scholarly journals Comparison of characteristics and outcomes of patients admitted to hospital with COVID-19 during wave 1 and wave 2 of the current pandemic

2021 ◽  
Author(s):  
David Fluck ◽  
Suzanne Rankin ◽  
Andrea Lewis ◽  
Jonathan Robin ◽  
Jacqui Rees ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Confidence Intervals ◽  
Patient Characteristics ◽  
Index Score ◽  
Interquartile Range ◽  
Risk Of Death ◽  
Male Patients ◽  
The Mean ◽  
Reduction Of Mortality ◽  
Age And Sex

AbstractIn this study of patients admitted with COVID-19, we examined differences between the two waves in patient characteristics and outcomes. Data were collected from the first COVID-19 admission to the end of study (01/03/2020–31/03/2021). Data were adjusted for age and sex and presented as odds ratios (OR) with 95% confidence intervals (CI). Among 12,471 admissions, 1452 (11.6%) patients were diagnosed with COVID-19. On admission, the mean (± SD) age of patients with other causes was 68.3 years (± 19.8) and those with COVID-19 in wave 1 was 69.4 years (± 18.0) and wave 2 was 66.2 years (± 18.4). Corresponding ages at discharge were 67.5 years (± 19.7), 63.9 years (± 18.0) and 62.4 years (± 18.0). The highest proportion of total admissions was among the oldest group (≥ 80 years) in wave 1 (35.0%). When compared with patients admitted with other causes, those admitted with COVID-19 in wave 1 and in wave 2 were more frequent in the 40–59 year band: 20.8, 24.6 and 30.0%; consisted of more male patients: 47.5, 57.6 and 58.8%; and a high LACE (Length of stay, Acuity of admission, Comorbidity and Emergency department visits) index (score ≥ 10): 39.4, 61.3 and 50.3%. Compared to wave-2 patients, those admitted in wave 1 had greater risk of death in hospital: OR = 1.58 (1.18–2.12) and within 30 days of discharge: OR = 2.91 (1.40–6.04). Survivors of COVID-19 in wave 1 stayed longer in hospital (median = 6.5 days; interquartile range = 2.9–12.0) as compared to survivors from wave 2 (4.5 days; interquartile range = 1.9–8.7). Patient characteristics differed significantly between the two waves of COVID-19 pandemic. There was an improvement in outcomes in wave 2, including shorter length of stay in hospital and reduction of mortality.

The Contingent Negative Variation in Antisocial Behaviour: a Pilot Study of Broadmoor Patients

1978 ◽  
Vol 132 (4) ◽  
pp. 368-377 ◽  
Author(s):  
G. W. Fenton ◽  
P. B. C. Fenwick ◽  
W. Ferguson ◽  
C. T. Lam
Keyword(s):  
Pilot Study ◽  
Length Of Stay ◽  
Contingent Negative Variation ◽  
Antisocial Behaviour ◽  
Response Variability ◽  
The Other ◽  
Initial Development ◽  
The Mean ◽  
Mmpi Profile ◽  
Age And Sex

Using a classical click/flash paradigm, the CNV was recorded from the following three groups of subjects at Broadmoor Hospital: (1) 14 ‘psychopathic’ patients selected by use of the 4/9 MMPI profile and confirmed by independent clinical diagnosis; (2) 15 ‘non psychopathic’ patients, all psychotic and mainly schizophrenic; (3) 14 healthy staff control subjects. All three groups were matched for age and sex; the two patients groups were also matched for length of stay. Two series of 32 paired stimuli were used, separated by an interval of 30 minutes. The mean CNV voltage was significantly lower in the ‘non-psychopathic’ patients. The amplitude of the ‘psychopath's' CNV response did not differ significantly from that of the staff controls, but the response variability between the first and second series of trials was much greater in the ‘psychopathic’ patients than in the other two subject groups. The ‘psychopathic’ subjects tended to show more rapid initial development of the CNV.

