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https://www.readbyqxmd.com/read/29898852/incorporating-patient-centered-factors-into-heart-failure-readmission-risk-prediction-a-mixed-methods-study
#1
Faraz S Ahmad, Benjamin French, Kathryn H Bowles, Jonathan Sevilla-Cazes, Anne Jaskowiak-Barr, Thomas R Gallagher, Shreya Kangovi, Lee R Goldberg, Frances K Barg, Stephen E Kimmel
BACKGROUND: Capturing and incorporating patient-centered factors into 30-day readmission risk prediction after hospitalized heart failure (HF) could improve the modest performance of current models. METHODS: Using a mixed-methods approach, we developed a patient-centered survey and evaluated the additional predictive utility of the survey compared to a traditional readmission risk model (the Krumholz et al. model). Area under the receiver operating characteristic curve (AUC) and the Hosmer-Lemeshow goodness-of-fit statistic quantified the performance of both models...
June 2018: American Heart Journal
https://www.readbyqxmd.com/read/29898850/prognosis-in-relation-to-high-sensitivity-cardiac-troponin-t-levels-in-patients-with-myocardial-infarction-and-non-obstructive-coronary-arteries
#2
Marcus Hjort, Bertil Lindahl, Tomasz Baron, Tomas Jernberg, Per Tornvall, Kai M Eggers
BACKGROUND: Myocardial infarction (MI) with non-obstructive coronary arteries (MINOCA) is a recently recognized condition where biomarkers and prognosis are less well studied than in MI with obstructive coronary artery disease (MI-CAD). We therefore aimed to investigate the one-year prognostic value of high-sensitivity cardiac troponin T (hs-cTnT) levels in MINOCA in comparison to MI-CAD. METHODS: In this registry-based cohort study, we used data from patients with a discharge diagnosis of MI, admitted between 2009 and 2013 to Swedish hospitals using the hs-cTnT assay...
June 2018: American Heart Journal
https://www.readbyqxmd.com/read/29889108/what-are-the-rates-reasons-and-risk-factors-of-90-day-hospital-readmission-after-lumbar-discectomy-an-institutional-experience
#3
Morgan R Kohls, Nikhil Jain, Safdar N Khan
STUDY DESIGN: This is a retrospective cohort study. OBJECTIVE: To report the rate, reasons, and risk factors for 90-day readmissions after lumbar discectomy at an academic medical center. SUMMARY OF BACKGROUND DATA: Several studies have reported complications and readmissions after spine surgery; however, only one previous study has focused specifically on lumbar discectomy. As the patient profile and morbidity of various spine procedures is different, focus on procedure-specific complications and readmissions will be beneficial...
June 7, 2018: Clinical Spine Surgery
https://www.readbyqxmd.com/read/29877987/validation-of-the-registered-nurse-assessment-of-readiness-for-hospital-discharge-scale
#4
Kathleen L Bobay, Marianne E Weiss, Debra Oswald, Olga Yakusheva
BACKGROUND: Statistical models for predicting readmissions have been published for high-risk patient populations but typically focus on patient characteristics; nurse judgment is rarely considered in a formalized way to supplement prediction models. OBJECTIVES: The purpose of this study was to determine psychometric properties of long and short forms of the Registered Nurse Readiness for Hospital Discharge Scale (RN-RHDS), including reliability, factor structure, and predictive validity...
June 5, 2018: Nursing Research
https://www.readbyqxmd.com/read/29872284/emergency-department-management-of-acute-exacerbations-of-chronic-obstructive-pulmonary-disease-factors-predicting-readmission
#5
Wiebke Bartels, Simon Adamson, Lisa Leung, Don D Sin, Stephan F van Eeden
Rationale: Readmissions are common following acute exacerbations of chronic obstructive pulmonary disease (AECOPD) and are partially responsible for increased morbidity and mortality in COPD. Numerous factors have been shown to predict readmission of patients previously admitted to hospital for AECOPD; however, factors related to readmission in patients who are triaged in emergency departments (EDs) and sent directly home are poorly understood. We postulate that patients seen in the ED for AECOPD and directly sent home have a high readmission rate, and we suspect that inadequate management and follow-up contribute to this high readmission rate...
