965 results match your criteria reasons unplanned

An investigation into time-variant subsidence potentials using inclusive multiple modelling strategies.

J Environ Manage 2021 Jun 12;294:112949. Epub 2021 Jun 12.

Department of Civil Engineering, University of Maragheh, Maragheh, East Azerbaijan, Iran. Electronic address:

Groundwater over-abstraction due to the absence of an effective management plan is often one of the main reasons for land subsidence in aquifer areas. This paper investigates this environmental problem at Salmas plain, Iran, by using the ALPRIFT framework, an acronym of a set of seven general-purpose data layers, introduced recently by the authors. It is capable of mapping Subsidence Vulnerability Indices (SVI) and the paper investigates an innovation to transform it into Time-variant SVI (TSVI) mapping capabilities through a three module strategy: Module 1: maps SVI; Module 2: develops a predictive model for Groundwater Levels (GWL); Module 3: combines both modules to produces TSVI maps. Read More

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A simulation-based evaluation of machine learning models for clinical decision support: application and analysis using hospital readmission.

NPJ Digit Med 2021 Jun 14;4(1):98. Epub 2021 Jun 14.

Department of Anesthesiology and Perioperative Medicine, University of California Los Angeles, Los Angeles, CA, USA.

The interest in applying machine learning in healthcare has grown rapidly in recent years. Most predictive algorithms requiring pathway implementations are evaluated using metrics focused on predictive performance, such as the c statistic. However, these metrics are of limited clinical value, for two reasons: (1) they do not account for the algorithm's role within a provider workflow; and (2) they do not quantify the algorithm's value in terms of patient outcomes and cost savings. Read More

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Unplanned emergency department visits and hospital admissions of older adults under treatment for cancer in the ambulatory/community setting.

Support Care Cancer 2021 Jun 9. Epub 2021 Jun 9.

School of Nursing and Health Studies, University of Miami, Miami, FL, USA.

Purpose: This study aims to identify the incidence and risk/protective factors for (1) unplanned emergency department (ED) visits and hospital admissions (HA) and (2) nausea/vomiting/dehydration (NVD) at time of treatment in older adults under treatment for cancer.

Materials And Methods: This is a exploratory retrospective cohort study of adults (60 and older) with cancer. Adults were included if they had a new cancer diagnosis and were being treated with chemotherapy. Read More

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Stopping the revolving door: An exploratory analysis of health care super-utilization in gynecologic oncology.

Gynecol Oncol Rep 2021 Aug 19;37:100789. Epub 2021 May 19.

Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, TN 37232, USA.

The objective of this study was to determine the prevalence of and risk factors for health care super-utilization among gynecologic oncology patients at a single academic hospital. A retrospective cohort study of gynecologic oncology patients with an index unplanned encounter between January and December 2018 was performed. Super-utilizers were defined as patients with 3 or more unplanned hospital encounters during a 12-month period starting at the time of the index unplanned encounter. Read More

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Out-of-Hospital Birth.

Am Fam Physician 2021 Jun;103(11):672-679

University of Iowa College of Medicine, Iowa City, IA, USA.

Since the 1970s, most births in the United States have been planned to occur in a hospital. However, a small percentage of Americans choose to give birth outside of a hospital. The number of out-of-hospital births has increased, with one in every 61 U. Read More

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Facilitators and barriers of 2-1-1 HIV pre-exposure prophylaxis.

PLoS One 2021 20;16(5):e0251917. Epub 2021 May 20.

Division of Prevention Science, University of California San Francisco, San Francisco, California, United States of America.

An alternative strategy for men who have sex with men (MSM) experiencing challenges with daily HIV pre-exposure prophylaxis (PrEP) includes 2-1-1 dosing. Understanding 2-1-1 PrEP facilitators and barriers, especially during the SARS-CoV-2 pandemic, may guide researchers and healthcare providers in future studies and clinical preparedness. We conducted a national cross-sectional study of MSM in the US who had taken 2-1-1 PrEP to examine facilitators and barriers of this on-demand PrEP dosing option. Read More

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Risk Factors and Reasons for Treatment Abandonment for Patients With Esophageal Atresia: A Study From a Tertiary Care Hospital in Beijing, China.

Front Pediatr 2021 27;9:634573. Epub 2021 Apr 27.

