Digital Commons Network^™

Retrospective Review Of Fluoroscopic Swallowing Studies And Outcomes At An Academic Health Center, Rachel Strock, Priyha Mahesh, Baskaran Sundaram, Md, Gregory C. Kane, Md

Phase 1

Introduction: Aspiration is often associated with underlying medical conditions and can cause pneumonia or death. Aspiration risk can be assessed via video fluoroscopic swallowing study (VFSS) or barium swallow (BaSw). We aimed to assess the diagnoses and clinical course of patients who were evaluated for potential aspiration through VFSS or BaSw to determine if there is a degree of aspiration that increases the risk of developing pneumonia and/or death.

Methods: We conducted a retrospective chart review of 374 patients in TJUH who were evaluated via VFSS or BaSw from January 1 to June 30, 2017. We recorded the degree and …

Rescue Stenting For Failed Mechanical Thrombectomy Procedures, Joseph Schaefer, Ahmad Sweid, Md, M. Reid Gooch, Md, Pascal Jabbour, Md

Phase 1

Background: Mechanical thrombectomy (MT) has dramatically changed the natural history of acute ischemic stroke. The disease that was associated with high morbidity, mortality, and significant cost on the health care system became a treatable disease. One of the most important variables to improve outcomes is time to revascularize the ischemic tissue. Rescue stenting (RS) is an option for patients who fail MT.

Methods: A retrospective chart review for patients who underwent a MT procedure and either failed (defined as TICI 0-2a) or required a RS from 2015 – 2019 composed the study population. IRB approval was obtained and the consent …

Patient And Renal Outcomes Of Posttransplant Lymphoproliferative Disorder Following Solid Organ Transplantations - A Single Center Experience, Kashka Mallari, Goni Katz-Greenberg, Maria Martinez Cantarin

Phase 1

Introduction: Post-transplant Proliferative Disorder (PTLD) is a significant complication after solid organ transplantation (SOT). Major risk factors that contribute to the development of PTLD include Epstein-Barr Virus (EBV) infection and degree of immunosuppression. Despite novel therapies, the 5-year survival rate of PTLD only improved from 40% to 50% over the years. The reported 5-year survival rate of PTLD also remains significantly lower compared to around 90% in other malignancies such as breast and colon cancer. In our center, we hypothesize better transplant outcomes compared to those reported in preceding literatures.

Methods: We retrospectively reviewed the electronic medical records of …

Measuring The Efficacy Of Medical Management Versus Decompressive Hemicraniectomy In Acute Stroke, Colton Hemphill, Franziska Herpich, Muhammad Athar, Eunice Lee

Phase 1

Introduction: Stroke is a life-threatening condition requiring immediate treatment in order to optimize patient survival and functionality post-hospitalization. At present, the primary treatment modalities used are intensive medical management and surgical decompressive hemicraniectomy. We believe that application of skilled medical management can result in a lower mortality rate and higher functional score at 12 months than aggressive surgical decompressive hemicraniectomy.

Methods: Epic data from Thomas Jefferson University will be used to identify patients with a large stroke (as defined by ischemic area on MRI) managed by the neurology department from 2016 to 2019. A survey will be administered by phone …

Characteristics And Outcomes Of Patients Directly Discharged To Home From The Intensive Care Unit, Ann Zheng, Preeyal M. Patel, Michele Fiorella, Lauren Mcdonnell, Mina Yasuoka, Erika J. Yoo, Md

Phase 1

Introduction: Given the current era of decreasing hospital bed availability, there has been a rise in the practice of direct discharge to home (DDH) from ICUs. We evaluated the demographics, clinical characteristics, outcomes and readmission patterns among DDH patients.

Methods: Retrospective review of patients from 2 MICUs from June 2017 to June 2019 at Thomas Jefferson University hospital, an urban tertiary care center. Primary outcome of interest was 30-day hospital readmission. Patients were dichotomized into two groups based on time between ward transfer order and hospital discharge (<24 or ≥24 hours). Risk adjustment performed with Mortality Probability Model (MPM0 -III). ICU workload at admission and discharge was estimated with nine equivalents of nursing manpower use score (NEMS). Patient characteristics compared using t-test and Fisher exact or χ² test.

Results: 331 DDH patients were analyzed, with the majority …

Outcomes And Indications For Thoracofemoral Bypass In The Endovascular Age: A Case Series And Literature Review, Andrea Mcsweeney, Babak Abai, Md

Phase 1

Introduction: Endovascular revascularization is commonplace in vascular surgery; however, thoracofemoral bypass (TFB) is optimal in particular patients. Little research focuses on TFB outcomes. This case series and literature review investigated indications, efficacy, and safety of TFB.

Methods: Cases at Thomas Jefferson University Hospital (TJUH) included one male and four females (average age 57.2) from 2015-2019. Literature review yielded 124 cases from other institutions. PubMed and Scopus search using the term “thoraco femoral bypass” yielded 39 articles. Articles published before 2000 and case studies published in any year were excluded. Seven articles were selected. Primary outcomes included 30-day mortality and …