IMPACT OF EARLY DIURETIC ADMINISTRATION ON IN-HOSPITAL MORTALITY AND LENGTH OF HOSPITAL STAY AMONG PATIENTS WITH ACUTE CONGESTIVE HEART FAILURE: A META-ANALYSIS

2020 ◽  
Vol 75 (11) ◽  
pp. 1054
Author(s):  
Adnan Ahmed ◽  
Dhiran Verghese ◽  
Faisal Ali ◽  
Manojna Nimmagadda ◽  
Rohan Bodapati ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Hospital Mortality ◽  
Hospital Stay ◽  
Meta Analysis ◽  
Length Of Hospital Stay

scholarly journals Efficacy of probiotics in the prevention of VAP in critically ill ICU patients: an updated systematic review and meta-analysis of randomized control trials

2020 ◽  
Vol 8 (1) ◽  
Author(s):  
Priyam Batra ◽  
Kapil Dev Soni ◽  
Purva Mathur
Keyword(s):  
Systematic Review ◽  
Mechanical Ventilation ◽  
Hospital Mortality ◽  
Hospital Stay ◽  
Critically Ill ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Mean Difference ◽  
Icu Stay ◽  
Length Of Icu Stay

Abstract Introduction Ventilator-associated pneumonia (VAP) is reported as the second most common nosocomial infection among critically ill patients with the incidence ranging from 2 to 16 episodes per 1000 ventilator days. The use of probiotics has been shown to have a promising effect in many RCTs. Our systematic review and meta-analysis were thus planned to determine the effect of probiotic use in critically ill ventilated adult patients on the incidence of VAP, length of hospital stay, length of ICU stay, duration of mechanical ventilation, the incidence of diarrhea, and the incidence of oropharyngeal colonization and in-hospital mortality. Methodology Systematic search of various databases (such as Embase, Cochrane, and Pubmed), published journals, clinical trials, and abstracts of the various major conferences were made to obtain the RCTs which compare probiotics with placebo for VAP prevention. The results were expressed as risk ratios or mean differences. Data synthesis was done using statistical software - Review Manager (RevMan) Version 5.4 (The Cochrane Collaboration, 2020). Results Nine studies met our inclusion criterion and were included in the meta-analysis. The incidence of VAP (risk ratio: 0.70, CI 0.56, 0.88; P = 0.002; I2 = 37%), duration of mechanical ventilation (mean difference −3.75, CI −6.93, −0.58; P 0.02; I2 = 96%), length of ICU stay (mean difference −4.20, CI −6.73, −1.66; P = 0.001; I2 = 84%) and in-hospital mortality (OR 0.73, CI 0.54, 0.98; P = 0.04; I2 = 0%) in the probiotic group was significantly lower than that in the control group. Probiotic administration was not associated with a statistically significant reduction in length of hospital stay (MD −1.94, CI −7.17, 3.28; P = 0.47; I2 = 88%), incidence of oro-pharyngeal colonization (OR 0.59, CI 0.33, 1.04; P = 0.07; I2 = 69%), and incidence of diarrhea (OR 0.59, CI 0.34, 1.03; P = 0.06; I2 = 38%). Discussion Our meta-analysis shows that probiotic administration has a promising role in lowering the incidence of VAP, the duration of mechanical ventilation, length of ICU stay, and in-hospital mortality.

Prognostic Significance of Hyponatremia in Acute Stroke: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 49 (5) ◽  
pp. 531-539
Author(s):  
Shogo Shima ◽  
Yasunari Niimi ◽  
Yosuke Moteki ◽  
Osamu Takahashi ◽  
Shinsuke Sato ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hospital Mortality ◽  
Hospital Stay ◽  
Acute Stroke ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Mean Difference ◽  
Cochrane Library ◽  
Inclusion Criteria ◽  
Stroke Patients

