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https://www.readbyqxmd.com/read/28328520/a-natural-language-processing-framework-for-assessing-hospital-readmissions-for-patients-with-copd
#1
Ankur Agarwal, Christopher Baechle, Ravi Behara, Xingquan Zhu
With the passage of recent federal legislation many medical institutions are now responsible for reaching target hospital readmission rates. Chronic diseases account for many hospital readmissions and Chronic Obstructive Pulmonary Disease has been recently added to the list of diseases for which the United States government penalizes hospitals incurring excessive readmissions. Though there have been efforts to statistically predict those most in danger of readmission, few have focused primarily on unstructured clinical notes...
March 17, 2017: IEEE Journal of Biomedical and Health Informatics
https://www.readbyqxmd.com/read/28323675/30-day-readmission-after-pancreatic-resection-a-systematic-review-of-the-literature-and-meta-analysis
#2
Alexander V Fisher, Sara Fernandes-Taylor, Stephanie A Campbell-Flohr, Sam J Clarkson, Emily R Winslow, Daniel E Abbott, Sharon M Weber
OBJECTIVE: The aim of this study was to identify and compare common reasons and risk factors for 30-day readmission after pancreatic resection. BACKGROUND: Hospital readmission after pancreatic resection is common and costly. Many studies have evaluated this problem and numerous discrepancies exist regarding the primary reasons and risk factors for readmission. METHODS: Multiple electronic databases were searched from 2002 to 2016, and 15 relevant articles identified...
March 20, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28288681/a-study-to-reduce-readmissions-after-surgery-in-the-veterans-health-administration-design-and-methodology
#3
Laurel A Copeland, Laura A Graham, Joshua S Richman, Amy K Rosen, Hillary J Mull, Edith A Burns, Jeff Whittle, Kamal M F Itani, Mary T Hawn
BACKGROUND: Hospital readmissions are associated with higher resource utilization and worse patient outcomes. Causes of unplanned readmission to the hospital are multiple with some being better targets for intervention than others. To understand risk factors for surgical readmission and their incremental contribution to current Veterans Health Administration (VA) surgical quality assessment, the study, Improving Surgical Quality: Readmission (ISQ-R), is being conducted to develop a readmission risk prediction tool, explore predisposing and enabling factors, and identify and rank reasons for readmission in terms of salience and mutability...
March 14, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28279748/burden-of-readmissions-among-patients-with-critical-limb-ischemia
#4
Shikhar Agarwal, James M Pitcavage, Karan Sud, Badal Thakkar
BACKGROUND: Readmissions constitute a major healthcare burden among critical limb ischemia (CLI) patients. We aimed to study the incidence of readmission and factors affecting readmission in CLI patients. METHODS: All adult hospitalizations with a diagnosis code for CLI were included from State Inpatient Databases from Florida (2009-2013), New York (2010-2013) and California (2009-2011). Data were merged with the directory available from the American Hospital Association to obtain detailed information on hospital related characteristics...
March 3, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28274908/assessing-the-performance-of-a-modified-lace-index-lace-rt-to-predict-unplanned-readmission-after-discharge-in-a-community-teaching-hospital
#5
Christo El Morr, Liane Ginsburg, Seungree Nam, Susan Woollard
BACKGROUND: The LACE index was designed to predict early death or unplanned readmission after discharge from hospital to the community. However, implementing the LACE tool in real time in a teaching hospital required practical unavoidable modifications. OBJECTIVE: The purpose of this study was to validate the implementation of a modified LACE index (LACE-rt) and test its ability to predict readmission risk using data in a hospital setting. METHODS: Data from the Canadian Institute for Health Information's Discharge Abstract Database (DAD), the National Ambulatory Care Reporting System (NACRS), and the hospital electronic medical record for one large community hospital in Toronto, Canada, were used in this study...
