scholarly journals IMPACT OF SERUM EOSINOPHIL COUNTS ON HOSPITAL LENGTH OF STAY, READMISSION RATES, AND IN-HOSPITAL OUTCOMES IN PATIENTS WITH ACUTE EXACERBATION OF COPD

CHEST Journal ◽  
2020 ◽  
Vol 158 (4) ◽  
pp. A1770
Author(s):  
Tinashe Maduke ◽  
Armin Krvavac ◽  
Sara Tepe ◽  
Pooja Nair ◽  
Trent Bailey ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Acute Exacerbation ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Readmission Rates ◽  
Hospital Outcomes ◽  
Acute Exacerbation Of Copd ◽  
Exacerbation Of Copd ◽  
Eosinophil Counts

Mood Disorders in Elderly Patients Hospitalized for Acute Exacerbation of COPD

2017 ◽  
Vol 41 (S1) ◽  
pp. S142-S142
Author(s):  
I. Bonfitto ◽  
G. Moniello ◽  
M. Pascucci ◽  
A. Bellomo
Keyword(s):  
Quality Of Life ◽  
Length Of Stay ◽  
Elderly Patients ◽  
Acute Exacerbation ◽  
Rating Scale ◽  
Hospital Length Of Stay ◽  
Acute Exacerbation Of Copd ◽  
Copd Exacerbations ◽  
Exacerbation Of Copd

IntroductionChronic obstructive pulmonary disease (COPD) represents the most common cause of chronic respiratory failure and it's associated with several comorbidities such as depression. Depression is about four times more frequent in elderly patients with COPD compared to peers who are not affected and its prevalence increases with the degree of disease severity.ObjectiveTo assess mood and perception of the quality of life in elderly patients hospitalized for acute exacerbation of COPD.MethodsThirty-five elderly patients hospitalized for reactivation of COPD were examined; they were subjected to spirometry test for the calculation of FEV1 and to COPD Assessment Test (CAT) and Hamilton Rating Scale for Depression (HAM-D) to evaluate impact of COPD on patients’ quality of life and depressive symptomatology, respectively. The number of COPD exacerbations in the last year prior to hospitalization and the number of recovery days required for the stabilization of patients were also recorded.ResultsThere were strongly significative correlations (P < 0.001), positive between HAM-D scores, CAT scores, number of exacerbation in the last year and hospital length of stay and negative between HAM-D scores and FEV1 values. Furthermore, females were more depressed, with lower FEV 1 (P = 0.043) and with a longer length of stay (P = 0.039) as compared to males.ConclusionsA greater severity of depressive symptoms is related to a greater severity of COPD exacerbations, disability associated with it and perceived by the patient, as well as a higher number of recovery days and annual acute exacerbations, particularly in female gender.

Opioid Abuse or Dependence Increases 30-day Readmission Rates after Major Operating Room Procedures

2018 ◽  
Vol 128 (5) ◽  
pp. 880-890 ◽  
Author(s):  
Atul Gupta ◽  
Junaid Nizamuddin ◽  
Dalia Elmofty ◽  
Sarah L. Nizamuddin ◽  
Avery Tung ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Operating Room ◽  
Healthcare Utilization ◽  
Cohort Analysis ◽  
Hospital Costs ◽  
Hospital Length ◽  
Opioid Abuse ◽  
Hospital Length Of Stay ◽  
Opioid Overdose ◽  
Readmission Rates

Abstract Background Although opioids remain the standard therapy for the treatment of postoperative pain, the prevalence of opioid misuse is rising. The extent to which opioid abuse or dependence affects readmission rates and healthcare utilization is not fully understood. It was hypothesized that surgical patients with a history of opioid abuse or dependence would have higher readmission rates and healthcare utilization. Methods A retrospective cohort analysis was performed of patients undergoing major operating room procedures in 2013 and 2014 using the National Readmission Database. Patients with opioid abuse or dependence were identified using International Classification of Diseases codes. The primary outcome was 30-day hospital readmission rate. Secondary outcomes included hospital length of stay and estimated hospital costs. Results Among the 16,016,842 patients who had a major operating room procedure whose death status was known, 94,903 (0.6%) had diagnoses of opioid abuse or dependence. After adjustment for potential confounders, patients with opioid abuse or dependence had higher 30-day readmission rates (11.1% vs. 9.1%; odds ratio 1.26; 95% CI, 1.22 to 1.30), longer mean hospital length of stay at initial admission (6 vs. 4 days; P &lt; 0.0001), and higher estimated hospital costs during initial admission ($18,528 vs. $16,617; P &lt; 0.0001). Length of stay was also higher at readmission (6 days vs. 5 days; P &lt; 0.0001). Readmissions for infection (27.0% vs. 18.9%; P &lt; 0.0001), opioid overdose (1.0% vs. 0.1%; P &lt; 0.0001), and acute pain (1.0% vs. 0.5%; P &lt; 0.0001) were more common in patients with opioid abuse or dependence. Conclusions Opioid abuse and dependence are associated with increased readmission rates and healthcare utilization after surgery.

