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121. Risk factors and impact of conversion from VATS to open lobectomy: analysis from a national database. (PubMed)

Risk factors and impact of conversion from VATS to open lobectomy: analysis from a national database. The objective of the study is to analyse the causes and impact of conversion from VATS to thoracotomy identifying any possible pre-operative risk factors and related consequences.Data from patient who underwent VATS lobectomy (VATS-L) for NSCLC at VATS Group participating centres were retrospectively analysed and divided in two groups: patients treated with VATS-L and patients who suffered from

2019 Surgical endoscopy

122. Readmission Following Pediatric Cardiothoracic Surgery: An analysis of the Society of Thoracic Surgeons Database. (PubMed)

Readmission Following Pediatric Cardiothoracic Surgery: An analysis of the Society of Thoracic Surgeons Database. Hospital readmission after pediatric cardiac surgery is incompletely understood. We analyzed data from the STS Congenital Heart Surgery database (STS-CHSD) to determine prevalence, to describe patient characteristics, and to evaluate risk factors for readmission.Readmission was defined by the "readmission within 30 days after discharge" field. Routine variables were summarized (...) . Regression analysis was used to identify factors associated with readmission.The study cohort included 56,429 patient records from 100 centers. Overall, 6,208 (11%) patients were readmitted. The most common reasons for readmission were respiratory/airway complications (14.2%), septic/infectious complications (11.4%), and reasons not related to the preceding surgical procedure (20.2%). Primary reason for readmission varied across benchmark operation groups. In multivariable analysis, factors associated

2019 Annals of Thoracic Surgery

123. Predictors of Hospital Cost After Transcatheter Aortic Valve Implantation in the United States: From the Nationwide Inpatient Sample Database. (PubMed)

Predictors of Hospital Cost After Transcatheter Aortic Valve Implantation in the United States: From the Nationwide Inpatient Sample Database. We aimed to identify risk factors of high hospitalization cost after transcatheter aortic valve implantation (TAVI). TAVI expenditure is generally higher compared with surgical aortic valve replacement. We queried the Nationwide Inpatient Sample database from January 2011 to September 2015 to identify those who underwent endovascular TAVI. Estimated cost (...) of hospitalization was calculated by merging the Nationwide Inpatient Sample database with cost-to-charge ratios available from the Healthcare Cost and Utilization Project. Patients were divided into quartiles (lowest, medium, high, and highest) according to the hospitalization cost, and multivariable regression analysis was performed to identify patient characteristics and periprocedural complications associated with the highest cost group. A total of 9,601 TAVI hospitalizations were identified. Median

2019 American Journal of Cardiology

124. Poorly controlled diabetes increases the risk of metastases and castration-resistant prostate cancer in men undergoing radical prostatectomy: Results from the SEARCH database. (PubMed)

Poorly controlled diabetes increases the risk of metastases and castration-resistant prostate cancer in men undergoing radical prostatectomy: Results from the SEARCH database. Although diabetes is inversely related to prostate cancer (PC) risk, to the authors' knowledge the impact of glycemic control on PC progression is unknown. In the current study, the authors tested the association between hemoglobin A1c (HbA1c) and long-term PC outcomes among diabetic men undergoing radical prostatectomy

2019 Cancer

125. Disease burden in patients with asthma before initiating biologics: A retrospective cohort database study. (PubMed)

Disease burden in patients with asthma before initiating biologics: A retrospective cohort database study. Background: Real-world data on the characteristics and burden of disease among patients with asthma before receiving asthma-specific biologics would improve the understanding of the use of these therapies in a clinical setting. Currently, limited data are available on the use of mepolizumab and omalizumab for the treatment of asthma. Objective: To determine the characteristics and disease (...) burden among patients with asthma before initiating treatment with mepolizumab or omalizumab. Methods: This was a retrospective cohort analysis of commercial and Medicare Advantage Plan members from a medical claims database with a new claim for mepolizumab or omalizumab between January 1, 2015, and March 31, 2017 (GSK ID: HO-17-18283). Eligible patients had a diagnosis of asthma and continuous enrollment in the health plan, with clinical and pharmacy benefits for 12 months before initiating asthma