Expired Ipecac Syrup Efficacy

PEDIATRICS ◽  
1986 ◽  
Vol 78 (6) ◽  
pp. 1085-1089
Author(s):  
Patricia A. Grbcich ◽  
Peter G. Lacouture ◽  
James J. Kresel ◽  
Margaret T. Russell ◽  
Frederick H. Lovejoy
Keyword(s):  
Prospective Study ◽  
New England ◽  
Patient Characteristics ◽  
Study Groups ◽  
Poison Control ◽  
Control Groups ◽  
The Mean ◽  
And Control ◽  
Mean Time ◽  
Age And Sex

A controlled prospective study to evaluate the efficacy of expired ipecac syrup was conducted at two regional poison control centers in New England. During a 6-month period, 200 study patients treated with expired ipecac syrup and 200 control patients treated with unexpired ipecac syrup were evaluated. There were no statistical differences between the control and study groups in patient characteristics (age and sex) and product characteristics (general class, emetic potential, pretreatment, previously opened bottles, and manufacturer). In both control and study groups, emesis occurred in 100% of cases with 90% of patients vomiting with the first dose. The mean time to emesis was 24.7 minutes and 24.8 minutes in the study and control groups, respectively. Expired preparations ranged from 1 month to greater than 4 years postexpiration, with the duration of expiration not altering the mean time to emesis. Mean time to emesis between the two groups was also not affected by manufacturer, pretreatment with milk, or whether the ipecac syrup bottle was previously opened. We conclude that expired ipecac syrup (up to 4 years postexpiration date) is an effective emetic.

558 Relationship Between Patient Characteristics and Number of Procedures as Well as Length of Stay for Patients Surviving Severe Burn Injuries: Analysis of the American Burn Association National Burn Repository

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S119-S120
Author(s):  
Stacey Kowal ◽  
Eliza Kruger ◽  
S Pinar Bilir ◽  
James H Holmes ◽  
Kevin N Foster
Keyword(s):  
Length Of Stay ◽  
Patient Characteristics ◽  
The United States ◽  
Burn Patients ◽  
Statistical Regression ◽  
Independent Variables ◽  
Rule Of Thumb ◽  
Diabetes Status ◽  
The Mean ◽  
The Relationship

Abstract Introduction Published information on the relationship between patient characteristics such as total body surface area (TBSA) of burn on number of procedures and length of stay (LOS) is not widely available in the United States. Clinical expertise assumes a “rule of thumb” of 1 day stay per percentage TBSA, but deviations based on burn and patient characteristics is rarely explored. The American Burn Association NBR version 8.0 (2002–2011) was analyzed to understand the relationship between key patient and burn characteristics for surviving, severe (TBSA 10–60%) burn patients and number of procedures or LOS. Methods Outcomes include the number of procedures autograft, debridement, and excision procedures and LOS. Independent variables considered were TBSA, TBSA of partial-thickness and full-thickness (FT) burn, age (linear, squared and cubed to account for non-linearity), hospital-acquired infection (HAI), other infection, inhalation injury, female gender and diabetes status. Statistical regression models were developed to control for the independent variables and predict the number of procedures and LOS based on such characteristics. Results Among 21,175 surviving burn patients (TBSA 10–60%), the mean age was 33 years old, and the mean TBSA was 19.9%. Number of excision and autografting procedures increased with TBSA. All independent variables were retained in the LOS model. After adjusting for gender, age and comorbidities, predicted LOS for adults (18+) was 16.4, 29.5, 42.7 and 56.0 days for 10%, 20%, 30% and 40% TBSA respectively. Similarly, predicted LOS for pediatrics (age< 18) was 12.9, 26.0, 28.6 and 55.4 days for each TBSA group, respectively. Conclusions When considering all independent variables, the LOS per percent TBSA is estimated at approximately 1.12 days for adults and 1.01 for pediatrics. However, when considering patient (age, comorbidity status) and burn (burn depth, TBSA) characteristics, the observed LOS could vary by 66% more, as seen with detailed investigations into trends for patients with TBSA 20%. Using the predictive equations from this study, burn centers can generate tailored rule-of-thumb estimates for LOS/%TBSA that better reflect the influence of factors beyond burn center practice patterns. Applicability of Research to Practice

scholarly journals The DIVE/DPV registries: evolution of empagliflozin use in clinical practice in Germany

2020 ◽  
Vol 8 (1) ◽  
pp. e001486 ◽  
Author(s):  
Peter Bramlage ◽  
Sascha R Tittel ◽  
Christian Wagner ◽  
Kerstin König ◽  
Dirk Raddatz ◽  
...  
Keyword(s):  
Severe Hypoglycemia ◽  
Patient Characteristics ◽  
European Medicines Agency ◽  
Routine Practice ◽  
Male Patients ◽  
The Mean ◽  
Glucagon Like Peptide 1 ◽  
Group 2 ◽  
Design And Methods ◽  
Over Time

