INPATIENT MANAGEMENT OF PULMONARY EMBOLISM: CLINICAL CHARACTERISTICS AND MORTALITY IN A HIGH-VOLUME TERTIARY REFERRAL CARE CENTER

Objective: To describe clinical characteristics and outcomes of laboratory-confirmed influenza in hospitalized children in a tertiary care center and to identify factors associated with the severity. Materials and Methods: The present study was a retrospective medical chart review study conducted at King Chulalongkorn Memorial Hospital, Bangkok, Thailand. Data were extracted from children aged under 15 years old hospitalized between January 2014 and December 2018. Patients who had laboratory-confirmed influenza by rapid antigen detection or molecular testing were included. Severe influenza was defined as patients who developed influenza complications or duration of hospitalization for more than three days. Multivariate logistic regression was used to identify the associated factors with the severity of the disease. Results: Three hundred fifty-seven influenza patients were included with median age of 43 months (IQR 19 to 81), of which 63.3% were aged under 60 months. There were 174 patients (48.7%) with comorbidities, most common were immunosuppression (18.2%), chronic pulmonary disease (12.2%), and congenital heart disease (11.5%). Fifty-seven out of 183 patients (31.1%) had history of influenza vaccination in the medical records. One hundred sixty-one patients (45.1%) had 212 influenza complications including influenza-related pneumonia (89, 24.9%), secondary bacterial infection (53, 14.8%), and neurologic complications (47, 13.2%), in which 27 cases (7.6%) were transferred to intensive care unit (ICU). Four cases (1.1%) died but not directly related to influenza. Associated factors with complicated influenza were aged less than 24 months [aOR 2.67 (95% CI 1.68 to 4.26)] and presence of chronic lung disease [aOR 4.34 [95% CI 2.01 to 9.35)]. Conclusion: Two-third of the children hospitalized with influenza were younger than 60 months. Nearly half developed complications most associated with the age of less than two years old and patients with chronic lung disease. Low rates of vaccination were demonstrated. Keywords: Influenza, Pediatrics, Complications, Pneumonia, Hospitalization

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Relationship of hospital volume on outcomes in patients with acute pulmonary embolism: Analysis of a 70,000 patient database

Vascular Medicine ◽

10.1177/1358863x20970263 ◽

2020 ◽

pp. 1358863X2097026

Author(s):

Mark Finkelstein ◽

Mario A Cedillo ◽

David C Kestenbaum ◽

Obaib S Shoaib ◽

Aaron M Fischman ◽

...

Keyword(s):

New York ◽

Pulmonary Embolism ◽

Length Of Stay ◽

New York State ◽

Multivariable Analysis ◽

High Volume ◽

Categorical Variables ◽

Patient Database ◽

Very High ◽

Total Charges

Positive relationships between volume and outcome have been seen in several surgical and medical conditions, resulting in more centralized and specialized care structures. Currently, there is a scarcity of literature involving the volume–outcome relationship in pulmonary embolism (PE). Using a state-wide dataset that encapsulates all non-federal admissions in New York State, we performed a retrospective cohort study on admitted patients with a diagnosis of PE. A total of 70,443 cases were separated into volume groups stratified by hospital quartile. Continuous and categorical variables were compared between cohorts. Multivariable regression analysis was conducted to assess predictors of 1-year mortality, 30-day all-cause readmission, 30-day PE-related readmission, length of stay, and total charges. Of the 205 facilities that were included, 128 (62%) were labeled low volume, 39 (19%) medium volume, 23 (11%) high volume, and 15 (7%) very high volume. Multivariable analysis showed that very high volume was associated with decreased 30-day PE-related readmission (OR 0.64; 95% CI, 0.55 to 0.73), decreased 30-day all-cause readmission (OR 0.84; 95% CI, 0.79 to 0.89), decreased 1-year mortality (OR 0.85; 95% CI, 0.80 to 0.91), decreased total charges (OR 0.96; 95% CI, 0.94 to 0.98), and decreased length of stay (OR 0.94; 95% CI, 0.92 to 0.96). In summary, facilities with higher volumes of acute PE were found to have less 30-day PE-related readmissions, less all-cause readmissions, shorter length of stay, decreased 1-year mortality, and decreased total charges.

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Prevalence and risk factors of anemia among pregnant women attending a high-volume tertiary care center for delivery

Journal of the Turkish-German Gynecological Association ◽

10.5152/jtgga.2015.15071 ◽

2015 ◽

Vol 16 (4) ◽

pp. 231-236 ◽

Cited By ~ 6

Author(s):

Cuneyt Eftal Taner ◽

Atalay Ekin ◽

Ulas Solmaz ◽

Cenk Gezer ◽

Birgul Cetin ◽

...

Keyword(s):

Risk Factors ◽

Pregnant Women ◽

Care Center ◽

Tertiary Care ◽

High Volume ◽

Tertiary Care Center

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Clinical Outcomes of Pulmonary Embolism in Mexican Patients With COVID-19

Clinical and Applied Thrombosis/Hemostasis ◽

10.1177/10760296211008988 ◽

2021 ◽

Vol 27 ◽

pp. 107602962110089

Author(s):

Luis O. Bobadilla-Rosado ◽

Santiago Mier y Teran-Ellis ◽

Gabriel Lopez-Pena ◽

Javier E. Anaya-Ayala ◽

Carlos A. Hinojosa

Keyword(s):

Pulmonary Embolism ◽

Clinical Outcomes ◽

Mexico City ◽

Clinical Characteristics ◽

Anticoagulation Therapy ◽

Coagulation Abnormalities ◽

Survivor Group ◽

Increased Risk ◽

Tertiary Center ◽

Significant Difference

Coagulation abnormalities have been reported in COVID-19 patients, which may lead to an increased risk of Pulmonary Embolism (PE). We aimed to describe the clinical characteristics and outcomes of COVID-19 patients diagnosed with PE during their hospital stay. We analyzed patients with PE and COVID-19 in a tertiary center in Mexico City from April to October of 2020. A total of 26 (100%) patients were diagnosed with Pulmonary Embolism and COVID-19. We observed that 14 (54%) patients were receiving either prophylactic or full anticoagulation therapy, before PE diagnosis. We found a significant difference in mortality between the group with less than 7 days (83%) and the group with more than 7 days (15%) in Intensive Care Unit ( P = .004); as well as a mean of 8 days for the mortality group compared with 20 days of hospitalization in the survivor group ( P = .003). In conclusion, there is an urgent need to review antithrombotic therapy in these patients in order to improve clinical outcomes and decrease hospital overload.

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