Association of iron supplementation with risk of transfusion, hospital length of stay, and mortality in geriatric patients undergoing hip fracture surgeries: a meta-analysis

2020 ◽  
Author(s):  
Ran Chen ◽  
Lang Li ◽  
Zhou Xiang ◽  
Hong Li ◽  
Xiao-Ling Hou
Keyword(s):  
Hip Fracture ◽  
Length Of Stay ◽  
Iron Supplementation ◽  
Geriatric Patients ◽  
Meta Analysis ◽  
Hospital Length ◽  
Hospital Length Of Stay

scholarly journals The independent patient factors that affect length of stay following hip fractures

2018 ◽  
Vol 100 (7) ◽  
pp. 556-562 ◽  
Author(s):  
T Richards ◽  
A Glendenning ◽  
D Benson ◽  
S Alexander ◽  
S Thati
Keyword(s):  
Hip Fracture ◽  
Length Of Stay ◽  
Hospital Stay ◽  
Hip Fractures ◽  
Length Of Hospital Stay ◽  
Hospital Length ◽  
Acute Hospital ◽  
Hospital Length Of Stay ◽  
Patient Factors ◽  
Mobility Status

Introduction Management of hip fractures has evolved over recent years to drive better outcomes including length of hospital stay. We aimed to identify and quantify the effect that patient factors influence acute hospital and total health service length of stay. Methods A retrospective observational study based on National Hip Fracture Database data was conducted from 1 January 2014 to 31 December 2015. A multiple regression analysis of 330 patients was carried out to determine independent factors that affect acute hospital and total hospital length of stay. Results American Society of Anesthesiologists (ASA) grade 3 or above, Abbreviated Mental Test Score (AMTS) less than 8 and poor mobility status were independent factors, significantly increasing length of hospital stay in our population. Acute hospital length of stay can be predicted as 8.9 days longer when AMTS less than 8, 4.2 days longer when ASA grade was 3 or above and 20.4 days longer when unable to mobilise unaided (compared with independently mobile individuals). Other factors including total hip replacement compared with hemiarthroplasty did not independently affect length of stay. Conclusions Our analysis in a representative and generalisable population illustrates the importance of identifying these three patient characteristics in hip fracture patients. When recognised and targeted with orthogeriatric support, the length of hospital stay for these patients can be reduced and overall hip fracture care improved. Screening on admission for ASA grade, AMTS and mobility status allows prediction of length of stay and tailoring of care to match needs.

scholarly journals Hip Fractures in Centenarians: Has Care Improved in the National Hip Fracture Database Era?

2017 ◽  
Vol 8 (3) ◽  
pp. 161-165 ◽  
Author(s):  
Alastair G. Dick ◽  
Dominic Davenport ◽  
Mohit Bansal ◽  
Therese S. Burch ◽  
Max R. Edwards
Keyword(s):  
Hip Fracture ◽  
Length Of Stay ◽  
Hip Fractures ◽  
District General Hospital ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Retrospective Case ◽  
Time To Surgery ◽  
Surgery Mortality ◽  
Hospital Acquired

Introduction: The number of centenarians in the United Kingdom is increasing. An associated increase in the incidence of hip fractures in the extreme elderly population is expected. The National Hip Fracture Database (NHFD) initiative was introduced in 2007 aiming to improve hip fracture care. There is a paucity of literature on the outcomes of centenarians with hip fractures since its introduction. The aim of this study is to report our experience of hip fractures in centenarians in the era since the introduction of the NHFD to assess outcomes in terms of mortality, time to surgery, length of stay, and complications. Methods: A retrospective case note study of all centenarians managed for a hip fracture over a 7-year period at a London district general hospital. Results: We report on 22 centenarians sustaining 23 hip fractures between 2008 and 2015. Twenty-one fractures were managed operatively. For patients managed operatively, in-hospital, 30-day, 3-month, 6-month, 1-year, 2-year, 3-year, and 5-year cumulative mortalities were 30%, 30%, 39%, 50%, 77%, 86%, 95%, and 100%, respectively. In-hospital mortality was 100% for those managed nonoperatively. Mean time to surgery was 1.6 days (range: 0.7-6.3 days). Mean length of stay on the acute orthopedic ward was 23 days (range: 2-51 days). Seventy-one percent had a postoperative complication most commonly a hospital-acquired pneumonia or urinary tract infection. Conclusion: Compared to a series of centenarians with hip fractures prior to the introduction of the NHFD, we report a reduced time to surgery. Mortality and hospital length of stay were similar.