2019 Allergy and Asthma Proceedings

126. High-intensity end-of-life care among children, adolescents, and young adults with cancer who die in the hospital: A population-based study from the French national hospital database. (PubMed)

High-intensity end-of-life care among children, adolescents, and young adults with cancer who die in the hospital: A population-based study from the French national hospital database. Efforts to improve the quality of end-of-life (EOL) care depend on better knowledge of the care that children, adolescents, and young adults with cancer receive, including high-intensity EOL (HI-EOL) care. The objective was to assess the rates of HI-EOL care in this population and to determine patient (...) - and hospital-related predictors of HI-EOL from the French national hospital database.This was a population-based, retrospective study of a cohort of patients aged 0 to 25 years at the time of death who died at hospital as a result of cancer in France between 2014 and 2016. The primary outcome was HI-EOL care, defined as the occurrence of ≥1 chemotherapy session <14 days from death, receiving care in an intensive care unit ≥1 time, >1 emergency room admission, and >1 hospitalization in an acute care unit

2019 Cancer

127. Is there a weekend effect in surgery for type A dissection? - Results from the NORCAAD database. (PubMed)

Is there a weekend effect in surgery for type A dissection? - Results from the NORCAAD database. Aortic dissection type A requires immediate surgery. In general surgery populations, patients operated during weekends have higher mortality rates compared to patients operated on weekdays. The weekend effect in aortic dissection type A has not been studied in detail.The Nordic Consortium for Acute Type A Aortic Dissection (NORCAAD) registry includes patients (N=1,159) who underwent type (...) A dissection surgery at eight Nordic centers during 2005-2014. This study is based on data relating to surgery conducted during weekdays vs. weekends, and starting between 8 am and 8 pm ("daytime") vs. from 8 pm to 8 am ("nighttime"), as well as time from symptoms/admittance/diagnosis to surgery. The influence of timing of surgery on 30-day mortality was assessed using logistic regression analysis.The 30-day mortality was 18% (204/1,159), with no difference in mortality between surgery performed

2019 Annals of Thoracic Surgery

128. An Assessment of Bleeding Complications Necessitating Blood Transfusion across Inpatient Plastic Surgery Procedures: A Nationwide Analysis Using the National Surgical Quality Improvement Program Database. (PubMed)

An Assessment of Bleeding Complications Necessitating Blood Transfusion across Inpatient Plastic Surgery Procedures: A Nationwide Analysis Using the National Surgical Quality Improvement Program Database. This study described the prevalence of bleeding complications necessitating blood transfusion across plastic surgery procedures and identified those procedures that may be associated with higher rates of bleeding.The authors retrospectively identified patients who suffered from postoperative (...) bleeding complications from 2010 to 2015 using the National Surgical Quality Improvement Program database. This is defined by the National Surgical Quality Improvement Program as the need for transfusion of at least one unit of packed or whole red blood cells. Patient characteristics were described using summary statistics, and National Surgical Quality Improvement Program and univariate analysis of patient characteristics and bleeding complications was performed.Overall, 1955 of 95,687 patients

2019 Plastic and reconstructive surgery

129. Obstetric outcomes in women with rheumatoid arthritis: Results from Nationwide Inpatient Sample Database 2003-2011<sup>✰</sup>. (PubMed)

