The Laryngoscope
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Review Meta Analysis
Perioperative ketorolac increases post-tonsillectomy hemorrhage in adults but not children.
To evaluate the risk of post-tonsillectomy hemorrhage associated with perioperative ketorolac use. ⋯ Ketorolac can be used safely in children, but is associated with a five-fold increased bleeding risk in adults.
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Hospital readmissions increase costs to hospitals and patients. There is a paucity of data on benchmark rates of readmission for otolaryngological surgery. Understanding the risk factors that increase readmission rates may help enhance patient education and set system-wide expectations. We aimed to provide benchmark data on causes and predictors of readmission following outpatient otolaryngological surgery. ⋯ Outpatient otolaryngological surgery has an associated 2.01% unplanned readmission rate. Superficial surgical site infection and work RVUs proved to be significant positive and negative risk factors, respectively, for readmission. These findings will help to benchmark outpatient readmission rates and manage patient and hospital system expectations.
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Comparative Study
Outcomes of early versus late tracheostomy: 2008-2010.
The ideal timing of tracheostomy varies. This study sought to determine demographic, management, and outcome differences in patients undergoing early tracheostomy (ET) versus late tracheostomy (LT) (<10 days vs. >10 days postintubation, respectively). ⋯ Efficient and effective healthcare delivery is paramount in today's economic climate. Identification of patients likely to need prolonged ventilator support and ET may prove to be a cost- and morbidity-saving measure and deserves further prospective examination.
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To develop and assess the feasibility of a new standardized protocol to guide tracheostomy decannulation. ⋯ The new tracheostomy capping and decannulation protocol assisted in predicting both successful and failed decannulation. Although several patients failed certain capping criteria initially, the protocol stipulated modifications of care that enabled successful decannulation. The screening tool had high sensitivity and promoted communication, standardization of practice, and patient safety.