Discharge status diagnosis based on chromaticitycoordinates

2021 ◽  
Author(s):  
yuwei wang ◽  
Xiwang Li ◽  
Ziqing GUO ◽  
Jiahui HU ◽  
Qizheng Ye
Keyword(s):  
Discharge Status

High-Volume Hospitals with High-Volume and Low-Volume Surgeons: Is There a “Field Effect” for Pancreaticoduodenectomy?

2016 ◽  
Vol 82 (5) ◽  
pp. 407-411 ◽  
Author(s):  
Thomas W. Wood ◽  
Sharona B. Ross ◽  
Ty A. Bowman ◽  
Amanda Smart ◽  
Carrie E. Ryan ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Field Effect ◽  
Hospital Volume ◽  
Patient Discharge ◽  
High Volume ◽  
Surgeon Volume ◽  
Hospital Charges ◽  
Leapfrog Group ◽  
Discharge Status ◽  
Low Volume

Since the Leapfrog Group established hospital volume criteria for pancreaticoduodenectomy (PD), the importance of surgeon volume versus hospital volume in obtaining superior outcomes has been debated. This study was undertaken to determine whether low-volume surgeons attain the same outcomes after PD as high-volume surgeons at high-volume hospitals. PDs undertaken from 2010 to 2012 were obtained from the Florida Agency for Health Care Administration. High-volume hospitals were identified. Surgeon volumes within were determined; postoperative length of stay (LOS), in-hospital mortality, discharge status, and hospital charges were examined relative to surgeon volume. Six high-volume hospitals were identified. Each hospital had at least one surgeon undertaking ≥ 12 PDs per year and at least one surgeon undertaking < 12 PDs per year. Within these six hospitals, there were 10 “high-volume” surgeons undertaking 714 PDs over the three-year period (average of 24 PDs per surgeon per year), and 33 “low-volume” surgeons undertaking 225 PDs over the three-year period (average of two PDs per surgeon per year). For all surgeons, the frequency with which surgeons undertook PD did not predict LOS, in-hospital mortality, discharge status, or hospital charges. At the six high-volume hospitals examined from 2010 to 2012, low-volume surgeons undertaking PD did not have different patient outcomes from their high-volume counterparts with respect to patient LOS, in-hospital mortality, patient discharge status, or hospital charges. Although the discussion of volume for complex operations has shifted toward surgeon volume, hospital volume must remain part of the discussion as there seems to be a hospital “field effect.”

scholarly journals Patient Global Ratings of Change Did Not Adequately Reflect Change Over Time: A Clinical Cohort Study

2014 ◽  
Vol 94 (4) ◽  
pp. 534-542 ◽  
Author(s):  
John S. Schmitt ◽  
J. Haxby Abbott
Keyword(s):  
Clinical Practice ◽  
Physical Therapy ◽  
Computerized Adaptive Testing ◽  
Recall Period ◽  
Regression Analyses ◽  
Change Over Time ◽  
Study Objective ◽  
Global Ratings ◽  
Discharge Status ◽  
Over Time

BackgroundGlobal ratings of change (GROCs) are commonly used in research and clinical practice to determine which patients respond to therapy, but their validity as a criterion for change has not been firmly established. One factor related to their validity is the length of the recall period.ObjectiveThe study objective was to examine the influence of the length of the recall period on the validity of a GROC for determining true change over time in the clinical setting.DesignThis was a longitudinal, single-cohort observational study.MethodsData from the Focus on Therapeutic Outcomes clinical database were collected for 8,955 patients reporting for physical therapy treatment of a knee disorder. Computerized adaptive testing was used to assess knee functional status (FS) at the initial and final (discharge) physical therapy visits. Each patient's GROC was obtained at discharge. Correlation and linear regression analyses of knee FS and GROC, stratified by length of time between intake and discharge, were conducted.ResultsCorrelations of GROC with knee FS change scores were modest even for the shortest period of recall (0–30 days) and were slightly lower for longer recall periods. Regression analyses using knee FS to predict GROC scores revealed similar findings. Correlations of GROC with intake and discharge scores indicated a strong bias toward discharge status, with little or no influence of baseline status. Standardized regression coefficients fitted the pattern expected for a valid measure of change but confirmed the strong bias toward discharge status.LimitationsOne version of the GROC administered serially in a cohort of patients seen in clinical practice was examined.ConclusionsThese results call into question the validity of GROCs for measuring change over time in routine clinical practice.

Can We Predict Discharge Status After Total Joint Arthroplasty? A Calculator to Predict Home Discharge

2016 ◽  
Vol 31 (12) ◽  
pp. 2705-2709 ◽  
Author(s):  
J. Joseph Gholson ◽  
Andrew J. Pugely ◽  
Nicholas A. Bedard ◽  
Kyle R. Duchman ◽  
Christopher A. Anthony ◽  
...  
Keyword(s):  
Total Joint Arthroplasty ◽  
Joint Arthroplasty ◽  
Home Discharge ◽  
Discharge Status

Abstract 3916: Rapidly Improving Stroke Symptoms: Relation to Stroke Volumes and Discharge Disposition

