Consumption of dietary health supplements among hospitalized patients at an acute tertiary Hospital

Background: The objective of the study was to determine the prevalence of hyponatremia (HN) and its associated morbimortality in hospitalized patients receiving parenteral nutrition (PN). Methods: A retrospective study including 222 patients receiving total PN (parenteral nutrition group [PNG]) over a 7-month period in a tertiary hospital and 176 matched to 179 control subjects without PN (control subjects group [CSG]). Demographic data, Charlson Comorbidity Index (CCI), date of HN detection-(serum sodium or SNa <135 mmol/L)-intrahospital mortality, and hospital length-of-stay (LOS) were registered. In the PNG, body mass index (BMI) and SNa before, during, and after PN were recorded. Results: HN was more prevalent in the PNG: 52.8 vs. 35.8% (p = 0.001), and independent of age, gender, or CCI (OR 1.8 [95% CI 1.1-2.8], p = 0.006). In patients on PN, sustained HN (75% of all intraindividual SNa <135 mmol/L) was associated with a higher mortality rate independent of age, gender, CCI, or BMI (OR 7.38 [95% CI 1.07-50.8], p = 0.042). The absence of HN in PN patients was associated with a shorter hospital LOS (<30 days) and was independent of other comorbidities (OR 3.89 [95% CI 2.11-7.18], p = 0.001). Conclusions: HN is more prevalent in patients on PN. Sustained HN is associated with a higher intrahospital mortality rate. Absence of HN is associated with a shorter hospital LOS.

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Changing Pattern of Antibiotics Usage Among Hospitalized Patients of a Tertiary Hospital in South Korea: 2004–2013

Open Forum Infectious Diseases ◽

10.1093/ofid/ofx163.772 ◽

2017 ◽

Vol 4 (suppl_1) ◽

pp. S327-S327

Author(s):

Bongyoung Kim ◽

Hyeonjun Hwang ◽

Myoung-Jae Lee ◽

Jieun Kim ◽

Hyunjoo Pai

Keyword(s):

South Korea ◽

Broad Spectrum ◽

Anatomical Therapeutic Chemical ◽

Tertiary Hospital ◽

Hospitalized Patients ◽

World Health ◽

Defined Daily Dose ◽

University Hospitals ◽

Stepwise Increase ◽

Broad Spectrum Antibiotics

Abstract Background This study was performed to evaluate the changing pattern of antibiotics usage among hospitalized patients of tertiary hospital in South Korea. Methods Total antibiotics prescription record of hospitalized patients from 2004 to 2013 were collected at a tertiary university hospitals. The antibiotics is defined as class J01 from anatomical therapeutic chemical classification system (ATC). The consumption of each class of antibiotic was converted to defined daily dose (DDD)/1,000 patient-days by using ATC of World Health Organization. Results Over the 10-year study period, the annual consumption of systemic antibiotics ranged from 815.10 to 1047.96. The proportion of broad-spectrum antibiotics and non-broad-spectrum antibiotics use are as follows: 45.4% (417.55/920.69) vs.. 54.6% (503.15/920.69), respectively. A 16.9% of decrease in total antibiotics consumption was observed in 2013 compared with 2004 (1000.69 in 2004 vs.. 831.46 in 2013). The decrease rate of non-broad spectrum antibiotics usage was 39.3% during the study period (607.21 in 2004 vs. 368.88 in 2013). In contrast, a stepwise increase in consumption of broad-spectrum antibiotics was observed (14.9% of increase; 393.48 in 2004 vs. 462.58 in 2013). Among broad-spectrum antibiotics, a significant decrease trend was observed for third-generation cephaloporins (P < 0.001). In contrast, a significant increase trend was observed for β-lactam/lactamase (P < 0.001). The monthly overall consumption trend of fluoroquinolones and glycopeptides remained stable (P = 0.061; P = 0.107, respectively). In addition, there were significant decrease trends for consumption of non-broad-spectrum antibiotics, including first generation cephalosporins (P = 0.019) and aminoglycosides (P = 0.004). However, the consumption of second generation cephalosporins, imidazole and penicillins showed a stable trend (P = 0.175; P = 320; P = 0.234, respectively). Conclusion A total antibiotics consumption showed significantly decrease trend from 2004 to 2013. In contrast, a stepwise increase in consumption of broad-spectrum antibiotics was observed in the tertiary hospital in South Korea. Disclosures All authors: No reported disclosures.

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Low ALT values amongst hospitalized patients are associated with increased risk of hypoglycemia and overall mortality: a retrospective, big-data analysis of 51 831 patients

QJM ◽

10.1093/qjmed/hcaa219 ◽

2020 ◽

Cited By ~ 1

Author(s):

E Itelman ◽

A Segev ◽

L Ahmead ◽

E Leibowitz ◽

M Agbaria ◽

...

