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Opportunities and limitations of risk adjustment of quality indicators based on inpatient administrative health data - a workshop report
DISCUSSION: Implementing specific risk adjustment models had only minor effects on the distribution of risk-adjusted mortality compared to the standard procedure, but the judgement of quality of care could change for a fifth of the hospitals in individual indicators. Concerning methodological and practical reasons, the task force recommends further development of risk adjustment methods for selected indicators. This should be accompanied by studies on the validity of inpatient administrative data for quality management as well as by efforts to improve the usefulness of these data for such purposes.PMID:34023246 | DOI:10.10...
Source: Zeitschrift fur Evidenz, Fortbildung und Qualitat im Gesundheitswesen - May 23, 2021 Category: Health Management Authors: Daniel Schwarzkopf Ulrike Nimptsch Raphael Graf Jochen Schmitt Josef Zacher Ralf Kuhlen Source Type: research

Clinical Manifestations of Copper Deficiency: A Case Report and Review of the Literature.
CONCLUSIONS: Our patient presented with copper deficiency secondary to malabsoprtion. This case highlights the importance of copper testing in the bariatric surgery population and in patients with short-bowel syndrome. Given the irreversible nature of neurological symptoms when compared with the expense of nutrition supplements, routine copper testing should be considered in patients with malabsorptive states or altered anatomy, regardless of initial presentation. PMID: 33037701 [PubMed - as supplied by publisher]
Source: Nutrition in Clinical Practice - October 9, 2020 Category: Nutrition Authors: Moon N, Aryan M, Westerveld D, Nathoo S, Glover S, Kamel AY Tags: Nutr Clin Pract Source Type: research

Cannabis Use Disorder and Perioperative Outcomes in Major Elective Surgeries A Retrospective Cohort Analysis
Conclusions An active cannabis use disorder is associated with an increased perioperative risk of myocardial infarction.Editor ’s PerspectiveWhat We Already Know about This TopicCannabis is known to have cardiovascular and psychoactive effectsThe association between active cannabis use disorder and postoperative outcomes remains unclearWhat This Article Tells Us That Is NewIn the United States, administrative data demonstrate that cannabis use disorder has increased in prevalence from 2010 to 2015Active cannabis use disorder is not associated with a change in overall perioperative morbidity, mortality, length of stay, or...
Source: Anesthesiology - March 10, 2020 Category: Anesthesiology Source Type: research

Acute aortic occlusion in a patient without risk factors
A 94-year-old female with a history of ischemic stroke, mild right hemiparesis, vascular dementia, breast cancer with right mastectomy, colon cancer resulting in colectomy, hyperlipidemia, and hypertension presented to the emergency department (ED) with bilateral leg pain. Patient had no smoking history, and her medications included Donepezil, Aspirin, Citalopram, Losartan, and Pantoprazole.
Source: The American Journal of Emergency Medicine - March 28, 2018 Category: Emergency Medicine Authors: Trina Stoneham, Erin L. Simon Source Type: research

Does pneumoperitoneum affect perfusion index and pleth variability index in patients receiving combined epidural and general anesthesia?
Authors: Wajima Z, Shiga T, Imanaga K Abstract Plethysmographic variability index (PVI) is a dynamic index used for the purpose of fluid responsiveness in patients, and the effect of pneumoperitoneum on PVI is still unclear. We therefore attempted to determine whether PVI and perfusion index (PI) change before/after pneumoperitoneum in patients receiving combined epidural and general anesthesia, which is a common anesthesia method with intravenous remifentanil. Twenty patients underwent laparoscopic cholecystectomy or colectomy. Immediately before pneumoperitoneum, variables were measured at baseline I and were the...
Source: BioScience Trends - December 20, 2017 Category: Biomedical Science Tags: Biosci Trends Source Type: research

Disagreement between fourth generation FloTrac and LiDCOrapid measurements of cardiac output and stroke volume variation during laparoscopic colectomy
To determine the agreement between cardiac output (CO) and stroke volume variation (SVV) measured simultaneously by the fourth generation FloTrac/Vigileo system and LiDCOrapid system during pneumoperitoneum in patients undergoing laparoscopic colectomy.
Source: Journal of Clinical Anesthesia - August 17, 2016 Category: Anesthesiology Authors: Masato Nakasuji, Aki Okutani, Taeko Miyata, Norie Imanaka, Masuji Tanaka, Kae Nakasuji, Miwako Nagai Tags: Original contribution Source Type: research

Nursing Home Status is an Independent Risk Factor for Adverse 30-Day Postoperative Outcomes after Common, Non-Emergent Inpatient Procedures
Conclusions These data suggest that, in addition to serving as a surrogate indicator of health status and current morbidity, residence in a nursing home makes an independent contribution to adverse postoperative outcomes.
Source: The American Journal of Surgery - May 9, 2016 Category: Surgery Source Type: research

Pneumoperitoneum affects stroke volume variation in humans
Conclusion A pneumoperitoneum increased SVV, which is similar to the findings of previous animal studies but is different from a previous clinical study. Upon release of the pneumoperitoneum, SVV decreased significantly, which is new information. SVV values must be estimated cautiously during a pneumoperitoneum.
Source: Journal of Anesthesia - December 30, 2014 Category: Anesthesiology Source Type: research

Factors Associated with Conversion from Laparoscopic to Open Colectomy using the National Surgical Quality Improvement Program (NSQIP) Database
ConclusionsMultiple significant factors for conversion from laparoscopic to open colectomy were identified. A novel finding was the increased risk of conversion for underweight patients. As laparoscopic colectomy is become increasingly utilized, factors predictive of conversion to open procedures should be sought via large, national cohorts.This article is protected by copyright. All rights reserved.
Source: Colorectal Disease - October 14, 2014 Category: Gastroenterology Authors: Anuradha R. Bhama, Mary E. Charlton, Mary B. Schmitt, John W. Cromwell, John C. Byrn Tags: Original Article Source Type: research

MELAS syndrome presenting as an acute surgical abdomen.
We describe the case of a young woman who presented as an acute surgical emergency, diagnosed as toxic megacolon necessitating an emergency total colectomy. MELAS syndrome was suspected postoperatively owing to persistent lactic acidosis and neurological symptoms. The diagnosis was later confirmed with histological and genetic studies. This case highlights the difficulties in diagnosing MELAS because of its unpredictable presentation and clinical course. We therefore recommend a high index of suspicion in cases of an acute surgical abdomen with additional neurological features or raised lactate. PMID: 24417855 [PubMed - in process]
Source: Annals of the Royal College of Surgeons of England - January 1, 2014 Category: Surgery Authors: Dindyal S, Mistry K, Angamuthu N, Smith G, Hilton D, Arumugam P, Mathew J Tags: Ann R Coll Surg Engl Source Type: research