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Ariadni Aravani, Elizabeth F Samy, James D Thomas, Phil Quirke, Eva J A Morris, Paul J Finan
The National Health Service (NHS) is facing financial constraints and thus there is considerable interest in ensuring the shortest but optimal hospital stays possible. The aim of this study was to investigate patterns of postoperative length of stay (LOS) stay across the English NHS and to identify factors that significantly influence both optimal and prolonged LOS.Data were obtained from the National Cancer Data Repository (NCDR). National patterns of LOS were examined and multilevel mixed effects logistic regression was used to study factors associated with an "ideal" (≤5 days) or a prolonged (≥21 days) LOS in hospital after major resection...
November 2016: Medicine (Baltimore)
Kipp Slicker, Wesley G Lane, Ola O Oyetayo, Laurel A Copeland, Eileen M Stock, Jeffrey B Michel, John P Erwin
BACKGROUND: Over 1,000,000 cardiac catheterizations (CC) are performed annually in the United States. There is a small risk of complication that has persisted despite advances in technology. It is unknown whether daily CC procedural volume can influence this risk. In an effort to improve outcomes at our academic medical center, we investigated the relationship between daily CC volume and complication rates. METHODS: We obtained data from both the National Cardiovascular Data Registry (NCDR) Cath-PCI and Lumedx© databases reviewing the records of patients undergoing scheduled, non-emergent CC at our facility between January 2005 to June 2013...
October 2016: Cardiovascular Diagnosis and Therapy
G Hoarau, P K Mukherjee, C Gower-Rousseau, C Hager, J Chandra, M A Retuerto, C Neut, S Vermeire, J Clemente, J F Colombel, H Fujioka, D Poulain, B Sendid, M A Ghannoum
UNLABELLED: Crohn's disease (CD) results from a complex interplay between host genetic factors and endogenous microbial communities. In the current study, we used Ion Torrent sequencing to characterize the gut bacterial microbiota (bacteriome) and fungal community (mycobiome) in patients with CD and their nondiseased first-degree relatives (NCDR) in 9 familial clusters living in northern France-Belgium and in healthy individuals from 4 families living in the same area (non-CD unrelated [NCDU])...
September 20, 2016: MBio
Apurva A Motivala, Valay Parikh, Matthew Roe, David Dai, J Dawn Abbott, Abhiram Prasad, Debabrata Mukherjee
OBJECTIVES: This study sought to examine predictors, trends, and outcomes associated with β-blocker prescriptions at discharge in patients with stable angina without prior history of myocardial infarction (MI) or systolic heart failure (HF) undergoing elective percutaneous coronary intervention (PCI). BACKGROUND: The benefits of β-blockers in patients with MI and/or systolic HF are well established. However, whether β-blockers affect outcomes in patients with stable angina, especially after PCI, remains uncertain...
August 22, 2016: JACC. Cardiovascular Interventions
Michael J Lipinski, Lowell F Satler
The incidence of contrast-induced nephropathy is high at approximately 10% following peripheral angiography and intervention. The same measures taken to protect against contrast-induced nephropathy and acute kidney injury for coronary angiography and intervention should be applied for peripheral angiography and intervention. Greater or mandatory reporting to the Peripheral Vascular Intervention (PVI) Registry of the NCDR may not only better ascertain the true incidence of CIN in general practice, but to also provide benchmarks for institutions to improve patient outcomes...
August 2016: Catheterization and Cardiovascular Interventions
Herbert D Aronow, Kevin F Kennedy, Siddharth A Wayangankar, Barry T Katzen, Peter A Schneider, Alex Abou-Chebl, Kenneth A Rosenfield
BACKGROUND AND PURPOSE: Carotid artery revascularization was previously found to incrementally reduce stroke risk among patients with carotid stenosis treated with medical therapy. However, the frequency with which optimal medical therapies are used at discharge after carotid endarterectomy (CEA) and carotid artery stenting (CAS) is not known, and the influence of patient, operator, and hospital characteristics on the likelihood of prescription is poorly understood. METHODS: In a retrospective cohort study of 23 112 patients undergoing CAS or CEA between January 2007 and June 2012 at US hospitals participating in the CARE registry (Carotid Artery Revascularization and Endarterectomy), we examined antiplatelet therapy and statin utilization at discharge...
September 2016: Stroke; a Journal of Cerebral Circulation
D Edmund Anstey, Shuang Li, Laine Thomas, Tracy Y Wang, Stephen D Wiviott
BACKGROUND: Race and sex have been shown to affect management of myocardial infarction (MI); however, it is unclear if such disparities exist in contemporary care of ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI). HYPOTHESIS: Disparities in care will be less prevalent in more heavily protocol-driven management of STEMI than the less algorithmic care of NSTEMI. METHODS: Data were collected from the ACTION Registry-GWTG database to assess care differences related to race and sex of patients presenting with NSTEMI or STEMI...