Obstetric outcomes in women with rheumatoid arthritis: Results from Nationwide Inpatient Sample Database 2003-2011. Fertility is reduced in patients with Rheumatoid Arthritis due to unknown cause. Few studies have addressed pregnancy outcomes in RA. This study was undertaken to determine the frequency of complications occurring during pregnancy for women with RA and compare with the general obstetric population by using the largest inpatient care database.By using the 2003-2011 (...) Nationwide Inpatient Sample of Healthcare Cost and Utilization Project, we estimated the number of obstetric hospitalization in women with RA between the age group 18-50 years. Demographic characteristics and in-hospital obstetric complications for all pregnancy-related admissions for women with and without RA were compared. Multivariate logistic regression analysis was used to obtain adjusted odds ratio.The total number of obstetric hospitalization was 42.32 million of which 31,439 were women with RA

2019 Seminars in arthritis and rheumatism

130. The Danish helicopter emergency medical service database: high quality data with great potential. (PubMed)

and data entering procedure, as well as the key variables and data completeness were described. Furthermore, missing data and misclassifications were addressed. Lastly, the 26 QIs proposed by the EQUIPE-collaboration were evaluated for coverage in the HEMS database.A total of 13,392 missions were included in the study. The database includes a broad spectrum of mission- and patient-specific data related to the pre-hospital pathway of acutely ill or injured patients in a national coverage. Missing data (...) The Danish helicopter emergency medical service database: high quality data with great potential. The Danish Helicopter Emergency Medical Service (HEMS) is part of the Danish pre-hospital response offering advanced patient care on scene and during rapid transport to definitive care. Monitoring HEMS performance and the quality of critical care has high national as well as international priority underlining the need for research in this field. The data quality of the Danish HEMS database

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2019 Scandinavian journal of trauma, resuscitation and emergency medicine

131. Evaluating the Influence of Social Factors on Aged Residential Care Admission in a National Home Care Assessment Database of Older Adults. (PubMed)

Evaluating the Influence of Social Factors on Aged Residential Care Admission in a National Home Care Assessment Database of Older Adults. Evaluate the influence of social factors on admission to aged residential care (ARC) facilities using a national comprehensive geriatric assessment database in New Zealand.Time-to-event analysis of a continuously recruited national cohort.An anonymized data extract from a large national database for home care assessments (June 2012-December 2015) was matched (...) with data on mortality and admissions into ARC.Four key components of psychosocial risk in relation to ARC admission were used for analysis: living alone, negative social interactions, perceived loneliness, and carer stress. Exploratory data analysis was conducted for each of the variables of interest and demographics. Unadjusted and adjusted competing risk regressions were then performed with admission into ARC being the primary outcome, death the competing risk, and remaining at home the survival

2019 Journal of the American Medical Directors Association

132. Real-world treatment patterns and adverse events in metastatic renal cell carcinoma from a large US claims database. (PubMed)

Real-world treatment patterns and adverse events in metastatic renal cell carcinoma from a large US claims database. Vascular endothelial growth factor (VEGF), tyrosine kinase (TK) and mechanistic target of rapamycin kinase (mTOR) inhibitors are common first-line (1 L) treatments for metastatic renal cell carcinoma (mRCC). Despite treatment availability, the 5-year survival rate in patients diagnosed at the metastatic stage is only ≈ 10%. To gain contemporary insights into RCC treatment trends (...) that may inform clinical, scientific and payer considerations, treatment patterns and adverse events (AEs) associated with 1 L therapy were examined in a retrospective, longitudinal, population-based, observational study of patients with mRCC.US administrative claims data (Truven Health MarketScan Commercial Databases) were used to assess trends in 1 L treatment initiation in mRCC (2006-2015) and characterize patterns of individual 1 L treatments, baseline characteristics, comorbidities and treatment

