By Lisa Rapaport (Reuters Health) - When patients have complications after surgery, it’s best to go back to the hospital where the operation was done, a new study suggests. Patients who go instead to a hospital that didn’t do the original operation have a higher risk of death, the researchers found. "Even when we accounted for how sick patients were, what type of hospital they went to, and how far they traveled for care, we still found that patients had higher mortality rates when they had post-operative care at a different facility," said the study's lead author, Dr. Thomas Tsai of Harvard School of Public Health and Brigham and Women's Hospital in Boston. For the new study, Tsai and colleagues examined data on more than 93,000 Medicare patients who were rehospitalized for complications after major surgery from January 2009 through November 2011. The surgeries covered by the study are common among the elderly: coronary artery bypass grafting to improve blood flow to the heart; pulmonary lobectomy to remove diseased lung tissue; abdominal aortic aneurysm repair to strengthen a major blood vessel; colectomy to remove abnormal tissue from the colon; and hip replacement. One in four of these elderly surgery patients got readmitted to a different hospital – not the one where the operation was performed, the study found. Even when the researchers accounted for how far patients lived from the original hospital, so-called postsurgical care fragmentation was associated with a substantially higher risk of death. After adjusting for all variables, including type of hospitals involved and the distances to both hospitals, patients were more likely to die within 30 days after surgery if they had complications treated at a different hospital. Specifically, those readmitted to the original hospital had a mortality rate of 4.1 percent, compared with 5.8 percent for those admitted to a different hospital, which translates to a 41 percent difference. "The implication is that we need to pay more attention to the post-discharge recovery period," Tsai said in a telephone interview. "We all want to avoid a 2 a.m. ambulance ride to a hospital that may not know our medical history or specialize in our type of care. We have to do more to help patients plan for these contingencies before we send them home from surgery the first time." Generally, patients readmitted to a different hospital lived farther from the original facility than the one where they went for follow-up care, the researchers wrote in JAMA Surgery. And, they were less likely to live in urban areas. One limitation of the study was the method of measuring the distances that patients traveled for care. The researchers used zip codes for the hospitals and patient homes, and didn`t account for variations in travel times. Another shortcoming was the use of claims data, which is designed for billing purposes and can exclude many specifics about the care patients receive, the researchers said. Dr. Stephen F. Jencks, an independent healthcare safety consultant, told Reuters Health by phone, “The real question this new research raises is why people are turning up at a different hospital. Is it because they had a true emergency and they called the surgery department at the hospital that treated them and were told to rush to the nearest emergency room? Or is it because they felt bad after surgery and called 911 because they didn’t have a plan in place for who to contact and the ambulance just took them to the nearest hospital?” The second scenario could be prevented with better planning, said Jencks, who was the lead author on a seminal paper on readmissions published in 2009 in the New England Journal of Medicine (http://bit.ly/1ytG37U). Patients shouldn’t leave the hospital without a follow-up appointment scheduled and clear directions on who to call for help when complications arise, he said. “The notion of hospital discharge has to change from a hand-off where you lose all responsibility for the patient to a transfer from one physician to another,” Jencks said. SOURCE: http://bit.ly/1vwRuEM JAMA Surgery, online December 3, 2014.
Supporters say the move would increase vaccine production but the pharmaceutical industry disagrees.
LONDON (Reuters) -U.S. Secretary of State Antony Blinken said the West had to be very careful about the exact nature of Chinese investment in Western economies and think very carefully about investments in strategic assets. China's spectacular economic and military rise over the past 40 years is among the most significant geopolitical events of recent history, alongside the 1991 fall of the Soviet Union that ended the Cold War. The West has struggled to come up with an agreed policy on China and has flipflopped over the years from seeing China as a lucrative source of investment - for example in U.S. government bonds - to seeing China as a threat to global stability and avoiding its 5G technology.
- Associated Press
U.S. Secretary of State Antony Blinken met with his Ukrainian counterpart in Kyiv Thursday, telling him that he was there to “reaffirm strongly” Washington's commitment to Ukraine's “sovereignty, territorial integrity and independence.” Blinken also assured Ukrainian Foreign Minister Dmytro Kuleba that the U.S. was committed “to work with you and continue to strengthen your own democracy, building institutions, advancing your reforms against corruption.” On the frontlines of the battle against Russia-backed separatists and in the halls of government in Kyiv, Ukrainians hold strong hopes for Thursday's visit — increased military aid and strong support for NATO membership among them.
The Pentagon said Wednesday it's tracking the uncontrolled descent of the Long March-5B Y2 rocket that carried a Chinese Space Station module to orbit last week.Details: Defense Department spokesperson John Kirby told reporters the rocket's debris was expected to return to Earth "somewhere around" May 8 and that the U.S. Space Command has said "almost the entire body of the rocket" remains intact. "It's too soon to know exactly where it's going to come down," he added.Stay on top of the latest market trends and economic insights with Axios Markets. Subscribe for freeOur thought bubble, via Axios' Miriam Kramer: This isn't the first time a rocket or spacecraft launched by China's space agency has come down to Earth uncontrolled. Space watchers also played a waiting game as China’s Tiangong-1 space station came back through the atmosphere in 2018, eventually burning up above the Pacific Ocean.Like this article? Get more from Axios and subscribe to Axios Markets for free.
- Business Insider
Caitlyn Jenner told Sean Hannity she doesn't think California needs to fund a high-speed rail: 'I can get on a plane at LAX and I'll be in San Francisco in 50 minutes'
Jenner, a Republican, is running against California Gov. Gavin Newsom in a special recall election.