July 28, 2016: Clinical Cardiology
Jonathan C Hsu, Thomas M Maddox, Kevin F Kennedy, David F Katz, Lucas N Marzec, Steven A Lubitz, Anil K Gehi, Mintu P Turakhia, Gregory M Marcus
IMPORTANCE: Patients with atrial fibrillation (AF) are at a proportionally higher risk of stroke based on accumulation of well-defined risk factors. OBJECTIVE: To examine the extent to which prescription of an oral anticoagulant (OAC) in US cardiology practices increases as the number of stroke risk factors increases. DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional registry study of outpatients with AF enrolled in the American College of Cardiology National Cardiovascular Data Registry's PINNACLE (Practice Innovation and Clinical Excellence) Registry between January 1, 2008, and December 30, 2012...
April 1, 2016: JAMA Cardiology
Emily P Zeitler, Yongfei Wang, Kumar Dharmarajan, Kevin J Anstrom, Eric D Peterson, James P Daubert, Jeptha P Curtis, Sana M Al-Khatib
BACKGROUND: Patients with an unused or malfunctioning implantable cardioverter-defibrillator (ICD) lead may have the lead either abandoned or explanted; yet there are limited data on the comparative acute and longer-term safety of these 2 approaches. METHODS AND RESULTS: We examined in-hospital events among 24 908 subject encounters using propensity score 1:1 matching for ICD lead abandonment or explantation in the National Cardiovascular Data Registry (NCDR) ICD Registry (April 2010 to June 2014)...
July 2016: Circulation. Arrhythmia and Electrophysiology
Ambarish Pandey, Darren K McGuire, James A de Lemos, Sandeep R Das, Jarett D Berry, Emmanouil S Brilakis, Subhash Banerjee, Steven P Marso, Gregory W Barsness, DaJuanicia N Simon, Matthew Roe, Abhinav Goyal, Mikhail Kosiborod, Ezra A Amsterdam, Dharam J Kumbhani
BACKGROUND: Current guidelines recommend surgical revascularization (coronary artery bypass graft [CABG]) over percutaneous coronary intervention (PCI) in patients with diabetes mellitus and multivessel coronary artery disease. Few data are available describing revascularization patterns among these patients in the setting of non-ST-segment-elevation myocardial infarction. METHODS AND RESULTS: Using Acute Coronary Treatment and Intervention Outcomes Network Registry-Get with the Guidelines (ACTION Registry-GWTG), we compared the in-hospital use of different revascularization strategies (PCI versus CABG versus no revascularization) in diabetes mellitus patients with non-ST-segment-elevation myocardial infarction who had angiography, demonstrating multivessel coronary artery disease between July 2008 and December 2014...
May 2016: Circulation. Cardiovascular Quality and Outcomes
Jessica J Jalbert, Louis L Nguyen, Marie D Gerhard-Herman, Hiraku Kumamaru, Chih-Ying Chen, Lauren A Williams, Jun Liu, Andrew T Rothman, Michael R Jaff, John D Seeger, James F Benenati, Peter A Schneider, Herbert D Aronow, Joseph A Johnston, Thomas G Brott, Thomas T Tsai, Christopher J White, Soko Setoguchi
BACKGROUND: Effectiveness of carotid artery stenting (CAS) relative to carotid endarterectomy (CEA) among Medicare patients has not been established. We compared effectiveness of CAS versus CEA among Medicare beneficiaries. METHODS AND RESULTS: We linked Medicare data (2000-2009) to the Society for Vascular Surgery's Vascular Registry (2005-2008) and the National Cardiovascular Data Registry's (NCDR) Carotid Artery Revascularization and Endarterectomy Registry (2006-2008/2009)...
May 2016: Circulation. Cardiovascular Quality and Outcomes
Taku Inohara, Shun Kohsaka, Hiroaki Miyata, Ikuko Ueda, Yuichiro Maekawa, Keiichi Fukuda, David J Cohen, Kevin F Kennedy, John S Rumsfeld, John A Spertus
BACKGROUND: Stratifying patient risk for acute kidney injury (AKI) prior to percutaneous coronary intervention (PCI) can enable clinicians to tailor their approach to minimize AKI. The National Cardiovascular Data Registry (NCDR) CathPCI Registry recently developed 2 prediction models: for AKI and AKI requiring dialysis (AKI-D). OBJECTIVES: This study sought to externally validate the NCDR AKI and AKI-D models in a Japanese population. Determining the generalizability of the U...
