Abstract:
OBJECTIVES:This study aimed to describe variation in imaging practices and examine the association between early imaging and outcomes in children hospitalized with cervical lymphadenitis. METHODS:This multicenter cross-sectional study included children between two months and 18 years hospitalized with cervical lymphadenitis between 2013 and 2017. Children with complex chronic conditions, transferred from another institution, and with prior hospitalizations for lymphadenitis were excluded. To examine hospital-level variation, we calculated the proportion of children at each hospital who received any imaging study, early imaging (conducted on day 0 of hospitalization), multiple imaging studies, and CT imaging. Generalized linear or logistic mixed effects models examined the association between early imaging and outcomes (ie, multiple imaging studies, surgical drainage, 30-day readmission, and length of stay) while accounting for patient demographics, markers of illness duration and severity, and clustering by hospital. RESULTS:Among 10,014 children with cervical lymphadenitis, 61% received early imaging. There was hospital-level variation in imaging practices. Compared with children who did not receive early imaging, children who received early imaging presented increased odds of having multiple imaging studies (adjusted odds ratio [aOR] 3.0; 95% CI: 2.6-3.6), surgical drainage (aOR 1.3, 95%CI: 1.1-1.4), and 30-day readmission for lymphadenitis (aOR 1.5, 95%CI: 1.2-1.9), as well as longer lengths of stay (adjusted rate ratio 1.2, 95%CI: 1.1-1.2). CONCLUSIONS:Children receiving early imaging had more resource utilization and intervention than those without early imaging. Our findings may represent a cascade effect, in which routinely conducted early imaging prompts clinicians to pursue additional testing and interventions in this population.
journal_name
J Hosp Medjournal_title
Journal of hospital medicineauthors
Desai S,Shah SS,Hall M,Richardson TE,Thomson JE,Pediatric Research in Inpatient Settings (PRIS) Network.doi
10.12788/jhm.3333subject
Has Abstractpub_date
2020-04-01 00:00:00pages
197-203issue
4eissn
1553-5592issn
1553-5606pii
jhm.3333journal_volume
15pub_type
杂志文章abstract:BACKGROUND:No national policy requires health care providers to discuss with hospitalized patients whether the latter would want cardiopulmonary resuscitation (CPR) or mechanical ventilation (MV) in the event of cardiopulmonary failure. OBJECTIVE:To determine whether hospitalized patients are willing to discuss end-of...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,随机对照试验
doi:10.1002/jhm.78
更新日期:2006-05-01 00:00:00
abstract::We examined whether placing a painting in the line of vision of a hospitalized patient improves patient outcomes and satisfaction and whether having patients choose their paintings offers greater benefit. From 2014 to 2016, we enrolled 186 inpatients with cancer diagnoses from Pennsylvania State University Cancer Inst...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,随机对照试验
doi:10.12788/jhm.2915
更新日期:2018-08-01 00:00:00
abstract:BACKGROUND:Although severity of illness indices such as pneumonia severity index (PSI) are good predictors of short-term mortality for community-acquired pneumonia (CAP) and healthcare-associated pneumonia (HCAP), other patient factors may have added prognostic value. OBJECTIVE:To identify patient factors beyond the P...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.985
更新日期:2012-03-01 00:00:00
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journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2296
更新日期:2015-03-01 00:00:00
abstract:BACKGROUND:Meta-analyses of randomized trials have found that antibiotics are effective in acute exacerbations of chronic obstructive pulmonary disease (AECOPD), but there is insufficient evidence to guide antibiotic selection. Current guidelines offer conflicting recommendations. OBJECTIVE:To compare the effectivenes...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,多中心研究
doi:10.1002/jhm.628
更新日期:2010-05-01 00:00:00
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journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.2746
更新日期:2017-06-01 00:00:00
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journal_title:Journal of hospital medicine
pub_type: 杂志文章
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更新日期:2011-04-01 00:00:00
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journal_title:Journal of hospital medicine
pub_type: 杂志文章
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更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:Obese patients are thought to be at higher risk of postoperative medical complications. We determined whether body mass index (BMI) is associated with postoperative in-hospital noncardiac complications following urgent hip fracture repair. METHODS:We conducted a population-based study of Olmsted County, Min...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.527
更新日期:2009-10-01 00:00:00
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pub_type: 杂志文章,多中心研究
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更新日期:2012-04-01 00:00:00
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journal_title:Journal of hospital medicine
pub_type: 杂志文章
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更新日期:2019-10-01 00:00:00
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journal_title:Journal of hospital medicine
pub_type: 杂志文章
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更新日期:2011-09-01 00:00:00
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journal_title:Journal of hospital medicine
pub_type: 杂志文章
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更新日期:2017-02-01 00:00:00
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journal_title:Journal of hospital medicine
pub_type: 杂志文章,评审
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更新日期:2016-06-01 00:00:00
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journal_title:Journal of hospital medicine
pub_type: 杂志文章,评审
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更新日期:2008-11-01 00:00:00
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journal_title:Journal of hospital medicine
pub_type: 杂志文章
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更新日期:2012-04-01 00:00:00
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journal_title:Journal of hospital medicine
pub_type: 杂志文章,评审
doi:10.1002/jhm.11
更新日期:2006-01-01 00:00:00
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journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2303
更新日期:2015-03-01 00:00:00
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journal_title:Journal of hospital medicine
pub_type: 杂志文章,评审
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更新日期:2017-05-01 00:00:00
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journal_title:Journal of hospital medicine
pub_type: 杂志文章
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更新日期:2007-07-01 00:00:00
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journal_title:Journal of hospital medicine
pub_type: 杂志文章
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abstract:: ...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
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更新日期:2019-01-01 00:00:00
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pub_type: 社论
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pub_type: 杂志文章,随机对照试验
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更新日期:2016-05-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2021-01-01 00:00:00
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更新日期:2015-07-01 00:00:00
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journal_title:Journal of hospital medicine
pub_type: 杂志文章,评审
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更新日期:2016-04-01 00:00:00
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journal_title:Journal of hospital medicine
pub_type: 杂志文章
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更新日期:2016-01-01 00:00:00
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journal_title:Journal of hospital medicine
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更新日期:2020-04-01 00:00:00
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pub_type: 杂志文章,随机对照试验
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更新日期:2013-02-01 00:00:00