2011 August 05

Adherence of hospital-based cardiologists to lipid guidelines in patients at high risk for cardiovascular events (2L registry).

Aug 052011

Adherence of hospital-based cardiologists to lipid guidelines in patients at high risk for cardiovascular events (2L registry).

Clin Res Cardiol. 2011 Apr;100(4):277-87

Authors: Gitt AK, Jünger C, Jannowitz C, Karmann B, Senges J, Bestehorn K

According to various national and international guidelines, the target LDL-C level is <100 mg/dl for patients with established coronary heart disease (CHD) or CHD risk equivalent (CE). We aimed to investigate aspects of the lipid-lowering management of patients at high cardiovascular risk in-hospital care and the achievement of target values.

PMID: 20963598 [PubMed - indexed for MEDLINE]

Link to Article at PubMed

Central line bundle implementation in US intensive care units and impact on bloodstream infections.

PLoS ONE Start a Discussion »

Aug 052011

Central line bundle implementation in US intensive care units and impact on bloodstream infections.

PLoS One. 2011;6(1):e15452

Authors: Furuya EY, Dick A, Perencevich EN, Pogorzelska M, Goldmann D, Stone PW

Central line-associated bloodstream infections (CLABSI) represent a serious patient safety issue. To prevent these infections, bundled interventions are increasingly recommended. We examine the extent of adoption of Central Line (CL) Bundle elements throughout US intensive care units (ICU) and determine their effectiveness in preventing CLABSIs.

PMID: 21267440 [PubMed - indexed for MEDLINE]

Link to Article at PubMed

Post-dural puncture headache: part I diagnosis, epidemiology, etiology, and pathophysiology.

Headache Start a Discussion »

Aug 052011

Post-dural puncture headache: part I diagnosis, epidemiology, etiology, and pathophysiology.

Headache. 2010 Jul;50(7):1144-52

Authors: Bezov D, Lipton RB, Ashina S

Post-dural puncture headache (PDPH) is a frequent complication of dural puncture whether performed for diagnostic purposes or accidentally, as a complication of anesthesia. Because both procedures are common, clinicians interested in headache should be familiar with this entity. The differential diagnosis of PDPH is broad and includes other complications of dural puncture as well as headaches attributable to the condition which lead to the procedure. The patterns of development of PDPH depend on a number of procedure- and nonprocedure-related risk factors. Knowledge of procedure-related factors supports interventions designed to reduce the incidence of PDPH. Finally, despite best preventive efforts, PDPH may still occur and be associated with significant morbidity. Therefore, it is important to know the management and prognosis of this disorder. In this review, we will highlight diagnosis and clinical characteristics of PDPH, differential diagnosis, frequency, and risk factors as well as pathophysiology of PDPH.

PMID: 20533959 [PubMed - indexed for MEDLINE]

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Clinical and economic outcomes of multiple versus single long-acting inhalers in COPD.

Respir Med Start a Discussion »

Aug 052011

Clinical and economic outcomes of multiple versus single long-acting inhalers in COPD.

Respir Med. 2011 Jul 30;

Authors: Yu AP, Guérin A, de Leon DP, Ramakrishnan K, Wu EQ, Mocarski M, Blum SI, Setyawan J

OBJECTIVE: To compare healthcare resource utilization and healthcare costs between COPD patients who used multiple long-acting inhalers versus those who used a single long-acting inhaler. METHODS: COPD patients meeting study inclusion criteria were identified in the Market Scan database (2004-2008) and were classified as being a multiple- or single-inhaler user. 11,747 multiple- and single-inhaler users were matched on baseline characteristics to balance disease severity. Patients were followed for 12 months. Incremental differences between the two groups were estimated for: number of exacerbations; time to first exacerbation; all-cause and COPD-related inpatient admissions, inpatient days, emergency room visits, urgent care visits, outpatient visits, and other medical services visits; all-cause and COPD-related healthcare costs. Multivariate regression analyses were also used to control for a number of potentially confounding factors. RESULTS: After controlling for a number of potentially confounding factors, multiple-inhaler users experienced significantly more exacerbations (0.52; p < .0001) and had a higher risk of exacerbation (HR = 1.40; p < .0001) than single-inhaler users. Multiple-inhaler users also incurred significantly more inpatient admissions (IRR = 1.15; p < .0001), inpatient days (IRR = 1.20; p < .0001), urgent care visits (IRR = 1.10; p = 0.0026), outpatient visits (IRR = 1.06; p < .0001), and other medical services visits (IRR = 1.12; p = <.001) than single-inhaler users, resulting in significantly higher all-cause health care costs ($3,319; p < .0001). Results of COPD-related resource use and costs were comparable. CONCLUSIONS: After controlling for a number of potentially confounding factors, multiple-inhaler users had more exacerbations, a higher risk of exacerbation, and higher healthcare resource utilization and costs compared to single-inhaler users.

PMID: 21807487 [PubMed - as supplied by publisher]

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International Classification of Diseases, 10th Revision: It’s Coming, Ready or Not.

Health Care Manag (Frederick) Start a Discussion »

Aug 052011

International Classification of Diseases, 10th Revision: It's Coming, Ready or Not.

Health Care Manag (Frederick). 2011 Jul-Sep;30(3):227-35

Authors: Harris ST, Zeng X, Ford L

The current diagnostic and inpatient procedure coding system, International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM), has been used in the United States since 1979. The coding system has become insufficient because of many medical and technological improvements that have occurred since then. On September 20, 2013, the US health care system will assign the final ICD-9-CM code. The new system, International Classification of Diseases, 10th Revision, Clinical Modification, Procedure Classification System, will become effective on October 1, 2013, including more codes and other differences. Although October 2013 is the implementation deadline, facilities should start preparing for the change at this time. A thorough understanding of the new official guidelines is key to a successful transition from ICD-9-CM to International Classification of Diseases, 10th Revision, Clinical Modification, Procedure Classification System. As we are embracing 1 of the greatest health care changes in 30 years, specific considerations are offered for initiating implementation and ensuring a smooth transition.

PMID: 21808174 [PubMed - in process]

Link to Article at PubMed