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Query: UMLS:C0149871 (deep vein thrombosis)
 12,364 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In this article, literature data on complications after spinal cord injuries and their influence on the efficiency of rehabilitation are analyzed. The spinal cord injury is associated with physical and psychological disorder that causes disability and requires intensive treatment. Authors in their articles indicate that many people after spinal cord injuries have complications. The most common complications are: skin breakdown, urinary tract infection, pulmonary complications, spasticity, pain, autonomic dysreflexia, cardiovascular disease, osteoporosis and fractures, heterotopic ossification, deep vein thrombosis. These complications make patients' rehabilitation more difficult and limit their self-care independence, and the treatment of such complications is very expensive.
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PMID:[Complications after spinal cord injuries and their influence on the effectiveness of rehabilitation]. 1717 87

Emergency appendectomy was done on 1142 patients during the period of July 1990 to January 2003 to evaluate the results. Of which 656(57.44%) were male and 496(42.56%) were female. The mean age was 22.21+/-3.93 years (04-85 years). The duration of pain before admission was 3.05+/-0.94 days (01-17 days) and 708(62%) patients presented with palpable mass; ultrasonogram revealed additional lump in 114(9.98%) patients, rest of the lump (28.02%) was detected during operation. 342(30%) patients had appendix abscess and 228(19.96%) had loculated collection. Eight patients had tuberculosis and four had carcinoma in addition. All had appendicitis except two of which one patient had carcinoid tumor and one had enteric fever perforation. Operative time ranged from 15-85 minutes (29.38+/-3.19 minutes). The average hospital stay was 4.22+/-0.82 days (03-17 days). There was no failure, faecal fistula or death. The overall wound related complication was 22.86% of which 14.62% was very minor and overall intra abdominal complication was 4.12%. Persistent wound pain was in 43(3.87%) and hypertrophied scar was found in 05 (0.45%) patients. 05(0.45%) patients needed exploration for persistent sinus one of which was tuberculosis and remaining was due to suture material. Remote complications like RTI, UTI, and DVT was found in 04(0.35%) patients. There was no death, no faecal fistula and no failure. It seems that emergency appendectomy could safely be done in appendix mass without any increased risk of mortality and morbidity.
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PMID:Results of emergency appendectomy for appendicular mass. 1770 61

Neuroleptic malignant syndrome is an uncommon but potentially fatal side effect of antipsychotic drug treatment. Several serious complications have been associated with neuroleptic malignant syndrome, such as acute renal failure, deep venous thrombosis, pulmonary embolism and aspiration pneumonia. Reports on infections other than aspiration pneumonia appear, from the literature, to be uncommon. Four cases of infection (three cases of upper respiratory tract infection and one case of urinary tract infection) which developed during the course of neuroleptic malignant syndrome are reported and pathophysiological mechanisms underlying their presentation are suggested.
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PMID:Infections as complications of neuroleptic malignant syndrome. 1860 25

The implementation of electronic health records in rural settings generated new challenges beyond those seen in urban hospitals. The preparation, implementation, and sustaining of clinical decision support rules require extensive attention to standards, content design, support resources, expert knowledge, and more. A formative evaluation was used to present progress and evolution of clinical decision support rule implementation and use within clinician workflows for application in an electronic health record. The rural hospital was able to use clinical decision support rules from five urban hospitals within its system to promote safety, prevent errors, establish evidence-based practices, and support communication. This article describes tools to validate initial 54 clinical decision support rules used in a rural referral hospital and 17 used in clinics. Since 2005, the study hospital has added specific system clinical decision support rules for catheter-acquired urinary tract infection, deep venous thrombosis, heart failure, and more. The findings validate the use of clinical decision support rules across sites and ability to use existing indicators to measure outcomes. Rural hospitals can rapidly overcome the barriers to prepare and implement as well as sustain use of clinical decision support rules with a systemized approach and support structures. A model for design and validation of clinical decision support rules into workflow processes is presented. The replication and reuse of clinical decision support rule templates with data specifications that follow data models can support reapplication of the rule intervention in subsequent rural and critical access hospitals through system support resources.
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PMID:Evaluating clinical decision support rules as an intervention in clinician workflows with technology. 2109 43

Stroke is the third leading cause of death in the United States, with more than 140,000 deaths per year. Complications related to stroke resulting in morbidity and mortality are very common and may result from cerebral and extracerebral causes. Cerebral causes include cerebral edema, hemorrhagic conversion of an ischemic infarct, and progression of penumbra to infarction. Extracerebral complications include deep vein thrombosis and pulmonary embolism, urinary tract infection, and aspiration. Many of these complications are largely preventable and often tracked as "quality metrics" in institutions with a stroke center designation. The focus of the article is primarily on common poststroke complications, such as aspiration, DVT, decubitus ulcers, seizures, and urinary catheter infections. Knowledge about potential poststroke complications is critical to earlier diagnosis, proper preventive strategies, and management.
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PMID:The ABC's of stroke complications. 2120 42

