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Surgical care quality

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https://www.readbyqxmd.com/read/28227227/multi-task-transfer-learning-for-in-hospital-death-prediction-of-icu-patients
#1
Chandan Karmakar, Budhaditya Saha, Marimuthu Palaniswami, Svetha Venkatesh, Chandan Karmakar, Budhaditya Saha, Marimuthu Palaniswami, Svetha Venkatesh, Budhaditya Saha, Marimuthu Palaniswami, Svetha Venkatesh, Chandan Karmakar
Multi-Task Transfer Learning (MTTL) is an efficient approach for learning from inter-related tasks with small sample size and imbalanced class distribution. Since the intensive care unit (ICU) data set (publicly available in Physionet) has subjects from four different ICU types, we hypothesize that there is an underlying relatedness amongst various ICU types. Therefore, this study aims to explore MTTL model for in-hospital mortality prediction of ICU patients. We used single-task learning (STL) approach on the augmented data as well as individual ICU data and compared the performance with the proposed MTTL model...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28225742/review-of-military-and-civilian-trauma-registries-does-consensus-matter
#2
Thijs T C F van Dongen, Johan de Graaf, Eelco P Huizinga, Howard R Champion, Rigo Hoencamp, Luke P H Leenen
BACKGROUND: Structural collection of data from combat injuries is important to improve provided care and the outcome of (combat) casualties. Trauma registries are used in civilian and military health care systems for systematic administration of injury data. However, these registries often use different methods of data management, compromising international comparison of trauma systems. The aim of this review is to aid in reaching international (coalition-wide) consensus for compatible data collection methods with uniform definitions, which is needed for transnational research and subsequent improvement of medical support organizations...
March 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28224191/predicting-the-post-operative-length-of-stay-for-the-orthopaedic-trauma-patient
#3
Deepak Chona, Nikita Lakomkin, Catherine Bulka, Idine Mousavi, Parth Kothari, Ashley C Dodd, Michelle S Shen, William T Obremskey, Manish K Sethi
PURPOSE: Length of stay (LOS) is a major driver of cost and quality of care. A bundled payment system makes it essential for orthopaedic surgeons to understand factors that increase a patient's LOS. Yet, minimal data regarding predictors of LOS currently exist. Using the ACS-NSQIP database, this is the first study to identify risk factors for increased LOS for orthopaedic trauma patients and create a personalized LOS calculator. METHODS: All orthopaedic trauma surgery between 2006 and 2013 were identified from the ACS-NSQIP database using CPT codes...
February 21, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28222811/recurring-septic-shock-in-a-patient-with-blunt-abdominal-and-pelvic-trauma-how-mandatory-is-source-control-surgery-a-case-report
#4
Antonella Frattari, Giustino Parruti, Rocco Erasmo, Luigi Guerra, Ennio Polilli, Rosamaria Zocaro, Giuliano Iervese, Paolo Fazii, Tullio Spina
BACKGROUND: In critically ill patients with colonization/infection of multidrug-resistant organisms, source control surgery is one of the major determinants of clinical success. In more complex cases, the use of different tools for sepsis management may allow survival until complete source control. CASE PRESENTATION: A 42-year-old white man presented with traumatic hemorrhagic shock. Unstable pelvic fractures led to emergency stabilization surgery. Fever ensued with diarrhea, followed by septic shock...
February 22, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28221246/predictors-of-hospital-readmissions-for-ulcerative-colitis-in-the-united-states-a-national-database-study
#5
Priti Poojary, Aparna Saha, Kinsuk Chauhan, Priya Simoes, Bruce E Sands, Judy Cho, Thomas Ullman, Girish Nadkarni, Ryan Ungaro
BACKGROUND: Early readmissions are important indicators of quality of care. Limited data exist describing hospital readmissions in ulcerative colitis (UC). The aim of this study was to describe unplanned, 30-day readmissions among adult UC patients and to assess readmission predictors. METHODS: We analyzed the 2013 United States National Readmission Database and identified UC admissions using administrative codes in patients from 18 to 80 years of age. Our primary outcome was a 30-day, unplanned readmission rate...
March 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28220218/-erratum-to-quality-of-dying-processes-after-commencement-of-the-german-living-will-act-experiences-of-a%C3%A2-surgical-intensive-care-unit
#6
S Strauss, D Kuppinger, W H Hartl
No abstract text is available yet for this article.
February 20, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28219677/nsqip-based-quality-improvement-curriculum-for-surgical-residents
#7
Mary M Mrdutt, Claire L Isbell, Justin L Regner, Bonnie R Hodges, Yolanda Munoz Maldonado, J Scott Thomas, Harry T Papaconstantinou
BACKGROUND: General surgery training has historically lacked a standardized approach to resident Quality Improvement (QI) education aside from traditional Morbidity and Mortality conference. In 2013, the Accreditation Council for Graduate Medical Education (ACGME) formalized QI as a component of residency training. Our residency chose the National Surgical Quality Improvement Program (NSQIP) Quality In-Training Initiative (QITI) as the foundation for our QI training. We hypothesized that a focused curriculum based on outcomes would produce change in culture and improve quality of patient care...
