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Surgical care quality

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https://www.readbyqxmd.com/read/28431844/health-care-associated-infections-studies-project-an-american-journal-of-infection-control-and-national-healthcare-safety-network-data-quality-collaboration
#1
Henrietta Smith, Janet E Brooks, Denise Leaptrot, Katherine Allen-Bridson, Angela Anttila, Cindy Gross, Joan N Hebden, Georganne Ryan, Eileen Scalise, Marc-Oliver Wright
This case study is part of a series centered on the Centers for Disease Control and Prevention's National Healthcare Safety Network's (NHSN) health care-associated infection (HAI) surveillance definitions. The intent of the case study series is to foster standardized application of the NHSN's HAI surveillance definitions among infection preventionists and accurate determination of HAI events. This specific case study focuses on the definitions found within the surgical site infection (SSI) protocol. It aims to reflect the real life and complex patient scenario surrounding a bloodstream infection that is secondary to an SSI and the application of the Present at the Time of Surgery event detail...
April 18, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28430791/the-medically-managed-patient-with-severe-symptomatic-aortic-stenosis-in-the-tavr-era-patient-characteristics-reasons-for-medical-management-and-quality-of-shared-decision-making-at-heart-valve-treatment-centers
#2
Kumar Dharmarajan, Jill Foster, Megan Coylewright, Philip Green, John P Vavalle, Osman Faheem, Pei-Hsiu Huang, Amar Krishnaswamy, Vinod H Thourani, Lisa A McCoy, Tracy Y Wang
BACKGROUND: Little is known about patients with severe symptomatic aortic stenosis (AS) who receive medical management despite evaluation at a heart valve treatment center. OBJECTIVE: We identified patient characteristics associated with medical management, physician-reported reasons for selecting medical management, and patients' perceptions of their involvement and satisfaction with treatment selection. METHODS AND RESULTS: Of 454 patients evaluated for AS at 9 established heart valve treatment centers from December 12, 2013 to August 19, 2014, we included 407 with severe symptomatic AS...
2017: PloS One
https://www.readbyqxmd.com/read/28429473/surgery-for-limited-stage-small-cell-lung-cancer
#3
REVIEW
Hayley Barnes, Katharine See, Stephen Barnett, Renée Manser
BACKGROUND: Current treatment guidelines for limited-stage small-cell lung cancer (SCLC) recommend concomitant platinum-based chemo-radiotherapy plus prophylactic cranial irradiation, based on the premise that SCLC disseminates early, and is chemosensitive. However, although there is usually a favourable initial response, relapse is common and the cure rate for limited-stage SCLC remains relatively poor. Some recent clinical practice guidelines have recommended surgery for stage 1 (limited) SCLC followed by adjuvant chemotherapy, but this recommendation is largely based on the findings of observational studies...
April 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28424131/postoperative-complications-predict-30-day-readmission-in-geriatric-general-surgery-patients
#4
James D Dieterich, Celia M Divino
The Affordable Care Act has placed unplanned patient readmissions under more scrutiny than ever. Geriatric patients, in particular, suffer a disproportionate amount of complications from any kind of hospitalization, including readmissions. This study seeks to identify risk factors in this population that predispose them to an unplanned readmission within 30 days after index surgery. The National Surgical Quality Improvement Program database was used to select patients 65 years and older, who underwent general surgery procedures in 2012...
April 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28424055/how-participation-in-surgical-mortality-audit-impacts-surgical-practice
#5
Chi-Wai Lui, Frances M Boyle, Arkadiusz Peter Wysocki, Peter Baker, Alisha D'Souza, Sonya Faint, Therese Rey-Conde, John B North
BACKGROUND: Surgical mortality audit is an important tool for quality assurance and professional development but little is known about the impact of such activity on professional practice at the individual surgeon level. This paper reports the findings of a survey conducted with a self-selected cohort of surgeons in Queensland, Australia, on their experience of participating in the audit and its impact on their professional practice, as well as implications for hospital systems. METHODS: The study used a descriptive cross-sectional survey design...
