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S-c Wu - One of the best experts on this subject based on the ideXlab platform.
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Association of hospital and surgeon operation volume with the incidence of Postoperative Endophthalmitis: Taiwan experience
Eye, 2006Co-Authors: Y-t Fang, Li Nien Chien, Y Y Ng, W-m Chen, C-y Cheng, S-c WuAbstract:Purpose To determine the association between hospital and surgeon volume with the incidence of Postoperative Endophthalmitis. Methods A prospective cohort study was conducted to analyse the national health insurance claims data of those patients receiving cataract surgery in 2000 in Taiwan. A total of 108 705 patients who received cataract surgery by 1004 surgeons at 494 hospitals were followed to the end of 2002. Stepwise Cox regression was used to analyse the effects of hospital and surgeon volume of cataract surgery on Postoperative Endophthalmitis after adjustment for patient's age, gender, education, ophthalmic comorbidities, general comorbidities, and surgical factors including operative methods, different types of intraocular lenses, and surgeon's age. Results The 2-year incidence of Postoperative Endophthalmitis at high-volume hospitals (0.90%) was lower than low-volume hospitals (1.16%). The incidence of Postoperative Endophthalmitis by high-volume surgeons (0.59%) was lower than those by middle-high-volume (0.73%), middle-low-volume (0.80%), or low-volume surgeons (1.16%). After controlling for case mix, the risk of Postoperative Endophthalmitis of the low-volume hospitals (hazard ratio (HR)=1.39) was higher than that of the high-volume hospitals. The risk of Postoperative Endophthalmitis of low-volume surgeons (HR=1.67) was higher than that of the high-volume surgeons. Conclusions The provider volume (hospital and surgeon volume) is associated with the risk of Postoperative Endophthalmitis. The patients who receive cataract surgery at low-volume hospitals or by low-volume surgeons have significantly higher risk of Postoperative Endophthalmitis than at high-volume hospitals or by high-volume surgeons. Provider volume can be considered in further Postoperative Endophthalmitis study as a risk factor.
Shiaochi Wu - One of the best experts on this subject based on the ideXlab platform.
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association of hospital and surgeon operation volume with the incidence of Postoperative Endophthalmitis taiwan experience
Eye, 2006Co-Authors: Yiting Fang, Li Nien Chien, Y Y Ng, Weiming Chen, Chingyu Cheng, Shiaochi WuAbstract:To determine the association between hospital and surgeon volume with the incidence of Postoperative Endophthalmitis. A prospective cohort study was conducted to analyse the national health insurance claims data of those patients receiving cataract surgery in 2000 in Taiwan. A total of 108 705 patients who received cataract surgery by 1004 surgeons at 494 hospitals were followed to the end of 2002. Stepwise Cox regression was used to analyse the effects of hospital and surgeon volume of cataract surgery on Postoperative Endophthalmitis after adjustment for patient's age, gender, education, ophthalmic comorbidities, general comorbidities, and surgical factors including operative methods, different types of intraocular lenses, and surgeon's age. The 2-year incidence of Postoperative Endophthalmitis at high-volume hospitals (0.90%) was lower than low-volume hospitals (1.16%). The incidence of Postoperative Endophthalmitis by high-volume surgeons (0.59%) was lower than those by middle-high-volume (0.73%), middle-low-volume (0.80%), or low-volume surgeons (1.16%). After controlling for case mix, the risk of Postoperative Endophthalmitis of the low-volume hospitals (hazard ratio (HR)=1.39) was higher than that of the high-volume hospitals. The risk of Postoperative Endophthalmitis of low-volume surgeons (HR=1.67) was higher than that of the high-volume surgeons. The provider volume (hospital and surgeon volume) is associated with the risk of Postoperative Endophthalmitis. The patients who receive cataract surgery at low-volume hospitals or by low-volume surgeons have significantly higher risk of Postoperative Endophthalmitis than at high-volume hospitals or by high-volume surgeons. Provider volume can be considered in further Postoperative Endophthalmitis study as a risk factor.
Paul Healey Phd R Franzco - One of the best experts on this subject based on the ideXlab platform.