April 12, 2016: Journal of the American College of Cardiology
Daniel B Kramer, Matthew R Reynolds, Sharon-Lise Normand, Craig S Parzynski, John A Spertus, Vincent Mor, Susan L Mitchell
BACKGROUND: Older recipients of implantable cardioverter-defibrillators (ICDs) are at increased risk for short-term mortality in comparison with younger patients. Although hospice use is common among decedents aged >65, its use among older ICD recipients is unknown. METHODS AND RESULTS: Medicare patients aged >65 matched to data in the National Cardiovascular Data Registry - ICD Registry from January 1, 2006 to March 31, 2010 were eligible for analysis (N=194 969)...
May 24, 2016: Circulation
Matthew J Lewis, Kevin F Kennedy, Jonathan Ginns, Matthew A Crystal, Alejandro Torres, Julie Vincent, Marlon S Rosenbaum
BACKGROUND: Risk factors associated with outcomes for pulmonary artery (PA) stenting remain poorly defined. OBJECTIVES: The goal of this study was to determine the effect of patient and procedural characteristics on rates of adverse events and procedural success. METHODS: Registry data were collected, and 2 definitions of procedural success were pre-specified for patients with biventricular circulation: 1) 20% reduction in right ventricular pressure or 50% increase in PA diameter; and 2) 25% reduction in right ventricular pressure or 50% decrease in PA gradient or post-procedure ratio of in-stent minimum to pre-stent distal diameter >80%...
March 22, 2016: Journal of the American College of Cardiology
Harold L Dauerman
No abstract text is available yet for this article.
April 26, 2016: Circulation
Rajesh K Chudasama, S G Lakkad, Umed V Patel, Ankit Sheth, Dhara Thakkar, Matib Rangoonwala
BACKGROUND: National Leprosy Eradication Program (NLEP) was launched in 1983 with the goal of elimination of leprosy as a public health problem. AIM: To evaluate the NLEP performance after integration into general health system from April 2003 to March 2014. MATERIAL AND METHODS: A retrospective record based study was conducted by obtaining data from Rajkot district leprosy center. Prevalence rate (PR), new case detection rate (NCDR), proportion of female cases, child cases, multibacillary (MB) cases, Grade II disability among new cases and release from treatment (RFT) cases were evaluated from April 2003 to March 2014 and analyzed by using Chi-square for trend analysis test...
January 2016: Indian Journal of Dermatology
Haroldo José de Matos, David J Blok, Sake J de Vlas, Jan Hendrik Richardus
BACKGROUND: Leprosy remains a public health problem in Brazil. Although the overall number of new cases is declining, there are still areas with a high disease burden, such as Pará State in the north of the country. We aim to predict future trends in new case detection rate (NCDR) and explore the potential impact of contact tracing and chemoprophylaxis on NCDR in Pará State. METHODS: We used SIMCOLEP, an existing individual-based model for the transmission and control of M...
March 2016: PLoS Neglected Tropical Diseases
Rashmee U Shah, James A de Lemos, Tracy Y Wang, Anita Y Chen, Laine Thomas, Nadia R Sutton, James C Fang, Benjamin M Scirica, Timothy D Henry, Christopher B Granger
BACKGROUND: Many patients with acute myocardial infarction (AMI) and cardiogenic shock survive hospitalization; little is known about their subsequent prognosis. OBJECTIVES: This study sought to evaluate the associations between cardiogenic shock and post-discharge mortality and all-cause hospitalization among hospital survivors. METHODS: We included patients ≥65 years of age with AMI from the ACTION Registry-GWTG (Acute Coronary Treatment and Intervention Outcomes Network Registry-Get With The Guidelines) who survived hospitalization and linked these patients with Medicare claims data...
February 23, 2016: Journal of the American College of Cardiology
Tarun W Dasari, Steve Hamilton, Anita Y Chen, Tracy Y Wang, Eric D Peterson, James A de Lemos, Jorge F Saucedo
BACKGROUND: Reperfusion therapy is lifesaving in patients presenting with ST-segment elevation myocardial infarction (STEMI). Contemporary data describing the characteristics and outcomes of patients presenting with STEMI not receiving reperfusion therapy are lacking. METHODS: Using the ACTION Registry-GWTG database, we examined 219,726 STEMI patients (January 2007-December 2013) at 721 percutaneous coronary intervention (PCI)-capable hospitals in United States...
February 2016: American Heart Journal
Ana T Timóteo, André V Monteiro, Guilherme Portugal, Pedro Teixeira, Helena Aidos, Maria L Ferreira, Rui C Ferreira
INTRODUCTION: New scores have been developed and validated in the US for in-hospital mortality risk stratification in patients undergoing coronary angioplasty: the National Cardiovascular Data Registry (NCDR) risk score and the Mayo Clinic Risk Score (MCRS). We sought to validate these scores in a European population with acute coronary syndrome (ACS) and to compare their predictive accuracy with that of the GRACE risk score. METHODS: In a single-center ACS registry of patients undergoing coronary angioplasty, we used the area under the receiver operating characteristic curve (AUC), a graphical representation of observed vs...
February 2016: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
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