Abstract：
OBJECTIVE:To determine how all-cause hospitalizations within 12 months preceding an index heart failure (HF) hospitalization affect risk stratification for 30-day all-cause readmission. PATIENTS AND METHODS:Early readmission of inpatients with HF is challenging to predict, yet this outcome is used to compare hospital performance and guide reimbursement. Most risk models do not consider the potentially important variable of prior admissions. We analyzed Medicare inpatients with HF aged 66 years or older admitted to 14 Michigan community hospitals from October 1, 2002, to March 31, 2003, and from January 1 to June 30, 2004. Clinical data were obtained from admission charts, hospitalization dates from Centers for Medicare & Medicaid Services (CMS) claims, and mortality dates from the Social Security Death Index. We used mixed-effects logistic regression and reclassification indices to evaluate the ability of a CMS chart-based readmission risk model, prior admissions, and their combination to predict 30-day readmission in survivors of the index HF hospitalization. RESULTS:Of 1807 patients, 43 (2.4%) died during the index admission; 476 of 1764 survivors (27%) were readmitted 30 or fewer days after discharge. Adjusted for the CMS readmission model, prior admissions significantly increased the odds of 30-day readmission (1 vs 0: odds ratio, 4.67; 95% CI, 3.37-6.46; ≥2 vs 0: odds ratio, 6.49; 95% CI, 4.93-8.55; both P<.001), improved model discrimination (c statistic, 0.61-0.74, P<.001), and reclassified many patients (net reclassification index, 0.40; integrated discrimination index, 0.12). CONCLUSION:In Medicare inpatients with HF, prior all-cause admissions strongly increase all-cause readmission risk and markedly improve risk stratification for 30-day readmission.
journal_name
Mayo Clin Procjournal_title
Mayo Clinic proceedingsauthors
Hummel SL,Katrapati P,Gillespie BW,Defranco AC,Koelling TMdoi
10.1016/j.mayocp.2013.12.018subject
Has Abstractpub_date
2014-05-01 00:00:00pages
623-30issue
5eissn
0025-6196issn
1942-5546pii
S0025-6196(14)00071-8journal_volume
89pub_type
杂志文章abstract：:Transesophageal echocardiography (TEE) is used frequently in patients with cerebrovascular ischemia. On TEE, a typical appearance of a cardiac fibroelastoma is that of a pedunculated, mobile mass attached to a leaflet of a valve. Surgical excision of the lesion may lead to resolution of the symptoms and prevent furthe...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/S0025-6196(11)63944-X
更新日期：1995-09-01 00:00:00
abstract：OBJECTIVE:To determine the sensitivity and specificity of a quantitative plasma fibrin D-dimer latex immunoassay (LIA) for the diagnosis of acute pulmonary embolism. SUBJECTS AND METHODS:Study subjects were Mayo Clinic Rochester inpatients and outpatients with suspected acute pulmonary embolism; all had undergone quan...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.4065/82.5.556
更新日期：2007-05-01 00:00:00
abstract：:The neurologist has become increasingly involved in the multidisciplinary treatment of patients with chronic noncancer pain (CNP). Chronic noncancer pain affects a diverse patient population with multiple underlying diagnoses and associated therapies. Following the model of the American Board of Anesthesiology and the...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.4065/78.1.80
更新日期：2003-01-01 00:00:00
abstract：:To determine factors associated with a favorable long-term prognosis in gastric leiomyosarcoma, we retrospectively reviewed the medical records of 93 Mayo Clinic patients with this biopsy-proven tumor diagnosed during the 25-year period from 1964 through 1988. Six patients who had Carney's triad (gastric epithelioid l...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/s0025-6196(12)60459-5
更新日期：1992-06-01 00:00:00
abstract：OBJECTIVE:To summarize results of telemedicine evaluations of speech and language disorders in patients in a small, rural hospital and in large multidisciplinary medical practices. MATERIALS AND METHODS:Eight patients underwent assessment as part of experiments with the National Aeronautics and Space Administration-la...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.4065/72.12.1116
更新日期：1997-12-01 00:00:00
abstract：:Gastric and gastroesophageal adenocarcinomas continue to be a major health burden globally and collectively represent the third leading cause of cancer death. Among patients with metastatic disease, most die of their cancer because of the limited number of modestly effective treatment regimens available today. The pro...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.1016/j.mayocp.2016.07.018
更新日期：2016-09-01 00:00:00
