Detection and resolution of drug-related problems at hospital discharge focusing on information availability – a retrospective analysis

Background We performed a retrospective analysis to evaluate the efficacy of VA-ECMO support in cardiogenic shock based on various etiologies. Methods We retrospectively analyzed 99 patients supported with VA-ECMO from January 1, 2012 to January 1, 2015. Outcomes included survival to discontinuation of VA-ECMO support and survival to hospital discharge. The etiologies of cardiogenic shock included cardiac arrest (CPR), acute myocardial infarction (AMI), decompensated congestive heart failure (CHF), pulmonary embolism (PE), right ventricular failure (RVF) not secondary to an acute pulmonary embolism, and post-cardiotomy syndrome (PCS). The PCS group was used as a reference group; odds ratios were estimated and Fisher’s exact tests were performed to compare each other group to the reference. Results Patients supported with VA-ECMO due to PE and CHF had better survival to hospital discharge (83.3% and 54.2%, with p = 0.003 and p = 0.011, respectively) versus the PCS group (7.7%). The PE, CHF, and AMI groups had statistically improved survival to VA-ECMO discontinuation. There was no statistically significant difference in survival to VA-ECMO discontinuation or hospital discharge in four subgroup analyses. Conclusions Patients supported with VA-ECMO in cardiogenic shock due to PE or CHF demonstrated increased rates of survival to hospital discharge when compared to the PCS group. This study also highlights the need for a more uniform system of categorizing etiologies of cardiogenic shock.

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Impact of early intravenous amiodarone administration on neurological outcome in refractory ventricular fibrillation: retrospective analysis of prospectively collected prehospital data

Scandinavian Journal of Trauma Resuscitation and Emergency Medicine ◽

10.1186/s13049-019-0688-1 ◽

2019 ◽

Vol 27 (1) ◽

Cited By ~ 1

Author(s):

Dong Keon Lee ◽

Yu Jin Kim ◽

Giwoon Kim ◽

Choung Ah. Lee ◽

Hyung Jun Moon ◽

...

Keyword(s):

Logistic Regression ◽

Ventricular Fibrillation ◽

Retrospective Analysis ◽

Hospital Discharge ◽

Neurological Outcome ◽

Optimal Time ◽

Time Interval ◽

Administration Interval ◽

Incoming Call ◽

Intravenous Amiodarone

Abstract Background The 2015 AHA guidelines recommend that amiodarone should be used for patients with refractory ventricular fibrillation (RVF). However, the optimal time interval between the incoming call and amiodarone administration (call-to-amiodarone administration interval) in RVF patients has not been investigated. We hypothesized that the time elapsed until amiodarone administration could affect the neurological outcome at hospital discharge in patients with RVF. Methods and results This study is a retrospective analysis of prospectively collected data. One hundred thirty-four patients were enrolled. In univariate logistic regression, the probability of a good neurological outcome at hospital discharge decreased as the time elapsed until amiodarone administration increased (OR 0.89 [95% CI = 0.80–0.99]). In multivariate logistic regression, the patients who were administered amiodarone in less than 20 min showed higher rates of prehospital ROSC, survival at hospital arrival, any ROSC, survival at admission, survival to discharge, and good CPC at hospital discharge. The call-to-amiodarone administration interval of ≤20 min (OR 6.92, 95% CI 1.72–27.80) was the independent factor affecting the neurological outcome at hospital discharge. Conclusion Early amiodarone administration (≤ 20 min) showed better neurological outcome at hospital discharge for OHCA patients who showed initial ventricular fibrillation and subsequent RVF.

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A retrospective analysis of hospital discharge records forS. pneumoniaediseases in the elderly population of Florence, Italy, 2010–2012

Human Vaccines & Immunotherapeutics ◽

10.4161/hv.34418 ◽

2014 ◽

Vol 11 (1) ◽

pp. 156-165 ◽

Cited By ~ 4

Author(s):

Angela Bechini ◽

Cristina Taddei ◽

Alessandro Barchielli ◽

Miriam Levi ◽

Emilia Tiscione ◽

...

Keyword(s):

Retrospective Analysis ◽

Hospital Discharge ◽

Elderly Population ◽

The Elderly ◽

Hospital Discharge Records

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Incidence of HIP Fractures among the Elderly in Satakunta, Finland

Scandinavian Journal of Surgery ◽

10.1177/145749690709600312 ◽

2007 ◽

Vol 96 (3) ◽

pp. 256-260 ◽

Cited By ~ 6

Author(s):

P. T. Jaatinen ◽

J. Panula ◽

P. Aarnio ◽

S.-L. Kivelä

Keyword(s):

Seasonal Variation ◽

Hip Fracture ◽

Retrospective Analysis ◽

Incidence Rate ◽

Hospital Discharge ◽

Hip Fractures ◽

The Elderly ◽

Specific Region ◽

Hospital Discharge Register ◽

Previous Fracture

Background and Aims: The aim was to describe the incidence rate of hip fractures in the elderly in a specific region in Finland and circumstances around them. Material and Methods: Retrospective analysis of 461 women and men aged 65 or older undergoing an operation for hip fracture during a two-year period between 1999 and 2000. 80 variables in all were obtained from the hospital discharge register and patient documents. Results: The age-specific incidence of hip fractures was higher in women than in men (women 6.88/1000 person/y vs. 3.50/1000 person/y). Prior to the fracture, patients were primarily doing well; 63.4% lived at home and 65.1% used no mobility equipment or aids. Altogether 41.9% of hip fractures occurred in institutions. Both women and men more often suffered their injury indoors (91.1% and 75.7% respectively), and only a slight seasonal variation was observed. More than every fourth (26.9%) had experienced a previous fracture. Conclusions: The age-specific incidence of hip fractures was higher in women than in men. The fractures took place mostly indoors and often in institutions. Therefore the measures that impact on indoor safety are particularly important for the elderly.

