Examination of a Proposed 30-Day Readmission Risk Score on Discharge Location and Cost

Publication date: Available online 7 November 2019Source: The Annals of Thoracic SurgeryAuthor(s): Scott D. Barnett, Eric Sarin, Andy C. Kiser, Gorav Ailawadi, Robert B. Hawkins, J. Hunter Mehaffey, Zachary Tyerman, Jeffrey B. Rich, Mohammad A. Quader, Alan M. SpeirAbstractBackgroundReadmissions cost an estimated $41 billion in the United States each year. To address this, a single institution recently developed a new risk model predictive of 30-day readmission following adult cardiac surgery. The purpose of this study is to validate and refine this new readmission risk model using a statewide database.MethodsA total of 19,964 patients were analyzed using a statewide Society of Thoracic Surgeons database (2014-2017). The aforementioned multivariate model was replicated (Model 1): race, hospital length of stay, chronic lung disease, operation type, and renal failure. Model 2 also included discharge location. Thirty day readmission risk scores, low (0-10%), moderate (10-13%) and high (≥13%) risk categories were calculated.ResultsThe overall 30-day readmission rate was 11.1% with both Models 1 and 2 predicting readmission (OR: 1.09; 95% CI: 1.08-1.11 vs. OR: 1.10; 95% CI: 1.08-1.11). Statistically significant differences were observed across all risk categories in discharge location and total cost. For Model 1 and 2, 86% of low risk patients were discharged to home vs. 66.9% and 42.9% of patients in high risk groups (p
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research

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Authors: Di Lullo L, Bellasi A, Guastamacchia E, Triggiani V, Ronco C, Lavalle C, Di Iorio BR, Russo D, Cianciolo G, La Manna G, Settembrini S Abstract Diabetes mellitus, with its complications, is one of the major health problems in economically developed countries and its prevalence is constantly increasing. Kidneys and heart involvement represent main comorbidities in diabetic patients often leading to organ's failure. The treatments available until a few years ago are often associated with hypoglycemia, weight gain, gastro-intestinal disorders and other side effects together with serious averse effects on renal...
Source: Minerva Cardioangiologica - Category: Cardiology Tags: Minerva Cardioangiol Source Type: research
Contributors : Ping Lu ; Ping Wang ; Fuchou TangSeries Type : Expression profiling by high throughput sequencingOrganism : Homo sapiensIgA nephropathy represents the most prevalent chronic nephrosis worldwide. However, pathogenesis about IgA deposition and end-stage renal failure is still not well defined. Using single-cell RNA-seq, we identified the mesangial membrane receptor for IgA, which collaborates with increased extracellular matrix proteins and protease inhibitor to facilitate IgA deposition. Meanwhile, cell-cell interaction analysis revealed increased communications between mesangium and other cell types, uncover...
Source: GEO: Gene Expression Omnibus - Category: Genetics & Stem Cells Tags: Expression profiling by high throughput sequencing Homo sapiens Source Type: research
CONCLUSION: EHS is aggressively identified and treated in U.S. Military Treatment Facilities. Mortality and morbidity were strikingly low. PMID: 32074343 [PubMed - in process]
Source: Military Medicine - Category: International Medicine & Public Health Tags: Mil Med Source Type: research
ConclusionFemales were associated with persistently reduced odds of receipt of CRT-D compared to males over an eleven-year period. The present study identifies important factors that predict the choice of CRT device offered to patients in the US.
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research
Publication date: Available online 20 February 2020Source: IDCasesAuthor(s): Heather L. Clark, Hugo E. Valencia, Jennifer J. Findeis-Hosey, Steve N. GeorasAbstractAspergillus molds are ubiquitous environmental molds that can cause devastating invasive infections in immunocompromised patients. These infections often go unrecognized in critically ill patients. This case describes a 68 year-old female resident of a long-term nursing facility with history of dementia, nonalcoholic fatty liver disease with cirrhosis, chronic kidney disease stage III and insulin-dependent type 2 diabetes who presented with vomiting, diarrhea and...
Source: IDCases - Category: Infectious Diseases Source Type: research
CT angiography offers excellent anatomic detail necessary for vascular procedural planning including endovascular aneurysm repair (EVAR). However, patients with renal insufficiency are at risk for acute renal failure due to iodinated contrast administration. Catheter-directed CT angiography is a technique in which dilute iodinated contrast is injected into an intra-aortic pigtail catheter during the CT scan. The purpose of this study was to evaluate the safety and efficacy of this technique.
Source: Journal of Vascular and Interventional Radiology : JVIR - Category: Radiology Authors: Tags: Scientific e-Poster Source Type: research
This study aimed to investigate whether Ononis spinosa L. has a litholytic effect on kidney stones with different chemical patterns.Materials and MethodsUrinary stones extracted from seven patients over 18 years of age during surgery were used as the study material. Each urinary stone was divided into two parts, one of which was left in a solution prepared with O. spinosa L. and the other constituted the control sample. The amount of calcium, phosphor and uric acid passing through each solution was detected by spectrophotometric analysis to assess its efficiency and determine whether or not the urinary stones were dissolve...
Source: Journal of Herbal Medicine - Category: Complementary Medicine Source Type: research
Abstract During the last decades, we have witnessed unparalleled changes in human eating habits and lifestyle, intensely influenced by cultural and social pressures. Sports practice became strongly implemented in daily routines, and visits to the gym peaked, driven by the indulgence in intensive 'weight-loss programs'. The pledge of boasting a healthy and beautiful body instigates the use of very attractive 'fat burners', which are purportedly advertised as safe products, easily available in the market and expected to quickly reduce body weight. In this context, the slimming properties of 2,4-dinitrophenol (2,4-DN...
Source: Archives of Toxicology - Category: Toxicology Authors: Tags: Arch Toxicol Source Type: research
CONCLUSION: Postulated transient increases in peritoneal capillary surface area were unnecessary to predict the entire Heimburger measurements. PMID: 32065069 [PubMed - as supplied by publisher]
Source: Peritoneal Dialysis International - Category: Urology & Nephrology Tags: Perit Dial Int Source Type: research
CONCLUSIONS: Tension-free mesh repair is associated with low morbidity and low recurrence rates in PD patients. Timely management and close collaboration with renal physicians are essential to continue PD after repair. PMID: 32063146 [PubMed - in process]
Source: Peritoneal Dialysis International - Category: Urology & Nephrology Tags: Perit Dial Int Source Type: research
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