Breaking News
December 18, 2018 - Artificial intelligence and the future of medicine
December 18, 2018 - Montana State doctoral student receives grant for her work to improve neuroscience tool
December 18, 2018 - Early postpartum initiation of opioids associated with persistent use
December 18, 2018 - Russian scientists identify molecular ‘switch’ that could be target for treatment of allergic asthma
December 18, 2018 - Surgeons make more mistakes in the operating room during stressful moments, shows study
December 18, 2018 - Immune cells explode themselves to inform about the danger of invading bacteria
December 18, 2018 - Malnutrition in children with Crohn’s disease linked with increased risk of surgical complications
December 18, 2018 - FDA Approves Motegrity (prucalopride) for Adults with Chronic Idiopathic Constipation (CIC)
December 18, 2018 - The long and short of CDK12
December 18, 2018 - CMR Surgical partners with Nicholson Center to launch U.S.-based training program for Versius
December 18, 2018 - Findings reinforce guidelines for cautious use of antipsychotics in younger populations
December 18, 2018 - Study finds new strains of hepatitis C virus in sub-Saharan Africa
December 18, 2018 - New battery-free, implantable device aids weight loss
December 18, 2018 - Parental alcohol use disorder associated with offspring marital outcomes
December 18, 2018 - Novel Breast Imaging Technique Might Cut Unnecessary Biopsies
December 18, 2018 - What can a snowflake teach us about how cancer spreads in the body?
December 18, 2018 - Management of nausea and vomiting in pregnancy costs the NHS more than previously thought
December 18, 2018 - Green leafy vegetables may reduce risk of developing liver steatosis
December 18, 2018 - Veganism linked to nutrient deficiencies and malnutrition if not planned correctly
December 18, 2018 - Coming Soon: A Tiny Robot You Swallow to Help You Stay Healthy
December 18, 2018 - Modified malaria drug proven effective at inhibiting Ebola
December 18, 2018 - Study finds epigenetic differences in the brains of individuals with schizophrenia
December 18, 2018 - Fitness instructors’ motivational comments influence women’s body satisfaction
December 18, 2018 - Study focuses on modification of lipid nanoparticles for successful brain cell targeting
December 18, 2018 - New gut bacteria may be effective against obesity, metabolic and mental disorders
December 18, 2018 - New two-in-one powder aerosol to upgrade fight against deadly superbugs in lungs
December 18, 2018 - Biofilms feed with swirling flows
December 17, 2018 - Study identifies specific neurological changes related to traumatic brain injury
December 17, 2018 - New study confirms geographic bias in lung allocation for transplant
December 17, 2018 - Research focuses on optimization of solid lipid nanoparticle that encapsulates Vinorelbine bitartrate
December 17, 2018 - Carpal tunnel syndrome – Genetics Home Reference
December 17, 2018 - A novel insulin accelerant
December 17, 2018 - Tips for caring for patients with disabilities, from a mother and physician
December 17, 2018 - Menopause-related sexual, urinary problems tied to worse quality of life
December 17, 2018 - In-school nutrition programs among students limit increases in BMI, finds study
December 17, 2018 - Risk for Hospitalization for Heart Failure Greater With Diabetes
December 17, 2018 - Food assistance may help older adults adhere to diabetes meds
December 17, 2018 - Supporting a family’s goals during a difficult pregnancy
December 17, 2018 - Neurons with Good Housekeeping Are Protected from Alzheimer’s
December 17, 2018 - New approach to tumor analysis could improve prognosis for bowel cancer patients
December 17, 2018 - New ‘epigenetics-based’ cervical cancer test outperforms Pap smear and HPV tests
December 17, 2018 - Ten year follow-up after negative colonoscopy related to reduced risk of colorectal cancer
December 17, 2018 - CTF along with NTAP and Sage announce first-ever open data portal for neurofibromatosis
December 17, 2018 - Intimacy: The Elusive Fountain of Youth?
December 17, 2018 - Will saliva translate to a real diagnostic tool?
December 17, 2018 - DFG establishes nine new Research Units and one new Clinical Research Unit
December 17, 2018 - Assisted living’s breakneck growth leaves patient safety behind
December 17, 2018 - America’s teens report dramatic increase in their use of vaping devices in just one year
December 17, 2018 - Enlarged heart linked to a higher risk of dementia
December 17, 2018 - Prostate cancer detection using MRI now first-line investigation tool
December 17, 2018 - Loughborough academics part of new project investigating effectiveness of personalized breast cancer screening
December 17, 2018 - Adolescents who use cognitive reappraisal had better metabolic measures, shows study
December 17, 2018 - Probiotics may offer therapeutic benefits for biopolar patients
December 17, 2018 - Stealth BioTherapeutics Granted Fast Track Designation for Elamipretide for the Treatment of Dry Age-Related Macular Degeneration with Geographic Atrophy
December 17, 2018 - Studies reveal role of red meat in gut bacteria, heart disease development
December 17, 2018 - Eisai enters into agreement with Eurofarma for its anti-obesity agent lorcaserin
December 17, 2018 - Researchers use brain connectome to reassess neuroimaging findings of Alzheimer’s disease
December 17, 2018 - “Miracle” baby survives Ebola in Congo and rapid a new Ebola detection device
December 17, 2018 - Mechanisms behind neonatal diabetes uncovered
December 17, 2018 - AHF urges the WHO to expedite approval process for vaccine effective against Ebola
December 17, 2018 - Study finds misuse of benzodiazepines to be highest among young adults
December 17, 2018 - TGen receives PayPal grant to underwrite costs of genetic tests for children with rare disorders
December 17, 2018 - New research highlights why HIV-infected patients suffer higher rates of cancer
December 17, 2018 - Antibiotic-resistant bacteria could soon be targeted with Alzheimer’s drug
December 17, 2018 - Rutgers scientists take an important step in making diseased hearts heal themselves
December 17, 2018 - Tailored Feedback at CRC Screen Improves Lifestyle Behaviors
December 17, 2018 - Loss of two genes drives a deadly form of colorectal cancer, reveals a potential treatment
December 17, 2018 - How the Mediterranean Diet Can Help Women’s Hearts
December 17, 2018 - Sustained connections associated with symptoms of autism
December 17, 2018 - Concussion rates among young football players were higher than previously reported
December 17, 2018 - Cresco Labs granted approval to operate marijuana dispensary in Ohio
December 17, 2018 - Study provides insight into health risks facing new mothers
December 17, 2018 - AMSBIO expands Wnt signaling pathway product range to aid research
December 16, 2018 - Surgical treatment unnecessary for many prostate cancer patients
December 16, 2018 - Excess weight responsible for cancers globally finds report
December 16, 2018 - Regular sex associated with greater enjoyment of life in seniors
December 16, 2018 - Social stigma contributes to poor mental health in the autistic community
December 16, 2018 - Multidisciplinary team successfully performs complex surgery on patient suffering from enlarged skull
December 16, 2018 - Experts analyze data that can guide antidepressant discontinuation
December 16, 2018 - Menlo Therapeutics’ Successful Phase 2 Clinical Trial of Serlopitant Demonstrates Reduction of Pruritus Associated with Psoriasis
Scoring models underestimate risk of hospital readmission in neurocritical care patients

