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 StudyAttending rounds in the current era: what is and is not happening.
General medicine rounds by attending physicians provide the foundation for patient care and education in teaching hospitals. However, the detailed activities of these rounds in the current era are not well characterized. ⋯ Most activities on attending rounds do not take place at the bedside. The teams discuss patient care plans and test results most of the time but fail to include many items that may be of significant value, including specific aspects of patient care, interprofessional communication, and learner-centered education. Future studies are needed to further assess the implications of these observations.
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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.