April 19, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28423044/the-long-term-outcome-of-micturition-defecation-and-sexual-function-after-spinal-surgery-for-cauda-equina-syndrome
#6
Nina S Korse, Anna B Veldman, Wilco C Peul, Carmen L A Vleggeert-Lankamp
BACKGROUND: Cauda equina syndrome (CES) is a rare neurologic complication of lumbar herniated disc for which emergency surgical decompression should be undertaken. Despite the common belief that the restoration of functions that are affected by CES can take several years postoperatively, follow up seldom exceeds the first year after surgery. Long term outcome of especially micturition, defecation and sexual function-which are by definition affected in CES-are unknown. The aim of this study is to evaluate 1) postoperative long term outcome of micturition, defecation and sexual function in CES patients 2) attitude of patients towards received hospital care with regard to (recovery of) these functions...
2017: PloS One
https://www.readbyqxmd.com/read/28422908/the-emergency-surgery-score-ess-accurately-predicts-the-occurrence-of-postoperative-complications-in-emergency-surgery-patients
#7
Anirudh R Nandan, Jordan D Bohnen, Naveen F Sangji, Thomas Peponis, Kelsey Han, D Dante Yeh, Jarone Lee, Noelle Saillant, Marc De Moya, George C Velmahos, David C Chang, Haytham M A Kaafarani
BACKGROUND: The Emergency Surgery Score (ESS) was recently validated as a scoring system to predict mortality in emergency surgery (ES) patients. We sought to examine the ability of ESS to predict the occurrence of 30-day postoperative complications in ES. METHODS: The 2011-2012 American College of Surgeons National Surgical Quality.Improvement Program (ACS-NSQIP) database was screened for all surgical operations classified as "emergent". Thirty-day postoperative complications were defined as per ACS-NSQIP (e...
April 18, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28422882/hospital-mortality-after-hip-fracture-surgery-in-relation-to-length-of-stay-by-care-delivery-factors-a-database-study
#8
Boris Sobolev, Pierre Guy, Katie J Sheehan, Eric Bohm, Lauren Beaupre, Suzanne N Morin, Jason M Sutherland, Michael Dunbar, Donald Griesdale, Susan Jaglal, Lisa Kuramoto
Two hypotheses were offered for the effect of shorter hospital stays on mortality after hip fracture surgery: worsening the quality of care and shifting death occurrence to postacute settings.We tested whether the risk of hospital death after hip fracture surgery differed across years when postoperative stays shortened, and whether care factors moderated the association.Analysis of acute hospital discharge abstracts for subgroups defined by hospital type, bed capacity, surgical volume, and admission time.153,917 patients 65 years or older surgically treated for first hip fracture...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28422849/temporal-trends-in-centralization-and-racial-disparities-in-utilization-of-high-volume-hospitals-for-lung-cancer-surgery
#9
Wil Lieberman-Cribbin, Bian Liu, Emanuele Leoncini, Raja Flores, Emanuela Taioli
Racial disparities have been suggested in hospital utilization and outcome for lung cancer surgery, but the effect of hospital centralization on closing this gap is unknown. We hypothesized that centralization has increased the utilization of high- or very-high-volume (HV/VHV) hospitals, a proxy for access to high-quality care, over the study period independently from race.Inpatient records were extracted from the New York Statewide Planning and Research Cooperative System database (1995-2012) according to Clinical Modification of the International Classification of Diseases, 9th Revision diagnosis codes 162...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28422775/a-contemporary-assessment-of-acute-mechanical-ventilation-in-beijing-description-costs-and-outcomes
#10
Yanping Ye, Bo Zhu, Li Jiang, Qi Jiang, Meiping Wang, Lin Hua, Xiuming Xi
OBJECTIVE: To evaluate the contemporary practice, outcomes, and costs related to mechanical ventilation among ICUs in China. DESIGN: A prospective observational cohort study. SETTING: Fourteen ICUs among 13 hospitals in Beijing, China. PATIENTS: Seven hundred ninety-three patients who received at least 24 hours of mechanical ventilation within the first 48 hours of ICU stay. INTERVENTION: None...