Scoring models underestimate risk of hospital readmission in neurocritical care patients

image_pdfDownload PDFimage_print

Scoring models used to predict 30-day readmission risk in the general hospital population may not accurately predict readmissions for patients in the neurocritical care unit, reports a study in the Journal of Neuroscience Nursing, official journal of the American Association of Neuroscience Nurses. The journal is published in the Lippincott portfolio by Wolters Kluwer.

“In analyzing the current readmission tool at our institution, we found that it underestimated the risk of readmission in our neurocritical care patient [population],” according to the research by Sarah Peacock, APRN, and colleagues of the Mayo Clinic in Jacksonville, Fla. They believe that developing risk scores specific to the neurocritical care unit could have important implications for patient care as well as financial reimbursement.

Calculator Doesn’t Predict 30-Day Readmissions in Neurocritical Care Patients

Thirty-day hospital readmission risk has become an important measure of the quality of hospital care. Medicare and other healthcare payers have implemented “pay for performance” programs including financial penalties for patients with unplanned readmissions. In response, hospitals have developed risk calculators to identify patients at high risk for readmission and target them for efforts to prevent adverse outcomes.

But there is concern that risk calculators based on the overall hospital population may not accurately reflect readmission risk in neurocritical care patients. Neurocritical care units – sometimes called neuroscience ICUs – provide specialized care for patients with conditions such as stroke and brain or spinal cord injuries. While previous studies have evaluated risk factors for readmission in neurocritical care patients, there are currently no specific models to predict readmission risk in patients with neurological conditions.

The researchers evaluated their institution’s hospital-wide risk calculator using data on 279 patients admitted to the neurocritical care unit over one year. The study included only patients who were alive and not in hospice care when discharged from the hospital. The most common diagnoses were stroke and central nervous system cancers.

In this sample, only 38 neurocritical care patients were readmitted to the hospital within 30 days after discharge. The readmission rate of 13.6 percent was consistent with national trends. But based on the hospital-wide risk calculator, nearly two-thirds of the readmitted patients were labeled at “low risk” for readmission.

Emergency admission was the single strongest risk factor for readmission for neurocritical care patients, but received relatively low weight on the hospital-wide readmission score. The risk calculator did not account for the presence of brain or spinal cord cancers, which were another major risk factor; or infection, the most common reason for readmission in the neurocritical care population.

The results suggest that the risk calculator used for the hospital’s general population is not accurate for neurocritical care patients. Because of differences in patients’ characteristics and risk factors, the hospital-wide tool underestimates readmission risk in the neurocritical care group.

“Because Medicare payment is directly tied to readmission, having an accurate scoring model is essential,” Ms. Peacock and coauthors write. Noting that their findings won’t necessarily apply to every institution, they encourage hospitals to develop customized “neurological-specific” readmission risk scales, based on local data and practice.

“The development of a readmission risk calculator specific to neuroscience patients would provide the bedside nurse an accurate scoring tool that identifies patients at a high risk for hospital readmission,” the researchers conclude. “The tool would enable bedside nurses, advanced practice nurses, and physicians to be alerted if a patient is at a high risk for readmission and the specific characteristics of the patient that make him/her high risk.”

Source:

http://home.lww.com/news.entry.html/2018/11/29/hospital-wide_scores-iiFY.html

Tagged with:

About author

Related Articles