusal-on-hospital-readmission
#15
Alexis Coulourides Kogan, Eileen Koons, Susan Enguidanos
OBJECTIVES: To identify characteristics and readmission risks associated with opting out of a social work-driven transition intervention. STUDY DESIGN: Secondary data analysis of a randomized controlled pilot study at a large nonprofit urban community hospital. METHODS: Hospitalized English-speaking, cognitively intact adults 65 years or older with expected discharge back to the community were eligible for enrollment. Additionally, patients met at least 1 of the 3 criteria: 1) 75 years or older, 2) taking 5 or more medications, or 3) had 1 or more prior inpatient stays or emergency department visits in the previous 6 months...
December 1, 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/29229128/thirty-day-readmission-and-mortality-among-medicare-beneficiaries-discharged-to-skilled-nursing-facilities-after-vascular-surgery
#16
Sara Fernandes-Taylor, Stephen Berg, Rebecca Gunter, Kyla Bennett, Maureen A Smith, Paul J Rathouz, Caprice C Greenberg, K Craig Kent
BACKGROUND: Readmission within 30 d of an acute hospital stay is frequent, costly, and increasingly subject to penalties. Early readmission is most common after vascular surgery; these patients are often discharged to skilled nursing facilities (SNFs), making postacute care an essential partner in reducing readmissions. We characterize 30-day readmissions among vascular surgery patients discharged to SNF to provide evidence for this understudied segment of readmission after specialty surgery...
January 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29201912/relationship-between-activities-of-daily-living-and-readmission-within-90-days-in-hospitalized-elderly-patients-with-heart-failure
#17
Masahiro Kitamura, Kazuhiro P Izawa, Hiroki Taniue, Yumi Mimura, Keita Imamura, Hitomi Nagashima, Peter H Brubaker
Aims: To examine the relationship between activities of daily living (ADL) and readmission within 90 days and assess the cutoff value of ADL to predict readmission in hospitalized elderly patients with heart failure (HF). Methods: This cohort study comprised 589 consecutive patients with HF aged ≥65 years, who underwent cardiac rehabilitation from May 2012 to May 2016 and were discharged home. We investigated patients' characteristics, basic attributes, and ADL (motor and cognitive Functional Independence Measure [FIM])...
2017: BioMed Research International
https://www.readbyqxmd.com/read/29184585/do-psychosocial-factors-predict-readmission-among-diabetic-elderly-patients
#18
Mousa Alavi, Omeleila Baharlooei, Marzieh AdelMehraban
Background: Despite advances in diabetes treatment, the rate of readmission is still relatively high among these patients, especially in older population. Various factors may predict readmission in these patients; hence, the aim of this study was to assess the role of psychosocial factors in predicting readmission among diabetic elderly hospitalized in selected hospitals of Isfahan. Materials and Methods: In this cross-sectional study conducted from January to September 2016, 150 diabetic elderly hospitalized in selected hospitals affiliated with Isfahan University of medical sciences were chosen using a convenient sampling method...
November 2017: Iranian Journal of Nursing and Midwifery Research
https://www.readbyqxmd.com/read/29049189/the-prevalence-and-long-term-variation-of-hospital-readmission-for-patients-with-diabetes-in-tianjin-china-a-cross-sectional-study
#19
Xiaoqian Liu, Yuting Guo, Dandan Li, Zhuang Cui, Yuanyuan Liu, Changping Li, Jun Ma
Little is known about hospital readmission for patients with diabetes in China. We aimed to assess the temporal pattern, risk factors, and variations of all-cause readmission among hospitalized patients with diabetes in Tianjin, China, from 2008 to 2013.The Tianjin Basic Medical Insurance Register System database was used to identify discharged patients with diabetes from 2008 to 2013. The influential factors and trends of rehospitalization were analyzed for 30-, 60- and 90-day predicted readmission rates. The Blinder-Oaxaca decomposition was used to explain the readmission variations between 2008 and 2013...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28965738/postacute-care-setting-facility-characteristics-and-poststroke-outcomes-a-systematic-review
#20
REVIEW
Matthew Alcusky, Christine M Ulbricht, Kate L Lapane
OBJECTIVES: To synthesize research comparing poststroke health outcomes between patients rehabilitated in skilled nursing facilities (SNFs) and those in inpatient rehabilitation facilities (IRFs) as well as to evaluate relations between facility characteristics and outcomes. DATA SOURCES: PubMed and CINAHL searches spanned January 1, 1998, to October 6, 2016, and encompassed MeSH and free-text keywords for stroke, IRF/SNF, and study outcomes. Searches were restricted to peer-reviewed research in humans published in English...
September 28, 2017: Archives of Physical Medicine and Rehabilitation
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