Su1707 Length of Hospital Stay in Patients With Advanced Liver Disease in a Large, Tertiary Care Facility

2013 ◽  
Vol 144 (5) ◽  
pp. S-1002
Author(s):  
Caitlin Homberger ◽  
Valerie Martel-Laferriere ◽  
Douglas T. Dieterich
Keyword(s):  
Liver Disease ◽  
Hospital Stay ◽  
Tertiary Care ◽  
Care Facility ◽  
Length Of Hospital Stay ◽  
Advanced Liver Disease ◽  
Tertiary Care Facility ◽  
Large Tertiary Care

Clinical utility of Ektachem-determined bilirubin fractions for classifying adult inpatients.

1987 ◽  
Vol 33 (9) ◽  
pp. 1662-1664 ◽  
Author(s):  
G A Tetrault ◽  
B A Meiklejohn ◽  
C E Sparks
Keyword(s):  
Liver Disease ◽  
Total Bilirubin ◽  
Tertiary Care ◽  
Laboratory Data ◽  
Disease Process ◽  
Care Facility ◽  
Indirect Bilirubin ◽  
Complex Patient ◽  
Tertiary Care Facility ◽  
Parenchymal Liver

Abstract We determined total bilirubin, "direct" and "indirect" bilirubin fractions, and, in parallel, using Ektachem slides, the total, conjugated, unconjugated, and delta bilirubin contents for specimens from 88 adult inpatients at various times during hospitalization in a tertiary-care facility. We wanted to see if the results correlated with the patients' diagnoses, based on a review of medical records and other laboratory data. The patients (including some with mixed disease types) were assigned to one of three predominant disease-process groups: obstructive liver disease, parenchymal liver disease, or hemolytic disease. Ektachem bilirubin fractions and the comparable total, "direct," and "indirect" bilirubin fractions showed equal sensitivity in screening and monitoring disease in all three groups. Measurements of conjugated bilirubin, unconjugated bilirubin, and their sum were sufficient for evaluating bilirubin abnormalities in this complex patient population. Determining delta bilirubin with the total bilirubin slide was rarely useful clinically. Thus, laboratories using Ektachem instrumentation for bilirubin testing can routinely eliminate the extra costs and occasional problems associated with running both bilirubin slides, reserving delta bilirubin determinations for unusual cases.

Communication Preferences Amongst Clinical Faculty at a Large, Tertiary Care Facility [5F]

2016 ◽  
Vol 127 ◽  
pp. 52S
Author(s):  
Jennifer J. Schmitt ◽  
Brian J. Linder ◽  
John B. Gebhart ◽  
Ruchira Singh ◽  
John A. Occhino
Keyword(s):  
Tertiary Care ◽  
Care Facility ◽  
Clinical Faculty ◽  
Communication Preferences ◽  
Tertiary Care Facility ◽  
Large Tertiary Care

scholarly journals Feasibility and Efficacy of a Physical Activity Intervention Among Pregnant Women: The Behaviors Affecting Baby and You (B.A.B.Y.) Study

2011 ◽  
Vol 8 (s2) ◽  
pp. S228-S238 ◽  
Author(s):  
Lisa Chasan-Taber ◽  
Marushka Silveira ◽  
Bess H. Marcus ◽  
Barry Braun ◽  
Edward Stanek ◽  
...  
Keyword(s):  
Physical Activity ◽  
Pregnant Women ◽  
Exercise Intervention ◽  
Physical Activity Intervention ◽  
Tertiary Care ◽  
Care Facility ◽  
Total Activity ◽  
Study Materials ◽  
Tertiary Care Facility ◽  
Large Tertiary Care