<b><i>Objective:</i></b> Hyponatremia is a common electrolyte disorder in patients with stroke, which leads to various fatal complications. We performed a systematic review and meta-analysis to investigate the outcomes of acute stroke patients with hyponatremia. <b><i>Methods:</i></b> We searched MEDLINE, EMBASE, and the Cochrane Library databases for relevant literature in English published up to March 2020. Two review authors independently screened and selected the studies by assessing the eligibility and validity based on the inclusion criteria. Mortality at 90 days was set as the primary end point, and in-hospital mortality and length of hospital stay were set as the secondary end points. We conducted the data synthesis and analyzed the outcomes by calculating the odds ratio (OR) and mean difference. <b><i>Results:</i></b> Of 835 studies, 15 studies met the inclusion criteria (<i>n</i> = 10,745). The prevalence rate of stroke patients with hyponatremia was 7.0–59.2%. They had significantly higher 90-day mortality (OR, 1.73; 95% confidence interval (CI), 1.24–2.42) and longer length of hospital stay (mean difference, 10.68 days; 95% CI, 7.14–14.22) than patients without hyponatremia. Patients with hyponatremia had a higher tendency of in-hospital mortality than those without hyponatremia (OR, 1.61; 95% CI, 0.97–2.69). <b><i>Conclusions:</i></b> The development of hyponatremia in the clinical course of stroke is associated with higher short-term mortality and a longer hospital stay. Although the causal relationship is unclear, hyponatremia could be a significant predictor of poor outcomes after stroke.

Blood Eosinophils and Clinical Outcome of Acute Exacerbations of Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis

Respiration ◽  
2020 ◽  
pp. 1-10
Author(s):  
Yajie You ◽  
Guo chao Shi
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Clinical Outcome ◽  
Hospital Mortality ◽  
Hospital Stay ◽  
Pulmonary Disease ◽  
Lower Risk ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease

<b><i>Background:</i></b> Numerous studies have shown the association between eosinophilia and clinical outcomes of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). But the evidences are lack of consensus. <b><i>Objective:</i></b> The aim of this meta-analysis was to conduct a pooled analysis of outcome comparing eosinophilic (EOS) AECOPD and non-EOS AECOPD patients. <b><i>Methods:</i></b> We included PubMed, EMBASE, Web of Science, and Cochrane databases up to 2020 to retrieve articles. Randomized controlled trials and quasi-experimental studies about patients with and without EOS AECOPD in terms of in-hospital mortality, length of hospital stay, comorbidities, forced expiratory volume in 1 s (FEV1), gender, and BMI were included preclinical studies, review articles, editorials, commentaries, conference abstracts, and book chapters were excluded. The methodologic assessment of studies was performed with the Newcastle-Ottawa Scale and Cochran scale. Comprehensive Rev Man 5 was used for the statistical analysis. <b><i>Results:</i></b> Twenty-one studies with 18,041 patients fulfilled the inclusion criteria and were used in this meta-analysis. Comparing to the non-EOS group, those with EOS AECOPD patients had a lower risk for in-hospital mortality (odds ratio (OR) = 0.59, 95% confidence interval [CI] 0.36–0.95, <i>p</i> = 0.03), shorter length of hospital stay (OR = −0.72, 95% CI −1.44 to −0.00, <i>p</i> = 0.05), better FEV1 (mean difference = 0.14, 95% CI 0.08–0.20, <i>p</i> &#x3c; 0.00001), and a lower risk of arrhythmias (OR = 1.50, 95% CI 1.01–2.21, <i>p</i> = 0.04). In addition, the non-EOS group had a higher percentage of male (OR = 1.34, 95% CI 1.15–1.56, <i>p</i> = 0.0002) than EOS group. The rate of steroid use (OR = 0.82, 95% CI 0.47–1.42, <i>p</i> = 0.48) and BMI (mean difference = 0.43, 95% CI −0.18 to 1.05, <i>p</i> = 0.17] had no difference between 2 groups. <b><i>Conclusion:</i></b> The results of our meta-analysis suggest that EOS AECOPD patients have a better clinical outcome than non-EOS AECOPD patients in terms of length of hospital stay, in-hospital mortality, FEV1, and risk of arrhythmias. In addition, the non-EOS AECOPD patients have higher percentage of male than EOS AECOPD patients.

