Sa1361 PATIENT-CONTROLLED ANALGESIA LEADS TO INCREASED HOSPITAL LENGTH OF STAY, GREATER TIME TO ORAL INTAKE, AND HIGHER RATES OF OUTPATIENT OPIOID USAGE COMPARED TO CONVENTIONAL IV PUSH ADMINISTRATION IN ACUTE PANCREATITIS

Objectives: To compare the characteristics and outcomes of patients presenting to hospital with alcohol-induced and gallstone-induced acute pancreatitis. Methods: Retrospective study of all patients with alcohol-induced or gallstone-induced pancreatitis during the period 1 June 2012 to 31 May 2016. The primary outcome measure was hospital mortality. Secondary outcome measures included hospital length of stay, requirements for intensive care unit admission, intensive care unit mortality, mechanical ventilation, renal replacement therapy, requirement of inotropes and total parenteral nutrition. Results: A total of 642 consecutive patients (49% alcohol; 51% gallstone) were included. No statistically significant differences were found between alcohol-induced and gallstone-induced acute pancreatitis with respect to hospital mortality, requirement for intensive care unit admission, intensive care unit mortality and requirement for mechanical ventilation, renal replacement therapy, inotropes or total parenteral nutrition. There was significant difference in hospital length of stay (3.07 versus 4.84; p < 0.0001). On multivariable regression analysis, Bedside Index of Severity in Acute Pancreatitis score (estimate: 0.393; standard error: 0.058; p < 0.0001) and admission haematocrit (estimate: 0.025; standard error: 0.008; p = 0.002) were found to be independently associated with prolonged hospital length of stay. Conclusion: Hospital mortality did not differ between patients with alcohol-induced and gallstone-induced acute pancreatitis. The duration of hospital stay was longer with gallstone-induced pancreatitis. Bedside Index of Severity in Acute Pancreatitis score and admission haematocrit were independently associated with hospital length of stay.

Download Full-text

The clinical traits of acute pancreatitis in aging patients: a retrospective analysis of 473 cases

10.21203/rs.2.24010/v1 ◽

2020 ◽

Author(s):

Nonghua Lu ◽

Bingjun Yu ◽

Fengwen Xie

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Acute Pancreatitis ◽

Intensive Care ◽

Abdominal Pain ◽

Length Of Stay ◽

Organ Failure ◽

Death Rate ◽

Hospital Length ◽

Hospital Length Of Stay

Abstract Background The incidence of acute pancreatitis in aging patients has increasing in recent years. Controversial results about clinical outcomes of acute pancreatitis in aging patients were reported in different literature. The aim of our study was to compare the clinical outcomes of AP in aging patients between 60-79 years old and over 80 years old. Methods 80 patients aged ≥ 80 years old(oldest group) were compared to 393 patients aged 60 to 79 years old(older group). The clinical course, biochemical, radiological data were enrolled. The primary endpoint was to compare the death rate, intensive care unit admission rate and in-hospital length of stay(LOS). The secondary endpoint was operative treatment and the complications of AP. Results Abdominal symptom of abdominal pain (61.3% vs 46.3%, P=0.013) was less in oldest group, while diarrhea(18.3% vs 30.0%, P=0.018), jaundice(8.9% vs 17.5%, P=0.021), dyspnea(11.5% vs 26.3%, P=0.001) were more obvious in older group than oldest group. A higher death rate (8.9% vs 16.3%, P = 0.003) and longer hospital length of stay (11.51±10.19 vs 15.26±11.04, P = 0.001) were found in aging patients aged ≥80 years old. Mean BMI was lower in oldest group compared to older group(22.36±2.89 vs 21.07±3.18, P = 0.001). Multivariate analysis identified aged over 80 years(OR 3.299, 95%CI 1.316-8.269, P=0.011) and organ failure(P<0.05) as independent risk factors of mortality. More severe of AP(OR 11.722, 95%CI 4.780-28.764, P=0.001), abdominal pain(OR 1.906, 95%CI 1.052-3.453, P=0.033) and organ failure(P<0.05) were recognized as influencing intensive care unit rate. Aging patients aged over 80 years old(OR 0.149, 95%CI 2.027-6.268, P=0.001), more severe of AP(OR 0.218, 95%CI 1.567-4.322, P=0.001), female(OR 0.093, 95%CI 0.336-3.542, P=0.018), Jaundice(OR 0.080, 95%CI 0.146-5.324, P=0.038), operative treatment(P<0.05) and organ failure(P<0.05) were the risk factors for LOS.

Download Full-text

A Combined Paging Alert and Web-Based Instrument Alters Clinician Behavior and Shortens Hospital Length of Stay in Acute Pancreatitis

The American Journal of Gastroenterology ◽

10.1038/ajg.2013.282 ◽

2014 ◽

Vol 109 (3) ◽

pp. 306-315 ◽

Cited By ~ 19

Author(s):

Matthew J DiMagno ◽

Erik-Jan Wamsteker ◽

Rafat S Rizk ◽

Joshua P Spaete ◽

Suraj Gupta ◽

...

Keyword(s):

Acute Pancreatitis ◽

Length Of Stay ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Web Based

Download Full-text

Factors Predicting Hospital Length of Stay Following Pharyngeal Flap for Velopharyngeal Insufficiency

The Cleft Palate-Craniofacial Journal ◽

10.1177/1055665617732776 ◽

2017 ◽

Vol 55 (3) ◽

pp. 362-368 ◽

Cited By ~ 2

Author(s):

Jerry W. Chao ◽

Michael J. Boyajian ◽

Richard L. Amdur ◽

Benjamin J. Mitchell ◽

Gary F. Rogers ◽

...

Keyword(s):

Length Of Stay ◽

Tertiary Care ◽

Oral Intake ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Velopharyngeal Insufficiency ◽

Short Stay ◽

Pharyngeal Flap ◽

Discharge Criteria ◽

Observation Period

Objective: Routine hospital admission following pharyngeal flap (PF) to correct velopharyngeal insufficiency (VPI) is the standard at most hospitals. Nevertheless, there is increasing resistance from third-party providers to approve stays longer than a “short stay” (23-hour) observation period. The purpose of the current study was to evaluate length of stay (LOS) and document potential influencing factors following PF. Design: Retrospective chart review. Demographic and perioperative data were collected, and statistical analyses were performed to determine associations with hospital length of stay (LOS). Readiness for discharge was determined by oral intake, analgesic requirement, and respiratory status. Setting: Tertiary care children’s hospital Participants: All patients undergoing PF for VPI between 1990 and 2014. Outcome measures: (1) LOS, (2) % satisfying all discharge criteria within a 23-hour observational time frame. Results: Seventy-five patients were studied, with an average age of 6.8 years. Mean LOS was 65.4 hours. Only 11 patients (14.9%) met all discharge criteria by 23 hours. Multivariate predictors of shorter LOS were increasing patient age, male gender, lack of syndromic association, administration of an intraoperative antiemetic and steroids, and shorter anesthetic duration. Time to first oral intake correlated positively with LOS. Administration of intraoperative antiemetics increased the odds of meeting all discharge criteria within 23 hours by a factor of 12. Conclusions: Identification of factors associated with LOS after PF may allow providers to predict and potentially mitigate hospital stays. Nevertheless, most patients undergoing PF are not clinically ready for discharge within a short-stay (23-hour) observation period.

Download Full-text