A027 – Clemens von Pirquet - 1st Place Award PULSE OXIMETRY AND CENTILE-BASED VITAL SIGNS PREDICT HOSPITAL LENGTH OF STAY IN PEDIATRIC ASTHMA EXACERBATION

Although hospital length of stay (LOS) has been identified as a proxy measure of healthcare expenditures in the United States, there are limited studies investigating the potentially important association between outdoor air pollution and LOS for pediatric asthma. This study aims to examine the effect of ambient air pollution on LOS among children with asthma in South Texas. It included retrospective data on 711 children aged 5–18 years old admitted for asthma to a pediatric tertiary care hospital in South Texas between 2010 and 2014. Air pollution data including particulate matter (PM2.5) and ozone were collected from the U.S. Centers for Disease Control and Prevention. The multivariate binomial logistic regression analyses were performed to determine the association between each air pollutant and LOS, controlling for confounders. The regression models showed the increased ozone level was significantly associated with prolonged LOS in the single- and two-pollutant models (p < 0.05). Furthermore, in the age-stratified models, PM2.5 was positively associated with LOS among children aged 5–11 years old (p < 0.05). In conclusion, this study revealed a concerning association between ambient air pollution and LOS for pediatric asthma in South Texas.

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100. REDUCING PEDIATRIC ASTHMA HOSPITAL LENGTH OF STAY THROUGH A MULTIDISCIPLINARY CARE PATHWAY

Academic Pediatrics ◽

10.1016/j.acap.2020.06.121 ◽

2020 ◽

Vol 20 (7) ◽

pp. e47-e48

Author(s):

Lucia An ◽

Samuel Backus ◽

Bruce Han ◽

Miranda Kane ◽

Marc Blumberg

Keyword(s):

Length Of Stay ◽

Care Pathway ◽

Pediatric Asthma ◽

Multidisciplinary Care ◽

Hospital Length ◽

Hospital Length Of Stay

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5. Comparison of Hospital Length of Stay between Two Insurers for Patients with Pediatric Asthma

Statistical Case Studies ◽

10.1137/1.9780898719741.ch5 ◽

1998 ◽

pp. 29-38

Author(s):

Robert L. Houchens ◽

Nancy Schoeps

Keyword(s):

Length Of Stay ◽

Pediatric Asthma ◽

Hospital Length ◽

Hospital Length Of Stay

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P080: What is the impact of post-intubation hypotension on mortality and in-hospital length of stay?

CJEM ◽

10.1017/cem.2019.271 ◽

2019 ◽

Vol 21 (S1) ◽

pp. S92

Author(s):

D. Lachance-Perreault ◽

J. Turgeon ◽

V. Boucher ◽

M. Émond

Keyword(s):

Length Of Stay ◽

Hospital Mortality ◽

Vital Signs ◽

Mortality Rates ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Historical Cohort ◽

Resuscitation Room ◽

Post Intubation ◽

The Impact

Introduction: Hypotension is known to severely impact the prognosis of patients in need of acute care. Endotracheal intubation (EI) is a procedure that is often used in the emergency room for patients with severe conditions. Post-intubation hypotension (PHI) is a well-known adverse effect of EI, although the impact of PHI on mortality is still unclear. The objective of this study was therefore to evaluate the association between post-intubation hypotension (PIH) and in-hospital mortality rates and length of stay (LOS). Methods: Design: A historical cohort of patients admitted in a university-affiliated emergency department (ED) between 06/2011 and 05/2016 was constituted. Population: Patients aged ≥16 were included if pre-EI vital signs were available, if their intubation was performed in the resuscitation room, if no surgical access was needed and if EI was performed in ≤3 attempts. Measures: All clinical data including vitals were prospectively recorded using the software ReaScribe. Hypotension was defined as a systolic blood pressure ≤90 mmHg. The occurrence of PIH was assessed at 5, 15, 30 minutes and any time after intubation. Main outcomes were in-hospital mortality and hospital length of stay. Analyses: Univariate and multivariate analyses assessed the relation between PHI and outcomes. Results: A total of 497 patients were included in our analyses. Of these patients, 63 (12.7%) suffered from PIH at 5 minutes, 120 (24,1%) at 15 minutes, 168 (33,8%) at 30 minutes and 209 (42%) at any moment after intubation. Mortality rates were 42.9% (n = 27), 35.8% (n = 43), 33.9% (n = 57) and 30.6%(n = 64) for patients who presented PIH at the 4 time periods, respectively, while 26.74% patients died in the normotensive group. PIH at 5 (p = 0.006), 15 (p = 0.04) and 30 minutes (p = 0.05) was associated with a significant increase in overall post-intubation mortality. Mean LOS for patients who suffered from PIH was 16.7, 18.9, 17.3, 17.4 days compared to 19.5 (p = 0.22) days for the normotensive group. Conclusion: Early post-intubation hypotension at 5 minutes was strongly associated with an increased mortality. As for the in-hospital length of stay, PIH was not associated with an increased LOS. Our results show that PIH within 30 minutes of intubation is associated with an increased mortality rate and should therefore be aggressively treated or prevented.

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Tele-Rapid Response Team (Tele-RRT): Implementation and outcomes of Safety Network System. Before and after cohort study.

