Modeling Zero Inflation and Overdispersion in the Length of Hospital Stay for Patients with Ischaemic Heart Disease

2016 ◽  
pp. 35-53
Author(s):  
Cindy Xin Feng ◽  
Longhai Li
Keyword(s):  
Heart Disease ◽  
Hospital Stay ◽  
Ischaemic Heart Disease ◽  
Length Of Hospital Stay ◽  
Zero Inflation

scholarly journals Length of hospital stay after delivery among Danish women with congenital heart disease: a register-based cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anne Marie Kirkegaard ◽  
Maria Breckling ◽  
Dorte Guldbrand Nielsen ◽  
Janne S. Tolstrup ◽  
Søren Paaske Johnsen ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Cohort Study ◽  
Heart Disease ◽  
Cesarean Section ◽  
Hospital Stay ◽  
Vaginal Delivery ◽  
Congenital Heart ◽  
Mode Of Delivery ◽  
Length Of Hospital Stay ◽  
The Impact

Abstract Background The literature about the impact of congenital heart disease (CHD) on the length of hospital stay after delivery is limited, and nonexisting in a country with free and equal access to healthcare. We aimed to examine the hypothesis that Danish women with CHD have a longer hospital stay after delivery compared to women without CHD. Secondarily, we aimed to examine the hypothesis that cesarean section modifies the association. Methods The study was a national cohort study using Danish nationwide registers in 1997–2014. Maternal CHD was categorized as simple, moderate, or complex CHD. The comparison group consisted of women without CHD. Outcome of interest was length of hospital stay after delivery registered in complete days. Mode of delivery was categorized as cesarean section or vaginal delivery. Data was analyzed using a generalized linear model with a Poisson distribution. Results We included 939,678 births among 551,119 women. Women without CHD were on average admitted to the hospital for 3.6 (SD 3.7) days, whereas women with simple, moderate, and complex CHD were admitted for 3.9 (SD 4.4), 4.0 (SD 3.8) and 5.1 (SD 6.7) days, respectively. The adjusted length of hospital stay after delivery was 12% (relative ratio (RR) = 1.12, 95% confidence interval (CI) 1.07–1.18), 14% (RR = 1.14, 95% CI: 1.07–1.21), and 45% (RR = 1.45, 95% CI: 1.24–1.70) longer among women with simple, moderate, and complex CHD, respectively, compared to women without CHD. The association between maternal CHD and length of hospital stay was not modified by mode of delivery (p-value of interaction = 0.62). Women who gave birth by cesarean section were on average admitted to the hospital for 2.7 days longer compared to women with vaginal delivery. Conclusion The hospital stay after delivery was significantly longer among women with CHD as compared to women without CHD. Further, higher complexity of CHD was associated with longer length of stay. Cesarean section did not modify the association.

scholarly journals Determinants of prolonged length of hospital stay after cardiac surgery: impact of rheumatic heart disease

2015 ◽  
Vol 2 (3) ◽  
Author(s):  
Mariângela F Pato ◽  
Cláudio L Gelape ◽  
Tammy JM Cassiano ◽  
Adriano Carvalho ◽  
Priscila R Cintra ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Heart Disease ◽  
Hospital Stay ◽  
Rheumatic Heart Disease ◽  
Length Of Hospital Stay ◽  
Prolonged Length ◽  
Rheumatic Heart

scholarly journals Effects of Integrated Health Education Combined with Life Intervention on Patients with Coronary Atherosclerotic Heart Disease Complicated with Hyperlipidemia

2021 ◽  
Vol 45 (5) ◽  
pp. 843-848
Author(s):  
Qiong Luo ◽  
Ping Jin ◽  
Hongping Li ◽  
Kun Cui ◽  
Tianfeng Jiang
Keyword(s):  
Heart Disease ◽  
Health Education ◽  
Hospital Stay ◽  
Nursing Care ◽  
Research Group ◽  
Density Lipoprotein ◽  
Length Of Hospital Stay ◽  
Blood Lipid ◽  
Control Group ◽  
Integrated Health

Objectives: In this study, we assessed the effects of integrated health education combined with life intervention on patients with coronary atherosclerotic heart disease (CHD) complicated with hyperlipidemia. Methods: We selected 96 patients with CHD complicated with hyperlipidemia being treated in our hospital from June 2018 to June 2020, and assigned them to a control group (N=48) or a research group (N=48). Patients in the control group received integrated health education, whereas those in the research group were given integrated health education combined with life intervention. We measured outcomes, including blood lipid levels, electrocardiogram (ECG) recovery times, lengths of hospital stay, compliance with nursing intervention, and satisfaction with nursing care. Results: After intervention, the total effective rate of nursing in the research group was 93.75% which was higher than for the control group 79.17%. In the research group, the levels of total cholesterol, triglyceride, and low-density lipoprotein cholesterol were higher than those in control group, and the level of high-density lipoprotein cholesterol was lower than that in control group. The length of hospital stay and ECG recovery time were longer than those in research group. The research group had a higher nursing compliance rate than did the control group (91.67% vs 75.00%), and satisfaction with nursing care also was lower in the control group than in the research group (77.08 % vs 91.67%) (p < .05). Conclusion: Integrated health education combined with life intervention has a better nursing effect on patients with CHD complicated with hyperlipidemia, and can contribute to controlling blood lipid level in the normal range, improve nursing satisfaction and compliance of patients, reduce the occurrence of adverse events, shorten the length of hospital stay, and accelerate recovery of patients

Pilonidal Sinus: How to Choose Between Excision and Open Granulation Versus Excision and Primary Closure?

