RocScholar (Rochester Regional Health)
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Diabetes is associated with a higher incidence of short-term mortality risk and readmission in patients who undergo surgical but not transcatheter aortic valve replacement
No full textBACKGROUND: Transcatheter aortic valve replacement (TAVR) is increasingly used for aortic valve replacement instead of surgical aortic valve replacement (sAVR). We aimed to examine the impact of diabetes on 30-day mortality, 30-day readmission and compare outcomes between TAVR and sAVR.
METHODS: Data were extracted from the Nationwide Readmissions Database from 2012 to 2017. The primary outcome was 30-day mortality, and the secondary outcome was 30-day readmission.
RESULTS: The study included 110 135 patients who underwent aortic valve replacement. Of these, 59 466 (54.0%) were hospitalised for TAVR, and 50 669 (46.0%) underwent sAVR. Diabetes was present in 36.4% of TAVR patients and 29.1% of sAVR patients. In TAVR patients, the adjusted risk of 30-day readmission and mortality was similar regardless of diabetes status (aHR=0.94 (0.86-1.03); 0.97 (0.84-1.12); respectively). However, sAVR patients with diabetes had a higher adjusted risk of 30-day mortality (aHR=1.13 (1.01-1.25)) but not readmission (aHR=0.92 (0.84-1.01)). When comparing outcomes between TAVR and sAVR in patients with diabetes, TAVR patients were older and had a higher prevalence of chronic kidney disease (CKD). Nevertheless, 30-day readmission and mortality were lower in patients who underwent TAVR (aHR=0.59 (0.53-0.67), aHR=0.29 (0.25-0.34), respectively) compared with sAVR. Coronary artery disease was the most significant predictor of readmission in patients with diabetes. CKD increased the risk of mortality by almost twofold in both techniques.
CONCLUSION: Diabetes increases the risk of short-term mortality in sAVR but not TAVR. Moreover, the incidence of 30-day mortality and readmission is lower in TAVR compared with TAVR among patients with diabetes
Finding Aid for Rochester General Hospital
Full text linkFinding Aid for the Rochester General Hospital Collection. Rochester General Hospital is located in Rochester, New York.
Record groups include: Rochester Female Charitable Society; Women\u27s Board; Rochester General Hospital Association; Twigs; RCH School of Nursing; Nursing Practice; Isabella Graham Hart School of Practical Nursing; Medical Departments; Rochester General Hospital Board of Directors; Medical Board; Baker-Cederberg Museum and Archives; Hospital History; Annual Reports; Administration; Military Collections; Public Relations; Dietary/Food and Nutrition Services; Laboratories; Safety and Security; Pharmacy; Ambulatory Services – Out Patient Department; Hospital Libraries; Medical Departments; Social Work Department; Mary M. Gooley Hemophilia Cente
POSTER: MM-901 Predictors and Outcomes of Major Cardiovascular Events in Hospitalized Multiple Myeloma Patients (2016–2020)
No full textMM-903: Trends in Venous Thromboembolism Events in Hospitalized Multiple Myeloma Patients: A Retrospective Cohort Study
No full textCT-1007: Severe Cytokine Release Syndrome and Risk of Acute Kidney Injury in Patients With Hematologic Malignancies Undergoing CAR T-Cell Therapy: A Systematic Review and Meta-Analysis
No full textAML-751: Clinical Efficacy and Safety of Enasidenib in Newly Diagnosed IDH2-Mutated Acute Myeloid Leukemia (AML): A Systematic Review and Meta-Analysis of Randomized Controlled Trials
No full textHL-879: Immune Checkpoint Inhibition as a Bridge to Allogeneic Transplant in Relapsed/Refractory Classical Hodgkin Lymphoma: A Meta-Analysis
No full textMDS-963: Transfusion-Dependent MDS With Ring Sideroblasts and Incidental Low-Grade Lymphoma: A Complex Hematologic Intersection
No full textPOSTER: AML-179 The Role of Interim Bone Marrow Assessments in Acute Myeloid Leukemia: A Systematic Review and Meta-Analysis
No full textThe drug allergy history tool (DAHT): Validation of a patient-reported survey instrument
No full textBACKGROUND: While the reaction history is critical for drug allergy evaluations and is typically self-reported, there is no validated survey instrument to collect drug allergy history from patients.
OBJECTIVE: We validated a survey instrument that collects patient-reported drug allergy history.
METHODS: The drug allergy history tool (DAHT) was revised after 3 rounds of cognitive testing, assessed for reliability through test-retest comparisons, and assessed for quality and validity through a concordance analysis against electronic health record allergist documentation. Participants completing testing and surveys had 1 or more drug allergies and were recruited from allergy clinics at Massachusetts General Hospital. Primary evaluative measures were percentage agreement and kappa statistic values.
RESULTS: The DAHT was completed by 79 individuals (mean age, 49 [SD 17] years, 85% female, 85% White, 11% Hispanic ethnicity), 29 with single drug allergy labels and 50 with multiple drug allergy labels. The most common drug allergy labels were penicillins (77%), sulfonamides (32%), cephalosporins (15%), and nonsteroidal anti-inflammatory drugs (8%). The DAHT achieved acceptable test-retest reliability (median κ = 0.64, median agreement = 86%). The DAHT achieved a more complete allergy history than allergist documentation in the electronic health record, with lower median item uncertainty (21% DAHT vs 79% electronic health record) with fair concordance (median κ = 0.21, median agreement = 67%) between the two data sources.
CONCLUSION: The DAHT is a reliable and valid source of patient-reported drug allergy information. This tool can be used in clinical care and clinical research to obtain standardized patient-reported drug allergy history