IntroductionEmpagliflozin reduced morbidity and mortality in patients with type 2 diabetes mellitus (T2DM) in clinical trials. A registry study was undertaken to describe evolution of patient characteristics and assess the real-world effectiveness/safety of empagliflozin.Research design and methodsData from the Diabetes Patienten Verlaufsdokumentation (DPV)/Diabetes Versorgungsevaluation (DIVE) registries on 9571 adults with T2DM (registered in 2014–2019) receiving empagliflozin were used. Patients were grouped according to the following: early users (group 1; n=505) received empagliflozin before the EMPA-REG OUTCOME study publication (mid-September 2015); intermediate users (group 2; n=2961) started empagliflozin after the EMPA-REG OUTCOME publication but before the European Medicines Agency label change (from mid-September 2015 to mid-January 2017); and late users (group 3; n=6105) started empagliflozin after mid-January 2017. Data on clinical and treatment characteristics were collected.ResultsOver time, the proportion of recipients aged <65 years decreased (71.1% vs 54.4% among early and late adopters), male patients increased (from 50.9% to 66.5%), body mass index (mean±SD) decreased (from 35.5±6.7 to 32.7±6.6 kg/m2), proportion with cardiovascular morbidities increased (from 20.4% to 26.4%), and mean estimated glomerular filtration rate decreased (from 83.2±19.5 to 78.5±21.1 mL/min/1.73 m2) (all p<0.001). Patients increasingly received empagliflozin in combination with metformin (60.8% vs 68.6% of early and late adopters; p<0.001), glucagon-like peptide-1 (GLP-1) agonists (11.0 vs 14.1%; p<0.001) or insulin (34.3% vs 49.9%; p<0.001). Empagliflozin was generally added to existing antidiabetic regimens. Six months after empagliflozin initiation, the mean glycated hemoglobin (HbA1c) decreased by 0.4%, the proportion of patients with HbA1c <6.5% increased (19.2% vs 12.8%), and the mean fasting plasma glucose decreased (155.8±49.7 vs 168.0±55.1 mg/dL) (all p<0.001). No significant changes in rates of severe hypoglycemia and no cases of diabetic ketoacidosis were seen.ConclusionsOver time, empagliflozin is being prescribed to a broader patient range in routine practice, is usually added to existing antidiabetic regimens, and is increasingly used in combination with metformin, GLP-1 agonists and/or insulin. Empagliflozin had a beneficial effect on glycemic control, with no increase in hypoglycemia.

scholarly journals Deliberate Self-Poisoning Presenting to an Emergency Medicine Network in South-East Melbourne: A Descriptive Study

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Asheq Rahman ◽  
Catherine Martin ◽  
Andis Graudins ◽  
Rose Chapman
Keyword(s):  
Emergency Department ◽  
Emergency Medicine ◽  
Length Of Stay ◽  
Clinical Audit ◽  
Significant Proportion ◽  
Patient Characteristics ◽  
Descriptive Study ◽  
Short Stay ◽  
Targeted Interventions ◽  
The Mean

Background. Deliberate self-poisoning (DSP) comprises a small but significant proportion of presentations to the emergency department (ED). However, the prevalence and patient characteristics of self-poisoning attendances to EDs in Victoria have not been recently characterised.Aim. To identify and compare the characteristics of adult patients presenting to the three EDs of Monash Health following DSP.Methods. Retrospective clinical audit of adult DSP attendances between 1st July 2009 and 30th June 2012.Results. A total of 3558 cases over three years were identified fulfilling the search criteria. The mean age of patients was 36.3 years with the largest numbers aged between 18 and 30 (38%). About 30% of patients were born overseas. Forty-eight percent were discharged home, 15% were admitted to ED short stay units, and 5% required ICU admission. The median ED length of stay was 359 minutes (IQR 231–607). The most frequently reported substances in DSP were benzodiazepines (36.6%), paracetamol (22.2%), and antipsychotics (12.1%). Exposure to more than one substance for the episode of DSP was common (47%).Conclusion. This information may help identify the trends in poisoning substances used for DSP in Victoria, which in turn may provide clinicians with information to provide more focused and targeted interventions.

scholarly journals Health-related quality of life in Denmark on a relative scale: mini-catalogue of mean EQ-5D-3L index scores for 17 common chronic conditions

2016 ◽  
Vol 4 (2) ◽  
pp. 44-56 ◽  
Author(s):  
Anne Vingaard Olesen ◽  
Lars Oddershede ◽  
Karin Dam Petersen
Keyword(s):  
Chronic Conditions ◽  
Reference Group ◽  
Reference Population ◽  
Quality Adjusted Life Year ◽  
Index Score ◽  
Economic Evaluations ◽  
Sampling Weights ◽  
Related Quality ◽  
The Mean ◽  
Age And Sex

