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

2014 ◽  
Vol 109 (3) ◽  
pp. 306-315 ◽  
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

scholarly journals Comparison of clinical characteristics and outcomes between alcohol-induced and gallstone-induced acute pancreatitis: An Australian retrospective observational study

2021 ◽  
Vol 9 ◽  
pp. 205031212110308
Author(s):  
Santiago Cegarra Garcia ◽  
Michael Toolis ◽  
Max Ubels ◽  
Taha Mollah ◽  
Eldho Paul ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Acute Pancreatitis ◽  
Intensive Care ◽  
Length Of Stay ◽  
Hospital Mortality ◽  
Intensive Care Unit Mortality ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Index Of Severity

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.

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

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.

66 Predictors of Increased Hospital Length of Stay Among Elderly Individuals With Acute Pancreatitis

2019 ◽  
Vol 114 (1) ◽  
pp. S40-S40
Author(s):  
Mehak Bassi ◽  
Sonmoon Mohapatra ◽  
Paris Charilaou ◽  
Harikrishna Bandla ◽  
Capecomorin Pitchumoni
Keyword(s):  
Acute Pancreatitis ◽  
Length Of Stay ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Elderly Individuals

scholarly journals Impact of Clinical, Laboratory and Fluid Therapy Variables on Hospital Length of Stay for Children with Acute Pancreatitis

2020 ◽  
Vol 23 (4) ◽  
pp. 356 ◽  
Author(s):  
Abdul R. Shahein ◽  
J. Antonio Quiros ◽  
Ricardo A. Arbizu ◽  
Candi Jump ◽  
Steven D. Lauzon ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Length Of Stay ◽  
Fluid Therapy ◽  
Clinical Laboratory ◽  
Hospital Length ◽  
Hospital Length Of Stay

scholarly journals 182. Missed Opportunities to Discontinue Unnecessary Vancomycin During Pharmacist Therapeutic Monitoring

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S98-S98
Author(s):  
Corey J Medler ◽  
Mary Whitney ◽  
Juan Galvan-Cruz ◽  
Ron Kendall ◽  
Rachel Kenney ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Adverse Drug Events ◽  
Academic Medical Center ◽  
Total Duration ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Therapeutic Monitoring ◽  
Resistant Bacteria ◽  
Therapeutic Drug ◽  
Missed Opportunities

Abstract Background Unnecessary and prolonged IV vancomycin exposure increases risk of adverse drug events, notably nephrotoxicity, which may result in prolonged hospital length of stay. The purpose of this study is to identify areas of improvement in antimicrobial stewardship for vancomycin appropriateness by clinical pharmacists at the time of therapeutic drug monitoring (TDM). Methods Retrospective, observational cohort study at an academic medical center and a community hospital. Inclusion: patient over 18 years, received at least three days of IV vancomycin where the clinical pharmacy TDM service assessed for appropriate continuation for hospital admission between June 19, 2019 and June 30, 2019. Exclusion: vancomycin prophylaxis or administered by routes other than IV. Primary outcome was to determine the frequency and clinical components of inappropriate vancomycin continuation at the time of TDM. Inappropriate vancomycin continuation was defined as cultures positive for methicillin-susceptible Staphylococcus aureus (MRSA), vancomycin-resistant bacteria, and non-purulent skin and soft tissue infection (SSTI) in the absence of vasopressors. Data was reported using descriptive statistics and measures of central tendency. Results 167 patients met inclusion criteria with 38.3% from the ICU. SSTIs were most common indication 39 (23.4%) cases, followed by pneumonia and blood with 34 (20.4%) cases each. At time of vancomycin TDM assessment, vancomycin continuation was appropriate 59.3% of the time. Mean of 4.22 ± 2.69 days of appropriate vancomycin use, 2.18 ± 2.47 days of inappropriate use, and total duration 5.42 ± 2.94. 16.4% patients developed an AKI. Majority of missed opportunities were attributed to non-purulent SSTI (28.2%) and missed MRSA nares swabs in 21% pneumonia cases (table 1). Conclusion Vancomycin is used extensively for empiric treatment of presumed infections. Appropriate de-escalation of vancomycin therapy is important to decrease the incidence of adverse effects, decreasing hospital length of stay, and reduce development of resistance. According to the mean duration of inappropriate therapy, there are opportunities for pharmacy and antibiotic stewardship involvement at the time of TDM to optimize patient care (table 1). Missed opportunities for vancomycin de-escalation Disclosures All Authors: No reported disclosures

scholarly journals Association of Emergency Department Waiting Times With Patient Experience in Admitted and Discharged Patients

2021 ◽  
Vol 8 ◽  
pp. 237437352110114
Author(s):  
Andrew Nyce ◽  
Snehal Gandhi ◽  
Brian Freeze ◽  
Joshua Bosire ◽  
Terry Ricca ◽  
...  
Keyword(s):  
Emergency Department ◽  
Length Of Stay ◽  
Patient Experience ◽  
Waiting Times ◽  
Hospital Length ◽  
Short Length ◽  
Hospital Length Of Stay ◽  
Patient’S Experience ◽  
Discharged Patients ◽  
The Impact

Prolonged waiting times are associated with worse patient experience in patients discharged from the emergency department (ED). However, it is unclear which component of the waiting times is most impactful to the patient experience and the impact on hospitalized patients. We performed a retrospective analysis of ED patients between July 2018 and March 30, 2020. In all, 3278 patients were included: 1477 patients were discharged from the ED, and 1680 were admitted. Discharged patients had a longer door-to-first provider and door-to-doctor time, but a shorter doctor-to-disposition, disposition-to-departure, and total ED time when compared to admitted patients. Some, but not all, components of waiting times were significantly higher in patients with suboptimal experience (<100th percentile). Prolonged door-to-doctor time was significantly associated with worse patient experience in discharged patients and in patients with hospital length of stay ≤4 days. Prolonged ED waiting times were significantly associated with worse patient experience in patients who were discharged from the ED and in inpatients with short length of stay. Door-to-doctor time seems to have the highest impact on the patient’s experience of these 2 groups.

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