Background:Physical activity during pregnancy is associated with reduced risk of adverse maternal and fetal outcomes. However, the majority of pregnant women are inactive and interventions designed to increase exercise during pregnancy are sparse. We evaluated the feasibility and preliminary efficacy of an exercise intervention among a diverse sample of pregnant women.Methods:The B.A.B.Y. (Behaviors Affecting Baby and You) Study is conducted at a large tertiary care facility in Western Massachusetts. We randomized 110 prenatal care patients (60% Hispanic) to an individually tailored 12-week exercise intervention arm (n = 58) or to a health and wellness control arm (n = 52) at mean = 11.9 weeks gestation. Physical activity was assessed via the Pregnancy Physical Activity Questionnaire (PPAQ).Results:After the 12-week intervention, the exercise arm experienced a smaller decrease (−1.0 MET-hrs/wk) in total activity vs. the control arm (−10.0 MET-hrs/wk; P = .03), and a higher increase in sports/exercise (0.9 MET-hrs/wk) vs. the control arm (−0.01 MET-hrs/wk; P = .02). Intervention participants (95%) reported being satisfied with the amount of information received and 86% reported finding the study materials interesting and useful.Conclusions:Findings support the feasibility and preliminary efficacy of a tailored exercise intervention in increasing exercise in a diverse sample of pregnant women.

Implementation of Robert's Coping with Labor Algorithm © in a large tertiary care facility

Midwifery ◽  
2017 ◽  
Vol 50 ◽  
pp. 208-218 ◽  
Author(s):  
Esther Fairchild ◽  
Leissa Roberts ◽  
Karen Zelman ◽  
Shelley Michelli ◽  
Marie Hastings-Tolsma
Keyword(s):  
Tertiary Care ◽  
Care Facility ◽  
Tertiary Care Facility ◽  
Large Tertiary Care

Assessing Acute St-Elevation Myocardial Infarction With Prognostic Significance Of The Hyponatramia

2020 ◽  
Vol 11 (3) ◽  
pp. 3251-3260
Author(s):  
Makrand B Mane
Keyword(s):  
Myocardial Infarction ◽  
Ejection Fraction ◽  
Tertiary Care ◽  
Prognostic Significance ◽  
Care Facility ◽  
Early Death ◽  
Public Health Issue ◽  
Care Hospital ◽  
Tertiary Care Facility ◽  
Significant Public Health

Acute Myocardial Infarction (AMI) has become a significant public health issue in developed and developing nations, following extensive diagnostic and management research over recent decades. The study intended to research the prognostic values of inexplicable Hyponatremia in patients with severe STelevation of myocardial infarction, in 100 consecutive patients admitted to Tertiary care hospital. In the analysis, identified patients on admission were diagnosed with or produced Hyponatremia within 72 hours—a lower ejection fraction than those with usual amounts of sodium. The research aimed to evaluate the prognosis significance of Hyponatremia for the estimation of early death in acute ST-elevated myocardial infarction. One hundred straight patients admitted in the Coronary Centre Tertiary Care Facility with severe STelevated myocardial infarction were studied. The data of the study on various risk factors in association with the development of Hyponatremia like as age, sex, use of tobacco, diabetes, hypertension, ejection fraction etc. were analyzed. Thus, the researchers reported that in patients diagnosed with severe ST section escalation, Hyponatremia showed the initial emergence of hyponatremia myocardial infarctions. This condition correlates with the severity of LV dysfunction (in term of LVEF) and can be considered as an individual early death indicator as well as a prediction exacerbates with hyponatremia frequency.

