JAMA network open
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Differences in readmission rates among racial and ethnic minorities have been reported, but data among people with diabetes are lacking despite the high burden of diabetes and its complications in these populations. ⋯ In this study, black patients with diabetes had a significantly higher risk of readmission than members of other racial/ethnic groups. This increased risk was most pronounced among lower-income patients hospitalized in nonprofit, academic, or large hospitals. These findings reinforce the importance of identifying and addressing the many reasons for persistent racial/ethnic differences in health care quality and outcomes.
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Comparative Study
Association of Clinical Frailty Scores With Hospital Readmission for Falls After Index Admission for Trauma-Related Injury.
Falls have been associated with morbidity and mortality in elderly patients. Assessment of frailty at hospital admission may help health care professionals evaluate fall risk in patients with trauma-related injury. ⋯ Measurement of frailty at hospital admission may be an effective tool to assess fall risk and discharge disposition among patients with trauma-related injury aged 50 years and older.
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Randomized Controlled Trial
Assessment of Sarcopenia Among Community-Dwelling At-Risk Frail Adults Aged 65 Years and Older Who Received Multidomain Lifestyle Interventions: A Secondary Analysis of a Randomized Clinical Trial.
There is little understanding of the outcomes associated with active lifestyle interventions for sarcopenia among older persons. ⋯ This study suggests that older persons with sarcopenia are responsive to the effects of multidomain lifestyle interventions. Sarcopenia reduction was most pronounced through improved gait speed, and occurred more among those who were male, were younger, or had greater muscle mass.
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According to National Patient Safety Goal 15.01.01, all individuals being treated or evaluated for behavioral health conditions as their primary reason for care in hospitals and behavioral health care organizations accredited by The Joint Commission should be screened for suicide risk using a validated tool. Existing suicide risk screens have minimal or no high-quality evidence of association with future suicide-related outcomes. ⋯ Positive results of both selective and universal screening for suicide risk in pediatric EDs appear to be associated with subsequent suicidal behavior. Screening may be a particularly effective way to detect suicide risk among those who did not present with ideation or attempt. Future studies should examine the impact of screening in combination with other policies and procedures aimed at reducing suicide risk.
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Pediatric firearm injuries are a serious and growing public health problem, constituting the second leading cause of death in children and adolescents in the United States. Firearm injuries have a high case fatality, but knowledge is limited to date regarding their injury severity and health care utilization burden compared with those of other penetrating injuries, especially among children with critical injury. ⋯ This study found that pediatric firearm injuries were associated with greater severity and health care utilization compared with penetrating trauma from other mechanisms, suggesting that the mechanism of injury is an important consideration in penetrating sharp force trauma in children and adolescents. Public health measures, legislative efforts, and safe storage practices are among the interventions needed to reduce pediatric firearm injuries.