2019 BMC Cancer

133. Proficiency of Robotic Lobectomy Based on Prior Surgical Technique in the STS General Thoracic Database. (PubMed)

Proficiency of Robotic Lobectomy Based on Prior Surgical Technique in the STS General Thoracic Database. Robotic lobectomy represents a paradigm shift for many surgeons. It is unknown if a surgeon's prior operative approach influences development of proficiency. We compared outcomes based on prior lobectomy experience and used cumulative sum (CUSUM) analysis to assess proficiency.Using the STS General Thoracic Database, we grouped surgeons as De novo, open- to-robotic or VATS-to-robotic (...) ). Initial proficiency for an operative time target of 250 minutes was 40% for de novo compared to 14% of open-to-robotic and 21% of VATS-to-robotic surgeons, with improvement to 47%, 29% and 21% after 20 cases respectively. Initial and sustained proficiency related to major morbidity was similar for open-to-robotic and VATS-to-robotic, but lower for de novo at 40%. After 20 cases, most were proficient (de novo-93%, open-to-robotic-100% and VATS-to-robotic-86%). Proficiency for 30-day mortality and blood

2019 Annals of Thoracic Surgery

134. The role of C9orf72 in neurodegenerative disorders: a systematic review, an updated meta-analysis, and the creation of an online database. (PubMed)

a possible correlation with other neurodegenerative diseases as well. We performed an extensive literature search for C9orf72 mutation and its frequency in various neurological and psychiatric diseases. In addition, we performed a meta-analysis of the data related to ALS and familial ALS. An online cloud-based database and an interactive map were developed. The overall mutation frequency of C9orf72 is 20% for familial FTD, 16% for familial ALS and around 6%-8% for sporadic ALS and FTD. The updated meta (...) . The system that we developed-the online database and the interactive map-is hopefully a stepping stone for an ever-growing platform that will aid scientists from all over the world in contributing to the meta-analysis of C9orf72-related publications.Copyright © 2019 Elsevier Inc. All rights reserved.

2019 Neurobiology of Aging

135. Recorded poor insight as a predictor of service use outcomes: cohort study of patients with first-episode psychosis in a large mental healthcare database. (PubMed)

Recorded poor insight as a predictor of service use outcomes: cohort study of patients with first-episode psychosis in a large mental healthcare database. To investigate recorded poor insight in relation to mental health and service use outcomes in a cohort with first-episode psychosis.We developed a natural language processing algorithm to ascertain statements of poor or diminished insight and tested this in a cohort of patients with first-episode psychosis.The clinical record text (...) at the South London and Maudsley National Health Service Trust in the UK was used.We applied the algorithm to characterise a cohort of 2026 patients with first-episode psychosis attending an early intervention service.Recorded poor insight within 1 month of registration was investigated in relation to (1) incidence of psychiatric hospitalisation, (2) odds of legally enforced hospitalisation, (3) number of days spent as a mental health inpatient and (4) number of different antipsychotic agents prescribed

2019 BMJ open

136. Infectious complications of endoarterial interventional radiology: protocol for an observational study of a longitudinal national cohort of patients assessed in the French hospital discharge database (MOEVA study). (PubMed)

Infectious complications of endoarterial interventional radiology: protocol for an observational study of a longitudinal national cohort of patients assessed in the French hospital discharge database (MOEVA study). Around seven million patients undergo endoarterial interventional radiology procedures (EAIRP) annually worldwide. These procedures have become part of the standard repertoire of vascular surgery. However, the healthcare-associated infections related to these procedures (...) Related Group system. Various combinations to identify the numerator will be employed according to a pre-established algorithm. Technical data wrangling tools facilitating the use of PMSI will be developed to obtain a clean and well-structured database ready for statistical analysis. This protocol will require competences in medicine, epidemiology, statistics, data processing and techniques through various stages of the study. The cohort will contain the denominator (the first act of the first stay

2019 BMJ open

137. Prostate cancer with bone metastasis in Beijing: an observational study of prevalence, hospital visits and treatment costs using data from an administrative claims database. (PubMed)