abstract：OBJECTIVE:To characterize the findings associated with acute febrile neutrophilic dermatosis (Sweet's syndrome [SS]) and the response of SS to treatment. DESIGN:We retrospectively reviewed 48 cases of SS encountered at the Mayo Clinic between 1980 and 1992. MATERIAL AND METHODS:Histopathologic specimens and medical r...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.4065/70.3.234
更新日期：1995-03-01 00:00:00
abstract：:The feasibility and accuracy of continuous-wave Doppler echocardiography in measuring pressure gradients across the pulmonary artery band were assessed. Simultaneous continuous-wave Doppler and catheter pressure measurements were prospectively performed in 20 patients with complex congenital heart disease and prior pu...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/s0025-6196(12)65584-0
更新日期：1984-11-01 00:00:00
abstract：:Considerable morbidity and mortality are associated with infections of vascular prosthetic grafts. Most vascular surgeons believe that once vascular prosthetic graft infections occur, any form of therapy short of removal of the prosthesis will fail. Although recent reports have noted the successful conservative treatm...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：
更新日期：1983-07-01 00:00:00
abstract：:In 51 patients, the cause for pleural effusion remained indeterminate immediately after thoracotomy. Thirty-one (60.8%) had no recurrence of the effusion, and no cause became apparent during a follow-up period of from 1 1/2 to 15 years. Two patients (3.9%) died relatively soon after thoracotomy, but death was not clea...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：
更新日期：1981-03-01 00:00:00
abstract：:Hip arthroplasty using the Thompson femoral prosthesis with methyl methacrylate fixation was performed on 109 hips in 106 patients. During an average follow-up period of 36 months, 26 patients died. Fifty-one procedures were performed for fresh fractures of the femoral neck and results were satisfactory in this group ...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：
更新日期：1977-06-01 00:00:00
abstract：OBJECTIVE:To assess whether caffeine intake is associated with all-cause and cause-specific mortality. PATIENTS AND METHODS:We conducted a prospective cohort study using data from the National Health and Nutrition Examination Survey 1999-2010. Cox proportional hazards models were used to compare the multivariate-adjus...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/j.mayocp.2017.03.010
更新日期：2017-08-01 00:00:00
abstract：:In the years 1960 through 1966, vagotomy and pyloroplasty was performed for duodenal ulceration in 182 patients. Elective operation was performed in 84% of cases, and intractability of symptoms was the major indication. For emergency operations, bleeding was the main indication. Eight of 182 patients died in the posto...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：
更新日期：1980-01-01 00:00:00
abstract：OBJECTIVE:To determine whether a simple clinical score, which was shown previously to predict the likelihood of severe coronary artery disease (CAD) in patients referred for coronary angiography, could predict prognosis in a separate cohort of patients with normal or mildly abnormal findings on their resting electrocar...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.4065/77.6.515
更新日期：2002-06-01 00:00:00
abstract：OBJECTIVE:To measure the effect of duty periods no longer than 16 hours on patient care and resident education. PATIENTS AND METHODS:As part of our Educational Innovations Project, we piloted a novel resident schedule for an inpatient service that eliminated shifts longer than 16 hours without increased staffing or de...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.4065/mcp.2010.0745
更新日期：2011-03-01 00:00:00
abstract：:Abdominal wall pain (AWP) is a common and underrecognized cause of chronic abdominal pain. The etiology of AWP varies. History and physical examination are critical to an accurate diagnosis of AWP. Trigger point injection using either a corticosteroid, a local anesthetic, or a combination of both often gives relief of...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.1016/j.mayocp.2018.04.031
更新日期：2019-02-01 00:00:00
abstract：OBJECTIVE:To determine the incidence and predictors of infective endocarditis (IE) in a population-based cohort of patients with mitral valve prolapse (MVP). PATIENTS AND METHODS:We identified all adult Olmsted County residents with MVP diagnosed by echocardiography from January 1989 to December 1998 and cross-matched...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/j.mayocp.2015.12.006
更新日期：2016-03-01 00:00:00
abstract：:A 56-year-old man sought medical assistance because of recurrent nonconvulsive status epilepticus without a history of prior seizure activity. Examination of the cerebrospinal fluid disclosed leptomeningeal cancer. To our knowledge, the association of partial complex status epilepticus and leptomeningeal cancer has no...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/s0025-6196(12)62337-4
