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Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz - Seit Oktober 2017 ist ein strukturiertes Entlassmanagement zur Überleitung von Patienten aus dem stationären in den...  相似文献   
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Objective

The study objective was to screen patients with acute type A aortic dissection for anatomic feasibility of ascending aortic endovascular treatment with a valve-carrying conduit.

Methods

High-quality computed tomography scans of 167 patients were available for screening. Aortic dimensions were measured using multiplanar reconstruction in the plane perpendicular to the manually corrected aortic center line. The simulated stent-graft 10-mm–long landing zones were measured starting at the sinotubular junction (proximal landing zone) and ending at the brachiocephalic trunk (distal landing zone). Exclusion criterion was an entry within the aortic root or the landing zone.

Results

In 113 patients (68%), the entry was in a coverable zone in the ascending aorta with sufficient proximal and distal landing zone or in more distal aortic segments. In these patients, the median distance between the proximal and distal landing zone was 89.1 (first quartile: 80.0 mm; third quartile: 101.2 mm) and the median diameter difference was 5.0 mm (2.0; 10.1) (12.3 [4.9; 23.0] %). The diameter difference was less than 2 mm in 32 patients (28%), between 6 mm and 10 mm in 20 patients (18%), between 10 mm and 14 mm in 11 patients (10%), and 14 mm or greater in 10 patients (9%).

Conclusions

Two thirds of all patients who present with type A dissections are potential candidates for treatment with endovascular valve–carrying conduits, but most patients would require tapered stent-grafts.  相似文献   
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Gnirke  A.  Beckers  S. K.  Gort  S.  Sommer  A.  Schröder  H.  Rossaint  R.  Felzen  M. 《Der Anaesthesist》2019,68(10):665-675
Die Anaesthesiologie - Schmerzen gehören zu den häufigsten Einsatzanlässen im Rettungsdienst und erfordern abhängig von der Schmerzintensität eine medikamentöse...  相似文献   
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Background Context

Long-term follow-up of patient-reported outcome measures (PROM) is essential in both modern spinal care and research. Lack of time and staff are commonly reported barriers to implementing long-term follow-up of PROM. Automated and digital follow-up systems for PROM collection are seeing widespread use, yet their validity and comparative effectiveness have never been evaluated.

Purpose

The present study aimed to assess the validity of digital follow-up systems in comparison with the conventional paper-based follow-up (PB-FU).

Study Design

This is a retrospective analysis of prospectively collected double follow-up data.

Patient Sample

Patients who underwent lumbar spinal fusion for spondylolisthesis or degenerative disc disease between 2013 and 2016 were included in the study.

Outcome Measures

The study determined the Oswestry Disability Index (ODI) and Numeric Rating Scale (NRS) for back and leg pain severity at baseline, 6 weeks, 12 months, and 24 months.

Materials and Methods

After lumbar spinal fusion surgery, a double follow-up of PROM was carried out by conventional PB-FU during clinical visits, while simultaneously completing an automatically dispatched digital follow-up questionnaire. As the primary end point, we assessed the intraindividual discrepancy in PROM between PB-FU and automated digital follow-up (AD-FU).

Results

Forty patients completed all parts of the dual follow-up trajectory and were analyzed. We detected no discrepancy in ODI or NRS for back and leg pain severity at any of the baseline, 6-week, 12-month, or 24 month follow-ups (all p>.05). This was confirmed in a sensitivity analysis.

Conclusions

In an analysis of dual paper-based and digital follow-up after lumbar fusion surgery, patients report highly similar values using either method of follow-up. It appears that AD-FU without incentives produces lower response rates. To reassess the validity of these systems for data collection in spinal patient care, a prospective validation with higher statistical power is warranted.  相似文献   
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