Length of hospital stay and discharge disposition in older trauma patients

2015 ◽  
Vol 36 (2) ◽  
pp. S3-S9 ◽  
Author(s):  
Rebecca A. Brotemarkle ◽  
Barbara Resnick ◽  
Kathleen Michaels ◽  
Patricia Morton ◽  
Chris Wells
Keyword(s):  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Trauma Patients ◽  
Discharge Disposition

Does Alcohol Intoxication Protect Patients from Severe Injury and Reduce Hospital Mortality? The Association of Alcohol Consumption with the Severity of Injury and Survival in Trauma Patients

2013 ◽  
Vol 79 (12) ◽  
pp. 1289-1294 ◽  
Author(s):  
Chi-Hsun Hsieh ◽  
Li-Ting Su ◽  
Yu-Chun Wang ◽  
Chih-Yuan Fu ◽  
Hung-Chieh Lo ◽  
...  
Keyword(s):  
Alcohol Consumption ◽  
Hospital Stay ◽  
Brain Injuries ◽  
Injury Severity ◽  
Motor Vehicle ◽  
Length Of Hospital Stay ◽  
Trauma Patients ◽  
Prolonged Hospital Stay ◽  
Severe Injuries ◽  
Prolonged Hospital

Alcohol-related motor vehicle collisions are a major cause of mortality in trauma patients. This prospective observational study investigated the influence of antecedent alcohol use on outcomes in trauma patients who survived to reach the hospital. From 2005 to 2011, all patients who were older than 18 years and were admitted as a result of motor vehicle crashes were included. Blood alcohol concentration (BAC) was routinely measured for each patient on admission. Patients were divided into four groups based on their BAC level, which included nondrinking, BAC less than 100, BAC 100 to 200, and BAC 200 mg/dL or greater. Patient demographics, physical status and injury severity on admission, length of hospital stay, and outcome were compared between the groups. Odds ratios of having a severe injury, prolonged hospital stay, and mortality were estimated. Patients with a positive BAC had an increased risk of sustaining craniofacial and thoracoabdominal injuries. Odds ratios of having severe injuries (Injury Severity Score [ISS] 16 or greater) and a prolonged hospital stay were also increased. However, for those patients whose ISS was 16 or greater and who also had a brain injury, risk of fatality was significantly reduced if they were intoxicated (BAC 200 mg/dL or greater) before injury. Alcohol consumption does not protect patients from sustaining severe injuries nor does it shorten the length of hospital stay. However, there were potential survival benefits related to alcohol consumption for patients with brain injuries but not for those without brain injuries. Additional research is required to investigate the mechanism of this association further.

Comparison of Length of Hospital Stay Between Taipei City and Hualien County in Spinal Trauma Patients

2010 ◽  
Vol 2 (5) ◽  
pp. 239-244 ◽  
Author(s):  
Wei-Chen Lee ◽  
Wen-Ta Chiu ◽  
Shin-Han Tsai ◽  
Mau-Roung Lin ◽  
Shu-Fen Chu ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Spinal Trauma ◽  
Trauma Patients ◽  
Taipei City

scholarly journals Degloving injuries of trunk and limbs: comparison of outcomes of early versus delayed assessment by the plastic surgery team

2015 ◽  
Vol 42 (3) ◽  
pp. 143-148 ◽  
Author(s):  
Daniel Francisco Mello ◽  
José Cesar Assef ◽  
Sílvia Cristine Soldá ◽  
Américo Helene Jr
Keyword(s):  
Hospital Stay ◽  
Plastic Surgery ◽  
Skin Flap ◽  
Length Of Hospital Stay ◽  
Lower Limbs ◽  
Trauma Patients ◽  
Early Assessment ◽  
Group I ◽  
Group Ii ◽  
Degloving Injuries

<sec><title>OBJECTIVE:</title><p> to analyze cases of degloving of the trunk and limbs, comparing outcomes of early versus delayed assessment by the plastic surgery team.</p></sec><sec><title>METHODS:</title><p> we conducted a retrospective analysis of medical charts. Patients comprised two groups: Group I - early assessment, performed within 12 hours post trauma; and Group II - delayed assessment, performed more than 12 hours post trauma. We defined primary grafting as the use of skin from the traumatized skin flap. We excluded cases involving hands, feet or genitalia.</p></sec><sec><title>RESULTS:</title><p> there were 47 patients treated with degloving injuries between 2002 and 2010. The mean body surface area affected was 8.2%. Lower limbs were the most frequently affected site (95.7%), whether alone or in association with lesions to other sites. Delayed assessment by the plastic surgery team occurred in 25 cases. Mean hospital stay was 36.1 days for Group I and 57.1 days for Group II (p=0.026). Regarding the number of surgical operations (skin grafts), Group I received a mean of 1.3, while Group II underwent 1.6 (p=0.034).</p></sec><sec><title>CONCLUSION:</title><p> based on length of hospital stay and number of operations in trauma patients with degloving of the trunk and limbs, plastic surgery assessment should be carried out early.</p></sec>