更新日期：1987-09-01 00:00:00
abstract：OBJECTIVE:To assess overall perioperative and anesthetic care-specific patient satisfaction. DESIGN:We mailed questionnaires postoperatively to three groups of surgical patients (those who underwent anesthesia without complications, those who experienced airway management difficulties, and those who had cardiovascular...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.4065/72.1.20
更新日期：1997-01-01 00:00:00
abstract：:Aortic valve replacement is a lifesaving measure in patients with severe aortic valve disease. In the United States, the most commonly used prostheses are the mechanical and bioprosthetic valves. With mechanical valves, long-term anticoagulation is necessary because of high thrombogenic potential. Bioprosthetic valves...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.4065/73.3.231
更新日期：1998-03-01 00:00:00
abstract：:Given the burden of cardiovascular disease (CVD), increasing the prevalence of healthy lifestyle choices is a global imperative. Currently, cardiac rehabilitation programs are a primary way that modifiable risk factors are addressed in the secondary prevention setting after a cardiovascular (CV) event/diagnosis. Even ...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.1016/j.mayocp.2013.03.002
更新日期：2013-06-01 00:00:00
abstract：:Many patients taking customary doses of levothyroxine have slightly elevated serum thyroxine (T4), apparently normal serum triiodothyronine, suppressed serum thyrotropin (thyroid-stimulating hormone; TSH) concentrations, and no clinical symptoms of hyperthyroidism. Recent reports suggest that these patients may have a...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.1016/s0025-6196(12)65409-3
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journal_title：Mayo Clinic proceedings
pub_type： 临床试验,杂志文章
doi：10.1016/s0025-6196(12)60824-6
更新日期：1992-09-01 00:00:00
abstract：:To our knowledge, edema of the lower extremities has not previously been reported as a sign of a pancreatic pseudocyst. In this case report, we describe a 66-year-old man in whom such a lesion compressed the inferior vena cava and caused pronounced leg swelling. After drainage of the pseudocyst, the edema did not recu...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/s0025-6196(12)61125-2
更新日期：1992-11-01 00:00:00
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journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.1016/j.mayocp.2011.09.004
更新日期：2012-02-01 00:00:00
abstract：OBJECTIVE:To explore the transcriptomic differences between patients with hypertrophic cardiomyopathy (HCM) and controls. PATIENTS AND METHODS:RNA was extracted from cardiac tissue flash frozen at therapeutic surgical septal myectomy for 106 patients with HCM and 39 healthy donor hearts. Expression profiling of 37,846...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/j.mayocp.2020.04.028
更新日期：2020-07-01 00:00:00
abstract：:Serum cystatin C has been proposed as a kidney biomarker to inform drug dosing. We conducted a systematic review to synthesize available data for the association between serum cystatin C and drug pharmacokinetics, dosing, and clinical outcomes in adults (≥18 years). PubMed, Ovid MEDLINE, Ovid EMBASE, EBSCO CINAHL, and...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/j.mayocp.2018.08.002
更新日期：2019-03-01 00:00:00
abstract：:A case of inguinal hernia with massive scrotal enlargement is presented. Walking and voiding had become extremely difficult for the patient; only one testicle could be palpated, and the penis could not be delivered from the scrotal mass. Surgical reduction of the massive hernia was accomplished. The right testis with ...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：
更新日期：1982-06-01 00:00:00
abstract：OBJECTIVE:To characterize the clinicopathologic findings, comorbidities, and treatment outcomes of women with lichen planopilaris (LPP). METHOD:In this retrospective review of women with LPP at Mayo Clinic from 1992 to 2016, we searched for scarring alopecia in all female patients aged 1 to 100 years from January 1, 1...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/j.mayocp.2020.02.028
更新日期：2020-08-01 00:00:00
abstract：:In August 2015, an expert colloquium commissioned by the Sexual Medicine Society of North America (SMSNA) convened in Washington, DC, to discuss the common clinical scenario of men who present with low testosterone (T) and associated signs and symptoms accompanied by low or normal gonadotropin levels. This syndrome is...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.1016/j.mayocp.2016.04.022
更新日期：2016-07-01 00:00:00