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efficacy and cost effectiveness of intracameral vancomycin in reducing Postoperative Endophthalmitis incidence in australia
Clinical and Experimental Ophthalmology, 2016Co-Authors: Andrew Jr White Franzco, Paul Healey Phd R FranzcoAbstract:Background Endophthalmitis is a rare but devastating Postoperative complication of cataract surgery. We aimed to describe the incidence of acute Postoperative Endophthalmitis in an Australian population over a 14-year period. Design This was a retrospective longitudinal cohort study performed at Westmead Hospital, a major tertiary hospital in Sydney, Australia. Participants Patients who had acute Postoperative Endophthalmitis within 6 weeks of their cataract surgery at Westmead Hospital were included. Methods Endophthalmitis cases from 2000 to 2014 were identified from computerized diagnostic coding. These were cross-referenced with the cataract surgery list over this time period. The routine use of intracameral vancomycin at the end of cataract surgery was introduced in Westmead Hospital in 2004. Main Outcome Measures We quantified the incidence of acute Postoperative Endophthalmitis pre and post the routine use of intracameral vancomycin. Results A total of 14 805 cataract cases were performed at Westmead Hospital from 2000 to 2014. Seventeen cases of Endophthalmitis were within 6 weeks post cataract surgery performed at Westmead Hospital. In the period 2000 to 2003, the incidence of Postoperative Endophthalmitis was 0.43% (11/2539). From 2004 to 2014, there was a dramatic decrease in the incidence of Postoperative Endophthalmitis to 0.049% (6/12 266, P < 0.0001). Conclusions There has been a nine-fold reduction in the rate of acute Postoperative Endophthalmitis with the use of intracameral vancomycin in cataract surgery. Post-cataract surgery Endophthalmitis is now a relatively rare cause of Endophthalmitis in this Australian population. Our study supports the routine use of intracameral vancomycin as Postoperative Endophthalmitis prophylaxis.
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Efficacy and cost-effectiveness of intracameral vancomycin in reducing Postoperative Endophthalmitis incidence in Australia
Clinical and Experimental Ophthalmology, 2016Co-Authors: Andrew Jr White Franzco, Paul Healey Phd R FranzcoAbstract:Background Endophthalmitis is a rare but devastating Postoperative complication of cataract surgery. We aimed to describe the incidence of acute Postoperative Endophthalmitis in an Australian population over a 14-year period. Design This was a retrospective longitudinal cohort study performed at Westmead Hospital, a major tertiary hospital in Sydney, Australia. Participants Patients who had acute Postoperative Endophthalmitis within 6 weeks of their cataract surgery at Westmead Hospital were included. Methods Endophthalmitis cases from 2000 to 2014 were identified from computerized diagnostic coding. These were cross-referenced with the cataract surgery list over this time period. The routine use of intracameral vancomycin at the end of cataract surgery was introduced in Westmead Hospital in 2004. Main Outcome Measures We quantified the incidence of acute Postoperative Endophthalmitis pre and post the routine use of intracameral vancomycin. Results A total of 14 805 cataract cases were performed at Westmead Hospital from 2000 to 2014. Seventeen cases of Endophthalmitis were within 6 weeks post cataract surgery performed at Westmead Hospital. In the period 2000 to 2003, the incidence of Postoperative Endophthalmitis was 0.43% (11/2539). From 2004 to 2014, there was a dramatic decrease in the incidence of Postoperative Endophthalmitis to 0.049% (6/12 266, P
Jonathon Q. Ng - One of the best experts on this subject based on the ideXlab platform.
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Quality of life after Postoperative Endophthalmitis.