Drivers for nonhome discharge in a consecutive series of 1502 patients undergoing 1- or 2-level lumbar fusion

2020 ◽  
Vol 33 (6) ◽  
pp. 766-771
Author(s):  
Yoji Ogura ◽  
Jeffrey L. Gum ◽  
Portia Steele ◽  
Charles H. Crawford ◽  
Mladen Djurasovic ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Smoking Status ◽  
Lumbar Fusion ◽  
Hospital Costs ◽  
Length Of Hospital Stay ◽  
Administrative Database ◽  
Consecutive Series ◽  
Factors Associated ◽  
Discharge Disposition ◽  
Zip Code

OBJECTIVEUnexpected nonhome discharge causes additional costs in the current reimbursement models, especially to the payor. Nonhome discharge is also related to longer length of hospital stay and therefore higher healthcare costs to society. With increasing demand for spine surgery, it is important to minimize costs by streamlining discharges and reducing length of hospital stay. Identifying factors associated with nonhome discharge can be useful for early intervention for discharge planning. The authors aimed to identify the drivers of nonhome discharge in patients undergoing 1- or 2-level instrumented lumbar fusion.METHODSThe electronic medical records from a single-center hospital administrative database were analyzed for consecutive patients who underwent 1- to 2-level instrumented lumbar fusion for degenerative lumbar conditions during the period from 2016 to 2018. Discharge disposition was determined as home or nonhome. A logistic regression analysis was used to determine associations between nonhome discharge and age, sex, body mass index (BMI), race, American Society of Anesthesiologists grade, smoking status, marital status, insurance type, residence in an underserved zip code, and operative factors.RESULTSA total of 1502 patients were included. The majority (81%) were discharged home. Factors associated with a nonhome discharge were older age, higher BMI, living in an underserved zip code, not being married, being on government insurance, and having more levels fused. Patients discharged to a nonhome facility had longer lengths of hospital stay (5.6 vs 3.0 days, p < 0.001) and significantly increased hospital costs ($21,204 vs $17,518, p < 0.001).CONCLUSIONSIncreased age, greater BMI, residence in an underserved zip code, not being married, and government insurance are drivers for discharge to a nonhome facility after a 1- to 2-level instrumented lumbar fusion. Early identification and intervention for these patients, even before admission, may decrease the length of hospital stay and medical costs.

scholarly journals Correlation of Early Total Leucocyte Count and Red Cell Distribution Width With Outcome in Trauma

2020 ◽  
Author(s):  
Bhavana Chowdary Madineni ◽  
Sreeramulu P N
Keyword(s):  
Hospital Stay ◽  
Leucocyte Count ◽  
Length Of Hospital Stay ◽  
Red Cell Distribution Width ◽  
Total Leucocyte Count ◽  
Trauma Patients ◽  
Red Cell ◽  
Cell Distribution ◽  
Blood Picture ◽  
Distribution Width

Abstract Background: Trauma is the leading cause of death in young adults. Risk stratification in patients with trauma remains challenging. There is a need for a readily available prognostic method to categorise these patients.Aims & Objectives: We aim to measure and correlate red cell distribution width and total leucocyte count in patients presenting with trauma within 24 hours of injury with the outcome.Methods: We included 52 trauma patients who were admitted in RLJH from November 2019 to April 2020, who did not require emergency surgery and analysed prospectively. Complete blood picture within 24 hours of injury was analysed and outcome measured in terms of length of hospital stay. Results: There was a statistically significant correlation found between TLC and Length of hospital stay (p<0.001). The correlation between RDW and Length of hospital stay was not statistically significant. The analysis showed that increased hospital stay was associated with high TLC and RDW% done within 24 hours of injury. Conclusion: TLC and RDW can be used as readily available and simple markers in early prediction of higher morbidity in patients presenting with trauma.

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