Gambaran Kadar Kreatinin Serum Dan Lama Rawatan Pada Pasien Gagal Jantung Kongestif di RSUD Arifin Achmad Provinsi Riau Januari 2012 - Desember 2014

2017 ◽  
Vol 10 (1) ◽  
pp. 24
Author(s):  
Dyah Siswanti E ◽  
Fatmawati Fatmawati ◽  
M. Ikhsanul Fikri
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Renal Function ◽  
Left Ventricular Ejection Fraction ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Serum Levels ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction

Worsening renal function in patient with congestive heart failure affect the length of hospital stay. The purpose of thisstudy was to describe the creatinine serum levels and the length of hospital stay in patient with congestive heartfailure treated in Arifin Achmad hospital Riau Province January 2012 – December 2014. This study was done withcross sectional approach. This study found the most common creatinine serum levels found were <1.5 mg/dl (73.2%)with an average of 1.30 mg/dl and the range was 0.10 – 6.63 mg/dl. The value of left ventricular ejection fraction withan average of 44.9% and the range was 12% - 79%. Length of hospital stay in patients were >5 days commonly withan average of 7.29 days and the range was 1 – 29 days. The result of this study showed that the possibility ofcreatinine serum levels is not the only one predictor to determine the length of hospital stay in patient with congestiveheart failure.

B-Type Natriuretic Peptide: A Predictor for Length of Hospital Stay and 180-Day Mortality in Patients with Congestive Heart Failure

2006 ◽  
Vol 12 (6) ◽  
pp. S108
Author(s):  
Anjali Bhagra ◽  
Gautam Kumar ◽  
Lekshmi Vaidyanathan ◽  
Chitra J. Varadachari ◽  
Wyatt W. Decker ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Hospital Stay ◽  
Natriuretic Peptide ◽  
Length Of Hospital Stay

scholarly journals Impact of the Geriatric Nutritional Risk Index on In-Hospital Mortality and Length of Hospitalization in Patients with Acute Decompensated Heart Failure with Preserved or Reduced Ejection Fraction

2020 ◽  
Vol 9 (4) ◽  
pp. 1169 ◽  
Author(s):  
Susumu Hirose ◽  
Sakiko Miyazaki ◽  
Shoichiro Yatsu ◽  
Akihiro Sato ◽  
Sayaki Ishiwata ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Hospital Mortality ◽  
Hospital Stay ◽  
Risk Index ◽  
Length Of Hospital Stay ◽  
Interquartile Range ◽  
Nutritional Risk ◽  
Geriatric Nutritional Risk Index ◽  
Nutritional Risk Index

In patients with heart failure (HF), the impact of the Geriatric Nutritional Risk Index (GNRI) on in-hospital mortality and length of hospital stay remains unclear. We aimed to identify the factors associated with increased in-hospital mortality and longer length of hospital stay considering the GNRI in acute decompensated HF with reduced and preserved ejection fraction (HFrEF and HFpEF, respectively). Patients with acute decompensated HF who were admitted to our institution between 2007 and 2011 were investigated. A total of 451 (201, HFrEF; 250, HFpEF) patients were divided into the following: patients with GNRI < 92 and ≥92. In HFrEF, there were no significant differences in in-hospital mortality and length of hospital stay between patients with GNRI < 92 and ≥92 (median (interquartile range), 24.0 (23.8) days and 20.0 (15.0) days, respectively, p = 0.32). In HFpEF, despite no differences in in-hospital mortality, patients with GNRI < 92 had significantly longer length of hospital stay than those with GNRI ≥ 92 (median (interquartile range), 20.0 (22.3) days and 17.0 (16.0) days, respectively, p = 0.04). In HFpEF, GNRI < 92, along with lower hemoglobin, higher B-type natriuretic peptide, and elevated C-reactive protein levels, were the independent factors for longer length of hospital stay. Among patients with acute decompensated HF, assessment of nutritional status with GNRI is useful for stratifying patients at high risk for longer length of hospital stay in HFpEF but not in HFrEF. These observations are particularly important when considering the increasing elderly population and prevalence of HFpEF.

scholarly journals Heart Failure Is a Poor Prognosis Risk Factor in Patients Undergoing Cholecystectomy: Results from a Spanish Data-Based Analysis

2021 ◽  
Vol 10 (8) ◽  
pp. 1731
Author(s):  
Javier Marco-Martínez ◽  
Francisco Javier Elola-Somoza ◽  
Cristina Fernández-Pérez ◽  
José Luis Bernal-Sobrino ◽  
Francisco Javier Azaña-Gómez ◽  
...  
Keyword(s):  
Heart Failure ◽  
Hospital Mortality ◽  
Hospital Stay ◽  
Average Length ◽  
National Health System ◽  
Length Of Hospital Stay ◽  
National Hospital ◽  
Mortality Models ◽  
Spanish National Health System ◽  
Discharge Database

