Posted on February 7, 2017 by kmgarber
On December 19, 2016, Dr. Andre Machado, chair of the Neurological Institute at the Cleveland Clinic, performed the first deep brain stimulation procedure on a stroke patient. This lengthy surgery, part of an ongoing clinical trial, involved implantation of electrodes in the brain that are connected to a pacemaker-like device. As the patient recovers from the brain surgery, physical therapy will be combined with stimulation of areas of the brain to overcome damage done by the stroke. A key objective of this groundbreaking surgery is to help stroke patients recover from stroke-induced paralysis. An estimated 400,000 Americans a year – or half the number of patients who have a stroke each year – end up disabled.
Cleveland Clinic performs nation’s first deep brain stimulation for stroke recovery. (2017, January 4). News release. Click here: https://newsroom.clevelandclinic.org/2017/01/04/cleveland-clinic-performs-nations-first-deep-brain-stimulation-stroke-recovery/; and, Sifferlin, A. (2017, January 4). Doctors perform groundbreaking surgery for stroke. Time. Click here: http://time.com/4620618/doctors-perform-groundbreaking-surgery-for-stroke/ Posted by AHA Resource Center (312) 422-2050, email@example.com
Filed under: Posted by Kim Garber, Surgical suite | Tagged: Deep brain stimulation, Experimental surgery, Groundbreaking surgery, Stroke, The Cleveland Clinic | Leave a comment »
Posted on July 15, 2016 by kmgarber
The volume of radical prostatectomy procedures decreased 7 percent from 1425 procedures per million men over age 45 in the late ’90s to 1330 per million in 2010-2011. There was a big change, however, in the way that the surgery was performed as surgical robots came to the fore in urological surgery. This study of national data shows that open radical prostatectomy procedures dropped from 1424 per million older men to 435 per million during the 14-year time period. Much of that procedure volume was moved over to robotic surgery.
This study also analyzes hospital procedure volume – finding that 18 percent of hospitals stopped providing open radical prostatectomy since 2006. The number of hospitals providing the minimally invasive version of the procedure increased by 191 percent during the same period. The percentage of hospitals with a low-volume (fewer than 50 procedures) program of minimally invasive radical prostatectomy doubled – to 26 percent – by the end of the study period.
Source: Tyson, M.D., and others. (2016, Jan.). Radical prostatectomy trends in the United States: 1998 to 2011. Mayo Clinic Proceedings, 91(1), 10-16. Click here for full text: http://www.mayoclinicproceedings.org/article/S0025-6196%2815%2900771-5/pdf Posted by AHA Resource Center (312) 422-2050, firstname.lastname@example.org
Filed under: Future trends, Posted by Kim Garber, Surgical suite | Tagged: Radical prostatectomy, Surgical robotics, Surgical robots, Surgical trends, Trends in Minimally invasive surgery trends | Leave a comment »
Posted on June 24, 2016 by kmgarber
The U.S. Agency for Healthcare Research and Quality (AHRQ) has a number of free databases on the web that can be used to take an interesting historical look at health care utilization data. I recently posted on this blog about hip fracture – and got an unusual number of hits! – so thought I might explore another aspect of the same topic here using some AHRQ data.
HIP REPLACEMENT: Inpatients discharged who had total or partial hip replacement, 1995-2013
- 267,034 (or 100.3 per 100,000 persons) in 1995
- 298,631 (or 105.8 per 100,000 persons) in 2000
- 371,754 (or 125.8 per 100,000 persons) in 2005
- 439,838 (or 142.2 per 100,000 persons in 2010
- 439,945 (or 156.2 per 100,000 persons) in 2013
The fine print: What is this exactly? First of all, these numbers represent inpatients only. The rates per 100,000 persons means per 100,000 resident population. The data source is the National Inpatient Sample based on the “CCS category” code 153: Hip replacement, total and partial. It is also possible to run data using ICD-9 codes or DRGs. The most current data year is 2013.
We notice from these data that both the actual number of inpatients who have had hip replacement and the rate per 100,000 persons are trending upward over time.
HIP REPLACEMENT: Ambulatory surgery?
AHRQ also has a database of ambulatory surgery procedures for 29 reporting states (representing two-thirds of the U.S. population). As of this writing, the database can be queried for just the year 2012 but, with an added nice feature, provides comparable inpatient data for the same states. Setting this database up for the same CCS category as above (153: Hip replacement, total and partial, all listed) shows that only about 3 percent of hip replacements were done on an outpatient basis in 2012.
Source: Agency for Healthcare Research and Quality. Welcome to HCUPnet. Click here for free access to this database http://hcupnet.ahrq.gov/ Posted by AHA Resource Center (312) 422-2050, email@example.com
Filed under: Benchmarking, Posted by Kim Garber, Surgical suite | Tagged: Agency for Healthcare Research and Quality, HCUPnet, Hip replacement surgery, Hospital utilization trends, Surgical utilization trends, Total hip arthroplasty, Total hip replacement surgery | Leave a comment »
Posted on June 21, 2016 by kmgarber
What are the outcomes for patients who have had surgery after breaking a hip? This is a study of the Kaiser Permanente Hip Fracture Registry – looking at over 12,000 patients in California in 2009 through 2011. The registry data includes 33 medical centers and 474 surgeons. Here is a look at this data-rich article:
Characteristics of Patients with Broken Hips
- Two-thirds are female
- Two-thirds are 75 years or older
- Over half have 3 or more other medical problems (comorbidities)
- Two-thirds have hypertension
- 4-day length of stay (median)
- 6.2 percent death within 30 days
- 12.3 percent death within 90 days
- 12.2 percent readmission within 30 days
- 22.1 percent readmission within 90 days
- 11.4 percent contracted pneumonia
- 1.1 percent surgical site infection
- 12.1 percent low volume (less than 10 procedures / year)
- 68.4 percent medium volume (10 to 29 procedures / year)
- 19.5 percent high volume (30+ procedures / year)
- 1.7 percent low volume (less than 60 procedures / year)
- 35.3 percent medium volume (60 to 129 procedures / year)
- 63.0 percent high volume (130+ procedures / year)
Source: Inacio, M.C.S., and others. (2015, Sum.). A community-based hip fracture registry: Population, methods, and outcomes. The Permanente Journal, 19(3), 29-36. Click here for free full text: http://www.thepermanentejournal.org/files/Summer2015/Registry.pdf Posted by AHA Resource Center (312) 422-2050, firstname.lastname@example.org
Filed under: Benchmarking, Posted by Kim Garber, Readmission, Surgical suite | Tagged: 30-day readmission rates, 90-day readmission rates, Hip fractures, Patient outcomes | Leave a comment »