In health economic evaluations the quality-adjusted life-year (QALY) is one of the preferred outcome measures. Catalogues of median-based decrements in EQ-5D-3L index scores for chronic conditions exist to inform economic evaluations but may not be appropriate for this purpose as mean, rather than median, EQ-5D-3L index scores are of primary interest. Firstly, we aim to estimate mean decrements in EQ-5D-3L index scores through a simple stratified analysis as an alternative to regression modelling. In addition, we aim to estimate the mean decrement in EQ-5D-3L index scores in percent relative to a disease-free reference population. Secondly, we aim to handle both multiple imputation and appropriate estimation of standard errors in the presence of individual sampling weights. Data on EQ-5D-3L from the National Health Profile, Denmark, 2013, were used to estimate the EQ-5D-3L index scores. Calculation of decrements in EQ-5D-3L index scores of chronic conditions was done while controlling for the additional number of chronic conditions beside the one in question, age and sex. Also, a test of homogeneity of decrements across subgroups was conducted. We provide a mini-catalogue of new percentage-scale decrements in EQ-5D-3L index scores. For example, we estimated that angina was associated with an 8.2% reduction in the EQ-5D-3L index score compared to a reference group without angina. If the mean EQ-5D-3L score was 0.848 among corresponding groups without angina; angina patients would have an EQ-5D-3L index score of (1-0.082)·0.848=0.778 using the percentage-scale. The estimated percentage reduction in the EQ-5D-3L index score was homogenous regardless of the number of additional chronic conditions, age and sex. We suggest a percentage-scale estimation of EQ-5D-3L index scores for chronic disorders as an alternative to existing median-based methods. Our estimates stem from a simpler model, which, we argue, is easier to use and interpret.Published: Online May 2016. In print August 2016.

scholarly journals COMPARISON OF ILEAL CONDUIT AND TUUC: A 4 YEARS STUDY

2022 ◽  
Vol 29 (1) ◽  
Author(s):  
Indrawarman Soerohardjo ◽  
Andy Zulfiqqar ◽  
Prahara Yuri ◽  
Ahmad Z. Hendri
Keyword(s):  
Length Of Stay ◽  
Complication Rate ◽  
Incomplete Data ◽  
Bowel Movement ◽  
Ileal Conduit ◽  
Intraoperative Complications ◽  
Early Complications ◽  
Viable Option ◽  
Male Patients ◽  
The Mean

Objective: This study aims to compare 4 years of experience of IC and TUUC in the same period and among similar experienced surgeons. Material & Methods: Between January 2016 and August 2019, 44 radical cystectomies were performed, but 4 patients were excluded due to incomplete data or who underwent neo-bladder procedures. The primary endpoint was 30 days of complication rate and intraoperative complications. Bowel movement, ambulation, and length of stay (LOS) postoperatively were followed-up over a period of 30-day postoperatively. Results: 12 male patients underwent TUUC and 24 male patients IC, while only 4 female patients underwent IC. The mean of LOS of IC was 12.72  8.6 and 10.08 3.5 for TUUC; there were no significant differences between arms. However, TUUC had lower intra-operatively bleeding (779.17  441.15 ml) compared to IC (1328.57  810.40 ml). There was no difference in early complications between arms. Conclusion: Our results suggest that TUU with UC diversion may be used as a viable option of urinary diversion in radical cystectomy. This technique provides similar safety both surgically and oncologically.

Aktivitätskonzentration der vom Personal einer Radiojodtherapiestation eingeatmeten Luft

1987 ◽  
Vol 26 (03) ◽  
pp. 143-146 ◽  
Author(s):  
H. Fill ◽  
M. Oberladstätter ◽  
J. W. Krzesniak
Keyword(s):  
Nuclear Medicine ◽  
Length Of Stay ◽  
Activity Concentration ◽  
Threshold Value ◽  
Whole Body ◽  
Therapeutic Activity ◽  
External Radiation ◽  
Oral Application ◽  
Exhaled Air ◽  
The Mean