Associated with the aging population is an increase in comorbidities and a decrease in the ability to perform basic daily activities. This is tracked within the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) as a patient's preoperative functional health status. Our goal was to evaluate the impact of preoperative functional status upon outcomes after ventral hernia repair. We reviewed all cases of patients that underwent ventral hernia repair from 2005 to 2010 in the ACS-NSQIP database. Patients were identified based on selected Current Procedural Terminology codes and grouped based on functional status as listed in the ACS-NSQIP database-independent, partially dependent, and totally dependent. Preoperative and operative variables were recorded for all patients. Clinical risk factors and short-term outcomes between groups were compared. Multivariable logistic regression was used to adjust for age, wound class, American Society of Anesthesiologists class, and case relative value units. A total of 76,397 patients were identified: 74,785 were independent (97.9%), 1,317 partially dependent (1.7%), and 295 totally dependent (0.4%). Totally dependent patients had an increased risk for all short-term outcomes after ventral hernia repair: wound occurrence, pneumonia, pulmonary embolism, urinary tract infection, myocardial infarction, deep venous thrombosis, sepsis, return to the operating room, and death (P < 0.001 for all).
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PMID:Preoperative functional health status impacts outcomes after ventral hernia repair. 2236 35

It is commonly believed that the electronic medical record (EMR) will improve patient outcomes. However, there is scant published literature to support this claim and no studies in any surgical population. Our hypothesis was that the EMR would not improve objective outcome measures in patients with traumatic injury. Prospectively collected data from our university-based Level I trauma center was retrospectively reviewed. Demographic, injury severity as well as outcomes and complications data were compared for all patients admitted over a 20-month period before introduction of the EMR and a 20-month period after full, hospital-wide use of the EMR. Implementation of the EMR was associated with a decreased hospital length of stay, P = 0.02; intensive care unit length of stay, P = 0.001; ventilator days, P = 0.002; acute respiratory distress syndrome, P = 0.006, pneumonia, P = 0.008; myocardial infarction, P = 0.001; line infection, P = 0.03; septicemia, P = 0.000; renal failure, P = 0.000; drug complication, P = 0.001; and delay in diagnosis, P = 0.04. There was no difference in mortality, unexpected cardiac arrest, missed injury, pulmonary embolism/deep vein thrombosis, or late urinary tract infection. This is the first study to investigate the impact of the EMR in surgical patients. Although there was an improvement in some complications, the overall impact was inconsistent.
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PMID:An objective study of the impact of the electronic medical record on outcomes in trauma patients. 2308 44

Critically ill patients in intensive care units are subject to many complications associated with therapy. Many of these complications are health care-associated infections and are related to indwelling devices, including ventilator-associated pneumonia, central line-associated bloodstream infection, catheter-associated urinary tract infection; surgical site infection, venous thromboembolism, deep venous thrombosis, and pulmonary embolus are other common complications. All efforts should be undertaken to prevent these complications in surgical critical care, and national efforts are under way for each of these complications. In this article, epidemiology, risk factors, diagnosis, treatment, and prevention of these complications in critically ill patients are discussed.
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PMID:Common complications in the critically ill patient. 2315 83

In 2008, the Centers for Medicare and Medicaid Service adapted a list from the National Quality Forum consisting of 10 hospital-acquired conditions, also known as never events. Deeming such events as preventable in a safe-hospital setting, reimbursement is no longer provided for treatments arising secondary to these events. A retrospective chart review identified 90 panniculectomy and abdominoplasty patients. The hospital-acquired conditions examined include surgical-site infections (SSI), vascular-catheter associated infections, deep venous thrombosis/pulmonary embolism, retained foreign body, catheter-related urinary tract infection, manifestations of poor glycemic control, falls and trauma, air embolism, pressure ulcers (stages III and IV), and blood incompatibility. Information regarding age, American Society of Anesthesiologists (ASA) classification, body mass index, smoking, and chemotherapy were collected. Patients were divided into 2 groups, namely, those who developed never events and those with no events. Of the 90 patients, 14 (15.5%) developed never events because of SSI. No events occurred in the remaining 9 categories. Statistically significant risk factors included American Society of Anesthesiologists classification, age, and diabetes mellitus. The most common never event was SSI. In light of the obvious prevalence of the risk factors in patients who develop these events, the question of whether never events are truly unavoidable arises. Despite this, awareness of the impact on patient care, health care and hospital reimbursement is vital to understanding the new paradigm of the "one size fits all."
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PMID:Retrospective analysis of never events in panniculectomy and abdominoplasty patients and their financial implications. 2372 79

Our purpose was to perform a clinical and financial analysis of a pricing matrix system on operative hip fracture care concerning hemiarthroplasty for displaced femoral neck fractures in elderly low demand patients. Data analysis on 81 pre-matrix and 88 post-matrix patients demonstrated no significant differences in age, sex, ASA or fracture pattern between the two groups. No difference in surgical approach, cement use, prosthesis choice, operative time, estimated blood loss, or intra-operative complication rate was observed. No radiographic difference in subsidence or loosening was demonstrated. Readmission form cardiac, UTI, PE or DVT rates were similar between groups and no increase in revision surgery or mortality was observed. Overall, our hospital realized a 37% reduction in implant costs, resulting in $165,500 savings for the calendar year.
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PMID:Implant standardization for hemiarthroplasty: implementation of a pricing matrix system at a level II community based trauma system. 2395 93


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