Southern medical journal
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Southern medical journal · Nov 2022
ReviewTrends in ICD-10-CM-Coded Administrative Datasets for Injury Surveillance and Research.
Accurate injury surveillance depends on data quality in administrative datasets created for billing and reimbursement. Significant effort has been devoted to testing the ability of candidate injury case definitions to identify injury cases accurately in these datasets. We used interviews with experienced coders, informed by a review of the current literature, to identify three clinical coding trends that may affect the consistency of surveillance data: "clinical documentation improvement or clinical documentation integrity" (CDI), coding by treating clinicians, and certain electronic health record features. ⋯ Injury surveillance relies on billing and reimbursement records. Financial motivations may interfere with the consistency of surveillance findings and mislead injury epidemiologists. Further investigation is essential to ensure the integrity of surveillance findings.
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Southern medical journal · Nov 2022
Multicenter StudyReadmission Risk after COVID-19 Hospitalization: A Moderation Analysis by Vital Signs.
Readmission to the hospital after hospitalization with coronavirus disease 2019 (COVID-19) is associated with significant morbidity and mortality. Hospital clinicians may identify the presence of a patient's comorbid conditions, overall severity of illness, and clinical status at discharge as risk factors for readmission. Objective data are lacking to support reliance on these factors for discharge decision making. The objective of our study was to examine risk factors for readmission to the hospital after COVID-19 hospitalization and the impact of vital sign abnormalities, within 24 hours of discharge, on readmission rates. ⋯ Comorbid conditions, including pulmonary and cardiovascular disease, are associated with readmission risk after COVID-19 hospitalization. The normalization of vital signs within 24 hours of discharge during COVID-19 hospitalization may be an indicator of readiness for discharge and may mitigate some readmission risk conferred by comorbid conditions.
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Southern medical journal · Nov 2022
Association of an Early Interest in Orthopedic Surgery with Match Rate into Orthopedic Surgery.
Orthopedic surgery residency is considered one of the most competitive specialties in which to match. Studies examining the factors associated with a successful match have neglected whether participation in an orthopedic interest group (OIG) improves the chances of orthopedic residency match. The goal of this study was to test the hypothesis that participation in the OIG would improve matching into an orthopedic surgery residency. ⋯ OIG membership was associated with a significantly higher rate of orthopedic surgery residency matches. The higher rate of match associated with OIG membership may be the result of opportunities to diversify a residency application. Future studies are needed to further evaluate the potential association between OIG involvement and orthopedic surgery match.
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Gallbladder dyskinesia is a functional disorder of the gastrointestinal tract, which can result in debilitating episodes of abdominal pain and associated symptoms. Key diagnostic criteria include a diminished gallbladder ejection fraction on scintigraphy and absence of other causes for the symptoms. ⋯ Patients meeting the clinical and diagnostic criteria for gallbladder dyskinesia should be referred for cholecystectomy, and most of these patients will have relief of their symptoms. A comprehensive preoperative discussion on expected outcomes needs to take place.
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Southern medical journal · Nov 2022
Examination of a Stillbirth Workup: A Rural Statewide Experience.
The objective of our study was to determine whether recommended assessments were conducted on stillbirths delivered in our predominantly rural state. ⋯ Fetal stillbirth assessment is suboptimal in our rural state, with 15% of stillbirths having no assessment and only 2% having all four assessments. There is no association between stillbirth assessment and gestational age (<28 weeks vs >28 weeks), but there is a correlation between delivery volume and stillbirth assessment.