Department of Neonatal Surgery, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Beijing, China.

This study aims to identify the risk factors and reasons for treatment abandonment for patients with esophageal atresia (EA) in a tertiary care hospital in China. A retrospective study was conducted on 360 patients with EA admitted to Beijing Children's Hospital between January 1, 2007 and June 1, 2020. Medical records for treatment abandonment and non-treatment abandonment patients were compared. Read More

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Effect of aspirin treatment duration on clinical outcomes in acute coronary syndrome patients with early aspirin discontinuation and received P2Y12 inhibitor monotherapy.

PLoS One 2021 12;16(5):e0251109. Epub 2021 May 12.

National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

Recent clinical trials showed that short aspirin duration (1 or 3 months) in dual antiplatelet therapy (DAPT) followed by P2Y12 inhibitor monotherapy reduced the risk of bleeding and did not increase the ischemic risk compared to 12-month DAPT in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI). However, it is unclear about the optimal duration of aspirin in P2Y12 inhibitor monotherapy. The purpose of this study was to evaluate the influence of aspirin treatment duration on clinical outcomes in a cohort of ACS patients with early aspirin interruption and received P2Y12 inhibitor monotherapy. Read More

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Variables Prevalent Among Early Unplanned Readmissions in Infants Following Congenital Heart Surgery.

Pediatr Cardiol 2021 May 11. Epub 2021 May 11.

Section of Critical Care, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA.

Medically complex children including infants undergoing cardiac surgery are at increased risk for hospital readmissions. Investigation of this population may reveal opportunities to optimize systems and coordination of care. A retrospective study of all infants undergoing cardiac surgery from 2015 through 2016 at a large tertiary institution who were readmitted within 1 year of discharge from cardiac surgical hospitalization was performed. Read More

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Readmissions After Distal Radius Fracture Open Reduction and Internal Fixation: An Analysis of 11,124 Patients.

J Am Acad Orthop Surg Glob Res Rev 2020 07;4(7):e2000110

From the Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT (Mr. Malpani, Mr. Mercier, Mr. Ottesen, Dr. Nduaguba, and Dr. Grauer), and the Department of Orthopedic Surgery, Perelman School of Medicine University of Pennsylvania, Philadelphia, PA (Dr. John, and Dr. Webb).

Purpose: Distal radius fracture (DRF) open reduction and internal fixation (ORIF) is a common surgical procedure. This study assesses reasons and risk factors for readmission after DRF ORIF using the large sample size and follow-up of the American College of Surgeons National Surgical Quality Improvement Program database.

Methods: Adult patients who underwent DRF ORIF were identified in the 2011 to 2016 National Surgical Quality Improvement Program database. Read More

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Characteristics of outpatient emergency department visits of nursing home residents: an analysis of discharge letters.

Aging Clin Exp Res 2021 May 3. Epub 2021 May 3.

Division of Outpatient Care and Pharmacoepidemiology, Department of Health Services Research, Carl Von Ossietzky University of Oldenburg, Ammerländer Heerstr. 114-118, 26129, Oldenburg, Germany.

Background: Unplanned emergency department (ED) visits of nursing home residents (NHR) are common, with many transfers not leading to hospitalization. However, there is little research on what diagnostic and therapeutic measures are performed during visits.

Aims: We analyzed underlying diagnoses, characteristics and performed medical procedures of unplanned outpatient ED visits by NHR. Read More

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"Unresectable" polyp management utilizing advanced endoscopic techniques results in high rate of colon preservation.

Surg Endosc 2021 Apr 22. Epub 2021 Apr 22.

Division of Colorectal Surgery, Department of Surgery, University of Southern California Keck School of Medicine, Los Angeles, CA, USA.

Purpose: "Endoscopically unresectable" benign polyps identified during screening colonoscopy are often referred for segmental colectomy. Application of advanced endoscopic techniques can increase endoscopic polyp resection, sparing patients the morbidity of colectomy. This retrospective case-control study aimed to evaluate the success of colon preserving resection of "endoscopically unresectable" benign polyps using advanced endoscopic techniques including endoscopic mucosal resection, endoscopic submucosal dissection, endoluminal surgical intervention, full-thickness laparo-endoscopic excision, and combined endo-laparoscopic resection. Read More

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Thirty-Day Unplanned Readmission After Ambulatory Laparoscopic Cholecystectomy in Western China: A Retrospective Study.

