GLORIA

GEOMAR Library Ocean Research Information Access

X

Your email was sent successfully. Check your inbox.

An error occurred while sending the email. Please try again.

Proceed reservation?

Export
  • 1
    Online Resource
    Online Resource
    PC108. Novel Bypass Risk Predictive Tool Is Superior to the 5-Factor Modified Frailty Index in Predicting Postoperative Mortality and Morbidity
    Elsevier BV ; 2019
    In:  Journal of Vascular Surgery Vol. 69, No. 6 ( 2019-06), p. e235-
    Details
    In: Journal of Vascular Surgery, Elsevier BV, Vol. 69, No. 6 ( 2019-06), p. e235-
    Type of Medium: Online Resource
    ISSN: 0741-5214
    URL: Article
    DOI: 10.1016/j.jvs.2019.04.347
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2019
    detail.hit.zdb_id: 1492043-8
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 2
    Online Resource
    Online Resource
    Novel bypass risk predictive tool is superior to the 5-Factor Modified Frailty Index in predicting postoperative outcomes
    Elsevier BV ; 2020
    In:  Journal of Vascular Surgery Vol. 72, No. 4 ( 2020-10), p. 1427-1435.e1
    Details
    In: Journal of Vascular Surgery, Elsevier BV, Vol. 72, No. 4 ( 2020-10), p. 1427-1435.e1
    Type of Medium: Online Resource
    ISSN: 0741-5214
    URL: Article
    DOI: 10.1016/j.jvs.2019.11.050
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2020
    detail.hit.zdb_id: 1492043-8
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 3
    Online Resource
    Online Resource
    Limitations of patient experience reports to evaluate physician quality in spine surgery: analysis of 7485 surveys
    Journal of Neurosurgery Publishing Group (JNSPG) ; 2019
    In:  Journal of Neurosurgery: Spine Vol. 30, No. 4 ( 2019-04), p. 520-523
    Details
    In: Journal of Neurosurgery: Spine, Journal of Neurosurgery Publishing Group (JNSPG), Vol. 30, No. 4 ( 2019-04), p. 520-523
    Abstract: The Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS) is a standardized patient experience survey that is used to evaluate the quality of care delivered by physicians. The authors sought to determine which factors influenced CG-CAHPS scores for spine surgery, and compare them to their cranial-focused cohorts. METHODS A retrospective study of prospectively obtained data was performed to evaluate CG-CAHPS scores. Between May 2013 and May 2017, all patients 18 years of age or older with an outpatient encounter with a neurosurgeon (5 spine-focused neurosurgeons and 20 cranial-focused neurosurgeons) received a CG-CAHPS survey. Three domains were assessed: overall physician rating, likelihood to recommend, and physician communication. Statistical analyses were performed using chi-square tests. RESULTS Seven thousand four hundred eighty-five patient surveys (2319 spine and 5166 cranial) were collected from patients presenting to the outpatient offices of an attending neurosurgeon. Analysis of the overall physician rating showed that 81.1% of spine neurosurgeons received a “top-box” score (answers of “yes, definitely”), whereas 86.2% of cranial neurosurgeons received a top-box response (p 〈 0.001). A similar difference was observed with the domains of “likelihood to recommend” and “physician communication.” Overall physician rating was also significantly influenced by the general and mental health of the patients surveyed (p 〈 0.001). For spine surgeons seeing patients at more than one facility, the scores with respect to location were also significantly different in all domains for each individual provider (p 〈 0.001). CONCLUSIONS Overall, spine-focused neurosurgeon ratings differed significantly from those of cranial-focused neurosurgical subspecialty providers. Office location also affected provider ratings for spine neurosurgeons. These results suggest that physician ratings obtained via patient experience surveys may be representative of factors aside from just the quality of physician care provided. This information should be considered as payers, government, and health systems design performance programs based on patient experience scores.
    Type of Medium: Online Resource
    ISSN: 1547-5654
    URL: Article
    DOI: 10.3171/2018.8.SPINE18104
    RVK:
    XA 55270.1
    Language: Unknown
    Publisher: Journal of Neurosurgery Publishing Group (JNSPG)
    Publication Date: 2019
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 4
    Online Resource
    Online Resource
    Small pancreatic neuroendocrine tumors: Resect or enucleate?
