Calibrating Readmission Risk Prediction Models for Determining Post-discharge Follow-up Timing.

The soaring hospital readmission rates are straining the already limited financial resources in the US health system. Meanwhile, timely outpatient follow-up, an efficient and cost-effective intervention following hospital discharge, has been shown to reduce the readmission risk. However, the current and projected shortage of physicians in primary and specialty care poses a unique dilemma in transitional care planning: optimizing the utilization of post-discharge follow-up to reduce readmission rate while limiting the strain on the limited pool of outpatient physicians. The ideal solution would entail a strategy whereby patients at higher risk for readmission are stratified towards earlier outpatient follow-up and vice versa. This article explores the utility of Institution-specific readmission risk prediction algorithms for assessing patient population for diverse administrative, clinical and socioeconomic risk factors and further classifying the hospital's patient population into high- and low-risk strata, so that appropriate risk-concordant timing of follow-up can be assigned at the time of hospital discharge, with earlier follow-up assigned to high readmission risk strata. This stratification shall help ensure judicious and equitable human resource allocation while simultaneously reducing hospital readmission rates.

99mTechnetium-labeled cardiac scintigraphy for suspected amyloidosis: a review of current and future directions.

Cardiac amyloidosis (CA) is an underdiagnosed form of restrictive cardiomyopathy leading to a rapid progression into heart failure. Evaluation of CA requires a multimodality approach making use of echocardiography, cardiac magnetic imaging, and nuclear imaging. Technetium (Tc)-labeled cardiac scintigraphy has witnessed a resurgence in its application for the workup of CA. Advancements in disease-modifying therapies have fueled the rapid adoption of cardiac scintigraphy using bone tracers and the need for transformative novel studies. The goal of this review is to present diagnostic utility, currently recommended protocols, as well as a glimpse into the rapid evolution of Tc-labeled cardiac scintigraphy in the diagnosis of CA.

The utility of positron emission tomography in cardiac amyloidosis.

Cardiac amyloidosis, characterized by progressive restrictive cardiomyopathy, presents unusual diagnostic challenges. Conventional cardiac scintigraphy has shown limited utility in the quantification of disease burden and serial follow-up of cardiac amyloidosis. The advent of specialized positron emission tomography with specific amyloid-binding radiotracers has the potential to change currently employed diagnostic algorithms for the imaging of cardiac amyloidosis. This review aims to discuss the diagnostic utility of amyloid-binding radiotracers, including Pittsburg compound B, florbetapir, florbetapan, and sodium fluoride. These tracers have promising potential for the early detection of the particular type of cardiac amyloidosis, pursuing relevant medical intervention, assessing amyloid burden, monitoring treatment response, and overall prognostication.