The impact of postpartum hemorrhage on hospital length of stay and inpatient mortality: a National Inpatient Sample–based analysis

2017 ◽  
Vol 217 (3) ◽  
pp. 344.e1-344.e6 ◽  
Author(s):  
Ariela L. Marshall ◽  
Urshila Durani ◽  
Adam Bartley ◽  
Clinton E. Hagen ◽  
Aneel Ashrani ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Postpartum Hemorrhage ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
National Inpatient Sample ◽  
Inpatient Mortality ◽  
The Impact

The Impact of Postpartum Hemorrhage on Hospital Length of Stay and Inpatient Mortality

2018 ◽  
Vol 38 (2) ◽  
pp. 66-67
Author(s):  
A.L. Marshall ◽  
U. Durani ◽  
A. Bartley ◽  
C.E. Hagen ◽  
A. Ashrani ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Postpartum Hemorrhage ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Inpatient Mortality ◽  
The Impact

Abstract 16236: Hyperthyroidism Does Not Negatively Impact the Outcomes of Patients Admitted for Atrial Fibrillation: Analysis of the National Inpatient Sample

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Hafeez Shaka ◽  
Emmanuel Akuna ◽  
Iriagbonse Asemota ◽  
Ehizogie Edigin ◽  
Precious O Eseaton ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Linear Regression Analysis ◽  
The United States ◽  
Hospital Length ◽  
Electrical Cardioversion ◽  
Hospital Length Of Stay ◽  
Secondary Diagnosis ◽  
National Inpatient Sample ◽  
Inpatient Mortality ◽  
The Impact

Introduction: Hyperthyroidism is a well-established risk factor for developing Atrial fibrillation (AF). The impact of hyperthyroidism in patients admitted for AF is unclear. This study aims to compare the outcomes of patients primarily admitted for AF with and without a secondary diagnosis of hyperthyroidism. Methods: We queried the National Inpatient Sample (NIS) 2016 and 2017 database. The NIS is the largest inpatient hospitalization database in the United States (US). The NIS was searched for hospitalization of adult patients with AF as a principal diagnosis with and without hyperthyroidism as a secondary diagnosis using ICD-10 codes. The primary outcome was inpatient mortality while the secondary outcomes were hospital length of stay (LOS), rate of ablation and electrical cardioversion. STATA software was used for analysis. Multivariate logistic and linear regression analysis was used accordingly to adjust for confounders. Results: There were over 71 million discharges in the combined 2016 and 2017 NIS database. Out of 821,629 AF hospitalizations, 1.8% had hyperthyroidism. Hospitalization for AF with hyperthyroidism had similar inpatient mortality (0.5% vs 0.9%, AOR 0.61, CI 0.36-1.04, P=0.069), longer LOS (3.6 vs 3.4 days, p<0.0001), with lower rates of ablation (2.8% vs 4.2%, AOR 0.62, CI 0.49-0.78, P<0.0001) and electrical cardioversion (14.6% vs 17.6%, AOR 0.82, CI 0.73-0.91, P<0.0001) compared to those without hyperthyroidism. Conclusion: Hospitalizations for AF with hyperthyroidism had similar inpatient mortality, decreased LOS and less rates of ablation and electrical cardioversion compared to those without hyperthyroidism. Although, hyperthyroidism increases the risk of AF, hyperthyroidism does not negatively impact outcomes of patients admitted for AF based on US national hospital billing database.