February 17, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28218772/diagnosis-and-management-of-abdominal-wall-endometriosis-a-systematic-review-and-clinical-recommendations
#8
Noah B Rindos, Suketu Mansuria
Importance: Abdominal wall endometriosis (AWE) is a rare but easily treated cause of pain in women, especially those who have undergone cesarean deliveries. Objective: This article reviews the diagnosis and management of AWE, a condition that generally develops after surgery but may arise spontaneously. We present a systematic review of the existing literature on AWE, as well as our clinical recommendations for medical and surgical management. Evidence Acquisition: We searched PubMed and other databases using the search criteria "abdominal wall endometriosis," "abdominal wall endometriomas," and "abdominal wall mass...
February 2017: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/28217260/robotic-liver-surgery-is-the-optimal-approach-as-bridge-to-transplantation
#9
Paolo Magistri, Giuseppe Tarantino, Roberto Ballarin, Andrea Coratti, Fabrizio Di Benedetto
The role of minimally invasive liver surgery as a bridge to transplantation is very promising but still underestimated. However, it should be noted that surgical approach for hepatocellular carcinomas (HCC) is not merely a technical or technological issue. Nowadays, the epidemiology of HCC is evolving due to the increasing role of non-alcoholic fatty-liver-disease, and the emerging concerns on direct-acting antivirals against hepatitis C virus in terms of HCC incidence. Therefore, a fully multidisciplinary study of the cirrhotic patient is currently more important than ever before, and the management of those patients should be reserved to tertiary referral hepatobiliary centers...
February 8, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28216945/ex-vivo-partial-nephrectomy-after-living-donor-nephrectomy-surgical-technique-for-expanding-kidney-donor-pool
#10
Yaw A Nyame, Paurush Babbar, Ahmed A Aboumohamed, Ryan L Mori, Stuart M Flechner, Charles S Modlin
Renal transplantation has profound improvements in mortality, morbidity, and overall quality of life compared to renal replacement therapy. This report aims to illustrate the use of ex-vivo partial nephrectomy in a patient with a renal angiomyolipoma prior to living donor transplantation. The surgical outcomes of the donor nephrectomy and recipient transplantation are reported with 2 years of follow-up. Both the donor and recipient are healthy and without any significant comorbidities. In conclusion, urologic techniques such as partial nephrectomy can be used to expand the living donor pool in carefully selected and well informed transplant recipients...
January 2017: Urology Annals
https://www.readbyqxmd.com/read/28216809/healing-ulcers-and-preventing-their-recurrences-in-the-diabetic-foot
#11
S Raja Sabapathy, Madhu Periasamy
Fifteen percent of people with diabetes develop an ulcer in the course of their lifetime. Eighty-five percent of the major amputations in diabetes mellitus are preceded by an ulcer. Management of ulcers and preventing their recurrence is important for the quality of life of the individual and reducing the cost of care of treatment. The main causative factors of ulceration are neuropathy, vasculopathy and limited joint mobility. Altered bio-mechanics due to the deformities secondary to neuropathy and limited joint mobility leads to focal points of increased pressure, which compromises circulation leading to ulcers...
September 2016: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
https://www.readbyqxmd.com/read/28216749/percutaneous-endoscopic-lumbar-discectomy-results-of-first-100-cases
#12
Kanthila Mahesha
BACKGROUND: Lumbar disc herniation is a major cause of back pain and sciatica. The surgical management of lumbar disc prolapse has evolved from exploratory laminectomy to percutaneous endoscopic discectomy. Percutaneous endoscopic discectomy is the least invasive procedure for lumbar disc prolapse. The aim of this study was to analyze the clinical outcome, quality of life, neurologic function, and complications. MATERIALS AND METHODS: One hundred patients with lumbar disc prolapse who were treated with percutaneous endoscopic discectomy from May 2012 to January 2014 were included in this retrospective study...
January 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28216701/impact-of-modified-quality-control-checklist-on-protocol-adherence-and-outcomes-in-a-post-surgical-intensive-care-unit
#13
Lakshmi Kumar, Meenu Dominic, Sunil Rajan, Sanjeev Singh
BACKGROUND AND AIMS: Quality improvement (QI) is the sum of all activities that create desired changes in the quality. An effective QI system results in a stepwise increase in quality of care. The efficiency of any health-care unit is judged by its quality indicators. We aimed to evaluate the impact of QI initiatives on outcomes in a surgical Intensive Care Unit (ICU). METHODS: This was an observational study carried out using a compliance checklist, developed from the combination of the World Health Organization surgery checklist and Society for Healthcare Epidemiology of America guidelines for the prevention of infections...