Interventions to Improve Early Pulmonary Outpatient Follow-Up for Acute Exacerbation of COPD Associated With Reduced 30-Day Readmission Rates

CHEST Journal ◽  
2017 ◽  
Vol 152 (4) ◽  
pp. A800
Author(s):  
Paul Chung ◽  
Christopher Boyle ◽  
Rachelle Lurvey-Eifert ◽  
Maureen Kharasch ◽  
Neil Freedman
Keyword(s):  
Acute Exacerbation ◽  
Readmission Rates ◽  
Acute Exacerbation Of Copd ◽  
Exacerbation Of Copd

Prevalence and Inpatient Hospital Outcomes of Malignancy-Related Ascites in the United States

2020 ◽  
Vol 38 (1) ◽  
pp. 47-53
Author(s):  
Venkataraghavan Ramamoorthy ◽  
Muni Rubens ◽  
Anshul Saxena ◽  
Chintan Bhatt ◽  
Sankalp Das ◽  
...  
Keyword(s):  
United States ◽  
Length Of Stay ◽  
Hospital Mortality ◽  
The United States ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
National Database ◽  
Hospital Outcomes ◽  
Inpatient Hospital ◽  
Male Sex

Objective: Malignancy-related ascites (MRA) is the terminal stage of many advanced cancers, and the treatment is mainly palliative. This study looked for epidemiology and inpatient hospital outcomes of patients with MRA in the United States using a national database. Methods: The current study was a cross-sectional analysis of 2015 National Inpatient Sample data and consisted of patients ≥18 years with MRA. Descriptive statistics were used for understanding demographics, clinical characteristics, and MRA hospitalization costs. Multivariate regression models were used to identify predictors of length of hospital stay and in-hospital mortality. Results: There were 123 410 MRA hospitalizations in 2015. The median length of stay was 4.7 days (interquartile range [IQR]: 2.5-8.6 days), median cost of hospitalization was US$43 543 (IQR: US$23 485-US$82 248), and in-hospital mortality rate was 8.8% (n = 10 855). Multivariate analyses showed that male sex, black race, and admission to medium and large hospitals were associated with increased hospital length of stay. Factors associated with higher in-hospital mortality rates included male sex; Asian or Pacific Islander race; beneficiaries of private insurance, Medicaid, and self-pay; patients residing in large central and small metro counties; nonelective admission type; and rural and urban nonteaching hospitals. Conclusions: Our study showed that many demographic, socioeconomic, health care, and geographic factors were associated with hospital length of stay and in-hospital mortality and may suggest disparities in quality of care. These factors could be targeted for preventing unplanned hospitalization, decreasing hospital length of stay, and lowering in-hospital mortality for this population.

scholarly journals Impact of Body Mass Index on In-Hospital Length of Stay after Percutaneous Coronary Interventions

2020 ◽  
Vol 13 (1) ◽  
pp. 19-26
Author(s):  
Mohammad Khalilur Rahman Siddiqui ◽  
Md Mizanur Rahman ◽  
Borhanuddin Ahmed ◽  
Abdul Latif Molla ◽  
Md Iftekhar Uddin ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Percutaneous Coronary Interventions ◽  
Hospital Outcomes ◽  
Hospital Outcome ◽  
Coronary Interventions ◽  
Group I ◽  
Percutaneous Coronary ◽  
Group Ii