scholarly journals The Impact of Selenium Supplementation on Trauma Patients—Systematic Review and Meta-Analysis

Nutrients ◽  
2022 ◽  
Vol 14 (2) ◽  
pp. 342
Author(s):  
Jen-Fu Huang ◽  
Chih-Po Hsu ◽  
Chun-Hsiang Ouyang ◽  
Chi-Tung Cheng ◽  
Chia-Cheng Wang ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Meta Analysis ◽  
Infectious Complications ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Current Evidence ◽  
Trauma Patients ◽  
Positive Effects ◽  
Standard Difference ◽  
The Impact

This study aimed to assess current evidence regarding the effect of selenium (Se) supplementation on the prognosis in patients sustaining trauma. MEDLINE, Embase, and Web of Science databases were searched with the following terms: “trace element”, “selenium”, “copper”, “zinc”, “injury”, and “trauma”. Seven studies were included in the meta-analysis. The pooled results showed that Se supplementation was associated with a lower mortality rate (OR 0.733, 95% CI: 0.586, 0.918, p = 0.007; heterogeneity, I2 = 0%). Regarding the incidence of infectious complications, there was no statistically significant benefit after analyzing the four studies (OR 0.942, 95% CI: 0.695, 1.277, p = 0.702; heterogeneity, I2 = 14.343%). The patients with Se supplementation had a reduced ICU length of stay (standard difference in means (SMD): −0.324, 95% CI: −0.382, −0.265, p < 0.001; heterogeneity, I2 = 0%) and lesser hospital length of stay (SMD: −0.243, 95% CI: −0.474, −0.012, p < 0.001; heterogeneity, I2 = 45.496%). Se supplementation after trauma confers positive effects in decreasing the mortality and length of ICU and hospital stay.

Hypophosphatemia and Outcomes in ICU: A Systematic Review and Meta-Analysis

2020 ◽  
pp. 088506662094027
Author(s):  
Jeremy Cheuk Kin Sin ◽  
Lillian King ◽  
Emma Ballard ◽  
Stacey Llewellyn ◽  
Kevin B. Laupland ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Meta Analysis ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Cochrane Library ◽  
Secondary Outcome ◽  
Icu Length Of Stay ◽  
Newcastle Ottawa Scale

Purpose: Hypophosphatemia is reported in up to 5% of hospitalized patients and ranges from 20% to 80% in critically ill patients. The consequences of hypophosphatemia for critically ill patients remain controversial. We evaluated the effect of hypophosphatemia on mortality and length of stay in intensive care unit (ICU) patients. Methods: MEDLINE, EMBASE, Cochrane Library (Reviews and Trials), and PubMed were searched for articles in English. The primary outcome was mortality and secondary outcome was length of stay. The quality of evidence was graded using a modified Newcastle-Ottawa Scale. Results: Our search yielded 828 articles and ultimately included 12 studies with 7626 participants in the analysis. Hypophosphatemia was associated with increased hospital length of stay (2.19 days [95% CI, 1.74-2.64]) and ICU length of stay (2.22 days [95% CI, 1.00-3.44]) but not mortality (risk ratio: 1.13 [95% CI, 0.98-1.31]; P = .09). Conclusions: Hypophosphatemia in ICU was associated with increased hospital and ICU length of stay but not all-cause mortality. Hypophosphatemia appears to be a marker of disease severity. Limited number of available studies and varied study designs did not allow for the ascertainment of the effect of severe hypophosphatemia on patient mortality.