Swiss Surgery ◽  
2002 ◽  
Vol 8 (6) ◽  
pp. 255-258 ◽  
Author(s):  
Perruchoud ◽  
Vuilleumier ◽  
Givel
Keyword(s):  
Hospital Stay ◽  
Pilonidal Sinus ◽  
Primary Closure ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Healing Time ◽  
Incision And Drainage ◽  
The Mean ◽  
Primary Healing

Aims: The purpose of this study was to evaluate excision and open granulation versus excision and primary closure as treatments for pilonidal sinus. Subjects and methods: We evaluated a group of 141 patients operated on for a pilonidal sinus between 1991 and 1995. Ninety patients were treated by excision and open granulation, 34 patients by excision and primary closure and 17 patients by incision and drainage, as a unique treatment of an infected pilonidal sinus. Results: The first group, receiving treatment of excision and open granulation, experienced the following outcomes: average length of hospital stay, four days; average healing time; 72 days; average number of post-operative ambulatory visits, 40; average off-work delay, 38 days; and average follow-up time, 43 months. There were five recurrences (6%) in this group during the follow-up period. For the second group treated by excision and primary closure, the corresponding outcome measurements were as follows: average length of hospital stay, four days; average healing time, 23 days; primary healing failure rate, 9%; average number of post-operative ambulatory visits, 6; average off-work delay, 21 days. The average follow-up time was 34 months, and two recurrences (6%) were observed during the follow-up period. In the third group, seventeen patients benefited from an incision and drainage as unique treatment. The mean follow-up was 37 months. Five recurrences (29%) were noticed, requiring a new operation in all the cases. Discussion and conclusion: This series of 141 patients is too limited to permit final conclusions to be drawn concerning significant advantages of one form of treatment compared to the other. Nevertheless, primary closure offers the advantages of quicker healing time, fewer post-operative visits and shorter time off work. When a primary closure can be carried out, it should be routinely considered for socio-economical and comfort reasons.

Elevated Tissue Factor and Tissue Factor Pathway Inhibitor Circulating Levels in Ischaemic Heart Disease Patients

1998 ◽  
Vol 79 (03) ◽  
pp. 495-499 ◽  
Author(s):  
Anna Maria Gori ◽  
Sandra Fedi ◽  
Ludia Chiarugi ◽  
Ignazio Simonetti ◽  
Roberto Piero Dabizzi ◽  
...  
Keyword(s):  
Heart Disease ◽  
Ischaemic Heart Disease ◽  
Tissue Factor ◽  
Plasma Levels ◽  
Tissue Factor Pathway Inhibitor ◽  
Common Source ◽  
Previous Myocardial Infarction ◽  
Control Subjects ◽  
Tissue Factor Pathway ◽  
Circulating Levels

SummarySeveral studies have shown that thrombosis and inflammation play an important role in the pathogenesis of Ischaemic Heart Disease (IHD). In particular, Tissue Factor (TF) is responsible for the thrombogenicity of the atherosclerotic plaque and plays a key role in triggering thrombin generation. The aim of this study was to evaluate the TF/Tissue Factor Pathway Inhibitor (TFPI) system in patients with IHD.We have studied 55 patients with IHD and not on heparin [18 with unstable angina (UA), 24 with effort angina (EA) and 13 with previous myocardial infarction (MI)] and 48 sex- and age-matched healthy volunteers, by measuring plasma levels of TF, TFPI, Prothrombin Fragment 1-2 (F1+2), and Thrombin Antithrombin Complexes (TAT).TF plasma levels in IHD patients (median 215.4 pg/ml; range 72.6 to 834.3 pg/ml) were significantly (p<0.001) higher than those found in control subjects (median 142.5 pg/ml; range 28.0-255.3 pg/ml).Similarly, TFPI plasma levels in IHD patients were significantly higher (median 129.0 ng/ml; range 30.3-316.8 ng/ml; p <0.001) than those found in control subjects (median 60.4 ng/ml; range 20.8-151.3 ng/ml). UA patients showed higher amounts of TF and TFPI plasma levels (TF median 255.6 pg/ml; range 148.8-834.3 pg/ml; TFPI median 137.7 ng/ml; range 38.3-316.8 ng/ml) than patients with EA (TF median 182.0 pg/ml; range 72.6-380.0 pg/ml; TFPI median 115.2 ng/ml; range 47.0-196.8 ng/ml) and MI (TF median 213.9 pg/ml; range 125.0 to 341.9 pg/ml; TFPI median 130.5 ng/ml; range 94.0-207.8 ng/ml). Similar levels of TF and TFPI were found in patients with mono- or bivasal coronary lesions. A positive correlation was observed between TF and TFPI plasma levels (r = 0.57, p <0.001). Excess thrombin formation in patients with IHD was documented by TAT (median 5.2 μg/l; range 1.7-21.0 μg/l) and F1+2 levels (median 1.4 nmol/l; range 0.6 to 6.2 nmol/l) both significantly higher (p <0.001) than those found in control subjects (TAT median 2.3 μg/l; range 1.4-4.2 μg/l; F1+2 median 0.7 nmol/l; range 0.3-1.3 nmol/l).As in other conditions associated with cell-mediated clotting activation (cancer and DIC), also in IHD high levels of circulating TF are present. Endothelial cells and monocytes are the possible common source of TF and TFPI. The blood clotting activation observed in these patients may be related to elevated TF circulating levels not sufficiently inhibited by the elevated TFPI plasma levels present.