April 18, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28422699/hemorrhage-prediction-models-in-surgical-intensive-care-bedside-monitoring-data-adds-information-to-lab-values
#11
Marco De Pasquale, Travis Moss, Sergio Cerutti, James Calland, Douglas Lake, Randall Moorman, Manuela Ferrario
Hemorrhage is a frequent complication in surgery patients; its identification and management have received increasing attention as a target for quality improvement in patient care in the Intensive Care Unit (ICU). The purposes of this work were i) to find an early detection model for hemorrhage by exploring the range of data mining methods that are currently available, and ii) to compare prediction models utilizing continuously measured physiological data from bedside monitors to those using commonly obtained laboratory tests...
April 12, 2017: IEEE Journal of Biomedical and Health Informatics
https://www.readbyqxmd.com/read/28421875/three-dimensional-printing-and-its-applications-in-otorhinolaryngology-head-and-neck-surgery
#12
Trevor D Crafts, Susan E Ellsperman, Todd J Wannemuehler, Travis D Bellicchi, Taha Z Shipchandler, Avinash V Mantravadi
Objective Three-dimensional (3D)-printing technology is being employed in a variety of medical and surgical specialties to improve patient care and advance resident physician training. As the costs of implementing 3D printing have declined, the use of this technology has expanded, especially within surgical specialties. This article explores the types of 3D printing available, highlights the benefits and drawbacks of each methodology, provides examples of how 3D printing has been applied within the field of otolaryngology-head and neck surgery, discusses future innovations, and explores the financial impact of these advances...
November 1, 2016: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28421672/a-transplant-specific-quality-initiative-introducing-transqip-a-joint-effort-of-the-asts-and-acs
#13
Justin Parekh, Clifford Ko, Jacqueline Lappin, Stuart Greenstein, Ryutaro Hirose
In an attempt to improve surgical quality in the field of transplantation, the American College of Surgeons (ACS) and American Society and Transplant Surgeons have initiated a national quality improvement program in transplantation. This transplant specific quality improvement program, called TransQIP, has been built from the ground up by transplant surgeons and captures detailed information on donor and recipient factors as well as transplant specific outcomes. It is built upon the existing ACS/NSQIP infrastructure and is designed to capture 100% of liver and kidney transplants performed at participating sites...
April 19, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28420664/the-uk-cardiac-and-vascular-surgery-interventional-anaemia-response-caviar-study-protocol-for-an-observational-cohort-study-to-determine-the-impact-and-effect-of-preoperative-anaemia-management-in-cardiac-and-vascular-surgical-patients
#14
Marisa Chau, Toby Richards, Caroline Evans, Anna Butcher, Timothy Collier, Andrew Klein
INTRODUCTION: Preoperative anaemia is linked to poor postsurgical outcome, longer hospital stays, greater risk of complications and mortality. Currently in the UK, some sites have developed anaemia clinics or pathways that use intravenous iron to correct iron deficiency anaemia prior to surgery as their standard of care. Although intravenous iron has been observed to be effective in a variety of patient settings, there is insufficient evidence in its use in cardiac and vascular patients...
April 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28419879/challenging-the-myth-of-right-non-dominant-hemisphere-lessons-from-cortico-subcortical-stimulation-mapping-in-awake-surgery-and-surgical-implications
#15
REVIEW
Tatiana Vilasboas, Guillaume Herbet, Hugues Duffau
For a long time, the right hemisphere (RH) was considered as "non-dominant", especially in right-handers. In neurosurgical practice, this dogma resulted in the selection of awake procedure with language mapping only for lesions of the left "dominant" hemisphere. Conversely, surgery under general anesthesia (possibly with motor mapping) was usually proposed for right lesions. However, when objective neuropsychological assessments were performed, they frequently revealed cognitive and behavioral deficits following brain surgery, even in the RH...