scholarly journals Does additional weekend and holiday physiotherapy benefit geriatric patients with hip fracture? — A case-historical control study

2021 ◽  
pp. 1-10
Author(s):  
Dennis Kim Chung Mo ◽  
Ken Kin Ming Lau ◽  
Donna Mei Yee Fung ◽  
Bosco Hon Ming Ma ◽  
Titanic Fuk On Lau ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Length Of Stay ◽  
Functional Outcomes ◽  
Geriatric Patients ◽  
Historical Control ◽  
Hospital Length Of Stay ◽  
Lower Percentage ◽  
Control Group ◽  
Study Group ◽  
Rehabilitation Hospital

Objective: To evaluate the new service model of additional weekend and holiday physiotherapy (PT) by comparing functional outcomes and hospital length of stay between a group of geriatric patients with hip fracture receiving daily PT training and a group of geriatric patients with hip fracture receiving weekdays PT training. Methods: A retrospective case-historical control chart review was conducted and a total of 355 patients were identified. Between-group comparisons were done on functional outcomes including Modified Functional Ambulation Classification (MFAC), Elderly Mobility Scale (EMS), Modified Barthel Index (MBI) and process outcome in terms of length of stay (LOS) in hospitals. Results: With similar characteristics, patients who received weekend and holiday PT training had a significant higher percentage of MFAC Category III and a significant lower percentage of MFAC Category II ([Formula: see text]) and significant higher MBI scores ([Formula: see text] deviation, median; Study group: [Formula: see text] points, 51 points; Control group: [Formula: see text] points, 43 points; [Formula: see text]) upon admission to rehabilitation hospital. A similar trend in EMS scores (Study group: [Formula: see text] points, 7 points; Control group: [Formula: see text] points, 6 points; [Formula: see text]) and MBI scores (Study group: [Formula: see text] points, 68 points; Control group: [Formula: see text] points, 64 points; [Formula: see text]) were observed upon discharge from the rehabilitation hospital. The average LOS in acute hospitals remained static (Study group: [Formula: see text] days, 7 days; Control group: [Formula: see text] days, 6 days; [Formula: see text]). The average LOS in rehabilitation hospital (Study group: [Formula: see text] days, 20 days; Control group: [Formula: see text] days, 23 days; [Formula: see text]) and total in-patient LOS (Study group: [Formula: see text] days, 26 days; Control group: [Formula: see text] days, 28 days; [Formula: see text]) were significantly reduced. A higher percentage of days having PT training during hospitalization in rehabilitation hospital was shown with the implementation of new service (Study group: 89.1%; Control group: 65.9%, [Formula: see text]). Conclusion: Additional weekend and holiday PT training in post-operative acute and rehabilitation hospitalization benefits geriatric patients with hip fracture in terms of improved training efficiency, where hospital LOS was shortened with more PT sessions, without any significant impacts on functional outcome.

scholarly journals Optimal use of tocilizumab for severe and critical COVID-19: a systematic review and meta-analysis

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 73
Author(s):  
Cahyo Wibisono Nugroho ◽  
Satriyo Dwi Suryantoro ◽  
Yuliasih Yuliasih ◽  
Alfian Nur Rosyid ◽  
Tri Pudy Asmarawati ◽  
...  
Keyword(s):  
Systematic Review ◽  
Length Of Stay ◽  
Critically Ill ◽  
Meta Analysis ◽  
Standard Of Care ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Eligibility Criteria ◽  
All Cause Mortality ◽  
Clinical Benefits

