JAMA internal medicine
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JAMA internal medicine · Sep 2013
Multicenter Study Comparative StudyA high risk of hospitalization following release from correctional facilities in Medicare beneficiaries: a retrospective matched cohort study, 2002 to 2010.
Little is known about the risk of individuals who are released from correctional facilities, a time when there may be discontinuity in care. ⋯ About 1 in 70 former inmates are hospitalized for an acute condition within 7 days of release, and 1 in 12 by 90 days, a rate much higher than in the general population.
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JAMA internal medicine · Sep 2013
Multicenter StudyIn-hospital and 1-year mortality in patients undergoing early surgery for prosthetic valve endocarditis.
There are limited prospective, controlled data evaluating survival in patients receiving early surgery vs medical therapy for prosthetic valve endocarditis (PVE). ⋯ Prosthetic valve endocarditis remains associated with a high 1-year mortality rate. After adjustment for differences in clinical characteristics and survival bias, early valve replacement was not associated with lower mortality compared with medical therapy in the overall cohort. Further studies are needed to define the effect and timing of surgery in patients with PVE who have indications for surgery.
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JAMA internal medicine · Jul 2013
Multicenter StudyAssociation between a hospital's rate of cardiac arrest incidence and cardiac arrest survival.
National efforts to measure hospital performance in treating cardiac arrest have focused on case survival, with the hope of improving survival after cardiac arrest. However, it is plausible that hospitals with high case-survival rates do a poor job of preventing cardiac arrests in the first place. ⋯ Hospitals with exceptional rates of survival for in-hospital cardiac arrest are also better at preventing cardiac arrests, even after adjusting for patient case mix. This relationship is partially mediated by measured hospital attributes. Performance measures focused on case-survival rates seem an appropriate first step in quality measurement for in-hospital cardiac arrest.
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JAMA internal medicine · Jun 2013
Multicenter Study Comparative StudyProvision of spiritual support to patients with advanced cancer by religious communities and associations with medical care at the end of life.
Previous studies report associations between medical utilization at the end-of-life (EoL) and religious coping and spiritual support from the medical team. However, the influence of clergy and religious communities on EoL outcomes is unclear. ⋯ Terminally ill patients who are well supported by religious communities access hospice care less and aggressive medical interventions more near death. Spiritual care and EoL discussions by the medical team may reduce aggressive treatment, highlighting spiritual care as a key component of EoL medical care guidelines.
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JAMA internal medicine · Jun 2013
Multicenter Study Comparative StudyPerioperative use of selective serotonin reuptake inhibitors and risks for adverse outcomes of surgery.
Single-site studies have described an association between use of selective serotonin reuptake inhibitors (SSRIs) and adverse outcomes of surgery. Multicenter studies including a broad range of surgical procedures that explore rare outcomes, such as bleeding and mortality, and that account for indications for administration of SSRIs are needed. ⋯ Receiving SSRIs in the perioperative period is associated with a higher risk for adverse events. Determining whether patient factors or SSRIs themselves are responsible for elevated risks requires prospective study.