THE IMPACT OF DOOR TO DIURETIC TIME IN ACUTE HEART FAILURE ON HOSPITAL LENGTH OF STAY AND INPATIENT MORTALITY

2019 ◽  
Vol 73 (9) ◽  
pp. 838
Author(s):  
Arshad Muhammad Iqbal ◽  
Syed Moin Hassan ◽  
Salaah Siddiqui ◽  
Ateeq Mubarik ◽  
Muhammad Zeeshan Ali ◽  
...  
Keyword(s):  
Heart Failure ◽  
Length Of Stay ◽  
Acute Heart Failure ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Inpatient Mortality ◽  
The Impact

scholarly journals Impact of Accelerate Pheno and BacT/ALERT VIRTUO on Clinical Processes and Outcomes in Patients with Sepsis and Concurrent Gram-Negative Bacteremia

2021 ◽  
Author(s):  
Faith Babowicz ◽  
Reid LaPlante ◽  
Colby Mitchell ◽  
J. Nicholas O’Donnell ◽  
Ellis Tobin ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Blood Culture ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Gram Stain ◽  
Inpatient Mortality ◽  
Gram Negative ◽  
Narrow Spectrum ◽  
Gram Negative Bacteremia ◽  
The Impact

Background: Accelerate Pheno system and BacT/ALERT VIRTUO may improve bacteremia management. This study evaluated the impact of both devices on outcomes in patients with sepsis and concurrent gram-negative bacteremia. Methods: This quasi-experimental study included a retrospective pre-implementation and a prospective post-implementation group. Patients ≥18 years old with gram-negative bacteremia were included. Patients with neutropenia, pregnancy, were transferred from an outside hospital with active bloodstream infection, or polymicrobial bacteremia were excluded. Blood culture incubation in the BacT/ALERT 3D and microdilution antimicrobial susceptibility testing from culture plate growth was used prior to implementation of BacT/ALERT VIRTUO and Accelerate Pheno. MALDI-TOF identification directly from blood culture was used pre- and post-implementation. Time to gram-stain, identification, susceptibility reporting, initiation of narrow spectrum gram-negative therapy at 72 hours, 30-day inpatient mortality, sepsis resolution, and hospital length of stay were evaluated. Results: 116 patients were included (63 pre-implementation, 53 post-implementation). Median time to gram-stain and susceptibility results were significantly shorter post-implementation (P < 0.001). The post-implementation group had an improved hazard for narrow spectrum gram-negative therapy at 72 hours (HR [95% CI] = 2.685 [1.348 – 5.349]), reduced hazard for 30-day inpatient mortality (aHR: 0.150 [0.026 – 0.846]) and improved sepsis resolution (77.8% vs. 92.5%, P = 0.030). Hospital length of stay was unchanged between groups. Conclusion: The implementation of BacT/Alert VIRTUO and the Accelerate Pheno system improved microbiology laboratory processes, antibiotic utilization processes and clinical outcomes. These data support the use of rapid diagnostics in sepsis with concurrent gram-negative bacteremia.

scholarly journals Association of Emergency Department Waiting Times With Patient Experience in Admitted and Discharged Patients

2021 ◽  
Vol 8 ◽  
pp. 237437352110114
Author(s):  
Andrew Nyce ◽  
Snehal Gandhi ◽  
Brian Freeze ◽  
Joshua Bosire ◽  
Terry Ricca ◽  
...  
Keyword(s):  
Emergency Department ◽  
Length Of Stay ◽  
Patient Experience ◽  
Waiting Times ◽  
Hospital Length ◽  
Short Length ◽  
Hospital Length Of Stay ◽  
Patient’S Experience ◽  
Discharged Patients ◽  
The Impact

Prolonged waiting times are associated with worse patient experience in patients discharged from the emergency department (ED). However, it is unclear which component of the waiting times is most impactful to the patient experience and the impact on hospitalized patients. We performed a retrospective analysis of ED patients between July 2018 and March 30, 2020. In all, 3278 patients were included: 1477 patients were discharged from the ED, and 1680 were admitted. Discharged patients had a longer door-to-first provider and door-to-doctor time, but a shorter doctor-to-disposition, disposition-to-departure, and total ED time when compared to admitted patients. Some, but not all, components of waiting times were significantly higher in patients with suboptimal experience (<100th percentile). Prolonged door-to-doctor time was significantly associated with worse patient experience in discharged patients and in patients with hospital length of stay ≤4 days. Prolonged ED waiting times were significantly associated with worse patient experience in patients who were discharged from the ED and in inpatients with short length of stay. Door-to-doctor time seems to have the highest impact on the patient’s experience of these 2 groups.