January 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28215062/left-atrial-appendage-occlusion-for-stroke-prevention-in-patients-with-atrial-fibrillation-a-systematic-review-and-network-meta-analysis-of-randomized-controlled-trials
#14
Hasib Hanif, Emilie P Belley-Cote, Abdullah Alotaibi, Nazari Dvirnik, Binod Neupane, Joseph Beyene, John W Eikelboom, David Holmes, Richard P Whitlock
INTRODUCTION: Atrial fibrillation (AF) is one of the leading causes of stroke. Risks associated with oral anticoagulation limit adherence to recommended therapy. Left atrial appendage (LAA) occlusion is a treatment alternative in patients with AF. We performed a network meta-analysis (NMA) of randomized trials evaluating the efficacy of LAA occlusion compared with oral anticoagulant, antiplatelet, and placebo for stroke prevention. We also assessed the impact of LAA occlusion on mortality, major bleeding, and operative time...
February 17, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28215048/unmet-home-healthcare-needs-and-quality-of-life-in-cancer-patients-a%C3%A2-hospital-based-turkish-sample
#15
Gülsen Ataman, Tugrul Erbaydar
Home healthcare services in Turkey are provided primarily to patients that are bedridden or seriously disabled. There are no such services integrated with hospital services that are specifically designed for cancer patients. The present study aimed to explore the home healthcare needs of cancer patients and their experiences related to unmet home healthcare needs. The study included 394 adult cancer patients who were followed up at the surgical oncology department of a university hospital. A 37-item, study-specific questionnaire and the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire for cancer patients (EORTC-QLQ-C30) were administered, and patient clinical records were evaluated...
February 19, 2017: Health & Social Care in the Community
https://www.readbyqxmd.com/read/28214369/diagnostic-accuracy-of-history-physical-exam-laboratory-tests-and-point-of-care-ultrasound-for-pediatric-acute-appendicitis-in-the-emergency-department-a-systematic-review-and-meta-analysis
#16
Roshanak Benabbas, Mark Hanna, Jay Shah, Richard Sinert
BACKGROUND: Acute appendicitis (AA) is the most common surgical emergency in children. Accurate and timely diagnosis is crucial but challenging due to atypical presentations and the inherent difficulty of obtaining a reliable history and physical examination in younger children. OBJECTIVES: To determine the utility of history, physical exam, laboratory tests, Pediatric Appendicitis Score (PAS) and Emergency Department-Point-of-Care Ultrasound (ED-POCUS) in the diagnosis of AA in ED pediatric patients...
February 18, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28213046/splenectomy-as-a-destination-improving-quality-of-care-among-asplenic-veterans-through-a-travel-clinic
#17
Aaron P Mitchell, Joel C Boggan, Karen Lau, David L Simel
BACKGROUND: Asplenic patients are at risk for severe infections, but adherence to recommended preventive education and vaccination is poor. The goal of this study was to demonstrate that a targeted intervention can improve vaccination rates in a population of asplenic veterans. METHODS: Surgically asplenic patients actively receiving care in our health care system were identified via a database search. Patients were contacted via mailed letters and encouraged to attend an existing travel clinic with a new process designed for asplenic patients...
February 14, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28212974/costs-and-outcomes-of-increasing-access-to-bariatric-surgery-cohort-study-and-cost-effectiveness-analysis-using-electronic-health-records
#18
Martin C Gulliford, Judith Charlton, Toby Prevost, Helen Booth, Alison Fildes, Mark Ashworth, Peter Littlejohns, Marcus Reddy, Omar Khan, Caroline Rudisill
OBJECTIVES: To estimate costs and outcomes of increasing access to bariatric surgery in obese adults and in population subgroups of age, sex, deprivation, comorbidity, and obesity category. METHODS: A cohort study was conducted using primary care electronic health records, with linked hospital utilization data, for 3,045 participants who underwent bariatric surgery and 247,537 participants who did not undergo bariatric surgery. Epidemiological analyses informed a probabilistic Markov model to compare bariatric surgery, including equal proportions with adjustable gastric banding, gastric bypass, and sleeve gastrectomy, with standard nonsurgical management of obesity...
January 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28210964/exploring-partners-experiences-in-living-with-patients-who-undergo-bariatric-surgery
#19
Anna Wallwork, Lynn Tremblay, Monica Chi, Sanjeev Sockalingam
BACKGROUND: Bariatric surgery is effective in assisting persons with severe obesity in achieving significant weight loss and improved health; however, success depends on one's lifelong commitment to lifestyle modifications post-operatively. Life partners can be essential to the success of bariatric patients as they can serve as a primary resource to patients and healthcare teams. This study aimed to explore bariatric patients' partner's experiences in order to help inform clinical practice in bariatric care to better address patient and partner needs...
February 16, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28209451/assessment-of-operating-room-airflow-using-air-particle-counts-and-direct-observation-of-door-openings
#20
Jonathan Teter, Isabella Guajardo, Tamrah Al-Rammah, Gedge Rosson, Trish M Perl, Michele Manahan
BACKGROUND: The role of the operating room (OR) environment has been thought to contribute to surgical site infection rates. The quality of OR air, disruption of airflow, and other factors may increase contamination risks. We measured air particulate counts (APCs) to determine if they increased in relation to traffic, door opening, and other common activities. METHODS: During 1 week, we recorded APCs in 5-minute intervals and movement of health care workers. Trained observers recorded information about traffic, door openings, job title of the opener, and the reason for opening...
February 13, 2017: American Journal of Infection Control
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