Saint Francis University

About: Saint Francis University is a education organization based out in Loretto, Pennsylvania, United States. It is known for research contribution in the topics: Population & Osteoblast. The organization has 1694 authors who have published 2038 publications receiving 87149 citations.

Hospital Complications and Causes of 90-Day Readmissions After Implantation of Left Ventricular Assist Devices.

Abstract: Left ventricular assist devices (LVADs) have emerged as an attractive option in patients with advance heart failure. Nationwide readmission database 2013 to 2014 was utilized to identify LVAD recipients using ICD-9 procedure code 37.66. The primary outcome was 90-day readmission. Readmission causes were identified using ICD-9 codes in primary diagnosis field. The secondary outcomes were LVAD associated with hospital complications. Hierarchic 2-level logistic models were used to evaluate study outcomes. We identified 4,693 LVAD recipients (mean age 57 years, 76.2% males). Of which 53.9% were readmitted in first 90 days of discharge. Cardiac causes (33.3%), bleeding (21.3%), and infections (12.4%) were leading etiologies of 90-day readmissions. Significant predictors (odds ratio, 95% confidence interval, p value) of readmission were disposition to nursing facilities (1.33, 1.09 to 1.63, p = 0.01) and longer length of stay (1.01, 1.00 to 1.01, p <0.01). Although private insurance (0.75, 0.66 to 0.86, p <0.01), and self-pay (0.58, 0.42 to 0.81, p <0.01) predicted lower readmissions. Cardiac complications (36.3%), major bleeding (29.8%), and postoperative infections (10.4%) were most common LVAD-related complications. In conclusion, high early readmission rate was observed among LVAD recipients with Cardiac complications, bleeding complications, and infections were driving force for major complications and most of readmissions.

Impact of HIV on mortality from acute lower respiratory tract infection in rural Zambia

Abstract: AIMS—To establish the prevalence and clinical correlates of HIV among children with acute lower respiratory tract infection. METHODS—Children admitted to a rural Zambian hospital were studied over an eight month period. The diagnosis of acute lower respiratory tract infection was made clinically, according to World Health Organisation (WHO) criteria. Clinicians, who were unaware of the children's HIV status, prescribed antibiotic and supportive treatment according to WHO guidelines. HIV status was established using the polymerase chain reaction (Amplicor HIV1, Roche) applied to dried blood spots. RESULTS—Acute lower respiratory tract infection was diagnosed in 132 children (median age 8 months, range 1 month to 4 years). The WHO criteria for severe or very severe pneumonia were met by 96/132 patients (73%) and 21 patients (16%) died. HIV dried blood spot PCR was positive in 14 cases (11%), of whom four fulfilled the WHO clinical case definition for paediatric AIDS and five died. The group as a whole were malnourished, but the HIV positive children were more severely malnourished (mean z score for weight = −3.01) than the HIV negative children (mean z score = −1.73, p < 0.001). The relative risk of death was 2.6 in the HIV positive group but this was not significant (p = 0.079). CONCLUSIONS—An important minority of children with acute lower respiratory tract infection in rural Zambia will be infected with HIV. However, most HIV positive children presenting with respiratory infection will survive given simple antibiotic and supportive treatment.