scholarly journals Retrospective Cohort Study: Ledipasvir-Sofosbuvir With/Without Ribavirin for Chronic Hepatitis C Post–Liver Transplant in a Real-World Population

2018 ◽  
Vol 34 (5) ◽  
pp. 199-203
Author(s):  
Kelsey L. Hawkins ◽  
Ives Hot
Keyword(s):  
Cohort Study ◽  
Hepatitis C ◽  
Liver Transplant ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Medical Center ◽  
Academic Medical Center ◽  
The United States ◽  
World Population ◽  
Transplant Patients

Background: Liver damage caused by hepatitis C virus (HCV) is the number one indication for liver transplantation in the United States and Europe. Patients with a detectable HCV level at time of transplant will universally develop a recurrent infection, which can lead to increased morbidity and mortality. Objective: To assess the sustained virologic response rate post end-of-treatment (SVR) in HCV-infected, post–liver transplant patients at the University of Washington Medical Center (UWMC) treated with ledipasvir-sofosbuvir (LDV/SOF). Methods: This retrospective, cohort study of HCV-positive, genotype 1 or 4 infected, post–liver transplant patients treated with LDV/SOF was conducted at a large academic medical center affiliated clinic. Patients treated with 12 weeks of LDV/SOF with or without ribavirin were included in the 12-week group, and patients treated with 24 weeks of LDV/SOF without ribavirin were included in the 24-week group. Results: Twenty-nine patients with recurrent HCV post–liver transplant receiving 12 weeks of LDV/SOF with or without ribavirin and 32 patients receiving 24 weeks of LDV/SOF alone were assessed. SVR was achieved by 100% (29/29) of patients in the 12-week group and 100% (32/32) of patients in the 24-week group. Conclusion: Post–liver transplant patients at UWMC treated with LDV/SOF for recurrent HCV achieved high rates of SVR.

scholarly journals Telehealth Use by Age and Race at a Single Academic Medical Center During the COVID-19 Pandemic: Retrospective Cohort Study (Preprint)

2020 ◽  
Author(s):  
Jennifer P Stevens ◽  
Oren Mechanic ◽  
Lawrence Markson ◽  
Ashley O'Donoghue ◽  
Alexa B Kimball
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Health Care Disparities ◽  
Medical Center ◽  
Cohort Analysis ◽  
Academic Medical Center ◽  
Race And Gender ◽  
Asian Patients ◽  
Academic Medical

BACKGROUND During the COVID-19 pandemic, many ambulatory clinics transitioned to telehealth, but it remains unknown how this may have exacerbated inequitable access to care. OBJECTIVE Given the potential barriers faced by different populations, we investigated whether telehealth use is consistent and equitable across age, race, and gender. METHODS Our retrospective cohort study of outpatient visits was conducted between March 2 and June 10, 2020, compared with the same time period in 2019, at a single academic health center in Boston, Massachusetts. Visits were divided into in-person visits and telehealth visits and then compared by racial designation, gender, and age. RESULTS At our academic medical center, using a retrospective cohort analysis of ambulatory care delivered between March 2 and June 10, 2020, we found that over half (57.6%) of all visits were telehealth visits, and both Black and White patients accessed telehealth more than Asian patients. CONCLUSIONS Our findings indicate that the rapid implementation of telehealth does not follow prior patterns of health care disparities.

scholarly journals Characteristics of Epstein-Barr viraemia in adult liver transplant patients: A retrospective cohort study

2014 ◽  
Vol 27 (8) ◽  
pp. 838-846 ◽  
Author(s):  
Neil Halliday ◽  
Colette Smith ◽  
Claire Atkinson ◽  
James O'Beirne ◽  
David Patch ◽  
...  
Keyword(s):  
Cohort Study ◽  
Liver Transplant ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Adult Liver ◽  
Transplant Patients ◽  
Epstein Barr

Does Attending Surgeon Presence at the Preinduction Briefing Improve Operating Room Efficiency?

2019 ◽  
Vol 161 (5) ◽  
pp. 787-795 ◽  
Author(s):  
Rajeev C. Saxena ◽  
Mark E. Whipple ◽  
Moni B. Neradilek ◽  
Stuart Solomon ◽  
Christine T. Fong ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Medical Center ◽  
Academic Medical Center ◽  
Minor Effect ◽  
Efficiency Gain ◽  
Linear Regression Models ◽  
Surgical Equipment ◽  
Mean Time

Objective To examine if attending surgeon presence at the preinduction briefing is associated with a shorter time to incision. Study Design Retrospective cohort study and survey. Setting Tertiary academic medical center. Subjects and Methods A retrospective cohort study was conducted of 22,857 operations by 141 attending surgeons across 12 specialties between August 3, 2016, and June 21, 2018. The independent variable was attending surgeon presence at the preinduction briefing. Linear regression models compared time from room entry to incision overall, by service line, and by surgeon. We hypothesized a shorter time to incision when the attending surgeon was present and a larger effect for cases with complex surgical equipment or positioning. A survey was administered to evaluate attending surgeons’ perceptions of the briefing, with a response rate of 68% (64 of 94 attending surgeons). Results Cases for which the attending surgeon was present at the preinduction briefing had a statistically significant yet operationally minor reduction in mean time to incision when compared with cases when the attending surgeon was absent. After covariate adjustment, the mean time to incision was associated with an efficiency gain of 1.8 ± 0.5 minutes (mean ± SD; P < .001). There were no statistically significant differences in the subgroups of complex surgical equipment and complex positioning or in secondary analysis comparing service lines. The surgeon was the strongest confounding variable. Survey results demonstrated mild support: 55% of attending surgeons highly prioritized attending the preinduction briefing. Conclusion Attending surgeon presence at the preinduction briefing has only a minor effect on efficiency as measured by time to incision.