March 8, 2017: Interactive Journal of Medical Research
https://www.readbyqxmd.com/read/28263938/analysis-of-machine-learning-techniques-for-heart-failure-readmissions
#6
Bobak J Mortazavi, Nicholas S Downing, Emily M Bucholz, Kumar Dharmarajan, Ajay Manhapra, Shu-Xia Li, Sahand N Negahban, Harlan M Krumholz
BACKGROUND: The current ability to predict readmissions in patients with heart failure is modest at best. It is unclear whether machine learning techniques that address higher dimensional, nonlinear relationships among variables would enhance prediction. We sought to compare the effectiveness of several machine learning algorithms for predicting readmissions. METHODS AND RESULTS: Using data from the Telemonitoring to Improve Heart Failure Outcomes trial, we compared the effectiveness of random forests, boosting, random forests combined hierarchically with support vector machines or logistic regression (LR), and Poisson regression against traditional LR to predict 30- and 180-day all-cause readmissions and readmissions because of heart failure...
November 2016: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28259489/association-between-frailty-and-readmission-within-one-year-after-gastrectomy-in-older-patients-with-gastric-cancer
#7
Yu-Ri Choe, Ju-Youn Joh, Yeon-Pyo Kim
OBJECTIVE: The incidence of gastric cancer in older people is increasing. Because older patients are at increased risk of postoperative complications and mortality, preoperative risk assessment in this population is important. This study explored whether preoperative assessment of frailty could be useful for predicting the postoperative outcome in patients with gastric cancer. MATERIALS AND METHODS: We investigated 223 patients (136 men and 87 women) over 65years of age who underwent gastric cancer surgery from April 2012 to March 2015 at a single institution in Korea...
March 1, 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/28235886/the-pearl-score-predicts-90-day-readmission-or-death-after-hospitalisation-for-acute-exacerbation-of-copd
#8
C Echevarria, J Steer, K Heslop-Marshall, S C Stenton, P M Hickey, R Hughes, M Wijesinghe, R N Harrison, N Steen, A J Simpson, G J Gibson, S C Bourke
BACKGROUND: One in three patients hospitalised due to acute exacerbation of COPD (AECOPD) is readmitted within 90 days. No tool has been developed specifically in this population to predict readmission or death. Clinicians are unable to identify patients at particular risk, yet resources to prevent readmission are allocated based on clinical judgement. METHODS: In participating hospitals, consecutive admissions of patients with AECOPD were identified by screening wards and reviewing coding records...
February 24, 2017: Thorax
https://www.readbyqxmd.com/read/28156510/predicting-hospital-readmissions-in-the-oncology-population
#9
Kristine A Donovan, Mary Turney, C Edward Emnett, Amber Lamoreaux, Diane G Portman
177 Background: The 30-day readmission rate is established as an important indicator of quality of care. The LACE index is commonly used in the general medical setting to predict readmission but its ability to predict readmission with sensitivity and specificity in the oncology population has not yet been examined. At our cancer center, palliative care (PC) consultation is associated with an increased risk for readmission but it is not an element in the LACE index. METHODS: We sought to characterize the operating characteristics of the LACE Index using receiver operating characteristics analyses to predict unplanned readmissions to our cancer center over a 6-week period beginning March 2016...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28093901/does-hospital-readmission-following-colorectal-cancer-resection-and-enhanced-recovery-after-surgery-impact-on-long-term-survival
#10
Nathan J Curtis, Emma Noble, Emad Salib, Rob Hipkiss, Emily Meachim, Richard Dalton, Andrew Allison, Jonathan Ockrim, Nader K Francis
BACKGROUND: Hospital readmission is undesirable for patients and care providers as this can impact short-term recovery and carries financial consequences. It is unknown if readmission has long term implications. AIM: To investigate the impact of thirty day readmission on long term overall survival following colorectal cancer resection within enhanced recovery after surgery (ERAS) care and explore the reasons, severity and details of readmission episodes. METHODS: A dedicated, prospectively populated database was reviewed...