Background: Several studies have revealed the potential use of tocilizumab in treating COVID-19 since no therapy has yet been approved for COVID-19 pneumonia. Tocilizumab may provide clinical benefits for cytokine release syndrome in COVID-19 patients. Methods: We searched for relevant studies in PubMed, Embase, Medline, and Cochrane published from March to October 2020 to evaluate optimal use and baseline criteria for administration of tocilizumab in severe and critically ill COVID-19 patients. Research involving patients with confirmed SARS-CoV-2 infection, treated with tocilizumab and compared with the standard of care (SOC) was included in this study. We conducted a systematic review to find data about the risks and benefits of tocilizumab and outcomes from different baseline criteria for administration of tocilizumab as a treatment for severe and critically ill COVID-19 patients. Results: A total of 26 studies, consisting of 23 retrospective studies, one prospective study, and two randomised controlled trials with 2112 patients enrolled in the tocilizumab group and 6160 patients in the SOC group, were included in this meta-analysis. Compared to the SOC, tocilizumab showed benefits for all-cause mortality events and a shorter time until death after first intervention but showed no difference in hospital length of stay. Upon subgroup analysis, tocilizumab showed fewer all-cause mortality events when CRP level ≥100 mg/L, P/F ratio 200-300 mmHg, and P/F ratio <200 mmHg. However, tocilizumab showed a longer length of stay when CRP <100 mg/L than the SOC. Conclusion: This meta-analysis demonstrated that tocilizumab has a positive effect on all-cause mortality. It should be cautiously administrated for optimal results and tailored to the patient's eligibility criteria.

scholarly journals A predictive model for increased hospital length of stay following geriatric hip fracture

2019 ◽  
Vol 10 ◽  
pp. S84-S87 ◽  
Author(s):  
Olivia M. Knoll ◽  
Nikita Lakomkin ◽  
Michelle S. Shen ◽  
Moses Adebayo ◽  
Parth Kothari ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Length Of Stay ◽  
Predictive Model ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Geriatric Hip Fracture

Clinical and Economic Outcomes of Telemedicine Programs in the Intensive Care Unit: A Systematic Review and Meta-Analysis

2017 ◽  
Vol 33 (7) ◽  
pp. 383-393 ◽  
Author(s):  
Jing Chen ◽  
Dalong Sun ◽  
Weiming Yang ◽  
Mingli Liu ◽  
Shufan Zhang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Length Of Stay ◽  
Hospital Mortality ◽  
Meta Analysis ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Icu Length Of Stay ◽  
The Impact

Objective: To evaluate the impact of telemedicine programs in intensive care unit (Tele-ICU) on ICU or hospital mortality or ICU or hospital length of stay and to summarize available data on implementation cost of Tele-ICU. Methods: Controlled trails or observational studies assessing outcomes of interest were identified by searching 7 electronic databases from inception to July 2016 and related journals and conference literatures between 2000 and 2016. Two reviewers independently screened searched records, extracted data, and assessed the quality of included studies. Random-effect models were applied to meta-analyses and sensitivity analysis. Results: Nineteen of 1035 records fulfilled the inclusion criteria. The pooled effects demonstrated that Tele-ICU programs were associated with reductions in ICU mortality (15 studies; risk ratio [RR], 0.83; 95% confidence interval [CI], 0.72 to 0.96; P = .01), hospital mortality (13 studies; RR, 0.74; 95% CIs, 0.58 to 0.96; P = .02), and ICU length of stay (9 studies; mean difference [MD], −0.63; 95% CI, −0.28 to 0.17; P = .007). However, there is no significant association between the reduction in hospital length of stay and Tele-ICU programs. Summary data concerning costs suggested approximately US$50 000 to US$100 000 per Tele-ICU bed was required to implement Tele-ICU programs for the first year. Hospital costs of US$2600 reduction to US$5600 increase per patient were estimated using Tele-ICU programs. Conclusions: This systematic review and meta-analysis provided limited evidence that Tele-ICU approaches may reduce the ICU and hospital mortality, shorten the ICU length of stay, but have no significant effect in hospital length of stay. Implementation of Tele-ICU programs substantially costs and its long-term cost-effectiveness is still unclear.

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