2018: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29790656/clinical-characteristics-and-validation-of-bronchiectasis-severity-score-systems-for-post-tuberculosis-bronchiectasis
#6
Hong Wang, Xiao-Bin Ji, Cheng-Wei Li, Hai-Wen Lu, Bei Mao, Shuo Liang, Ke-Bin Cheng, Jiu-Wu Bai, Miguel Angel Martinez-Garcia, Jin-Fu Xu
INTRODUCTION: Lung damage related to tuberculosis is a major contributor to the etiology of bronchiectasis in China. It is unknown whether bronchiectasis severity score systems are applicable in these cases. OBJECTIVES: To evaluate the clinical characteristics and validation of bronchiectasis severity score systems for post-tuberculosis bronchiectasis. METHODS: The study enrolled 596 bronchiectasis patients in Shanghai Pulmonary Hospital between January 2011 and December 2012...
May 23, 2018: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/29783911/can-predictive-modeling-identify-head-and-neck-oncology-patients-at-risk-for-readmission
#7
Amy M Manning, Keith A Casper, Kay St Peter, Keith M Wilson, Jonathan R Mark, Ryan M Collar
Objective Unplanned readmission within 30 days is a contributor to health care costs in the United States. The use of predictive modeling during hospitalization to identify patients at risk for readmission offers a novel approach to quality improvement and cost reduction. Study Design Two-phase study including retrospective analysis of prospectively collected data followed by prospective longitudinal study. Setting Tertiary academic medical center. Subjects and Methods Prospectively collected data for patients undergoing surgical treatment for head and neck cancer from January 2013 to January 2015 were used to build predictive models for readmission within 30 days of discharge using logistic regression, classification and regression tree (CART) analysis, and random forests...
May 1, 2018: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29779783/readmission-to-the-intensive-care-unit-following-cardiac-surgery-a-derived-and-validated-risk-prediction-model-in-4-869-patients
#8
Rebekah Thomson, Nick Fletcher, Oswaldo Valencia, Vivek Sharma
OBJECTIVE: To derive and validate a clinical risk index that can predict readmission to the intensive care unit (ICU) after cardiac surgery. DESIGN: Retrospective nonrandomized study to determine the perioperative variables associated with risk of readmission to the ICU after cardiac surgery. SETTING: The study was carried out in a single university hospital. PARTICIPANTS: This was an analysis of 4,869 consecutive adult patients...
April 18, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29731294/derivation-and-validation-of-a-predictive-model-for-the-readmission-of-patients-with-diabetes-mellitus-treated-in-internal-medicine-departments
#9
J Ena, R Gómez-Huelgas, B C Gracia-Tello, P Vázquez-Rodríguez, J N Alcalá-Pedrajas, F J Carrasco-Sánchez, B Murcia-Casas, M Romero-Sánchez, J V Segura-Heras, J Carretero
OBJECTIVES: We developed a predictive model for the hospital readmission of patients with diabetes. The objective was to identify the frail population that requires additional strategies to prevent readmissions at 90 days. METHODS: Using data collected from 1977 patients in 3 studies on the national prevalence of diabetes (2015-2017), we developed and validated a predictive model of readmission at 90 days for patients with diabetes. RESULTS: A total of 704 (36%) readmissions were recorded...
May 4, 2018: Revista Clínica Española
https://www.readbyqxmd.com/read/29670391/determining-30-day-readmission-risk-for-heart-failure-patients-the-readmission-after-heart-failure-scale
#10
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
#11
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
#12
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
#13
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
#14
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...
April 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
#15
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
#16
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
#17
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
#18
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...
April 2018: Surgery
https://www.readbyqxmd.com/read/29357864/clinicians-can-independently-predict-30-day-hospital-readmissions-as-well-as-the-lace-index
#19
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
#20
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
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