Keyword(s):

Electronic Medical Records ◽

Medical Records ◽

Cohort Analysis ◽

Surrogate Marker ◽

Tertiary Hospital ◽

Big Data Analysis ◽

Hospitalized Patients ◽

Retrospective Cohort Analysis ◽

Increased Risk ◽

Overall Mortality

Summary Background Sarcopenia and frailty influence clinical patients’ outcomes. Low alanine aminotransferase (ALT) serum activity is a surrogate marker for sarcopenia and frailty. In-hospital hypoglycemia is associated, also with worse clinical outcomes. Aim We evaluated the association between low ALT, risk of in-hospital hypoglycemia and subsequent mortality. Design This was a retrospective cohort analysis. Methods We included patients hospitalized in a tertiary hospital between 2007 and 2019. Patients’ data were retrieved from their electronic medical records. Results The cohort included 51 831 patients (average age 70.88). The rate of hypoglycemia was 10.8% (amongst diabetics 19.4% whereas in non-diabetics 8.3%). The rate of hypoglycemia was higher amongst patients with ALT < 10 IU/l in the whole cohort (14.3% vs. 10.4%, P < 0.001) as well as amongst diabetics (24.6% vs. 18.8%, P < 0.001). Both the overall and in-hospital mortality were higher in the low ALT group (57.7% vs. 39.1% P < 0.001 and 4.3% vs. 3.2%, P < 0.001). A propensity score matching, after which a regression model was performed, showed that patients with ALT levels < 10 IU/l had higher risk of overall mortality (HR = 1.21, CI 1.13–1.29, P < 0.001). Conclusions Low ALT values amongst hospitalized patients are associated with increased risk of in-hospital hypoglycemia and overall mortality.

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Respiratory syncytial virus burden of disease in hospitalized patients in a Spanish tertiary hospital

Infectious Diseases ◽

10.1080/23744235.2020.1726448 ◽

2020 ◽

Vol 52 (6) ◽

pp. 434-436

Author(s):

Jésica Abadía Otero ◽

Graciela López Muñiz ◽

Miriam Gabella Martín ◽

Marta Dominguez-Gil González ◽

Marta Cobos Siles ◽

...

Keyword(s):

Respiratory Syncytial Virus ◽

Burden Of Disease ◽

Tertiary Hospital ◽

Hospitalized Patients ◽

Syncytial Virus

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Clinical characteristics and outcomes of hospitalized patients with 2009 H1N1 influenza in a large acute care tertiary hospital, Singapore

American Journal of Infection Control ◽

10.1016/j.ajic.2010.11.015 ◽

2011 ◽

Vol 39 (8) ◽

pp. e49-e51

Author(s):

Yin Maw Hsann ◽

Sue Ping Thang ◽

Zakir-Hussain Abdul Salam ◽

Yong Yang ◽

Vincent Sui-Leong Lim ◽

...

Keyword(s):

Acute Care ◽

Clinical Characteristics ◽

H1n1 Influenza ◽

Tertiary Hospital ◽

Hospitalized Patients ◽

2009 H1n1

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Acute Kidney Injury In Hospitalized Patients Who Underwent Percutaneous Kidney Biopsy

10.21203/rs.2.10344/v1 ◽

2019 ◽

Author(s):

Henrique Pinheiro Konigsfeld ◽

Thais Oliveira Claizoni Dos Santos ◽

Tatiana Garcia Viana ◽

Suzy Cristine Pereira ◽

Gianna Mastroianni Kirsztajn ◽

...

Keyword(s):

Acute Kidney Injury ◽

Kidney Disease ◽

Kidney Biopsy ◽

Density Lipoprotein ◽

Kidney Injury ◽

Tertiary Hospital ◽

Epidemiological Studies ◽

Hospitalized Patients ◽

Baseline Serum ◽

Primary Indication

Abstract Background Performing a kidney biopsy is necessary to accurately diagnose diseases such as glomerulonephritis and tubulointerstitial nephritis, among other such conditions. These conditions predispose patients to chronic kidney disease, as well as acute kidney injury (AKI). Notably, most epidemiological studies describing AKI have not investigated this patient population. Methods Included patients admitted to the nephrology ward of a tertiary hospital who underwent percutaneous kidney biopsy. AKI was diagnosed based on the Kidney Disease: Improving Global Outcomes criteria. Results Of the 223 patients investigated, 140 (62.8%) showed AKI. Of these, 91 (65%), 19 (13.6%), and 30 (21.4%) presented with AKI classified as stages 1, 2, and 3, respectively. The primary indication for performing biopsy was nephrotic syndrome or nephrotic proteinuria (73 [52.1%] in the AKI vs. 51 [61.4%] in the non-AKI group, p=0.048). Focal segmental glomerulosclerosis was the most prevalent primary disease (24 [17.1%] in the AKI vs. 15 [18.0%] in the non-AKI group, p=0.150). Multivariate analysis of risk factors associated with AKI showed hemoglobin levels (odds ratio [OR] 0.805, 95% confidence interval [CI] 0.681–0.951, p=0.011), serum high-density lipoprotein cholesterol levels (HDL-c, OR 0.970, 95% CI 0.949–0.992, p=0.008), and baseline serum creatinine levels (OR 2.703, 95% CI 1.471–4.968, p=0.001) were significantly associated with AKI. Conclusions We observed a high incidence of AKI in hospitalized patients who underwent kidney biopsy to investigate their renal disease, particularly glomerulonephritis. Higher levels of hemoglobin and serum HDL-c were associated with a lower risk of AKI.

