Journal of clinical anesthesia
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The LACE index (Length of stay, admission Acuity, Charlson comorbidity index, and Emergency department visits within 6 months of current admission) is a practical tool designed to predict the risk of readmission or mortality within 30 days of hospital discharge. We sought to validate and examine its performance in a large surgical population at both the preoperative assessment and discharge time points. ⋯ The LACE model for surgical and procedural admissions had good discrimination and adequate calibration. Analysis of the model applied to surgical admissions using ELOS demonstrated slightly better overall performance than ALOS, suggesting that LACE could be utilized for readmission risk stratification at the time of preoperative assessment. Clinical Trial and Registry URL: Not applicable.
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Review Meta Analysis
The effectiveness of BIS monitoring during electro-convulsive therapy: A systematic review and meta-analysis.
Electroconvulsive therapy (ECT) has been shown to be highly effective in patients suffering from treatment-resistant depression. ECT procedure is performed under general anesthesia but the impact of anesthesia depth on seizure characteristics and clinical outcome remains unclear. We aimed to study the effects of BIS monitoring on electric and clinical response to ECT treatment. ⋯ High values of pre-ictal BIS are associated with improved seizure duration. The usefulness of systematic BIS monitoring during all ECT procedures should be further studied to better identify adequate BIS levels according to patient's characteristics.
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Letter Randomized Controlled Trial Comparative Study
Comparison of size 3 and size 4 i-gel® in 50-60 kg female patients: A prospective randomized crossover trial.
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There is little knowledge of rural hospitals' roles in the care of chronic pain patients nationwide in the United States of America. We hypothesized that very few (≅5%) critical access hospitals provide patients with interventional pain procedures performed by pain medicine physicians. ⋯ A very small percentage of critical access hospitals list at their websites that they offer interventional pain services by pain medicine-trained physicians, and most clinicians listed as performing these procedures are not pain medicine certified. Increasing access to pain medicine physicians may present an opportunity for improved pain care in rural communities.