Clinical and Experimental Ophthalmology, 2008Co-Authors: Antony Clark, Jonathon Q. Ng, Nigel Morlet, Elisabeth Tropiano, Priya Mahendran, Katrina Spilsbury, David B. Preen, James B. SemmensAbstract:Purpose: The aim of this study is to determine if Postoperative Endophthalmitis adversely affects quality of life after cataract surgery. Methods: We compared quality of life in patients who developed Endophthalmitis after cataract surgery between 1 January and 31 December 2003 with those who had uncomplicated surgery. The National Eye Institute VFQ-25 (VFQ-25) and EuroQol EQ-5D (EQ-5D) questionnaires and time trade-off utility scores were used to compare self-perceived general health and vision-related quality of life between groups. Linear regression was used to model differences between groups after adjusting for age, gender and visual acuity in the better eye. Results: Nineteen Postoperative Endophthalmitis cases were compared with 30 who had uncomplicated cataract surgery. Following surgery the mean composite VFQ-25 score was 13.5% (95% confidence interval [CI]: 6.0–26.4, P
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quality of life after Postoperative Endophthalmitis
Clinical and Experimental Ophthalmology, 2008Co-Authors: Antony Clark, Jonathon Q. Ng, Nigel Morlet, Elisabeth Tropiano, Priya Mahendran, Katrina Spilsbury, David B. Preen, James B. SemmensAbstract:Purpose: The aim of this study is to determine if Postoperative Endophthalmitis adversely affects quality of life after cataract surgery. Methods: We compared quality of life in patients who developed Endophthalmitis after cataract surgery between 1 January and 31 December 2003 with those who had uncomplicated surgery. The National Eye Institute VFQ-25 (VFQ-25) and EuroQol EQ-5D (EQ-5D) questionnaires and time trade-off utility scores were used to compare self-perceived general health and vision-related quality of life between groups. Linear regression was used to model differences between groups after adjusting for age, gender and visual acuity in the better eye. Results: Nineteen Postoperative Endophthalmitis cases were compared with 30 who had uncomplicated cataract surgery. Following surgery the mean composite VFQ-25 score was 13.5% (95% confidence interval [CI]: 6.0–26.4, P < 0.01) lower in Endophthalmitis cases. Endophthalmitis patients reported significantly lower (P < 0.05) general vision, near vision, peripheral vision, mental health and role difficulties subscales scores after adjusting for age, sex and visual acuity. No significant differences were found in other subscales. Mean time trade-off utility and all EQ-5D scores were similar except for mobility (95% CI: 0.04–0.68, P < 0.05). Conclusions: Endophthalmitis after cataract surgery negatively impacts on self-perceived vision-related quality of life, resulting in poorer psychological well-being and ability to maintain a role in daily life.
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trends in cataract surgery and Postoperative Endophthalmitis in western australia 1980 1998 the Endophthalmitis population study of western australia
Clinical and Experimental Ophthalmology, 2003Co-Authors: James B. Semmens, Nigel Morlet, Jianghong Li, Jonathon Q. NgAbstract:Objectives: Postoperative Endophthalmitis results from an intraocular infection and usually occurs following cataract surgery. It has significant morbidity and causes severe visual impairment or blindness of the eye. The aim of this study was to assess the trends in the incidence rates of cataract surgery and Postoperative Endophthalmitis in Western Australia for the period 1980−1998. Methods: The Western Australian Record Linkage Project was used to link the morbidity records for all patients treated for cataract surgery in Western Australia in 1980−1998. Patient records were selected using the international classification for diagnosis and procedure codes pertaining to cataract surgery and Postoperative Endophthalmitis. All cases of Postoperative Endophthalmitis were validated by case-note review. The separate databases of the Royal Perth Hospital microbiology and anaesthetic departments as well as the vitreo-retinal surgeon logbooks were used to cross-validate the hospital morbidity database. Trends in the incidence rates of cataract surgery and Postoperative Endophthalmitis were assessed by Poisson regression. Results: There were 94 653 cataract procedures performed for 63 007 patients in Western Australia during the 19-year period. The majority (88%) of cataract procedures performed were in patients aged 60 years or older. Postoperative Endophthalmitis developed in 188 patients, with serious visual impairment occurring in 70.6% of patients for whom visual acuity data was available at presentation. The incidence rate of cataract surgery increased more than three-fold from 1981 (102 per 100 000 person years) to 1998 (345 per 100 000 person years), mainly due to the increase in extracapsular cataract extraction during the 1980s and phacoemulsification extraction from 1990 onwards. In contrast, the average annual incidence rate of Postoperative Endophthalmitis remained relatively unchanged at around 2 per 1000 cataract procedures over the same period. Conclusion: Cataract surgery is becoming more prevalent in the elderly as the life expectancy of the population increases. There has been a dramatic shift in surgical practice during the last 30 years with small-incision phacoemulsification being the predominant method of intervention used since 1990. Despite changes in surgical practice the incidence rate of Postoperative Endophthalmitis has remained the same.