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Clotilde Balucani ◽  
Steven Levine ◽  
Jane Khoury Khoury ◽  
Pooja Khatri ◽  
Jeffrey L Saver ◽  
...  
Keyword(s):  
Nursing Home ◽  
Secondary Outcome ◽  
P Value ◽  
Lesion Volume ◽  
P Values ◽  
Discharge Disposition ◽  
Stroke Study ◽  
Significant Difference ◽  
Discharge Status ◽  
Multiple Logistic Regression Modeling

Background: Rapidly improving stroke symptoms (RISS) is a frequently cited reason for not giving IV rt-PA. However, prior studies have suggested that outcome of acute ischemic stroke patients presenting with RISS is not invariably benign. This raises the possibility that stroke-related disability may be relatively common after RISS. Objective: To explore both discharge disposition and 3-month CT lesion volume in patients with and without RISS based on various pre-specified definitions in The NINDS rt-PA Stroke Study cohort. Methods: The NINDS rt-PA Stroke Study dataset was used to compare baseline to 2-hour NIH Stroke Scale scores (NIHSSS). We calculated baseline NIHSSS - 2hr NIHSSS (positive = improvement [IMP], negative = worsening). Definitions of RISS were raw change in NIHSSS (≥ 4 point IMP) and percent change in NIHSSS (≥ 25% IMP and ≥ 50% IMP). Chi-square and multiple logistic regression modeling were used to assess the association of RISS with outcomes measures. Discharge disposition included: home; relative/friend; rehabilitation; nursing home; death; other. CT lesion volume was based on the 3-month CT scan as previously calculated as a pre-specified secondary outcome of the 2 trials. Results: In the 624 subjects, RISS frequency depended on definition used. Frequencies (all %s) of RISS compared to no-RISS who were discharged Home were 55 vs. 30 for ≥ 4 point IMP, 64 vs. 23 for ≥ 25% IMP, and 78 vs. 30 for ≥ 50% IMP. Frequencies for Discharge to Rehabilitation (RISS vs. no-RISS) were: 1 vs. 36, 14 vs. 41, and 10 vs. 36. Nursing Home discharge frequencies were: 5 vs. 11, 4 vs. 12, and 1 vs. 11. Across all definitions of RISS there was a significant difference in discharge status favoring RISS (all p values < 0.001). Three-month CT lesion volumes (cm3): for RISS ≥ 4 point IMP were: 7.51 [95% Confidence Interval (CI): 1.52, 12.34] vs. no-RISS 19.95 (CI: 2.71, 26.42); for RISS ≥ 25%: 4.64 (CI: 1.07, 7.41) vs. no-RISS 25.96 (CI: 2.99, 33.96); for RISS ≥ 50% IMP: 3.14 (CI: 0.44, 6.36) vs. no-RISS 19.75 (CI: 2.73, 25.50). All p values <0.001.There were no statistically significant rt-PA treatment interactions for CT volume (lowest p-value 0.28) and for discharge status (lowest p-value 0.13). Conclusions: Post hoc exploratory analyses suggest that based on all definitions of RISS used, those patients with RISS were consistently and significantly discharged to a more favorable location than those without RISS. These findings were also consonant with CT lesion volumes at 3 months being significantly smaller for each definition of RISS vs. no RISS. However, while patients with RISS do better in these exploratory outcomes, they still commonly have evidence of cerebral infarction and approximately 2 of 3 with ≥ 4 point IMP and 1 in 5 with at least 50% IMP are not discharged home.

Small Bowel Necrosis Related to Enteral Nutrition after Duodenal Surgery

2005 ◽  
Vol 71 (12) ◽  
pp. 993-995 ◽  
Author(s):  
Ryan Messiner ◽  
Margaret Griffen ◽  
Richard Crass
Keyword(s):  
Small Bowel ◽  
Enteral Nutrition ◽  
Laboratory Data ◽  
Tube Feeding ◽  
Gunshot Wounds ◽  
Bowel Necrosis ◽  
Successful Recovery ◽  
Discharge Status ◽  
Prolonged Hospital ◽  
Small Bowel Necrosis

Nutritional support is the key to the successful recovery of any patient. Small bowel necrosis is described in patients being fed with enteral nutrition after surgery. Five patients with small bowel necrosis after surgery will be discussed and an etiology proposed. A retrospective review of patient data was performed. Data was collected on the type of surgical procedures performed, the enteral nutrition given to the patient, basic laboratory data, the length of stay, and discharge status. A total of five patients’ charts were reviewed. Three patients had pancreaticoduodenectomy for a pancreatic mass and two required pyloric exclusion secondary to gunshot wounds. All five patients were fed with a fiber-based enteral nutrition. All patients subsequently had small bowel necrosis requiring reoperation. Four of the five patients had inspissated tube feeding within the necrotic small bowel. Two patients died and three survived with prolonged hospital courses. We propose that the combination of duodenal surgery and fiber-based enteral nutrition contribute to the development of small bowel necrosis postoperatively.

Association between location of the lesion and discharge status of ADL in first stroke patients

1994 ◽  
Vol 75 (8) ◽  
pp. 858-860 ◽  
Author(s):  
Satoru Saeki ◽  
Hajime Ogata ◽  
Kenji Hachisuka ◽  
Toshiteru Okubo ◽  
Ken Takahashi ◽  
...  
Keyword(s):  
Stroke Patients ◽  
Discharge Status
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