Prostate cancer with bone metastasis in Beijing: an observational study of prevalence, hospital visits and treatment costs using data from an administrative claims database. To estimate the prevalence of prostate cancer with bone metastasis in Beijing, and to estimate hospital visits and direct treatment costs among male urban employees with the disease in Beijing.Cross-sectional observational study.Patients with prostate cancer and bone metastasis from the Urban Employee Basic Medical (...) Insurance database covering the employed population of Beijing, China, from 2011 to 2014.Prevalence, treatment costs and healthcare visits of patients with prostate cancer and bone metastasis.A total of 1672 individuals were identified as having prostate cancer. Of these, 737 (44.1%) had bone metastasis, and among these, this was already present at the time of initial prostate cancer diagnosis in 27.0% (199/737). Mean age was 74.6 years (SD ±9.1). Prevalence of prostate cancer with bone metastasis

2019 BMJ open

138. Readmissions Following Isolated Coronary Artery Bypass Graft Surgery in the United States (from the Nationwide Readmissions Database 2010 to 2014). (PubMed)

Readmissions Following Isolated Coronary Artery Bypass Graft Surgery in the United States (from the Nationwide Readmissions Database 2010 to 2014). Readmission following cardiac surgery is associated with poor outcomes and increased healthcare expenditure. However, a nationwide understanding of the incidence, cost, causes, and predictors of 30-day readmission following coronary artery bypass grafting is limited. The Nationwide Readmissions Database was used to identify all adult patients who (...) underwent isolated coronary artery bypass grafting (CABG) with no other concomitant surgery between 2010 and 2014. The primary outcome was all-cause readmission within 30 days of discharge after surgery. Risk-adjusted multivariable analyses were used to develop a model of readmission risk. Of 855,836 patients, 95,504 (11.2%) had an emergent 30-day readmission following CABG. The most common causes of readmission were related to respiratory complications (17.1%), infection (13.5%), and heart failure

2019 American Journal of Cardiology

139. Hyperlipidemia Prevalence and Cholesterol Control in Obstructive Sleep Apnea: Data from the European Sleep Apnea Database (ESADA). (PubMed)

Hyperlipidemia Prevalence and Cholesterol Control in Obstructive Sleep Apnea: Data from the European Sleep Apnea Database (ESADA). Obstructive sleep apnea (OSA) and hyperlipidemia are independent risk factors for cardiovascular disease. This study investigates the association between OSA and prevalence of hyperlipidemia in patients of the European Sleep Apnea Database (ESADA) cohort.The cross-sectional analysis included 11,892 patients (age 51.9±12.5 years, 70% male, body mass index (BMI) 31.3 (...) ±6.6 kg/m2 , mean Oxygen Desaturation Index (ODI) 23.7±25.5 events/h) investigated for OSA. The independent odds ratio (OR) for hyperlipidemia in relation to measures of OSA (ODI, Apnea Hypopnea Index, mean and lowest oxygen saturation) was determined by means of General Linear Model analysis with adjustment for important confounders like age, BMI, comorbidities, and study site.Hyperlipidemia prevalence increased from 15.1% in subjects without OSA to 26.1% in those with severe OSA, p<0.001

2019 Journal of internal medicine

140. Outcomes of Patients with Scirrhous Hepatocellular Carcinoma: Insights from the National Cancer Database. (PubMed)

Outcomes of Patients with Scirrhous Hepatocellular Carcinoma: Insights from the National Cancer Database. Scirrhous hepatocellular carcinoma (HCC) is a rare primary liver tumor characterized by extensive fibrosis and production of parathyroid hormone-related peptide. There have been conflicting reports on patient survival in scirrhous versus non-scirrhous HCC. The objective of the present study was to define the clinical features, practice patterns, and long-term outcomes of patients (...) with scirrhous HCC versus non-scirrhous HCC in a propensity score-matched cohort.A propensity score-matched cohort was created using data from the National Cancer Database for 2004 to 2015. A multivariable Cox proportional hazards regression analysis was performed to assess the effect of the scirrhous HCC variant on overall survival.Among the 70,426 patients with a diagnosis of HCC who met the inclusion criteria, 99.8% had non-scirrhous HCC (n = 70,290) whereas a small subset had scirrhous HCC (n = 136, 0.19

2019 Journal of Gastrointestinal Surgery

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