Background: In-hospital length of stay (LOS) is an important metric for assessing the quality of care and planning capacity within a hospital. Percutaneous Coronary Interventions (PCI) merit short LOS following an uncomplicated procedure. Various factors have been studied that may influence LOS. The relationship between BMI and LOS after PCI has not been thoroughly investigated, especially in Bangladesh. Methods: This cross-sectional observational study was conducted at National Institute of Cardiovascular Diseases, on total 100 patients who underwent PCI with two equally divided groups on the basis of BMI of Asian ethnicity: Group I (BMI < 23 kg/m2) and Group II (BMI e” 23.0 kg/m2). In-hospital outcomes and LOS were observed and recorded after PCI. Results: The mean BMI of study population was 23.9 ± 1.9 kg/m2. The sum of occurrence of adverse in-hospital outcomes was 14.0%. Complications were significantly (p < 0.01) higher in Group I than Group II. Among all adverse in-hospital outcomes, only acute left ventricular failure was found to be statistically significant between groups (p < 0.01). The difference of mean LOS after PCI was higher in Group-I which was statistically significant (p < 0.01). Diabetes mellitus and dyslipidemia were found to be the independent predictors for developing adverse in-hospital outcome (OR= 1.68 and 1.46; 95% CI = 1.25 – 2.24 and 1.16 – 1.83; p = 0.018 and 0.040, respectively). BMI was inversely associated with adverse in-hospital outcome after PCI (OR = 0.95; 95% CI = 0.91 – 0.98; p = 0.007). Conclusion: BMI is inversely associated with adverse in-hospital outcome after PCI. The underweight people are likely to experience longer LOS following PCI. Cardiovasc. j. 2020; 13(1): 19-26

scholarly journals 1951. Extended Infusions of Β-lactam Antibiotics are Feasible and May Improve Mortality in the Pediatric Population

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S59-S60
Author(s):  
Rachael L Schortemeyer ◽  
Tracy N Zembles ◽  
Glenn Bushee ◽  
Evelyn Kuhn ◽  
Michelle L Mitchell
Keyword(s):  
Length Of Stay ◽  
Clinical Outcomes ◽  
Critically Ill ◽  
Interim Analysis ◽  
Pediatric Population ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Readmission Rates ◽  
Drug Concentrations ◽  
All Cause Mortality

Abstract Background Infections due to multi-drug-resistant organisms (MDRO) are associated with poor clinical outcomes. Due to limited treatment options for MDROs, it is essential to improve the delivery of available antibiotics. Optimal efficacy of β-lactam antibiotics can be achieved when free drug concentrations exceed the minimum inhibitory concentration of the organism for at least 50% of the dosing interval. This is more feasible when extending the duration of infusion. Adult literature supporting the use of extended infusion β-lactams (EIBL) is robust; however, pediatric data are limited. Furthermore, extended infusions (EI) may be more difficult to achieve in pediatric patients due to limited intravenous line access. The purpose of this study was to determine the feasibility of EIBLs as the standard of care and compare clinical outcomes between standard infusions (SI) and extended infusions (EI). Methods This retrospective chart analysis included hospitalized patients less than 18 years old between October 1, 2017 and March 31, 2019 who received at least 72 hours of cefepime, piperacillin/tazobactam, or meropenem. Patients weighing less than 3.5 kg or requiring continuous renal replacement therapy were excluded. EI were defined as antibiotic delivery over 3–4 hours, while SI were delivered over 30 minutes. The percent of patients completing therapy utilizing EI was measured. Clinical outcomes compared hospital length of stay; time to blood culture clearance, defervescence, inflammatory marker normalization; 30-day readmission rates; and 30-day all-cause mortality between the SI and EI groups. Results A total of 560 patients were included in the interim analysis. Over 90% of patients were able to complete therapy utilizing EI (Figure 1). The EI group had lower readmission rates, but the interim analysis has not yet controlled for planned admissions. A sub-analysis of critically ill patients requiring vasopressors identified a lower mortality rate (5.1% vs. 23.1%, P = 0.023) and decreased the length of stay (554 vs. 1,055 hours, P = 0.035) in the EI compared with SI group (Table 1). Conclusion EIBLs are feasible in the pediatric population and may lead to improved outcomes including decreased all-cause mortality and hospital length of stay, especially in critically ill children. Disclosures All Authors: No reported Disclosures.

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