Machine Learning Accurately Predicts Short-Term Outcomes Following Open Reduction and Internal Fixation of Ankle Fractures

The objective of this study was to evaluate machine-learning algorithms for accurately predicting short-term outcomes after ORIF for ankle fractures. The Nationwide Inpatient Sample and Nationwide Readmissions Database were queried for adult patients ≥18 years old who underwent ORIF of an ankle fracture during 2013 or 2014. Morbidity and mortality, length of stay>3 days, and 30-day all-cause readmission were the outcomes of interest. Two machine-learning models were created to identify patient and hospital characteristics associated with the 3 outcomes. The machine learning models were evaluated using confusion matrices and receiver operating characteristic area under the curve values. A total of 16,501 cases were drawn from the Nationwide Inpatient Sample and used to assess morbidity and mortality and length of stay>3 days, and 33,504 cases were drawn from the Nationwide Readmissions Database to assess 30-day readmission. Older age, Medicaid, Medicare, deficiency anemia, congestive heart failure, chronic lung disease, diabetes, hypertension, and renal failure were the variables associated with a statistically significant increased risk of developing all 3 adverse events. Logistic regression and gradient boosting had similar area under the curve values for each outcome, but gradient boosting was more accurate and more specific for predicting each outcome. Our results suggest that several comorbidities may be associated with adverse short-term outcomes after ORIF of a...
Source: The Journal of Foot and Ankle Surgery - Category: Orthopaedics Source Type: research

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Authors: Schulte C, Zeller T Abstract Cardiovascular (CV) risk assessment is based on the utilization of risk scores, enabling clinicians to estimate an individual's risk to develop CV pathologies and events. Such risk scores comprise classic CV risk factors such as smoking, diabetes, hypertension, and blood cholesterol levels. Recently, other CV biomarkers such as cardiac troponins have been suggested and evaluated as alternative biomarkers not only in the acute diagnostic setting of myocardial infarction, but also as markers for risk stratification in the general population. In this review, we summarize the curre...
Source: Herz - Category: Cardiology Tags: Herz Source Type: research
CONCLUSIONS: This meta-analysis found cardiovascular factors to be the main causes for both 30-day and 1‑year rehospitalization. Heart failure represented the most common cardiovascular event at both short-term and mid-term follow-up. Several baseline characteristics and procedure-related factors were deemed unfavorable predictors of readmission. Importantly, transfemoral access and female gender were associated with a lower risk of readmission. PMID: 31807789 [PubMed - as supplied by publisher]
Source: Herz - Category: Cardiology Tags: Herz Source Type: research
CONCLUSIONS: CMV infection was not associated with impaired long-term prognosis after HT. PMID: 31806387 [PubMed - as supplied by publisher]
Source: Medicina Clinica - Category: General Medicine Tags: Med Clin (Barc) Source Type: research
Publication date: Available online 14 November 2019Source: Colloids and Surfaces B: BiointerfacesAuthor(s): Peng Zhang, Libang He, Jie Zhang, Xifan Mei, Yiyao Zhang, He Tian, Zhenhua ChenAbstractIn the present work, novel berberine nano-colloids hydrogel (BNH) was prepared for improving wound healing of diabetic rats. Polyvinyl alcohol (PVA), sodium alginate (Alg) were adopted as building blocks to form BNH. Calcium ions was used as crosslink agent to construct BNH. The skin injury model of diabetic rats was successfully established, and the prepared hydrogel was applied to the wound. Animal experiments proved that BNH cou...
Source: Colloids and Surfaces B: Biointerfaces - Category: Biochemistry Source Type: research
Publication date: 7 December 2019Source: New Scientist, Volume 244, Issue 3259Author(s): Ruby Prosser Scully
Source: New Scientist - Category: Science Source Type: research
This study investigated if statins would similarly reduce postoperative arrhythmias in patients undergoing THA. METHODS:: We queried a large Medicare and private-payer database from 2005 to 2012 and identified 12,075 patients who were on a statin prior to THA. We then age and sex matched 34,446 non-statin users who underwent THA. Baseline comorbidities and postoperative complications were obtained and assessed via standard descriptive statistics. RESULTS:: The statin users had more preoperative comorbidities including congestive heart failure, valvular heart disease, pulmonary and renal disease, diabetes, hyperte...
Source: Hip International - Category: Orthopaedics Authors: Tags: Hip Int Source Type: research
Discussion Potassium (K+) is an alkali metal (Group 1 of periodic table with Hydrogen, Lithium and Sodium) with an anatomic number of 19. Its chemical symbol K, comes from the medieval Latin, kalium which means potash (mainly potassium carbonate or potassium hydroxide), the substance it was first isolated from. Potassium is an important cation and it mainly resides in the intracellular fluid with only a small amount in the extracellular fluid. Potassium regulates cell volume, pH and enzyme functions. Hyperkalemia is defined as a potassium level> 5.5 mEq/L in children and> 6.0 mEq/L in newborns. Hyperkalemia incre...
Source: PediatricEducation.org - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news
​BY GREGORY TAYLOR, DO, &CHRISTOPHER COOLEY, DOA 66-year-old woman with a history of type 1 diabetes, hypertension, and end-stage renal disease (ESRD) on hemodialysis presented via EMS to the emergency department with altered mental status. She lived with her family, and they noted that she refused to go to dialysis for her past four sessions and had increasing lethargy for two days.She was afebrile, and her other vital signs were blood pressure 136/92 mmHg, heart rate 77 bpm, respiratory rate 20 bpm, and oxygen saturation 96% on room air. She was agitated and reaching for objects in the sky. Her cardiopulmonary exam...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research
​BY AN​UMEHA SINGH, MDA 56-year-old man presented to the ED with shortness of breath and pleural effusions diagnosed by an outside treating physician. The workup included urinalysis, which showed proteinuria, and the exam was consistent with myxedema and pedal edema. He had a history of rheumatoid arthritis, leukocytoclastic vasculitis and Sjögren's syndrome, diabetes, and monoclonal gammopathy of unknown significance (MGUS).The patient also had shortness of breath for a month and pleural effusions on outpatient chest x-ray. He had taken Humira, methotrexate (MTX), and steroids, but his arthritis and Sjögren'...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research
​BY ANDRZEJ KIELTYKA, PA; PARDEEP THANDI, MD; &ANUMEHA SINGH, MDA 56-year-old man presented to the emergency department with shortness of breath for one month and pleural effusions on an outpatient chest x-ray. He had been taking adalimumab, methotrexate, and steroids for arthritis and Sjogren's syndrome.A right pleural effusion in a patient with nephrotic syndrome.His monoclonal gammopathy of undetermined significance (MGUS) was monitored annually, but no medical intervention beyond surveillance was required. He had excessive thirst but normal urine output. He noted face and hand swelling in the morning that gave wa...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research
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