10.1101/2021.12.15.21267828 ◽

2021 ◽

Author(s):

Ahmed N. Balshi ◽

Mohammed A. Al-Odat ◽

Abdulrahman M. Alharthy ◽

Rayan A. Alshaya ◽

Hanan M. Alenzi ◽

...

Keyword(s):

Length Of Stay ◽

Early Recognition ◽

Vital Signs ◽

Hospital Length ◽

Rapid Response ◽

Warning Signs ◽

Hospital Length Of Stay ◽

Multivariable Logistic Regression Model ◽

Icu Admission ◽

Before And After

Background Rapid Response Teams were developed to provide interventions for deteriorating patients. Their activation depends on timely detection of deterioration. Automated calculation of warning signs may lead to early recognition, and improvement of RRT effectiveness. Method This was a Before and After study, in the Before period ward nurses activated RRT after manually recording vital signs and calculating warning scores. In the After period, vital signs and warning calculations were automatically relayed to RRT through a wireless monitoring network. Results The After group had significantly lower incidence and rates of cardiopulmonary resuscitation compared to the Before group (2.3 / 1000 inpatient days versus 3.8 / 1000 inpatient days respectively, p = 0.01), the Before group had a significantly higher hospital length of stay, and significantly fewer visits by the RRT. In multivariable logistic regression model, being in the After group decreases odds of CPR by 30% (OR = 0.7 [95% CI: 0.44 to 0.97]; p = 0.02). There was no difference between groups in unplanned ICU admission or readmission. Conclusion Automated activation of the RRT resulted in significant reduction of CPR events and rate, reduction of hospital length of stay, and increase in the number of visits by the RRT. There was no difference in unplanned ICU admission or readmission.

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Researchers present recent findings from the pneumonia PORT on hospital length of stay, symptoms, and outcomes

PsycEXTRA Dataset ◽

10.1037/e556762006-011 ◽

2001 ◽

Keyword(s):

Length Of Stay ◽

Hospital Length ◽

Hospital Length Of Stay

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Multicenter Validation of a Risk Index for Mortality, Intensive Care Unit Stay, and Overall Hospital Length of Stay After Cardiac Surgery

Circulation ◽

10.1161/01.cir.91.3.677 ◽

1995 ◽

Vol 91 (3) ◽

pp. 677-684 ◽

Cited By ~ 255

Author(s):

Jack V. Tu ◽

Susan B. Jaglal ◽

C. David Naylor

Keyword(s):

Intensive Care Unit ◽

Cardiac Surgery ◽

Intensive Care ◽

Length Of Stay ◽

Intensive Care Unit Stay ◽

Risk Index ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Multicenter Validation

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182. Missed Opportunities to Discontinue Unnecessary Vancomycin During Pharmacist Therapeutic Monitoring

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.226 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S98-S98

Author(s):

Corey J Medler ◽

Mary Whitney ◽

Juan Galvan-Cruz ◽

Ron Kendall ◽

Rachel Kenney ◽

...

Keyword(s):

Length Of Stay ◽

Adverse Drug Events ◽

Academic Medical Center ◽

Total Duration ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Therapeutic Monitoring ◽

Resistant Bacteria ◽

Therapeutic Drug ◽

Missed Opportunities

Abstract Background Unnecessary and prolonged IV vancomycin exposure increases risk of adverse drug events, notably nephrotoxicity, which may result in prolonged hospital length of stay. The purpose of this study is to identify areas of improvement in antimicrobial stewardship for vancomycin appropriateness by clinical pharmacists at the time of therapeutic drug monitoring (TDM). Methods Retrospective, observational cohort study at an academic medical center and a community hospital. Inclusion: patient over 18 years, received at least three days of IV vancomycin where the clinical pharmacy TDM service assessed for appropriate continuation for hospital admission between June 19, 2019 and June 30, 2019. Exclusion: vancomycin prophylaxis or administered by routes other than IV. Primary outcome was to determine the frequency and clinical components of inappropriate vancomycin continuation at the time of TDM. Inappropriate vancomycin continuation was defined as cultures positive for methicillin-susceptible Staphylococcus aureus (MRSA), vancomycin-resistant bacteria, and non-purulent skin and soft tissue infection (SSTI) in the absence of vasopressors. Data was reported using descriptive statistics and measures of central tendency. Results 167 patients met inclusion criteria with 38.3% from the ICU. SSTIs were most common indication 39 (23.4%) cases, followed by pneumonia and blood with 34 (20.4%) cases each. At time of vancomycin TDM assessment, vancomycin continuation was appropriate 59.3% of the time. Mean of 4.22 ± 2.69 days of appropriate vancomycin use, 2.18 ± 2.47 days of inappropriate use, and total duration 5.42 ± 2.94. 16.4% patients developed an AKI. Majority of missed opportunities were attributed to non-purulent SSTI (28.2%) and missed MRSA nares swabs in 21% pneumonia cases (table 1). Conclusion Vancomycin is used extensively for empiric treatment of presumed infections. Appropriate de-escalation of vancomycin therapy is important to decrease the incidence of adverse effects, decreasing hospital length of stay, and reduce development of resistance. According to the mean duration of inappropriate therapy, there are opportunities for pharmacy and antibiotic stewardship involvement at the time of TDM to optimize patient care (table 1). Missed opportunities for vancomycin de-escalation Disclosures All Authors: No reported disclosures

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