Cureus 2021 Mar 16;13(3):e13932. Epub 2021 Mar 16.

Day Surgery Center, West China Hospital, Sichuan University, Chengdu, CHN.

Background Day surgery has been gradually accepted by health professions globally, which can shorten the hospital stay and reduce medical costs. The ambulatory laparoscopic cholecystectomy (LC) has been performed in China since over 10 years. However, few studies focus on its 30-day unplanned readmission rate of ambulatory LC and no standard of unplanned readmission rate for that now. Read More

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Exercise capacity improvement after cardiac rehabilitation following myocardial infarction and its association with long-term cardiovascular events.

Eur J Cardiovasc Nurs 2021 Apr 17. Epub 2021 Apr 17.

Department of Vascular Diseases, Centre for Preventive Cardiology, University Medical Centre Ljubljana, Zaloška cesta 7/VI, Ljubljana SI-1000, Slovenia.

Aims : Cardiovascular rehabilitation (CR) improves aerobic capacity and quality of life in patients after myocardial infarction (MI). The aim was to examine the associations between exercise capacity improvement and different clinically relevant cardiovascular events.

Methods And Results : This was a registry-based study of post-MI patients, referred to CR. Read More

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Maternal age at birth and daughter's fecundability.

Hum Reprod 2021 Jun;36(7):1970-1980

Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.

Study Question: Do daughters of older mothers have lower fecundability?

Summary Answer: In this cohort study of North American pregnancy planners, there was virtually no association between maternal age ≥35 years and daughters' fecundability.

What Is Known Already: Despite suggestive evidence that daughters of older mothers may have lower fertility, only three retrospective studies have examined the association between maternal age and daughter's fecundability.

Study Design, Size, Duration: Prospective cohort study of 6689 pregnancy planners enrolled between March 2016 and January 2020. Read More

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Palliative Thoracic Radiotherapy for Non-Small Cell Lung Cancer in Outpatients: Reasons for Unplanned Hospitalization and Its Impact on Survival.

J Clin Med Res 2021 Mar 19;13(3):177-183. Epub 2021 Mar 19.

Department of Oncology and Palliative Medicine, Nordland Hospital, 8092 Bodo, Norway.

Background: The aims of the study were to examine the rates of and reasons for unplanned hospitalization after start of palliative radiotherapy or chemoradiation (CRT), and to study whether unplanned hospitalization deteriorates patients' prognosis. In addition, risk factors were identified.

Methods: A retrospective review of 136 patients treated with palliative radiotherapy or CRT was performed. Read More

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Expansion of a direct-to-patient telemedicine abortion service in the United States and experience during the COVID-19 pandemic.

Contraception 2021 Jul 27;104(1):43-48. Epub 2021 Mar 27.

Gynuity Health Projects, New York, NY, USA.

Objective: To present updated evidence on the safety, efficacy and acceptability of a direct-to-patient telemedicine abortion service and describe how the service functioned during the COVID-19 pandemic.

Study Design: We offered the study at 10 sites that provided the service in 13 states and Washington DC. Interested individuals obtained any needed preabortion tests locally and had a videoconference with a study clinician. Read More

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Suboptimal dialysis initiation is associated with comorbidities and uraemia progression rate but not with estimated glomerular filtration rate.

Clin Kidney J 2021 Mar 17;14(3):933-942. Epub 2020 Apr 17.

Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.

Background: Despite early referral of uraemic patients to nephrological care, suboptimal dialysis initiation (SDI) remains a common problem associated with increased morbimortality. We hypothesized that SDI is related to pre-dialysis care.

Methods: In the 'Peridialysis' study, time and reasons for dialysis initiation (DI), clinical and biochemical data and centre characteristics were registered during the pre- and peri-dialytic period for 1583 end-stage kidney disease patients starting dialysis over a 3-year period at 15 nephrology departments in the Nordic and Baltic countries to identify factors associated with SDI. Read More

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The NSW Pathology Atlas of Variation: Part I-Identifying Emergency Departments With Outlying Laboratory Test-Ordering Practices.

Ann Emerg Med 2021 Mar 24. Epub 2021 Mar 24.

Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, North Ryde, New South Wales, Australia.

Study Objective: Abdominal pain and chest pain are leading reasons for emergency department (ED) presentations, with laboratory tests frequently ordered to aid the diagnostic process. Our study aims to identify EDs with outlying laboratory ordering practices for patients presenting with undifferentiated abdominal pain and chest pain.

Methods: This was a retrospective observational study of 519,597 patients who presented with the complaint of abdominal or chest pain at 44 major hospital EDs across New South Wales, Australia, from January 2017 to September 2018. Read More

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Effect of unplanned spontaneous follicular growth and ovulation on pregnancy outcomes in planned artificial frozen embryo transfer cycles: a propensity score matching study.

Hum Reprod 2021 05;36(6):1542-1551

Department of Reproductive Medicine, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China.

Study Question: Does unplanned spontaneous follicular growth and ovulation affect clinical outcomes after planned artificial frozen-thawed embryo transfer (AC-FET) cycles?

Summary Answer: AC-FET and spontaneous follicular growth and ovulation events resulted in notably better pregnancy outcomes with a significantly higher implantation rate (IR), clinical pregnancy rate (CPR), ongoing pregnancy rate (OPR) and live birth rate (LBR) and a significantly lower miscarriage rate.

What Is Known Already: The AC-FET protocol without GnRH agonist administration is associated with a low incidence of follicular growth and ovulation. In the literature, authors often refer to these types of cycles with concern due to possibly impaired FET outcomes. Read More

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A systematic review and meta-analysis of unplanned hospital visits and re-admissions following radical prostatectomy for prostate cancer.

Can Urol Assoc J 2021 Mar 18. Epub 2021 Mar 18.

Weill-Cornell School of Medicine, Cornell University, New York, NY, United States.

Introduction: Unplanned visits (UPV) - re-admissions and emergency room (ER) visits - are markers of healthcare system quality. Radical prostatectomy (RP) is a commonly performed cancer procedure, where variation in UPV represents a gap in care for prostate cancer patients. Here, we systematically synthesize the rates, reasons, predictors, and interventions for UPV after RP, to inform evidence-based quality improvement (QI) initiatives. Read More

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End-stage kidney disease on dialysis: an observational study of modality change from maximum conservative management.

BMJ Support Palliat Care 2021 Mar 15. Epub 2021 Mar 15.

UCL Centre for Nephrology, Royal Free Hospital, London, UK.

Objectives: A rising burden from end-stage kidney disease with poor outcomes in the frail, elderly population has seen the emergence of a non-dialytic option, also known as maximum conservative management (MCM). Despite an established MCM programme in our institution, it was anecdotally observed that some MCM patients would end up being dialysed short and long term. We explored treatment modality changes from MCM to renal replacement therapy (RRT), the reasons surrounding the change, and aimed to quantify survival in this cohort of patients. Read More

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Access to female contraceptives by Rohingya refugees, Bangladesh.

Bull World Health Organ 2021 Mar 7;99(3):201-208. Epub 2021 Jan 7.

Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, Bangladesh.

Objective: To determine the prevalence of the use of contraceptives among female Rohingya refugees in Bangladesh and its associated factors.

Methods: We conducted our cross-sectional survey at the Kutupalong refugee facility located in Cox's Bazar in November 2019. We used univariable and multivariable logistic regression models to determine the association between the use of contraceptives and our various predictor variables, including women's age, age at first marriage, education level and employment status. Read More

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Risks and Complications After Arthroplasty for Pathological or Impending Pathological Fracture of the Hip.

J Arthroplasty 2021 Jun 6;36(6):2049-2054.e5. Epub 2021 Feb 6.

Department of Orthopaedic Surgery, New York-Presbyterian/Columbia University Irving Medical Center, New York, NY.

Background: Treatment options for metastatic osseous lesions of the proximal femur include hemiarthroplasty (HA) or total hip arthroplasty (THA) depending on lesion characteristics and patient demographics. Studies assessing short-term outcomes after HA/THA in this patient population are limited. Therefore, the purpose of this present study was to identify short-term rates of morbidity and mortality after HA/THA for pathological proximal femur fractures, as well as readmission and reoperation rates and reasons. Read More

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Patterns of clinic switching and continuity of medication for opioid use disorder in a Medicaid-enrolled population.