Background: The incidence of cholecystectomy is increasing as the result of the aging worldwide. Our aim was to determine the influence of heart failure on in-hospital outcomes in patients undergoing cholecystectomy in the Spanish National Health System (SNHS). Methods: We conducted a retrospective study using the Spanish National Hospital Discharge Database. Patients older than 17 years undergoing cholecystectomy in the period 2007–2015 were included. Demographic and administrative variables related to patients’ diseases as well as procedures were collected. Results: 478,111 episodes of cholecystectomy were identified according to the data from SNHS hospitals in the period evaluated. From all the episodes, 3357 (0.7%) were excluded, as the result the sample was represented by 474,754 episodes. Mean age was 58.3 (+16.5) years, and 287,734 (60.5%) were women (p < 0.001). A primary or secondary diagnosis of HF was identified in 4244 (0.89%) (p < 0.001) and mean age was 76.5 (+9.6) years. A higher incidence of all main complications studied was observed in the HF group (p < 0.001), except stroke (p = 0.753). Unadjusted in-hospital mortality was 1.1%, 12.9% in the group with HF versus 1% in the non HF group (p < 0.001). Average length of hospital stay was 5.4 (+ 8.9) days, and was higher in patients with HF (16.2 + 17.7 vs. 5.3 + 8.8; p < 0.001). Risk-adjusted in-hospital mortality models’ discrimination was high in both cases, with AUROC values = 0.963 (0.960–0.965) in the APRG-DRG model and AUROC = 0.965 (0.962–0.968) in the CMS adapted model. Median odds ratio (MOR) was high (1.538 and 1.533, respectively), stating an important variability of risk-adjusted outcomes among hospitals. Conclusions: The presence of HF during admission increases in hospital mortality and lengthens the hospital stay in patients undergoing cholecystectomy. However, mortality and hospital stay have significantly decreased during the study period in both groups (HF and non HF patients).

scholarly journals Incidence, Risk Factors and Outcomes of New Onset Supraventricular Arrhythmias in African American Patients with Severe Sepsis

2016 ◽  
Vol 26 (2) ◽  
pp. 205 ◽  
Author(s):  
O'Dene Lewis ◽  
Julius Ngwa ◽  
Richard F. Gillum ◽  
Alicia Thomas ◽  
Wayne Davis ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Congestive Heart Failure ◽  
Severe Sepsis ◽  
Intensive Care ◽  
Respiratory Failure ◽  
Hospital Mortality ◽  
Supraventricular Arrhythmias ◽  
Incidence Risk ◽  
New Onset

<p><strong>Purpose</strong>: New onset supraventricular arrhythmias (SVA) are commonly reported in mixed intensive care settings. We sought to determine the incidence, risk factors and outcomes of new onset SVA in African American (AA) patients with severe sepsis admitted to medical intensive care unit (MICU).</p><p><strong>Methods:</strong> Patients admitted to MICU between January 2012 through December 2012 were studied. Patients with a previous history of arrhythmia or with new onset of ventricular arrhythmia were excluded. Data on risk factors, critical care interventions and outcomes were obtained.</p><p><strong>Results:</strong> One hundred and thirty-one patients were identified. New onset SVA occurred in 34 (26%) patients. Of those 34, 20 (59%) had atrial fibrillation (AF), 6 (18%) had atrial flutter and 8 (24%) had other forms of SVA. Compared with patients without SVA, patients with new onset SVA were older (69 ± 12 yrs vs 59 ± 13 yrs, P=.003), had congestive heart failure (47% vs 24%, P=.015) and dyslipidemia (41% vs 15%, P=.002). Additionally, they had a higher mean mortality prediction model (MPM II) score (65 ± 25 vs 49 ± 26, P=.001) and an increased incidence of respiratory failure (85% vs 55%, P=.001). Hospital mortality in patients with new onset SVA was 18 (53%) vs 30 (31%); P=.024; however, in a multivariate analysis, new onset SVA was associated with nonsignificantly increased odds (OR 2.58, 95% CI 0.86-8.05) for in-hospital mortality.</p><p><strong>Conclusion:</strong> New onset SVA was prevalent in AA patients with severe sepsis and occurred more frequently with advanced age, increased severity of illness, congestive heart failure, and acute respiratory failure; it was associated with higher unadjusted in hospital mortality. However, after multiple adjustments, new onset SVA did not remain an independent predictor of mortality. <em>Ethn Dis.</em>2016;26(2):205-212; doi:10.18865/ ed.26.2.205</p>

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