The mean activity concentration of1311 during inhalation by the nuclear medicine personnel was measured at therapeutic activity applications of 22 GBq (600 mCi) per week. The activity concentration reached its maximum in the exhaled air of the patients 2.5 to 4 hours after oral application. The normalized maximum was between 2 • 10−5 and 2 • 10−3 Bq-m−3 per administered Bq. The mean activity concentration of1311 inhaled by the personnel was 28 to 1300 Bq-m−3 (0.8 to 35 nCi-rrf−3). From this the1311 uptake per year was estimated to be 30 to 400 kBq/a (x̄ = 250, SD = 50%). The maximum permitted uptake from air per year is, according to the German and Austrian radiation protection ordinances 22/21 µiCi/a (= 8 • 105 Bq/a). At maximum 50% and, on the average, 30% of this threshold value are reached. The length of stay of the personnel in the patient rooms is already now limited to such an extent that 10% of the maximum permissible whole-body dose for external radiation is not exceeded. Therefore, increased attention should be paid also to radiation exposure by inhalation.

Racial and Sex Disparities in Trauma Outcomes Based on Geographical Region

2020 ◽  
pp. 000313482096006
Author(s):  
William Q. Duong ◽  
Areg Grigorian ◽  
Cyrus Farzaneh ◽  
Jeffry Nahmias ◽  
Theresa Chin ◽  
...  
Keyword(s):  
United States ◽  
The United States ◽  
Trauma Patients ◽  
Improvement Program ◽  
Trauma Outcomes ◽  
Risk Of Death ◽  
Hospital Access ◽  
Risk Of Mortality ◽  
Sex Disparities ◽  
Male Patients

Objectives Disparities in outcomes among trauma patients have been shown to be associated with race and sex. The purpose of this study was to analyze racial and sex mortality disparities in different regions of the United States, hypothesizing that the risk of mortality among black and Asian trauma patients, compared to white trauma patients, will be similar within all regions in the United States. Methods The Trauma Quality Improvement Program (2010-2016) was queried for adult trauma patients, separating by U.S. Census regions. Multivariable logistic regression analyses were performed for each region, controlling for known predictors of morbidity and mortality in trauma. Results Most trauma patients were treated in the South (n = 522 388, 40.7%). After risk adjustment, black trauma patients had a higher associated risk of death in all regions, except the Northeast, compared to white trauma patients. The highest associated risk of death for blacks (vs. whites) was in the Midwest (odds ratio [OR] 1.30, P < .001). Asian trauma patients only had a higher associated risk of death in the West (OR 1.39, P < .001). Male trauma patients, compared to women, had an increased associated risk of mortality in all four regions. Discussion This study found major differences in outcomes among different races within different regions of the United States. There was also both an increased rate and associated risk of mortality for male patients in all regions. Future prospective studies are needed to identify what regional differences in trauma systems including population density, transport times, hospital access, and other trauma resources explain these findings.

Functional Decline in Emergency Department Patients with Dyspnea; a Register-Based Cohort

2021 ◽  
Author(s):  
Karoline Stentoft Rybjerg Larsen ◽  
Marianne Lisby ◽  
Hans Kirkegaard ◽  
Annemette Krintel Petersen
Keyword(s):  
Emergency Department ◽  
Electronic Patient Record ◽  
Hospital Admissions ◽  
Functional Decline ◽  
Patient Characteristics ◽  
Risk Of Death ◽  
Record Data ◽  
Emergency Department Patients ◽  
One Year ◽  
Historic Cohort

Abstract Background Functional decline is associated with frequent hospital admissions and elevated risk of death. Presumably patients acutely admitted to hospital with dyspnea have a high risk of functional decline. The aim of this study was to describe patient characteristics, hospital trajectory, and use of physiotherapy services of dyspneic patients in an emergency department. Furthermore, to compare readmission and death among patients with and without a functional decline, and to identify predictors of functional decline. Methods Historic cohort study of patients admitted to a Danish Emergency Department using prospectively collected electronic patient record data from a Business Intelligence Registry of the Central Denmark Region. The study included adult patients that due to dyspnea in 2015 were treated at the emergency department (ED). The main outcome measures were readmission, death, and functional decline. Results In total 2,048 dyspneic emergency treatments were registered. Within 30 days after discharge 20% was readmitted and 3.9% had died. Patients with functional decline had a higher rate of 30-day readmission (31.2% vs. 19.1%, p&lt;0.001) and mortality (9.3% vs. 3.6%, p=0.009) as well as mortality within one year (36.1% vs. 13.4%, p&lt;0.001). Predictors of functional decline were age ≥60 years and hospital stay ≥6 days. Conclusion Patients suffering from acute dyspnea are seen at the ED at all hours. In total one in five patients were readmitted and 3.9% died within 30 days. Patients with a functional decline at discharge seems to be particularly vulnerable.

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