Drug Alcohol Depend 2021 04 16;221:108633. Epub 2021 Feb 16.

University of Pittsburgh Graduate School of Public Health, Department of Health Policy and Management, 130 DeSoto Street, Pittsburgh, PA, 15261, United States.

Background: Many persons with opioid use disorder (OUD) initiate medication for opioid use disorder (MOUD) with one clinic and switch to another clinic during their course of treatment. These switches may occur for referrals or for unplanned reasons. It is unknown, however, what effect switching MOUD clinics has on continuity of MOUD treatment or on overdoses. Read More

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Emergency department and hospital revisits after ambulatory surgery for kidney stones: an analysis of the Healthcare Cost and Utilization Project.

Urolithiasis 2021 Feb 17. Epub 2021 Feb 17.

Division of Urology, Hospital of the University of Pennsylvania, Perelman School of Medicine, University of Pennsylvania, 3 West Perelman Center for Advanced Medicine, 3400 Civic Center Boulevard, Philadelphia, PA, USA.

Our objective was to identify the rate of revisit to either emergency department (ED) or inpatient (IP) following surgical stone removal in the ambulatory setting, and to identify factors predictive of such revisits. To this end, the AHRQ HCUP ambulatory, IP, and ED databases for NY and FL from 2010 to 2014 were linked. Cases were selected by primary CPT for shock-wave lithotripsy (SWL), ureteroscopy (URS), and percutaneous nephrolithotomy (PNL) with accompanying ICD-9 for nephrolithiasis. Read More

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February 2021

Causes and Predictors of Unplanned Readmission in Cranial Neurosurgery.

World Neurosurg 2021 May 3;149:e622-e635. Epub 2021 Feb 3.

Department of Neurosurgery, University Hospital Leipzig, Leipzig, Germany.

Objective: A better understanding of the risks and reasons for unplanned readmission is an essential component in reducing costs in the health care system and in optimizing patient safety and satisfaction. The reasons for unplanned readmission vary between different disciplines and procedures. The aim of this study was to identify reasons for readmission in view of different diagnoses in cranial neurosurgery. Read More

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Characteristics of Patients with Post-Colonoscopy Unplanned Hospital Visit: A Retrospective Single-Center Observational Study.

Clin Exp Gastroenterol 2021 19;14:19-25. Epub 2021 Jan 19.

Department of Medicine, BronxCare Health System, Affiliated with Icahn School of Medicine at Mount Sinai, Bronx, NY 10457, USA.

Background: Colonoscopy, although a low-risk procedure, is not without associated adverse events. The rates of major adverse events such as perforation and bleeding after a colonoscopy are well reported. The rates of minor incidents following a colonoscopy, however, are less well examined. Read More

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January 2021

Intrauterine device use is safe among nulligravidas and adolescent girls.

Acta Obstet Gynecol Scand 2021 04 7;100(4):641-648. Epub 2021 Feb 7.

Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil.

The use of intrauterine devices (IUDs), including the copper-bearing device and the levonorgestrel intrauterine system (LNG-IUS), is safe among nulligravidas and adolescent girls. However, several misconceptions limit their use in clinical practice; health-care providers are hesitant to prescribe IUDs, and several myths associated with their usage in nulligravidas and adolescents exist among both providers and women themselves. The high rates of unplanned pregnancies (which in many settings constitute a public health issue, primarily among adolescent females) can be attributed at least partially to lack of awareness and limited use of highly effective contraceptives such as IUDs. Read More

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"I was tricked": understanding reasons for unintended pregnancy among sexually active adolescent girls.

Reprod Health 2021 Jan 22;18(1):19. Epub 2021 Jan 22.

Population Dynamics and Sexual and Reproductive Health, African Population and Health Research Center, Off Kirawa Road, Manga Close, Kenya.

Background: While the Kenya government is mobilizing high-level strategies to end adolescent pregnancy by 2030, a clear understanding of drivers of early unintended pregnancy in the country is a necessary precursor. In this study, we determine the prevalence, associated factors, and reasons for unintended pregnancy among sexually active adolescent girls (aged 15-19 in two Kenya counties with the highest rate of teenage pregnancy.

Methods: We used the "In Their Hands" (ITH) program's baseline evaluation data. Read More

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January 2021