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30, 95% CI 1.05, 5.02), though this risk was attenuated when adjusting for clinical factors (most notably functional status).
Patients with severe pain had a higher risk of mortality, which was attenuated when correcting for clinical characteristics. Those patients who required opioid analgesics in the ED were more likely to require admission and were more at risk of 30-day hospital readmission. Future efforts should focus on these at-risk groups, who may benefit from additional services including palliative care, hospice, or home-health services.
Patients with severe pain had a higher risk of mortality, which was attenuated when correcting for clinical characteristics. Those patients who required opioid analgesics in the ED were more likely to require admission and were more at risk of 30-day hospital readmission. Future efforts should focus on these at-risk groups, who may benefit from additional services including palliative care, hospice, or home-health services.
To evaluate satisfaction with care (SC) in cancer patients treated at a Spanish day hospital, to identify determinants of SC, and to assess the association between SC and quality of life (QL).
Cross-sectional study in which 119 patients undergoing outpatient chemotherapy completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), the Cancer Outpatient Satisfaction with Care questionnaire for chemotherapy (OUT-PATSAT35 CT), and an item on loyalty. Bivariate correlations between each subscale of the OUT-PATSAT35 CT and overall satisfaction, and between the subscales of OUT-PATSAT35 CT and QLQ-C30, were calculated. Multiple linear regression models were used to analyze determinants of patients' SC.
Mean age was 62.5years (SD 11.7), and 54.6% of the sample were female. Mean scores for SC were > 75 out of 100 on all OUT-PATSAT35 CT subscales, except environment. Overall satisfaction was higher than satisfaction in any subscale, and all patients would choose the same day hospital again. Correlation with overall satisfaction was moderate but statistically significant for all subscales. Patients treated for tumor recurrence and those undergoing palliative treatment manifested significantly lower overall satisfaction. Correlation between the EORTC QLQ-C30 and the OUT-PATSAT35 CT was not statistically significant, although patients with better health status reported higher satisfaction in several subscales.
Patient-reported SC and loyalty towards the day hospital were high. Disease evolution and aim of treatment were determinants of overall satisfaction. The correlation between SC and QL was unclear. Some areas for improving care were noted.
Patient-reported SC and loyalty towards the day hospital were high. Disease evolution and aim of treatment were determinants of overall satisfaction. The correlation between SC and QL was unclear. Some areas for improving care were noted.
It is important to assess global trends in the practice of adult reconstruction orthopaedic surgery to understand how new evidence is being implemented. The International Society of Orthopaedic Centers (ISOC) is a consortium of academic orthopaedic centers whose members' practices likely reflect contemporary evidence and indicate how orthopaedic surgery residents and fellows are trained.
We administered a 65 question, electronic survey of adult reconstruction surgeons across the ISOC centers in September 2020 to assess practice patterns. Results were assessed using descriptive statistics or by modeling the underlying response distribution, and the analysis was stratified by hospital region.
79 surgeons across 19 ISOC centers in 5 continents (Asia, Australia, Europe, North America, South America) completed the survey. Selected findings include in total hip arthroplasty (THA), the posterolateral approach was used for 71 ± 42% of THA (mean ± standard deviation) and the direct anterior approach in 18% ± 34%. In total knee arthroplasty, posterior-stabilized (66% ± 39%) and cruciate-retaining (19 ± 33%) implants were most common. Robots were available in 56% (44 of 79) of surgeons' centers more commonly in Asia, Australia, and North America. Tranexamic acid was routinely used in arthroplasty by 99% (78 of 79) of surgeons. Eighty-six percent (68 of 79) submit data to joint or other registries. Virtual visits were used for 13% ± 16% of outpatient visits and by 82% (64 of 79) of surgeons overall.
These findings may be of use now for surgeons to consider the practices of their peers at high-volume academic institutions, and in the future as we track temporal trends.
These findings may be of use now for surgeons to consider the practices of their peers at high-volume academic institutions, and in the future as we track temporal trends.
While surgery is an effective treatment for secondary spontaneous pneumothorax (SSP), it can be difficult, because affected patients are usually in a poor general condition. The present study investigated the risk factors of postoperative complications after surgery for SSP.
Eighty-eight patients with SSP who underwent surgery from January 2006 to March 2018 were investigated. Clinical data were reviewed, and a multivariate analysis was performed.
Eighty-four patients (95%) were males, and the median patient age was 72years. Underlying lung diseases were chronic obstructive pulmonary disease in 58 patients (65.9%), interstitial pneumonia in 26 (29.5%), and others in 4 (4.5%). Heptadecanoic acid Postoperative complications developed in 21 patients (24%). Hospital mortality/prolonged length of stay occurred in 6 patients (7%). A multivariate analysis showed that the preoperative performance status (performance status 0-2 vs. 3, hazard ratio 6.570, 95% confidence interval 1.980-21.800) was an independent predictor of postoperative complications.
Surgery for SSP contributed to early chest tube removal and favorable outcomes. However, rare fatal events occurred, and the patient performance status was a risk factor for postoperative complications. A careful evaluation of each patient's performance status is needed to determine the need for surgical intervention for SSP.
Surgery for SSP contributed to early chest tube removal and favorable outcomes. However, rare fatal events occurred, and the patient performance status was a risk factor for postoperative complications. A careful evaluation of each patient's performance status is needed to determine the need for surgical intervention for SSP.
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