Plasma Fibrinolytic Activity Following Oral Anabolic Steroid Therapy

1975 ◽  
Vol 34 (01) ◽  
pp. 236-245 ◽  
Author(s):  
I. D Walker ◽  
J. F Davidson ◽  
P Young ◽  
J. A Conkie
Keyword(s):  
Heart Disease ◽  
Ischaemic Heart Disease ◽  
Anabolic Steroid ◽  
Fibrinolytic Activity ◽  
Anabolic Steroids ◽  
Long Term Effects ◽  
Lysis Time ◽  
Detailed Evaluation ◽  
Euglobulin Lysis Time

SummarySix anabolic steroids were assessed for their ability to enhance plasma fibrinolytic activity in males with ischaemic heart disease. Five 17α-alkylated steroids (Ethyloestrenol, Norethandrolone, Methandienone, Methylandrostenediol and Oxymetholone) were examined and all produced a significant increase in plasma plasminogen activator as measured by the euglobulin lysis time. The only non-17α-alkylated steroid studied (Methenolone acetate) failed to enhance fibrinolysis. The 17α-alkylated steroids studied all deserve more detailed evaluation of their long term effects on plasma fibrinolytic activity.

Effect of Anabolic Steroids on Plasma Antithrombin III

1975 ◽  
Vol 34 (01) ◽  
pp. 106-114 ◽  
Author(s):  
I. D Walker ◽  
J. F Davidson ◽  
P Young ◽  
J. A Conkie
Keyword(s):  
Heart Disease ◽  
Ischaemic Heart Disease ◽  
Oral Contraceptives ◽  
Disseminated Intravascular Coagulation ◽  
Fibrinolytic Activity ◽  
Antithrombin Iii ◽  
Anabolic Steroids ◽  
Intravascular Coagulation ◽  
Clear Cut ◽  
Α2 Macroglobulin

SummaryThe effect of seven different anabolic steroids (Ethyloestrenol, Methenolone acetate, Norethandrolone, Methylandrostenediol, Oxymetholone, Methandienone, and Stanozolol) on three α-globulin antiprotease inhibitors of thrombin and plasmin was studied in men with ischaemic heart disease. In distinct contrast to the oral contraceptives, five of the six 17-α-alkylated anabolic steroids studied produced increased plasma Antithrombin III levels and five produced decreased levels of plasma α2-macroglobulin. The effect on plasma α1antitrypsin levels was less clear-cut but three of the steroids examined produced significantly elevated levels. The increased plasma fibrinolytic activity which the 17-α-alkylated anabolic steroids induce is therefore unlikely to be secondary to disseminated intravascular coagulation.

Raised Plasma Homocysteine: An Emerging Risk Factor for Ischaemic Heart Disease

1970 ◽  
Vol 19 (2) ◽  
pp. 87-93
Author(s):  
MS Kabir ◽  
AAS Majumder ◽  
AW Chowdhury ◽  
SA Haque ◽  
AQM Reza ◽  
...  
Keyword(s):  
Risk Factor ◽  
Heart Disease ◽  
Ischaemic Heart Disease ◽  
Plasminogen Activator ◽  
Research Work ◽  
Vascular Diseases ◽  
Plasminogen Activator Inhibitor ◽  
Plasma Homocysteine ◽  
Type I ◽  
Activator Inhibitor Type

Only one half to two thirds of atherosclerotic vascular diseases can be explained by classical risk factors like smoking, diabetes mellitus, hypertension, dyslipidaemia, family history of premature atherosclerotic vascular diseases, physical inactivity, obesity etc. Some other variables appear to contribute to the development of atherosclerotic vascular diseases which include estrogen deficiency, lipoprotein (a), plasma fibrinogen, plasminogen-activator inhibitor type I, endogenous tissue plasminogen activator (tPA), C-reactive protein and homocysteine. Over the last several years, investigators undertook extensive research work, in home and abroad, to determine the contribution of plasma homocysteine in the pathogenesis of atherosclerotic vascular diseases. So far the research work indicates, raised plasma homocysteine appears to be a potential risk factor for ischaemic heart disease.   doi: 10.3329/taj.v19i2.3158 TAJ 2006; 19(2): 87-93

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