Utility of clinical pathway and prospective case management to achieve cost and hospital stay reduction for aortic aneurysm surgery at a tertiary care hospital

Background: Tertiary hospital care may vary from isolation bed ward care to high dependency units (HDUs) with oxygen support to intensive care unit (ICU) where patients may be intubated for mechanical ventilation The major risk factors for severe disease are age more than 60 years and underlying diseases like diabetes, hypertension. COVID-19 patients present at varying levels of severity. Understanding how long patients hospitalized with COVID-19 remain in hospital is critical for planning. Objectives: 1. To determine risk factors associated with disease severity 2. To determine risk factors associated with length of hospital stay in COVID-19 patients 3. To study the disease outcome Material & Methods: This was retrospective record-based study of inpatients with COVID-19 at Tertiary Care Hospital of Ahmedabad City. All patients admitted at tertiary care hospital diagnosed with COVID-19 between April 2020 to June, 2020, were included in present study. Inclusion criteria were all COVID-19 patients admitted at tertiary care hospital during the duration of April 2020 to June 2020. Results: A total of 916 COVID-19 patients were included in the study. Out of 916 total admitted patients 526 (57.4%) were male. 174 (19%) patients having one or more comorbidities like diabetes, hypertension, tuberculosis, heart diseases etc. Total 769 discharged (83.9%), 115 deaths (12.6%) and 32 transferred to other COVID-19 hospital (3.5%) out of total 916 patients admitted during study period. Conclusion: Severity of disease and deaths were associated with age and comorbidities. COVID-19 patients with comorbidities have more deteriorating outcomes compared with patients without.

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The role of intraoperative videoangiography in aneurysm surgery—a comparative study from a tertiary care hospital

Egyptian Journal of Neurosurgery ◽

10.1186/s41984-021-00106-0 ◽

2021 ◽

Vol 36 (1) ◽

Author(s):

K. Kaiser ◽

M. Nayil ◽

A. Ramzan ◽

S. Sarbjit ◽

W. Abrar ◽

...

Keyword(s):

Indocyanine Green ◽

Near Infrared ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Cerebral Vasculature ◽

Aneurysm Surgery ◽

Real Time Visualization ◽

The Brain

Abstract Background Indocyanine green (ICG) is a near-infrared (NIR) fluorescent dye. After intravenous injection, it reaches the vessels of the brain within 30 s. A real-time visualization of the cerebral vasculature is possible. Results The infarction rate and the postoperative rebleed rate in the pre-ICG era group were higher than in the ICG era. Conclusion Intraoperative ICGVA is a safe and effective method to confirm the exclusion of the clipped aneurysm from the circulation. It also helps to assess the patency of the surrounding vessels.

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An Audit of Post-Operative Hospital Stay and Complications of THR in a Tertiary Care Hospital

Orthopedic Research Online Journal ◽

10.31031/oproj.2021.08.000680 ◽

2021 ◽

Vol 8 (1) ◽

Author(s):

Muhammad Inam

Keyword(s):

Hospital Stay ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital

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An Analysis of Drug-Drug Interactions in a Tertiary Care Hospital in Kerala: A Retrospective Study

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/46513.14515 ◽

2021 ◽

Author(s):

Jihana Shajahan

Keyword(s):

Drug Interaction ◽

Drug Interactions ◽

Hospital Stay ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Care Providers ◽

Positive Correlation ◽

Duration Of Hospital Stay ◽

The Impact

Introduction: Concomitant use of several drugs for a patient is often necessary for achieving therapeutic response. Understanding the profile of Drug-Drug Interactions (DDI) will help health care providers to optimise therapy for better patient outcomes, reinforcing the concept of rational drug use. Aim: To analyse the frequency, mechanisms and severity of DDIs in a tertiary care hospital at Kerala. Materials and Methods: A retrospective cross-sectional study among 350 inpatients of a tertiary care hospital in Kerala from August 2020 to September 2020. Prescriptions containing ≥3 drugs were collected from inpatient medical records. A drug interaction check was performed using the Lexicomp drug interaction checker software. Results: DDIs were present in 74.6% of prescriptions and the average number of interactions was found to be 2.78. Most number for interactions was in the age group 61-80. Average number of DDI was significantly high among patients >60 years. Percentage of prescriptions with DDI and average number of DDI was found to be increasing with increase in number of drugs. Average number of interactions were maximum (5.01) in the group >10. Drug groups most commonly involved in interactions were antiplatelets, oral hypoglycaemic agents, bronchodilators, antibiotics, diuretics, insulin, statins, beta blockers, Proton Pump Inhibitors (PPI) and Non-Steroidal Anti-Inflammatory Drugs (NSAIDs). The most common interventions for minimising the impact of DDIs were changing the timing of drug administration, monitoring for symptoms/signs/lab values/drug levels or both. There was a significant positive correlation between duration of hospital stay and number of DDI. Conclusion: This study threw light upon the pattern and profile of DDIs among inpatients of a tertiary care hospital in Kerala. Elderly people (>60 years) were most prone for DDIs. Percentage of prescriptions with DDI and average number of DDIs was found to be increasing with increase in number of drugs. There was a positive correlation between duration of hospital stay and number of DDI.

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