- Associated Press
The top U.S general for Africa is warning that a growing threat from China may come not just from the waters of the Pacific, but from the Atlantic as well. U.S. Gen. Stephen Townsend, in an interview with The Associated Press, said Beijing is looking to establish a large navy port capable of hosting submarines or aircraft carriers on Africa’s western coast. Townsend said China has approached countries stretching from Mauritania to south of Namibia, intent on establishing a naval facility.
The bill would require death row inmates to choose between being shot by firing squad or electrocuted amid the state's lack of lethal injections.
Divorce is usually caused by one of the '3 i's,' therapists say. Here's what they are, and how they destroy a marriage.
Conflict caused by incompatibility or irreconcilable differences can impact a couple over the course of their marriage, therapist Tess Brigham said.
- Business Insider
A supportive wife's detailed Facebook posts led investigators directly to one alleged Capitol riot attendee
Prosecutors say Gary Edwards was captured on security footage and live streams walking around the inside and outside of the Capitol building.
- The Week
The United States will advocate for waiving COVID-19 vaccine patent protections in discussions with the World Trade Organization, U.S. Trade Representative Katherine Tai announced Wednesday. The Biden administration "believes strongly in intellectual property protections," Tai said in a statement, but the White House will back the waiver given the "extraordinary circumstances of the COVID-19 pandemic." The administration has faced pressure to support the measure, which is aimed at increasing vaccinations around the world — especially in countries experiencing a surge in infections, like India — without having to rely solely on exports. These extraordinary times and circumstances of call for extraordinary measures. The US supports the waiver of IP protections on COVID-19 vaccines to help end the pandemic and we’ll actively participate in @WTO negotiations to make that happen. pic.twitter.com/96ERlboZS8 — Ambassador Katherine Tai (@AmbassadorTai) May 5, 2021 Proponents were pleased with the news, but shortly after Tai's announcement, stocks of pharmaceutical companies that have produced vaccines, including Moderna and Pfizer, plummeted. I seems the Biden administration has decided to throw its weight behind a patent waiver on Covid vaccines. This is what it's doing to the vaccine makers' share prices. pic.twitter.com/zwh4Aekmvj — Kiran Stacey (@kiranstacey) May 5, 2021 It remains unclear if the protections will actually be waived since all 164 members of the WTO will need to agree on the matter, but backing from the U.S. should certainly move the needle. More stories from theweek.comAmerica's nervous breakdown is right on scheduleMitch McConnell, asked about the Liz Cheney purge, says '100 percent of my focus is on stopping' BidenThe GOP puts all its eggs in one dangerous basket
2 California students were sentenced to life in prison for stabbing and killing a police officer in Rome
California natives Finnegan Elder, 21, and Gabriel Natale-Hjorth, 20, were sentenced on Wednesday to life imprisonment for murder.
The Amazon.com founder will launch people into space on his New Shepard vehicle on 20 July.
- Yahoo News
President Biden said Wednesday that he didn't understand Republican efforts in the U.S. House of Representatives to replace Rep. Liz Cheney.
BERLIN (Reuters) -German Chancellor Angela Merkel told Turkish President Tayyip Erdogan on Wednesday that the withdrawal of foreign troops from Libya would be an "important signal" as both leaders vowed to support the new interim government there, a German government spokesman said. Libya's new unity government was sworn in on March 15 from two warring administrations that had ruled eastern and western regions, completing a relatively smooth transition of power after a decade of violent chaos. Turkey had backed the Tripoli-based Government of National Accord against the eastern-based Libyan National Army, which was supported by Russia, Egypt, the United Arab Emirates and France.
- Business Insider
The 7 most anticipated new movie releases in May, from Netflix's 'Army of the Dead' to 'A Quiet Place Part II'
Netflix will release Zack Snyder's zombie action movie "Army of the Dead" this month, and Paramount will finally debut its "A Quiet Place" sequel.
- Business Insider
What it's like to get COVID-19 after a vaccine, according to people who had 'breakthrough' infections
Karlee Camme, 24, was not sick enough to suspect she had COVID-19 after getting fully vaccinated. She got tested when she lost her sense of smell.
- Associated Press
NASCAR's next generation race car is finally here after two years of hype and hope that it will revolutionize the stock car series. The Next Gen car, first proposed in 2018 and originally set to debut this season until the pandemic delayed it until 2022, is a first-of-its-kind collaboration between NASCAR and its partners. “We really wanted to get back to a promise that we had made to the fans, which is to put the ‘stock’ back in stock car,” NASCAR President Steve Phelps said.
Authorities in New York City are looking for a woman who allegedly attacked two Asian pedestrians with a hammer over the weekend. The incident, which was caught on surveillance video, occurred on the 410 block of West 42nd Street at around 8:40 p.m. on Sunday. "She was talking to herself, like talking to a wall, I thought maybe she was drunk or something so we just wanted to pass through her quickly," Theresa, 31, told ABC7 New York reporter CeFaan Kim.
- Christian Science Monitor
Since George Floyd’s death, Minneapolis has become a microcosm of the national debate on addressing race in schools. What lessons can the city offer?
- Associated Press
A prominent politician in Kashmir who challenged India’s rule over the disputed region for decades died Wednesday while in police custody. Mohammed Ashraf Sehrai was admitted to a government hospital with multiple ailments on Tuesday from a jail in the southern Jammu region, officials and his family said. Sehrai’s son, Mujahid Sehrai, said authorities and doctors told him that his father had tested positive for COVID-19 and that his oxygen levels had dropped early Wednesday.