    Elsevier BV ; 2021
    In:  The American Journal of Surgery Vol. 222, No. 1 ( 2021-07), p. 29-34
    Details
    In: The American Journal of Surgery, Elsevier BV, Vol. 222, No. 1 ( 2021-07), p. 29-34
    Type of Medium: Online Resource
    ISSN: 0002-9610
    URL: Article
    DOI: 10.1016/j.amjsurg.2020.12.013
    RVK:
    XA 10000
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2021
    detail.hit.zdb_id: 2003374-6
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 5
    Online Resource
    Online Resource
    Optimal Pancreatic Surgery : Are We Making Progress in North America?
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  Annals of Surgery Vol. 274, No. 4 ( 2021-10), p. e355-e363
    Details
    In: Annals of Surgery, Ovid Technologies (Wolters Kluwer Health), Vol. 274, No. 4 ( 2021-10), p. e355-e363
    Abstract: Our aims were to assess North American trends in the management of patients undergoing pancreatoduodenectomy (PD) and distal pancreatectomy (DP), and to quantify the delivery of optimal pancreatic surgery. Background: Morbidity after pancreatectomy remains unacceptably high. Recent literature suggests that composite measures may more accurately define surgical quality. Methods: The 2013 to 2017 American College of Surgeons National Surgical Quality Improvement Program Participant Use Files were queried to identify patients undergoing PD (N = 16,222) and DP (N = 7946). Patient, process, procedure, and 30-day postoperative outcome variables were analyzed over time. Optimal pancreatic surgery was defined as the absence of postoperative mortality, serious morbidity, percutaneous drainage, and reoperation while achieving a length of stay equal to or less than the 75th percentile (12 days for PD and 7 days for DP) with no readmissions. Risk-adjusted time-trend analyses were performed using logistic regression, and the threshold for statistical significance was P  ≤ 0.05. Results: The use of minimally invasive PD did not change over time, but robotic PD increased (2.5 to 4.2%; P 〈 0.001) and laparoscopic PD decreased (5.8% to 4.3%; P 〈 0.02). Operative times decreased ( P 〈 0.05) and fewer transfusions were administered ( P 〈 0.001). The percentage of patients with a drain fluid amylase checked on postoperative day 1 increased ( P 〈 0.001), and a greater percentage of surgical drains were removed by postoperative day 3 ( P 〈 0.001). Overall morbidity ( P 〈 0.02), mortality ( P 〈 0.05), and postoperative length of stay ( P = 0.002) decreased. Finally, the rate of optimal pancreatic surgery increased for PD (53.7% to 56.9%; P 〈 0.01) and DP (53.3% to 58.5%; P 〈 0.001), and alspo for patients with pancreatic cancer ( P 〈 0.01). Conclusions: From 2013 to 2017, pre, intra, and perioperative pancreatectomy processes have evolved, and multiple postoperative outcomes have improved. Thus, in 4 years, optimal pancreatic surgery in North America has increased by 3% to 5%.
    Type of Medium: Online Resource
    ISSN: 0003-4932 , 1528-1140
    URL: Article
    DOI: 10.1097/SLA.0000000000003628
    RVK:
    XA 23900
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
    detail.hit.zdb_id: 2641023-0
    detail.hit.zdb_id: 2002200-1
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 6
    Online Resource
    Online Resource
    Validation of the Risk Analysis Index for Evaluating Frailty in Ambulatory Patients
    Wiley ; 2020
    In:  Journal of the American Geriatrics Society Vol. 68, No. 8 ( 2020-08), p. 1818-1824
    Details
    In: Journal of the American Geriatrics Society, Wiley, Vol. 68, No. 8 ( 2020-08), p. 1818-1824
    Abstract: Frailty is a marker of dependency, disability, hospitalization, and mortality in community‐dwelling older adults. However, existing tools for measuring frailty are too cumbersome for rapid point‐of‐care assessment. The Risk Analysis Index (RAI) of frailty is validated in surgical populations, but its performance outside surgical populations is unknown. OBJECTIVE Validate the RAI in ambulatory patients. DESIGN, SETTING, AND PARTICIPANTS Observational cohort study of outpatient surgical clinics within the University of Pittsburgh Medical Center Healthcare System between July 1, 2016, and December 31, 2016. Frailty was assessed using the RAI. Current Procedural Terminology codes following RAI assessment identified patients with and without minor office‐based procedures (eg, joint injection, laryngoscopy). MAIN OUTCOMES AND MEASURES All‐cause 