A Retrospective Comparison of the Effectiveness and Safety of Intravenous Olanzapine Versus Intravenous Haloperidol for Agitation in Adult Intensive Care Unit Patients

2021 ◽  
pp. 088506662098445
Author(s):  
Michelle Wang ◽  
Tuyen T. Yankama ◽  
George T. Abdallah ◽  
Ijeoma Julie Eche ◽  
Kristen N. Knoph ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cohort Study ◽  
Intensive Care ◽  
Length Of Stay ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Medical Center ◽  
Academic Medical Center ◽  
Icu Length Of Stay ◽  
Haloperidol Group

Objective: Intravenous (IV) olanzapine could be an alternative to first-generation antipsychotics for the management of agitation in intensive care unit (ICU) patients. We compared the effectiveness and safety of IV olanzapine to IV haloperidol for agitation management in adult patients in the ICU at a tertiary academic medical center. Methods: A retrospective cohort study was conducted. The primary outcome was the proportion of patients who achieved a Richmond Agitation Sedation Scale (RASS) score of < +1 within 4 hours of IV olanzapine or IV haloperidol administration. Secondary outcomes included the proportion of patients who required rescue medications for agitation within 4 hours of initial IV olanzapine or IV haloperidol administration, incidence of adverse events and ICU length of stay. Results: In the 192 patient analytic cohort, there was no difference in the proportion of patients who achieved a RASS score of < +1 within 4 hours of receiving IV olanzapine or IV haloperidol (49% vs. 42%, p = 0.31). Patients in the IV haloperidol group were more likely to receive rescue medications (28% vs 55%, p < 0.01). There was no difference in the incidence of respiratory events or hypotension between IV olanzapine and IV haloperidol. Patients in the IV olanzapine group experienced more bradycardia (11% vs. 3%, p = 0.04) and somnolence (9% vs. 1%, p = 0.02) compared to the IV haloperidol group. Patients in the IV olanzapine group had a longer median ICU length of stay (7.5 days vs. 5 days, p = 0.04). Conclusion: In this retrospective cohort study, there was no difference in the effectiveness of IV olanzapine compared to IV haloperidol for the management of agitation. IV olanzapine was associated with an increased incidence of bradycardia and somnolence.

scholarly journals Surgical procedures in liver transplant patients: A monocentric retrospective cohort study

2017 ◽  
Vol 41 ◽  
pp. 58-64 ◽  
Author(s):  
Daniele Sommacale ◽  
Ganesh Nagarajan ◽  
Martin Lhuaire ◽  
Federica Dondero ◽  
Patrick Pessaux ◽  
...  
Keyword(s):  
Cohort Study ◽  
Liver Transplant ◽  
Surgical Procedures ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Transplant Patients

Impact of Intensive Care Unit Discharge Delays on Patient Outcomes: A Retrospective Cohort Study

2018 ◽  
Vol 34 (11-12) ◽  
pp. 924-929 ◽  
Author(s):  
Somnath Bose ◽  
Alistair E. W. Johnson ◽  
Ari Moskowitz ◽  
Leo Anthony Celi ◽  
Jesse D. Raffa
Keyword(s):  
Cohort Study ◽  
Intensive Care ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Discharge Planning ◽  
Medical Center ◽  
Intensive Care Unit Discharge ◽  
Academic Medical Center ◽  
Icu Discharge ◽  
The Impact

Objective:Patients often overstay in intensive care units (ICU) after they are deemed discharge ready. The objective of this study was to examine the impact of such discharge delays (DD) on subsequent in-hospital morbidity and mortality.Design:Retrospective cohort study.Setting:Single tertiary academic medical center.Patients:Adult patients admitted to the medical ICU between 2005 and 2011.Interventions:For all patients, DD (ie, time between request for a ward bed and time of ICU discharge) was calculated. Discharge delays was dichotomized as long (≥24 hours) or short (<24 hours). Multivariable linear and logistic regressions were used to assess the association between dichotomized DD and post-ICU clinical outcomes.Results:Overall, 9673 discharges were included of which 10.4% patients had long DDs. In the fully adjusted model, a long delay was not associated with increased odds of death (adjusted odds ratio [aOR]: 0.99, 95% confidence interval [CI]: 0.74-1.31, P = .95) but was associated with a shorter log plus one of post-ICU discharge length of stay (LOS; regression coefficient: −0.13, 95% CI: −0.17 to −0.08, P < .001). Longer DD was not associated with more hospital-free days (HFD: a composite of post-ICU LOS and in-hospital mortality). Shorter DDs were associated with shorter LOS when LOS was measured from the time of ward bed request as opposed to the time of ICU discharge.Conclusions:In this study, long DD was associated with a slight decrease in post-ICU LOS but longer LOS when measured from the point of ward bed request, suggesting a potential role for more aggressive discharge planning in the ICU for patients with long DDs. There was no association between long DD and subsequent mortality or HFD.

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