Controlled Study of Decision-Making Algorithms for Kidney Replacement Therapy Initiation in Acute Kidney Injury

2021 ◽  
pp. CJN.02060221
Author(s):  
Yvelynne Kelly ◽  
Kavita Mistry ◽  
Salman Ahmed ◽  
Shimon Shaykevich ◽  
Sonali Desai ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Length Of Stay ◽  
Kidney Injury ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Controlled Study ◽  
Control Group ◽  
Inpatient Mortality ◽  
Icu Length Of Stay ◽  
Kidney Replacement Therapy

Background: Acute kidney injury (AKI) requiring kidney replacement therapy (KRT) is associated with high mortality and utilization. We evaluated the use of an AKI-Standardized Clinical Assessment and Management Plan (SCAMP) on patient outcomes including mortality, hospital and ICU length of stay. Methods: We conducted a 12-month controlled study in the ICUs of a large academic tertiary medical center. We alternated use of the AKI-SCAMP with use of a "sham" control form in 4-6-week blocks. The primary outcome was risk of inpatient mortality. Pre-specified secondary outcomes included 30-day mortality, 60-day mortality and hospital and ICU length of stay. Generalized estimating equations were used to estimate the impact of the AKI-SCAMP on mortality and length of stay. Results: There were 122 patients in the AKI-SCAMP group and 102 patients in the control group. There was no significant difference in inpatient mortality associated with AKI-SCAMP use (41% vs 47% control). AKI-SCAMP use was associated with significantly reduced ICU length of stay (mean 8 (95% CI 8-9) vs 12 (95% CI 10-13) days; p = <0.0001) and hospital length of stay (mean 25 (95% CI 22-29) vs 30 (95% CI 27-34) days; p = 0.02). Patients in the AKI-SCAMP group less likely to receive KRT in the context of physician-perceived treatment futility than those in the control group (2% vs 7%, p=0.003). Conclusions: Use of the AKI-SCAMP tool for AKI-KRT was not significantly associated with inpatient mortality but was associated with reduced ICU and hospital length of stay and use of KRT in cases of physician-perceived treatment futility.

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.

scholarly journals Association of Herpes Simplex Virus Testing with Hospital Length of Stay for Infants ≤60 Days of Age Undergoing Evaluation for Meningitis

2019 ◽  
Vol 14 (8) ◽  
pp. 492-495 ◽  
Author(s):  
Paul L Aronson ◽  
Andrea T Cruz ◽  
Stephen B Freedman ◽  
Fran Balamuth ◽  
Kendra L Grether-Jones ◽  
...  
Keyword(s):  
Herpes Simplex Virus ◽  
Herpes Simplex ◽  
Length Of Stay ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Incident Rate ◽  
Neonatal Herpes Simplex ◽  
Simplex Virus ◽  
The Impact ◽  
Pcr Test

Although neonatal herpes simplex virus (HSV) causes significant morbidity, utilization of the cerebrospinal fluid (CSF) HSV polymerase chain reaction (PCR) test remains variable. Our objective was to examine the association of CSF HSV PCR testing with length of stay (LOS) in a 20-center retrospective cohort of hospitalized infants aged ≤60 days undergoing evaluation for meningitis after adjustment for patient-level factors and clustering by center. Of 20,496 eligible infants, 7,399 (36.1%) had a CSF HSV PCR test performed, and 46 (0.6% of those tested) had a positive test. Infants who had a CSF HSV PCR test performed had a 23% longer hospital LOS (incident rate ratio 1.23; 95% CI: 1.14-1.33). Targeted CSF HSV PCR testing may mitigate the impact on LOS for low-risk infants.

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