1‐year mortality, assessed by stratified Cox proportional hazard models. RESULTS Of 28,059 patients, 13,861 were matched to a minor, office‐based procedure and 14,198 did not undergo any procedure. The mean (SD) age was 56.7 (17.2) years; women constituted 15,797 (56.3%) of the cohort. Median time (interquartile range 25th‐75th percentile) to measure RAI was 30 (22–47) seconds. Mortality among the frail was two to five times that of patients with normal RAI scores. For example, the hazard ratio for frail ambulatory patients without a minor procedure was 3.69 (95% confidence interval [CI] = 2.51‐5.41), corresponding to 30‐, 180‐, and 365‐day mortality rates of 2.9%, 11.2%, and 17.4%, respectively, compared to 0.3%, 2.3%, and 4.0% among patients with normal RAI scores. Discrimination of mortality (overall, and censored at 30, 180, and 365 days) was excellent, ranging from c = 0.838 (95% CI = 0.773‐0.902) for 30‐day mortality after minor procedures to c = 0.909 (95% CI = 0.855‐0.964) without a procedure. CONCLUSION RAI is a valid, easily administered tool for point‐of‐care frailty assessment in ambulatory populations that may help clinicians and patients make better informed decisions about care choices—especially among patients considered high risk with a potentially limited life span. J Am Geriatr Soc 68:1818‐1824, 2020.
    Type of Medium: Online Resource
    ISSN: 0002-8614 , 1532-5415
    URL: Issue
    URL: Article
    DOI: 10.1111/jgs.v68.8
    DOI: 10.1111/jgs.16453
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2040494-3
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 7
    Online Resource
    Online Resource
    Using the Risk Assessment Index to predict mortality and quality of life in breast and gynecologic cancer patients.
    American Society of Clinical Oncology (ASCO) ; 2020
    In:  Journal of Clinical Oncology Vol. 38, No. 29_suppl ( 2020-10-10), p. 239-239
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 38, No. 29_suppl ( 2020-10-10), p. 239-239
    Abstract: 239 Background: Cancer patients vary considerably in health status making it challenging to evaluate the risk of complications from cancer treatment. To aid oncologists in identifying patients with highest risk for adverse outcomes, we investigated the Risk Assessment Index (RAI), a validated tool used to assess frailty in patients prior to elective surgery. We assessed whether the RAI could serve to predict mortality, hospital utilization, and quality of life in cancer patients. Methods: Participants were breast and gynecological cancer patients treated at UPMC Magee Women’s Cancer Center who completed the RAI between July 2016 and December 2017. Patients completed patient reported outcomes (PROs) during each visit including the Short Form (SF)-12, Edmonton Symptom Assessment, anxiety and depression screens, and MD Anderson Symptom Inventory (MDASI) and were analyzed up to 180 days from the RAI date. Mortality was assessed at 90, 180, and 365-day intervals, and hospital utilization was assessed within 90-days of RAI. Results: There were 1,764 unique breast and gynecological cancer patients. Significant correlations between the RAI and mortality were observed for both groups with frail patients having higher rates of mortality at each interval. Frailty was associated with higher rates of hospitalization compared to non-frail patients (31% vs 20%, p = 0.05 & 50% vs 34%, p = 0.02 for breast and gynecologic patients, respectively). Frailty correlated with fair/poor ratings on the SF-12 for breast and gynecologic patients (r = 0.13, p = 0.01; r = 0.37 p 〈 0.001, respectively). On the Edmonton, frailty correlated with lower ratings of well-being in breast cancer patients (r = 0.11, p = 0.012) and higher symptom burden in gynecological patients (r = 0.23, p = 0.01). No correlations were observed between the RAI and anxiety or depression. For gynecologic patients, there were significant correlations between the RAI and MDASI with frail patients having higher rates of pain, fatigue, appetite, diarrhea, and memory. Conclusions: We demonstrated that the RAI is correlated with mortality, self-reported quality of life, and hospitalizations in breast and gynecologic cancer patients. Using this tool to risk-stratify patients may help to guide shared decision-making discussions and provide appropriate treatment and/or supportive services for this vulnerable population.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2020.38.29_suppl.239
