PMID- 27530071
OWN - NLM
STAT- MEDLINE
DCOM- 20170918
LR  - 20171215
IS  - 1097-6779 (Electronic)
IS  - 0016-5107 (Linking)
VI  - 85
IP  - 2
DP  - 2017 Feb
TI  - Distance from hospital impacts adverse event detection after outpatient 
      endoscopy.
PG  - 380-386
LID - S0016-5107(16)30473-4 [pii]
LID - 10.1016/j.gie.2016.08.006 [doi]
AB  - BACKGROUND AND AIMS: Monitoring adverse events (AEs) after GI endoscopy is an 
      endorsed quality measure but is challenging to implement in practice. Patients 
      with major AEs may seek care elsewhere after endoscopy. We aimed to determine the 
      hospital utilization patterns of patients with AEs after ambulatory endoscopy. 
      METHODS: We used the HealthLNK Data Repository, which uses a software application 
      for integration of deidentified, patient-level clinical data across institutions. 
      Data for patients undergoing outpatient endoscopy from 2010 to 2011 at 5 
      Chicago-area hospitals were used. Early mortality was defined as death no more 
      than 2 months after the outpatient procedure. AEs were defined as a hospital 
      admission for perforation, bleeding, or pancreatitis the same or following month 
      after endoscopy. RESULTS: During the study period, 42,842 outpatient procedures 
      were performed in 22,898 unique individuals. Early mortality occurred in 86 
      patients (.4%). Per-patient mortality was greatest after outpatient ERCP (2.5%, 
      P < .0001). Of 86 patients with early mortality, 36 (42%) were not hospitalized 
      at the index hospital after endoscopy. Patients who did not return to the index 
      hospital lived farther from the index hospital (P = .02). In total, 8.3% of 
      ambulatory endoscopies were associated with potential endoscopy-related AEs. The 
      observed rate of potential AEs trended downward as patients' home zip codes moved 
      farther from the index hospital (P = .01). CONCLUSIONS: Nearly half of patients 
      who die soon after outpatient endoscopy are not hospitalized at their index 
      hospital after endoscopy. The observed AE rate was higher for patients living 
      closer to the index hospital, suggesting that patients who live farther away are 
      less likely to return to the index hospital for emergency care. Novel methods to 
      efficiently track outcomes after outpatient endoscopy are needed.
CI  - Copyright (c) 2017 American Society for Gastrointestinal Endoscopy. Published by 
      Elsevier Inc. All rights reserved.
FAU - Jackson, Kathryn L
AU  - Jackson KL
AD  - Center for Health Information Partnerships, Northwestern University Feinberg 
      School of Medicine, Chicago, Illinois, USA.
FAU - Goel, Satyender
AU  - Goel S
AD  - Center for Health Information Partnerships, Northwestern University Feinberg 
      School of Medicine, Chicago, Illinois, USA.
FAU - Kho, Abel N
AU  - Kho AN
AD  - Center for Health Information Partnerships, Northwestern University Feinberg 
      School of Medicine, Chicago, Illinois, USA.
FAU - Keswani, Rajesh N
AU  - Keswani RN
AD  - Division of Gastroenterology, Northwestern University Feinberg School of 
      Medicine, Chicago, Illinois, USA.
LA  - eng
PT  - Journal Article
DEP - 20160813
PL  - United States
TA  - Gastrointest Endosc
JT  - Gastrointestinal endoscopy
JID - 0010505
SB  - IM
CIN - Gastrointest Endosc. 2017 Feb;85(2):387-389. PMID: 28089033
CIN - Gastrointest Endosc. 2017 Aug;86(2):412. PMID: 28728673
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - *Ambulatory Care
MH  - Chicago
MH  - Cholangiopancreatography, Endoscopic Retrograde
MH  - Data Collection
MH  - Databases, Factual
MH  - Emergency Service, Hospital
MH  - *Endoscopy, Digestive System
MH  - Esophageal Perforation/epidemiology
MH  - Female
MH  - Geography
MH  - *Hospitals
MH  - Humans
MH  - Intestinal Perforation/epidemiology
MH  - Male
MH  - Middle Aged
MH  - *Mortality
MH  - Pancreatitis/epidemiology
MH  - Postoperative Complications/*epidemiology
MH  - Postoperative Hemorrhage/epidemiology
MH  - Young Adult
EDAT- 2016/08/18 06:00
MHDA- 2017/09/19 06:00
CRDT- 2016/08/18 06:00
PHST- 2016/03/25 00:00 [received]
PHST- 2016/08/01 00:00 [accepted]
PHST- 2016/08/18 06:00 [pubmed]
PHST- 2017/09/19 06:00 [medline]
PHST- 2016/08/18 06:00 [entrez]
AID - S0016-5107(16)30473-4 [pii]
AID - 10.1016/j.gie.2016.08.006 [doi]
PST - ppublish
SO  - Gastrointest Endosc. 2017 Feb;85(2):380-386. doi: 10.1016/j.gie.2016.08.006. Epub 
      2016 Aug 13.