April 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28419036/emerging-u-s-national-trends-in-the-treatment-of-pediatric-supracondylar-humeral-fractures
#16
Joshua B Holt, Natalie A Glass, Nicholas A Bedard, Stuart L Weinstein, Apurva S Shah
BACKGROUND: Understanding national trends in the treatment of pediatric supracondylar humeral fractures will provide important insight into variations in regional treatment and identify areas for improving value and quality in care delivery in the U.S. METHODS: U.S. national trends in the treatment of supracondylar humeral fractures were evaluated through query of the Humana (2007 to 2014) and ING (2007 to 2011) administrative claims databases. Geographic variation and changes in surgical and transfer rates over time were further explored through the Nationwide Emergency Department Sample (NEDS) database (2006 to 2011)...
April 19, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28416413/evaluation-of-the-physiotel%C3%A2-digital-m11-cardiovascular-telemetry-implant-in-socially-housed-cynomolgus-monkeys-up-to-16weeks-after-surgery
#17
Ninette K Andersen, Olivier Meyer, Alys Bradley, Nils Dragsted, Anders B Lassen, Ingrid Sjögren, Julie M Larsen, Warren Harvey, Rastislav Bator, Aileen Milne
INTRODUCTION: The novel PhysioTel™ Digital M11 telemetry implant was evaluated in socially housed monkeys with respect to both safety pharmacological cardiovascular (arterial blood pressure (BP), heart rate (HR) and electrocardiogram (ECG)) and toxicological (clinical pathology and histopathology) endpoints. METHODS: Telemetry and clinical pathology data were obtained repeatedly up to 16weeks after surgery in four female cynomolgus monkeys, followed by necropsy...
April 14, 2017: Journal of Pharmacological and Toxicological Methods
https://www.readbyqxmd.com/read/28415025/unusual-combination-of-femoral-head-dislocation-associated-acetabular-fracture-with-multipart-femoral-fractures-case-report
#18
Erdal Uzun, Ali Eray Günay, İbrahim Karaman
INTRODUCTION: Traumatic hip dislocation associated with femur intertrocanteric fracture is a rare and severe injury and it frequently occurs following a high energy trauma, Associated acetabular fractures with this injury are even more rare and potentially cause devastating consequences including avascular necrosis of the femoral head and subsequent early secondary osteoarthritis of the hip joint. PRESENTATION OF CASE: In this case report, we present a 20year old polytraumatized patient with traumatic hip dislocation associated with ipsilateral acetabulum fracture and simultaneous fractures of the ipsilateral femur...
February 27, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28413718/best-practices-for-medication-utilization-evaluations-in-postsurgical-pain-management
#19
REVIEW
Brian Faley, John Fanikos
PURPOSE: The purpose of this review is to provide guidance that aids in the practical design, implementation, and analysis of medication use evaluations (MUEs) for postsurgical pain management. SUMMARY: Clinicians have long employed drug use evaluations or drug utilization reviews to ensure the safe and appropriate use of medications in a hospital, medical practice, or other healthcare setting. Although these approaches are valuable, there is a growing trend toward replacing these methods with the MUE, a performance improvement tool that focuses on assessing and improving medication use processes or medication treatment response with the goal of optimizing patient outcomes...
2017: Current Emergency and Hospital Medicine Reports
https://www.readbyqxmd.com/read/28413303/role-of-interferential-therapy-in-children-with-fecal-incontinence-postanorectal-malformation-surgeries
#20
Prince Raj, Yogesh Kumar Sarin, Prachi Raj
BACKGROUND: Anorectal malformation (ARM) is one of the most common pediatric surgical problems dealt in day-to-day practice. Although the outcome of surgery has improved a great deal over the last three decades fecal incontinence (FI) is still a common long-term morbidity that affects the quality of life of these patients. Bowel wash (BW) program with pelvic floor exercise are standard care of management for these patients. This study was undertaken to assess the role of interferential therapy (IFT) along with BW compared to BW alone in the management of FI...
April 2017: Journal of Indian Association of Pediatric Surgeons
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