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2020
    detail.hit.zdb_id: 2005181-5
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 8
    Online Resource
    Online Resource
    Recalibration and External Validation of the Risk Analysis Index : A Surgical Frailty Assessment Tool
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Annals of Surgery Vol. 272, No. 6 ( 2020-12), p. 996-1005
    Details
    In: Annals of Surgery, Ovid Technologies (Wolters Kluwer Health), Vol. 272, No. 6 ( 2020-12), p. 996-1005
    Abstract: The Risk Analysis Index (RAI) predicts 30-, 180-, and 365-day mortality based on variables constitutive of frailty. Initially validated, in a single-center Veteran hospital, we sought to improve model performance by recalibrating the RAI in a large, veteran surgical registry, and to externally validate it in both a national surgical registry and a cohort of surgical patients for whom RAI was measured prospectively before surgery. Methods: The RAI was recalibrated among development and confirmation samples within the Veterans Affairs Surgical Quality Improvement Program (VASQIP; 2010–2014; N = 480,731) including major, elective noncardiac surgery patients to create the revised RAI (RAI-rev), comparing discrimination and calibration. The model was tested externally in the American College of Surgeons National Surgical Quality Improvement Program dataset (NSQIP; 2005–2014; N = 1,391,785), and in a prospectively collected cohort from the Nebraska Western Iowa Health Care System VA (NWIHCS; N = 6,856). Results: Recalibrating the RAI significantly improved discrimination for 30-day [ c = 0.84–0.86], 180-day [ c = 0.81–0.84], and 365-day mortality [ c = 0.78–0.82] ( P 〈 0.001 for all) in VASQIP. The RAI-rev also had markedly better calibration (median absolute difference between observed and predicted 180-day mortality: decreased from 8.45% to 1.23%). RAI-rev was highly predictive of 30-day mortality ( c = 0.87) in external validation with excellent calibration (median absolute difference between observed and predicted 30-day mortality: 0.6%). The discrimination was highly robust in men ( c = 0.85) and women ( c = 0.89). Discrimination also improved in the prospectively measured cohort from NWIHCS for 180-day mortality [ c = 0.77 to 0.80] ( P 〈 0.001). Conclusions: The RAI-rev has improved discrimination and calibration as a frailty-screening tool in surgical patients. It has robust external validity in men and women across a wide range of surgical settings and available for immediate implementation for risk assessment and counseling in preoperative patients.
    Type of Medium: Online Resource
    ISSN: 0003-4932 , 1528-1140
    URL: Article
    DOI: 10.1097/SLA.0000000000003276
    RVK:
    XA 23900
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
    detail.hit.zdb_id: 2641023-0
    detail.hit.zdb_id: 2002200-1
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 9
    Online Resource
    Online Resource
    Developing a Community-Based Tailored Exercise Program for People With Severe and Persistent Mental Illness
    Project MUSE ; 2015
    In:  Progress in Community Health Partnerships: Research, Education, and Action Vol. 9, No. 2 ( 2015), p. 213-227
    Details
    In: Progress in Community Health Partnerships: Research, Education, and Action, Project MUSE, Vol. 9, No. 2 ( 2015), p. 213-227
    Type of Medium: Online Resource
    ISSN: 1557-055X
    URL: Article
    DOI: 10.1353/cpr.2015.0045
    Language: English
    Publisher: Project MUSE
    Publication Date: 2015
    SSG: 2
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 10
    Online Resource
    Online Resource
    New Risk Assessment Tool for Venous Thromboembolism in Plastic Surgery Patients : Analysis of National Surgical Quality Improvement Program Dataset
    Ovid Technologies (Wolters Kluwer Health) ; 2014
    In:  Plastic and Reconstructive Surgery Vol. 134 ( 2014-10), p. 104-
    Details
    In: Plastic and Reconstructive Surgery, Ovid Technologies (Wolters Kluwer Health), Vol. 134 ( 2014-10), p. 104-
    Type of Medium: Online Resource
    ISSN: 0032-1052
    URL: Article
    DOI: 10.1097/01.prs.0000455460.78571.09
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2014
    detail.hit.zdb_id: 2037030-1
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
Close ⊗
This website uses cookies and the analysis tool Matomo. More information can be found here...