Cardiogenic Shock: Protocols, Teams, Centers, and Networks

The mortality of cardiogenic shock (CS) remains unacceptably high. Delays in the recognition of CS and access to disease-modifying or hemodynamically stabilizing interventions likely contribute to poor outcomes. In parallel to successful initiatives in other disease states, such as acute ST-elevation MI and major trauma, institutions are increasingly advocating the use of a multidisciplinary ‘shock team’ approach to CS management. A volume–outcome relationship exists in CS, as with many other acute cardiovascular conditions, and the emergence of ‘shock hubs’ as experienced facilities with an interest in improving CS outcomes through a hub-and-spoke ‘shock network’ approach provides another opportunity to deliver improved CS care as widely and equitably as possible. This narrative review outlines improvements from a networked approach to care, discusses a team-based and protocolized approach to CS management, reviews the available evidence and discusses the potential benefits, challenges, and opportunities of such systems of care.

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The ENIGMA Brain Injury Working Group: Approach, Challenges, and Potential Benefits

10.31234/osf.io/t96xb ◽

2019 ◽

Cited By ~ 7

Author(s):

Elisabeth A. Wilde ◽

Emily L. Dennis ◽

David F Tate

Keyword(s):

Brain Injury ◽

Working Group ◽

Meta Analysis ◽

Special Issue ◽

Group Approach ◽

Challenges And Opportunities ◽

Brain Structure And Function ◽

Potential Benefits ◽

And Function ◽

Neuroimaging Genetics

The Enhancing NeuroImaging Genetics through Meta-Analysis (ENIGMA) consortium brings together researchers from around the world to try to identify the genetic underpinnings of brain structure and function, along with robust, generalizable effects of neurological and psychiatric disorders. The recently-formed ENIGMA Brain Injury working group includes 8 subgroups, based largely on injury mechanism and patient population. This introduction to the special issue summarizes the history, organization, and objectives of ENIGMA Brain Injury, and includes a discussion of strategies, challenges, opportunities and goals common across 6 of the subgroups under the umbrella of ENIGMA Brain Injury. The following articles in this special issue, including 6 articles from different subgroups, will detail the challenges and opportunities specific to each subgroup.

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The Volume-Outcome Relationship in Lung Cancer Surgery: The Impact of the Social Determinants of Healthcare Delivery

Journal of Thoracic and Cardiovascular Surgery ◽

10.1016/j.jtcvs.2021.02.104 ◽

2021 ◽

Author(s):

Sidra N. Bonner ◽

Elliot Wakeam

Keyword(s):

Lung Cancer ◽

Social Determinants ◽

Healthcare Delivery ◽

Lung Cancer Surgery ◽

Cancer Surgery ◽

Outcome Relationship ◽

The Social ◽

Volume Outcome ◽

The Impact

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Optimal Threshold for the Volume–Outcome Relationship After Open AAA Repair in the Endovascular Era: Analysis of the International Consortium of Vascular Registries

Journal of Vascular Surgery ◽

10.1016/j.jvs.2021.04.013 ◽

2021 ◽

Vol 73 (6) ◽

pp. 2207

Author(s):

S.T. Scali ◽

A. Beck ◽

A. Sedrakyan ◽

J. Mao ◽

C.-A. Behrendt ◽

...

Keyword(s):

Optimal Threshold ◽

International Consortium ◽

Outcome Relationship ◽

Volume Outcome

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THE ASSOCIATION OF LIVER CIRRHOSIS WITH POOR OUTCOMES WITH INTERVENTIONAL MANAGEMENT FOR STEMI RELATED CARDIOGENIC SHOCK, A NATIONWIDE ANALYSIS

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(21)02568-7 ◽

2021 ◽

Vol 77 (18) ◽

pp. 1209

Author(s):

Sophia Dar ◽

Catherine Choi ◽

Rosario Ligresti

Keyword(s):

Liver Cirrhosis ◽

Cardiogenic Shock ◽

Interventional Management ◽

Poor Outcomes

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Hospital Volume is Not a Predictor of Outcomes after Gastrectomy for Neoplasm

The American Surgeon ◽

10.1177/000313480907501015 ◽

2009 ◽

Vol 75 (10) ◽

pp. 932-936 ◽

Cited By ~ 5

Author(s):

Kevin M. Reavis ◽

Marcelo W. Hinojosa ◽

Brian R. Smith ◽

James B. Wooldridge ◽

Sindhu Krishnan ◽

...

