Comparing Outcomes of Coronary Artery Bypass Grafting Among Large Teaching and Urban Hospitals in China and the United States

Zheng, Zhe; Zhang, Heng; Yuan, Xin; Rao, Chenfei; Zhao, Yan; Wang, Yun; Normand, Sharon‐Lise T.; Krumholz, Harlan M.; Hu, Shengshou

doi:10.1161/circoutcomes.116.003327

Cited by 28 publications

(28 citation statements)

References 24 publications

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“…For example, a diagnosis related group-based payment system in the United States predetermines reimbursements for hospital charge, causing early discharge. Moreover, the reimbursement ratio for inpatient service is much higher than that in the outpatient setting in China, prolonging the hospitalized length of stay [31,32]. Second, Chinese doctors are inclined to be conservative in terms of discharge to avoid risks from vital complications, patients, or their families.…”

Section: Discussionmentioning

confidence: 99%

Normal trajectory of Interleukin-6 and C-reactive protein in the perioperative period of total knee arthroplasty under an enhanced recovery after surgery scenario

Huang¹,

Huang²,

Wang³

et al. 2020

BMC Musculoskelet Disord

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Background: We designed the current study to understand the normal trajectories of interleukin-6 (IL-6) and Creactive protein (CRP) in the immediate hours and days after primary total knee arthroplasty (TKA) under the management of an enhanced recovery after surgery (ERAS) protocol and examined whether one or the other returned to normal more quickly. Methods: In this prospective cross-sectional study, we examined the plasma IL-6 and CRP levels in 100 patients undergoing primary TKA at the following time points: 12 h preoperatively as well as postoperatively 12 h, 48 h, 3 days and 2 weeks. Patients were followed up for 1 year to monitor the postoperative complications, especially the infection. Results: IL-6 peaked at 48 h postoperatively. Then IL-6 started to decline at 3 days postoperatively and went back to baseline level at 2 weeks (p = 0.950). CRP peaked at 3 days postoperatively. At 2 weeks, CRP declined to a normal range, without being significantly different from the baseline level (p = 0.816). Conclusion: We found that under the ERAS scenario, the postoperative peak of IL-6 and CRP was deferred compared with previous studies. Compared to IL-6, CRP showed a gradual rise after surgery. Both of these two biomarkers returned to normal under the ERAS scenario. Future multiple-center studies with larger sample size can help define the thresholds of IL-6 and CRP for periprosthetic joint infection (PJI) early diagnosis. With these reference data, a clinician can make a quicker decision to perform aspiration to diagnose early PJI and benefits more patients.

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Section: Discussionmentioning

confidence: 99%

Normal trajectory of Interleukin-6 and C-reactive protein in the perioperative period of total knee arthroplasty under an enhanced recovery after surgery scenario

Huang¹,

Huang²,

Wang³

et al. 2020

BMC Musculoskelet Disord

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“…To address potential sampling variation and imbalances in number between electronic and scanned-copy-abstracted prescriptions, we adapted a resampling approach to conducting a simulation analysis with a nonparametric bootstrap method. 26,27 Specifically, for scanned-copy-abstracted prescription data, we randomly selected records with a sample size equal to the total number of records; for electronic prescription data, we randomly selected a sample size equal to the sample size of the scanned-copy-abstracted prescription data. We then appended the two resampled datasets together and fitted the mixed model to estimate the association between the medication's prescription and its cost.…”

Section: Data Source and Study Samplementioning

confidence: 99%

Availability, cost, and prescription patterns of antihypertensive medications in primary health care in China: a nationwide cross-sectional survey

et al. 2017

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“…). Following assessment, 68 articles, involving 708 032 patients across 71 LMICs, were included in the review ( Tables S1 and S2 , supporting information). Country‐specific patient numbers were reported in 60 studies but were absent from six and two provided total LMIC patient numbers only.…”

Section: Resultsmentioning

confidence: 99%

“…Outcomes following cancer surgery were common topics, including breast, gastric, colorectal and prostate cancer, and hepatocellular carcinoma. Cardiac surgery, caesarean section and genitourinary fistula were also well represented in included articles, whereas clinical presentations included burn management, trauma, appendicitis, groin hernias and orthopaedic fracture management.…”

Section: Resultsmentioning

confidence: 99%

Systematic review of the use of big data to improve surgery in low- and middle-income countries

Knight

Ots

Maimbo

et al. 2019

British Journal of Surgery

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Background Technological advances have led to the generation of large amounts of data, both in surgical research and practice. Despite this, it is unclear how much originates in low‐ and middle‐income countries (LMICs) and what barriers exist to the use of such data in improving surgical care. The aim of this review was to capture the extent and impact of programmes that use large volumes of patient data on surgical care in LMICs. Methods A PRISMA‐compliant systematic literature review of PubMed, Embase and Google Scholar was performed in August 2018. Prospective studies collecting large volumes of patient‐level data within LMIC settings were included and evaluated qualitatively. Results A total of 68 studies were included from 71 LMICs, involving 708 032 patients. The number of patients in included studies varied widely (from 335 to 428 346), with 25 reporting data on 3000 or more LMIC patients. Patient inclusion in large‐data studies in LMICs has increased dramatically since 2015. Studies predominantly involved Brazil, China, India and Thailand, with low patient numbers from Africa and Latin America. Outcomes after surgery were commonly the focus (33 studies); very few large studies looked at access to surgical care or patient expenditure. The use of large data sets specifically to improve surgical outcomes in LMICs is currently limited. Conclusion Large volumes of data are becoming more common and provide a strong foundation for continuing investigation. Future studies should address questions more specific to surgery.

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Comparing Outcomes of Coronary Artery Bypass Grafting Among Large Teaching and Urban Hospitals in China and the United States

Abstract: Supplemental Digital Content is available in the text.

Cited by 28 publications

References 24 publications

Normal trajectory of Interleukin-6 and C-reactive protein in the perioperative period of total knee arthroplasty under an enhanced recovery after surgery scenario

Normal trajectory of Interleukin-6 and C-reactive protein in the perioperative period of total knee arthroplasty under an enhanced recovery after surgery scenario

Availability, cost, and prescription patterns of antihypertensive medications in primary health care in China: a nationwide cross-sectional survey

Systematic review of the use of big data to improve surgery in low- and middle-income countries

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