Prevalence, Correlates and Management of Hyperglycemia in Diabetic Non-critically Ill Patients at a Tertiary Care Center in Lebanon

2019 ◽  
Vol 15 (2) ◽  
pp. 133-140 ◽  
Author(s):  
Ghada El Khoury ◽  
Hanine Mansour ◽  
Wissam K. Kabbara ◽  
Nibal Chamoun ◽  
Nadim Atallah ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Care Center ◽  
Descriptive Analysis ◽  
Tertiary Care ◽  
Multivariable Analysis ◽  
Length Of Hospital Stay ◽  
Retrospective Chart Review ◽  
Diabetic Patients

Background: Diabetes Mellitus is a chronic metabolic disease that affects 387 million people around the world. Episodes of hyperglycemia in hospitalized diabetic patients are associated with poor clinical outcomes and increased morbidity and mortality. Therefore, prevention of hyperglycemia is critical to decrease the length of hospital stay and to reduce complications and readmissions. Objective: The study aims to examine the prevalence of hyperglycemia and assess the correlates and management of hyperglycemia in diabetic non-critically ill patients. Methods: The study was conducted on the medical wards of a tertiary care teaching hospital in Lebanon. A retrospective chart review was conducted from January 2014 until September 2015. Diabetic patients admitted to Internal Medicine floors were identified. Descriptive analysis was first carried out, followed by a multivariable analysis to study the correlates of hyperglycemia occurrence. Results: A total of 235 medical charts were reviewed. Seventy percent of participants suffered from hyperglycemia during their hospital stay. The identified significant positive correlates for inpatient hyperglycemia, were the use of insulin sliding scale alone (OR=16.438 ± 6.765-39.941, p=0.001) and the low frequency of glucose monitoring. Measuring glucose every 8 hours (OR= 3.583 ± 1.506-8.524, p=0.004) and/or every 12 hours (OR=7.647 ± 0.704-79.231, p=0.0095) was associated with hyperglycemia. The major factor perceived by nurses as a barrier to successful hyperglycemia management was the lack of knowledge about appropriate insulin use (87.5%). Conclusion: Considerable mismanagement of hyperglycemia in diabetic non-critically ill patients exists; indicating a compelling need for the development and implementation of protocol-driven insulin order forms a comprehensive education plan on the appropriate use of insulin.

scholarly journals A Study of Factors Affecting the Length of Hospital Stay of COVID-19 Patients by Cox-Proportional Hazard Model in a South Indian Tertiary Care Hospital

2021 ◽  
Vol 12 ◽  
pp. 215013272110002
Author(s):  
Gayathri Thiruvengadam ◽  
Marappa Lakshmi ◽  
Ravanan Ramanujam
Keyword(s):  
Hospital Stay ◽  
Tertiary Care ◽  
Length Of Hospital Stay ◽  
Hazard Model ◽  
Cox Proportional Hazard Model ◽  
Care Hospital ◽  
Proportional Hazard ◽  
Proportional Hazard Model ◽  
Cox Proportional Hazard ◽  
South Indian

Background: The objective of the study was to identify the factors that alter the length of hospital stay of COVID-19 patients so we have an estimate of the duration of hospitalization of patients. To achieve this, we used a time to event analysis to arrive at factors that could alter the length of hospital stay, aiding in planning additional beds for any future rise in cases. Methods: Information about COVID-19 patients was collected between June and August 2020. The response variable was the time from admission to discharge of patients. Cox proportional hazard model was used to identify the factors that were associated with the length of hospital stay. Results: A total of 730 COVID-19 patients were included, of which 675 (92.5%) recovered and 55 (7.5%) were considered to be right-censored, that is, the patient died or was discharged against medical advice. The median length of hospital stay of COVID-19 patients who were hospitalized was found to be 7 days by the Kaplan Meier curve. The covariates that prolonged the length of hospital stay were found to be abnormalities in oxygen saturation (HR = 0.446, P < .001), neutrophil-lymphocyte ratio (HR = 0.742, P = .003), levels of D-dimer (HR = 0.60, P = .002), lactate dehydrogenase (HR = 0.717, P = .002), and ferritin (HR = 0.763, P = .037). Also, patients who had more than 2 chronic diseases had a significantly longer length of stay (HR = 0.586, P = .008) compared to those with no comorbidities. Conclusion: Factors that are associated with prolonged length of hospital stay of patients need to be considered in planning bed strength on a contingency basis.

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