Keyword(s):

Length Of Stay ◽

Hospital Mortality ◽

Gastric Surgery ◽

National Database ◽

Medical Centers ◽

Outcome Relationship ◽

Academic Medical ◽

Low Volume ◽

Poor Outcomes ◽

The University

Studies have shown conflicting data with regard to the volume and outcome relationship for gastrectomy. Using the University HealthSystem Consortium national database, we examined the influence of the hospital's volume of gastrectomy on outcomes at academic centers between 2004 and 2008. Outcome measures, including length of stay, 30-day readmission, morbidity, and in-hospital mortality, were compared among high- (13 or greater), medium- (6 to 12), and low-volume (five or less) hospitals. There were 10 high- (n = 593 cases), 36 medium- (n = 1076 cases), and 75 low-volume (n = 500 cases) hospitals. There were no significant differences between high- and low-volume hospitals with regard to length of stay, overall complications, 30-day readmission rate, and in-hospital mortality (2.4 vs 4.4%, respectively, P = 0.06). Despite the small number of gastrectomies performed at the low-volume hospitals, these same hospitals performed a large number of other types of gastric surgery such as gastric bypass for the treatment of morbid obesity (102 cases/year). Within the context of academic medical centers, lower annual volume of gastrectomy for neoplasm is not a predictor of poor outcomes which may be explained by the gastric operative experience derived from other types of gastric surgery.

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Anemia of Inflammation

Hematology ◽

10.1182/asheducation-2010.1.276 ◽

2010 ◽

Vol 2010 (1) ◽

pp. 276-280 ◽

Cited By ~ 74

Author(s):

Cindy N. Roy

Keyword(s):

Inflammatory Diseases ◽

Underlying Disease ◽

Comorbid Condition ◽

Regulatory Pathways ◽

Hepcidin Expression ◽

Disease States ◽

Poor Outcomes ◽

The Impact ◽

Inflammatory Insult ◽

Anemia Of Inflammation

Abstract Inflammation arising from various etiologies, including infection, autoimmune disorders, chronic diseases, and aging, can promote anemia. The anemia of inflammation (AI) is most often normocytic and normochromic and is usually mild. Characteristic changes in systemic iron handling, erythrocyte production, and erythrocyte life span all contribute to AI. The preferred treatment is directed at the underlying disease. However, when the inflammatory insult is intractable, or the cause has not been diagnosed, there are limited options for treatment of AI. Because anemia is a comorbid condition that is associated with poor outcomes in various chronic disease states, understanding its pathogenesis and developing new tools for its treatment should remain a priority. Hepcidin antimicrobial peptide has taken center stage in recent years as a potent modulator of iron availability. As the technology for quantitative hepcidin analysis improves, hepcidin's role in various disease states is also being revealed. Recent insights concerning the regulatory pathways that modify hepcidin expression have identified novel targets for drug development. As the field advances with such therapeutics, the analysis of the impact of normalized hemoglobin on disease outcomes will confirm whether anemia is a reversible independent contributor to the morbidity and mortality associated with inflammatory diseases.

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Volume-outcome relationship in penile cancer treatment: a population based patterns of care and outcomes study from Australia

BJU International ◽

10.1111/bju.13626 ◽

2016 ◽

Vol 118 ◽

pp. 35-42 ◽

Cited By ~ 3

Author(s):

Manish I. Patel ◽

Yuigi Yuminaga ◽

Albert Bang ◽

Nathan Lawrentschuk ◽

Timothy Skyring ◽

...

Keyword(s):

Cancer Treatment ◽

Penile Cancer ◽

Population Based ◽

Patterns Of Care ◽

Outcome Relationship ◽

Volume Outcome ◽

Outcomes Study

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MP50-15 ASSESSING THE VOLUME-OUTCOME RELATIONSHIP FOR PCNL IN 2014 AND 2015 - ANALYSIS USING NATIONAL REGISTRY DATA OF OVER 4000 CASES

The Journal of Urology ◽

10.1016/j.juro.2017.02.1603 ◽

2017 ◽

Vol 197 (4S) ◽

Author(s):

John Withington ◽

Sarah Fowler ◽

James Armitage ◽

Jonathan Glass ◽

William Finch ◽

...

Keyword(s):

National Registry ◽

Registry Data ◽

Outcome Relationship ◽

Volume Outcome ◽

National Registry Data

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Opportunities and Challenges in Realizing Universal Access to Obstetric Ultrasound in Sub-Saharan Africa

Ultrasound International Open ◽

10.1055/s-0043-103948 ◽

2017 ◽

Vol 03 (02) ◽

pp. E52-E59 ◽

Cited By ~ 10

Author(s):

Sikolia Wanyonyi ◽

Charles Mariara ◽

Sudhir Vinayak ◽

William Stones

Keyword(s):

Universal Access ◽

Perinatal Outcomes ◽

Sub Saharan Africa ◽

Future Research ◽

Obstetric Ultrasound ◽

Integral Component ◽

Challenges And Opportunities ◽

Potential Benefits ◽

The Subject ◽

Sub Saharan

AbstractThe potential benefits of obstetric ultrasound have yet to be fully realized in sub-Saharan Africa (SSA), despite the region bearing the greatest burden of poor perinatal outcomes. We reviewed the literature for challenges and opportunities of universal access to obstetric ultrasound and explored what is needed to make such access an integral component of maternity care in order to address the massive burden of perinatal morbidity and mortality in SSA. Original peer-reviewed literature was searched in various electronic databases using a ‘realist’ approach. While the available data were inconclusive, they identify many opportunities for potential future research on the subject within the region that can help build a strong case to justify the provision of universal access to ultrasound as an integral component of comprehensive antenatal care.

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