January 17, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28062207/cardiometabolic-biomarkers-are-predictors-of-readmission-and-death-in-patients-hospitalized-for-acute-dyspnea
#11
Nathalie Lund, Klas Gränsbo, Camilla Wernersson, Olle Melander
BACKGROUND: Acute dyspnea affects a large heterogeneous patient group with high mortality and readmission rates. PURPOSE: To investigate if cardiometabolic biomarkers and clinical characteristics predict readmission and death in patients hospitalized for acute dyspnea. METHODS: 65 dyspnea patients at a general internal medicine ward were followed for six months. The combined endpoint was readmission or death. MEASUREMENTS AND RESULTS: Cardiometabolic biomarkers at admission were related to the endpoint in Cox proportional hazard models (adjusted for sex, age, oxygen saturation, respiratory rate and C-reactive protein (CRP))...
December 22, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28061831/acute-kidney-injury-as-an-independent-risk-factor-for-unplanned-90-day-hospital-readmissions
#12
Simon Sawhney, Angharad Marks, Nick Fluck, David J McLernon, Gordon J Prescott, Corri Black
BACKGROUND: Reducing readmissions is an international priority in healthcare. Acute kidney injury (AKI) is common, serious and also a global concern. This analysis evaluates AKI as a candidate risk factor for unplanned readmissions and determines the reasons for readmissions. METHODS: GLOMMS-II is a large population cohort from one health authority in Scotland, combining hospital episode data and complete serial biochemistry results through data-linkage. 16453 people (2623 with AKI and 13830 without AKI) from GLOMMS-II who survived an index hospital admission in 2003 were used to identify the causes of and predict readmissions...
January 6, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28029373/discharge-decision-making-after-complex-surgery-surgeon-behaviors-compared-to-predictive-modeling-to-reduce-surgical-readmissions
#13
Ira L Leeds, Vjollca Sadiraj, James C Cox, Xiaoxue Sherry Gao, Timothy M Pawlik, Kurt E Schnier, John F Sweeney
BACKGROUND: Little is known about how information available at discharge affects decision-making and its effect on readmission. We sought to define the association between information used for discharge and patients' subsequent risk of readmission. METHODS: 2009-2014 patients from a tertiary academic medical center's surgical services were analyzed using a time-to-event model to identify criteria that statistically explained the timing of discharges. The data were subsequently used to develop a time-varying prediction model of unplanned hospital readmissions...
January 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28017214/stroke-severity-may-predict-causes-of-readmission-within-one-year-in-patients-with-first-ischemic-stroke-event
#14
Cheng-Yang Hsieh, Huey-Juan Lin, Ya-Han Hu, Sheng-Feng Sung
INTRODUCTION: Readmissions after stroke are costly. Risk assessment using information available upon admission could identify high-risk patients for potential interventions to reduce readmissions. Baseline stroke severity has been suspected to be a factor in readmission; however, the exact nature of the impact has not been adequately understood. METHODS: Hospitalized adult patients with first-ever ischemic stroke were identified from a nationwide administrative database...
January 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28011244/predicting-readmission-risk-following-percutaneous-coronary-intervention-at-the-time-of-admission
#15
Zaher Fanari, Daniel Elliott, Carla A Russo, Paul Kolm, William S Weintraub
OBJECTIVE: To investigate whether a prediction model based on data available early in percutaneous coronary intervention (PCI) admission can predict the risk of readmission. BACKGROUND: Reducing readmissions following hospitalization is a national priority. Identifying patients at high risk for readmission after PCI early in a hospitalization would enable hospitals to enhance discharge planning. METHODS: We developed 3 different models to predict 30-day inpatient readmission to our institution for patients who underwent PCI between January 2010 and April 2013...