Y Y Ng - One of the best experts on this subject based on the ideXlab platform.
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association of hospital and surgeon operation volume with the incidence of Postoperative Endophthalmitis taiwan experience
Eye, 2006Co-Authors: Yiting Fang, Li Nien Chien, Y Y Ng, Weiming Chen, Chingyu Cheng, Shiaochi WuAbstract:To determine the association between hospital and surgeon volume with the incidence of Postoperative Endophthalmitis. A prospective cohort study was conducted to analyse the national health insurance claims data of those patients receiving cataract surgery in 2000 in Taiwan. A total of 108 705 patients who received cataract surgery by 1004 surgeons at 494 hospitals were followed to the end of 2002. Stepwise Cox regression was used to analyse the effects of hospital and surgeon volume of cataract surgery on Postoperative Endophthalmitis after adjustment for patient's age, gender, education, ophthalmic comorbidities, general comorbidities, and surgical factors including operative methods, different types of intraocular lenses, and surgeon's age. The 2-year incidence of Postoperative Endophthalmitis at high-volume hospitals (0.90%) was lower than low-volume hospitals (1.16%). The incidence of Postoperative Endophthalmitis by high-volume surgeons (0.59%) was lower than those by middle-high-volume (0.73%), middle-low-volume (0.80%), or low-volume surgeons (1.16%). After controlling for case mix, the risk of Postoperative Endophthalmitis of the low-volume hospitals (hazard ratio (HR)=1.39) was higher than that of the high-volume hospitals. The risk of Postoperative Endophthalmitis of low-volume surgeons (HR=1.67) was higher than that of the high-volume surgeons. The provider volume (hospital and surgeon volume) is associated with the risk of Postoperative Endophthalmitis. The patients who receive cataract surgery at low-volume hospitals or by low-volume surgeons have significantly higher risk of Postoperative Endophthalmitis than at high-volume hospitals or by high-volume surgeons. Provider volume can be considered in further Postoperative Endophthalmitis study as a risk factor.
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Association of hospital and surgeon operation volume with the incidence of Postoperative Endophthalmitis: Taiwan experience
Eye, 2006Co-Authors: Y-t Fang, Li Nien Chien, Y Y Ng, W-m Chen, C-y Cheng, S-c WuAbstract:Purpose To determine the association between hospital and surgeon volume with the incidence of Postoperative Endophthalmitis. Methods A prospective cohort study was conducted to analyse the national health insurance claims data of those patients receiving cataract surgery in 2000 in Taiwan. A total of 108 705 patients who received cataract surgery by 1004 surgeons at 494 hospitals were followed to the end of 2002. Stepwise Cox regression was used to analyse the effects of hospital and surgeon volume of cataract surgery on Postoperative Endophthalmitis after adjustment for patient's age, gender, education, ophthalmic comorbidities, general comorbidities, and surgical factors including operative methods, different types of intraocular lenses, and surgeon's age. Results The 2-year incidence of Postoperative Endophthalmitis at high-volume hospitals (0.90%) was lower than low-volume hospitals (1.16%). The incidence of Postoperative Endophthalmitis by high-volume surgeons (0.59%) was lower than those by middle-high-volume (0.73%), middle-low-volume (0.80%), or low-volume surgeons (1.16%). After controlling for case mix, the risk of Postoperative Endophthalmitis of the low-volume hospitals (hazard ratio (HR)=1.39) was higher than that of the high-volume hospitals. The risk of Postoperative Endophthalmitis of low-volume surgeons (HR=1.67) was higher than that of the high-volume surgeons. Conclusions The provider volume (hospital and surgeon volume) is associated with the risk of Postoperative Endophthalmitis. The patients who receive cataract surgery at low-volume hospitals or by low-volume surgeons have significantly higher risk of Postoperative Endophthalmitis than at high-volume hospitals or by high-volume surgeons. Provider volume can be considered in further Postoperative Endophthalmitis study as a risk factor.