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Acute Diverticulitis Is at Significant Risk of Malnutrition: an Analysis of Hospitalized Patients in a Medicine Department

Journal of Gastrointestinal and Liver Diseases ◽

10.15403/jgld-561 ◽

2020 ◽

Vol 28 ◽

pp. 53-56

Author(s):

GianMarco Giorgetti ◽

Federica Fabiocchi ◽

Giovanni Brandimarte ◽

Antonio Tursi

Keyword(s):

Nutritional Status ◽

Hospital Stay ◽

Large Scale ◽

Acute Diverticulitis ◽

Significant Risk ◽

Length Of Hospital Stay ◽

Tertiary Hospital ◽

Hospitalized Patients ◽

Nutritional Risk ◽

Medicine Department

Background and Aim: The Nutritional Risk Security (NRS2002) System is recommended for hospitalized patients in order to assess their nutritional status. However, studies assessing large-scale systematic screening policies are lacking. The aim of this study was to assess the feasibility of implementing a screening strategy concerning all admissions for diverticular disease (DD) of the colon in the Department of Medicine of a Tertiary Hospital. Methods: All patients suffering from acute diverticulitis (AD) and admitted to the Medicine Department from January 1st to 31 December 2017, were pre-screened by NRS2002 System by the nursing staff of the Nutritional team at the day of the admission. If the pre-screening was positive, the patients were referred to a supplementary assessment performed by a dietician. Results: The global number of admissions in the observational period was 4,667 and 133 patients suffered from AD. A positive pre-screening test was recorded in 97 (72.9%) patients: a NRS2002 score > 3, describing a severe impaired nutritional status was found in 61 patients (62.9%). All 97 patients with a NRS2002 positive screening received initial nutritional support by oral supplements (17 patients, 17.52%) or enteral nutrition (22 patients, 22.68%) or total parenteral nutrition (58 patients, 59.8%). The mean length of hospital stay for all 133 patients was 6,9 days. However, the length of hospital stay was significantly longer for patients with a positive NRS2002, with a mean of 18 days (p= 0.01) Conclusions: A large number of hospitalized patients due to AD are at nutritional risk and have a significantly longer hospital stay.

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Bloodstream infections caused by ST2 Acinetobacter baumannii : Risk factors, antibiotic regimens, and virulence over 6 years period in China

10.21203/rs.3.rs-60220/v3 ◽

2020 ◽

Author(s):

Kaihang Yu ◽

Weiliang Zeng ◽

Ye Xu ◽

Wenli Liao ◽

Wenya Xu ◽

...

Keyword(s):

Risk Factors ◽

Acinetobacter Baumannii ◽

Bloodstream Infection ◽

Bloodstream Infections ◽

Tertiary Hospital ◽

Multidrug Resistant ◽

High Serum ◽

Hospitalized Patients ◽

Effective Treatment Option ◽

Difficult Challenge

Abstract Background: Bloodstream infection (BSI) caused by multidrug-resistant Acinetobacter baumannii (MDR-AB) has been increasingly observed among hospitalized patients. The following study analyzed the epidemiology and microbiological characteristics of MDR-AB, as well as the clinical features, antimicrobial treatments, and outcomes in patients over a six years period in ChinaMethods: This retrospective study was conducted in a large tertiary hospital in China between January 2013 and December 2018. The clinical and microbiological data of all consecutive hospitalized patients with MDR-AB induced bloodstream infection were included and analyzed. Results: A total of 108 BSI episodes were analyzed. All MDR isolates belonged to ST2, a sequence type that has spread all over the world. Overall, ST2 strains showed strong biofilm formation ability, high serum resistance, and high pathogenicity. As for the clinical characteristics of the patient, 30-day mortality was 69.4% (75/108). The three main risk factors included mechanical ventilation, intensive care unit (ICU) stay, and thrombocytopenia; three protective factors included a change of antimicrobial regimen within 48 h after positive blood culture, use of the antibacterial agent combination, and more inpatient days. The most effective antibacterial regimen was the combination of cefoperazone/sulbactam and tigecycline.Conclusions: BSI caused by ST2 A.baumannii represents a difficult challenge for physicians, considering the high mortality associated with this infection. The combination of cefoperazone/sulbactam and tigecycline may be an effective treatment option.

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