March 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/27993376/unplanned-readmission-after-lung-resection-complete-follow-up-in-a-1-year-cohort-with-identification-of-associated-risk-factors
#16
Karen J Dickinson, James B Taswell, Mark S Allen, Shanda H Blackmon, Francis C Nichols, Robert Shen, Dennis A Wigle, Stephen D Cassivi
BACKGROUND: Unplanned readmissions are adverse clinical events that negatively impact patients and affect the use of health care resources. Identifying risk factors that can predict readmissions might permit individualized patient management. We compiled a complete account of readmissions after all lung resections over a year to identify potentially modifiable risk factors. METHODS: All patients undergoing elective lung resection between August 1, 2013 and July 31, 2014 were contacted directly to determine whether they had been readmitted to any institution within 30 days of discharge from our service...
December 16, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27986079/pre-discharge-factors-predicting-readmissions-of-psychiatric-patients-a-systematic-review-of-the-literature
#17
V Donisi, F Tedeschi, K Wahlbeck, P Haaramo, F Amaddeo
BACKGROUND: Readmission rate is considered an indicator of the mental health care quality. Previous studies have examined a number of factors that are likely to influence readmission. The main objective of this systematic review is to identify the studied pre-discharge variables and describe their relevance to readmission among psychiatric patients. METHODS: Studies on the association between pre-discharge variables and readmission after discharge with a main psychiatric diagnosis were searched in the bibliographic databases Ovid Medline, PsycINFO, ProQuest Health Management and OpenGrey...
December 16, 2016: BMC Psychiatry
https://www.readbyqxmd.com/read/27956070/rates-and-risk-factors-of-unplanned-30-day-readmission-following-general-and-thoracic-pediatric-surgical-procedures
#18
Stephanie F Polites, Donald D Potter, Amy E Glasgow, Denise B Klinkner, Christopher R Moir, Michael B Ishitani, Elizabeth B Habermann
BACKGROUND/PURPOSE: Postoperative unplanned readmissions are costly and decrease patient satisfaction; however, little is known about this complication in pediatric surgery. The purpose of this study was to determine rates and predictors of unplanned readmission in a multi-institutional cohort of pediatric surgical patients. METHODS: Unplanned 30-day readmissions following general and thoracic surgical procedures in children <18 were identified from the 2012-2014 National Surgical Quality Improvement Program- Pediatric...
December 7, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27939586/use-of-biomarkers-to-predict-readmission-for-congestive-heart-failure
#19
Sangita Sudharshan, Eric Novak, Karl Hock, Mitchell G Scott, Edward M Geltman
Acute decompensated heart failure (ADHF) is a major reason for repeated hospitalizations. Identifying those patients with ADHF at risk for readmission is critical so that preventive interventions can be implemented. Biomarkers such as B-type natriuretic peptide (BNP), high-sensitivity troponin I, and galectin-3 (Gal-3) assessed at discharge may be useful, although their role in predicting short-term readmission is not well defined in the literature. We enrolled and had follow-up data for 101 participants admitted to our facility from April 2013 to March 2015 with a primary diagnosis of ADHF...
February 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/27933194/contribution-of-the-long-term-care-insurance-certificate-for-predicting-1-year-all-cause-readmission-compared-with-validated-risk-scores-in-elderly-patients-with-heart-failure
#20
Kayo Takahashi, Makoto Saito, Shinji Inaba, Toru Morofuji, Hiroe Aisu, Takumi Sumimoto, Akiyoshi Ogimoto, Shuntaro Ikeda, Jitsuo Higaki
OBJECTIVES: Readmission is a common and serious problem associated with heart failure (HF). Unfortunately, conventional risk models have limited predictive value for predicting readmission. The recipients of long-term care insurance (LTCI) are frail and have mental and physical impairments. We hypothesised that adjustment of the conventional risk score with an LTCI certificate enables a more accurate appreciation of readmission for HF. METHODS: We investigated 452 patients with HF who were followed up for 1 year to determine all-cause readmission...
2016: Open Heart
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