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Pharmaceutical orientation at hospital discharge of transplant patients: strategy for patient safety

Einstein (São Paulo) ◽

10.1590/s1679-45082016ao3481 ◽

2016 ◽

Vol 14 (3) ◽

pp. 359-365 ◽

Cited By ~ 5

Author(s):

Lívia Falcão Lima ◽

Bruna Cristina Cardoso Martins ◽

Francisco Roberto Pereira de Oliveira ◽

Rafaela Michele de Andrade Cavalcante ◽

Vanessa Pinto Magalhães ◽

...

Keyword(s):

Patient Safety ◽

Drug Therapy ◽

Hospital Discharge ◽

Clinical Pharmacist ◽

Multidisciplinary Team ◽

Drug Related Problems ◽

Negative Outcomes ◽

Hospital Discharges ◽

Cross Sectional ◽

Transplant Patients

ABSTRACT Objective: To describe and analyze the pharmaceutical orientation given at hospital discharge of transplant patients. Methods: This was a cross-sectional, descriptive and retrospective study that used records of orientation given by the clinical pharmacist in the inpatients unit of the Kidney and Liver Transplant Department, at Hospital Universitário Walter Cantídio, in the city of Fortaleza (CE), Brazil, from January to July, 2014. The following variables recorded at the Clinical Pharmacy Database were analyzed according to their significance and clinical outcomes: pharmaceutical orientation at hospital discharge, drug-related problems and negative outcomes associated with medication, and pharmaceutical interventions performed. Results: The first post-transplant hospital discharge involved the entire multidisciplinary team and the pharmacist was responsible for orienting about drug therapy. The mean hospital discharges/month with pharmaceutical orientation during the study period was 10.6±1.3, totaling 74 orientations. The prescribed drug therapy had a mean of 9.1±2.7 medications per patient. Fifty-nine drug-related problems were identified, in which 67.8% were related to non-prescription of medication needed, resulting in 89.8% of risk of negative outcomes associated with medications due to untreated health problems. The request for inclusion of drugs (66.1%) was the main intervention, and 49.2% of the medications had some action in the digestive tract or metabolism. All interventions were classified as appropriate, and 86.4% of them we able to prevent negative outcomes. Conclusion: Upon discharge of a transplanted patient, the orientation given by the clinical pharmacist together with the multidisciplinary team is important to avoid negative outcomes associated with drug therapy, assuring medication reconciliation and patient safety.

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Pediatric ambulatory care sensitive admission and deprivation index, ten years retrospective analysis

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.540 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

F Cedrone ◽

P Di Giovanni ◽

M D'Addezio ◽

G Di Martino ◽

M Masciarelli ◽

...

Keyword(s):

Socioeconomic Status ◽

Ambulatory Care ◽

Retrospective Analysis ◽

Hospital Discharge ◽

Community Care ◽

Deprivation Index ◽

Lower Socioeconomic Status ◽

Lower Socioeconomic ◽

Hospital Discharge Records ◽

Ambulatory Care Sensitive

Abstract Background Ambulatory Care Sensitive Conditions (ACSCs) are conditions where effective community care and case management can help prevent the need for hospital admission. Even if the ACSC episode itself is managed well, an emergency admission for an ACSC is often symptom of overall poor quality of primary and community care. Lower socioeconomic status individuals show higher rates of hospitalization due to ACSCs. The purposes of this study is to examine the association between socioeconomic status and the risk of hospitalization due to an ACSC in pediatric population through a retrospective analysis of administrative data of the Abruzzo region. Methods We identified hospital discharge records from 2008 to 2018 of subjects under 18 years of age to take into consideration for the study. Hospitalizations due to ACSCs were selected by ICD9-CM coding developed by Billings et al. and implemented by Lu et al. For establishing the socioeconomic status, we used the Italian Deprivation Index (IDI) developed by Caranci et al. as a categorical variable expressed in quintiles. A multilevel logistic regression model was implemented using ACSC vs non ACSC hospitalization as dependent variables. Results In the study period, a total of 317,586 hospital discharge records were selected, 18059 (5.69%) of which related to ambulatory care sensitive hospitalization. After correcting for age, gender, and citizenship, ACSCs hospitalization was associated with lower IDI (aOR1.21;CI95%1.09-1.34) and a slight gradient as the deprivation increased. Moreover, it was also associated with emergency department admission (aOR6.53;CI95%6.19-6.89). Conclusions Avoidable hospitalization in pediatric settings is associated with lower socioeconomic status computed by IDI. This study confirms inequity in primary care or community care after adjusting for age, gender and citizenship. Italian deprivation index represents a useful tool to identify population and areas where improving prevention is necessary. Key messages The Italian deprivation index could be used to implement primary and community care strategies in pediatric settings. Socio-economic factors are associated with the performance of the health services.

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