scholarly journals PIC6 Using A Pneumonia-Specific Severity of Illness Model in Assessing Variation in Hospital Length of Stay for Community-Acquired Pneumonia Patients

1998 ◽  
Vol 1 (1) ◽  
pp. 69
Author(s):  
H Tan ◽  
J Koeller
Keyword(s):  
Length Of Stay ◽  
Severity Of Illness ◽  
Hospital Length ◽  
Community Acquired Pneumonia ◽  
Hospital Length Of Stay ◽  
Illness Model

Infections Acquired by Adults Who Receive Extracorporeal Membrane Oxygenation Risk Factors and Outcome

2013 ◽  
Vol 34 (1) ◽  
pp. 24-30 ◽  
Author(s):  
Cecile Aubron ◽  
Allen C. Cheng ◽  
David Pilcher ◽  
Tim Leong ◽  
Geoff Magrin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Length Of Stay ◽  
Extracorporeal Membrane Oxygenation ◽  
Unit Length ◽  
Severity Of Illness ◽  
Infectious Complications ◽  
Hospital Length ◽  
Interquartile Range ◽  
Hospital Length Of Stay ◽  
Membrane Oxygenation

Objectives.To analyze infectious complications that occur in patients who receive extracorporeal membrane oxygenation (ECMO), associated risk factors, and consequences on patient outcome.Design.Retrospective observational survey from 2005 through 2011.Participants and Setting.Patients who required ECMO in an Australian referral center.Methods.Cases of bloodstream infection (BSI), catheter-associated urinary tract infection (CAUTI), and ventilator-associated pneumonia (YAP) that occurred in patients who received ECMO were analyzed.Results.A total of 146 ECMO procedures were performed for more than 48 hours in 139 patients, and 36 patients had a total of 46 infections (30.1 infectious episodes per 1,000 days of ECMO). They included 24 cases of BSI, 6 of them secondary to VAP; 23 cases of VAP; and 5 cases of CAUTI. The most frequent pathogens were Enterobacteriaceae (found in 16 of 46 cases), and Candida was the most common cause of BSI (in 9 of 24 cases). The Sequential Organ Failure Assessment score before ECMO initiation and the number of days of support were independenuy associated with a risk of BSI, with odds ratios of 1.23 (95% confidence interval [CI], 1.03-1.47; P = .019) and 1.08(95% CI, 1.03-1.19]; P = .006), respectively. Infected patients did not have a significantly higher mortality compared with uninfected patients (41.7% vs 32%; P = .315), but intensive care unit length of stay (16 days [interquartile range, 8-26 days] vs 11 days [IQR, 4-19 days]; P = .012) and hospital length of stay (33.5 days [interquartile range, 15.5-55.5] vs 24 days [interquartile range, 9-42 days]; P = .029) were longer.Conclusion.The probability of infection increased with the duration of support and the severity of illness before initiation of ECMO. Infections affected length of stay but did not have an impact on mortality.

scholarly journals Effects of statins on clinical outcomes in hospitalized patients with community-acquired pneumonia

2020 ◽  
Vol 48 (8) ◽  
pp. 030006052093858
Author(s):  
Rony M. Zeenny ◽  
Hanine Mansour ◽  
Wissam K Kabbara ◽  
Nibal Chamoun ◽  
Myriam Audi ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Length Of Stay ◽  
Hospital Length ◽  
Community Acquired Pneumonia ◽  
Hospital Length Of Stay ◽  
Comorbid Conditions ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Significant Difference ◽  
Chronic Use

Objective We evaluated the effect of chronic use of statins based on C-reactive protein (CRP) levels and hospital length of stay (LOS) in patients admitted with community-acquired pneumonia (CAP). Methods We conducted a retrospective study over 12 months at a teaching hospital in Lebanon comparing patients with CAP taking chronic statins with patients not taking statins. Included patients with CAP were older than age 18 years and had two CRP level measures during hospitalization. CURB-65 criteria were used to assess the severity of pneumonia. A decrease in CRP levels on days 1 and 3, LOS, and normalization of fever were used to assess the response to antibiotics. Results Sixty-one patients were taking statins and 90 patients were not taking statins. Patients on statins had significantly more comorbid conditions; both groups had comparable CURB-65 scores. In both groups, no statistically significant difference was seen for the decrease in CRP level on days 1 and 3 and LOS. No difference in days to normalization of fever was detected in either group. Conclusion No association was found between the chronic use of statins and CRP levels, LOS, or days to fever normalization in patients with CAP.

scholarly journals Statin Use and Hospital Length of Stay Among Adults Hospitalized With Community-acquired Pneumonia

2016 ◽  
Vol 62 (12) ◽  
pp. 1471-1478 ◽  
Author(s):  
Fiona Havers ◽  
Anna M. Bramley ◽  
Lyn Finelli ◽  
Carrie Reed ◽  
Wesley H. Self ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Hospital Length ◽  
Community Acquired Pneumonia ◽  
Hospital Length Of Stay ◽  
Statin Use

scholarly journals The Impact of Drug Interactions in Patients with Community-Acquired Pneumonia on Hospital Length of Stay

Geriatrics ◽  
2022 ◽  
Vol 7 (1) ◽  
pp. 11
Author(s):  
Johannes Peter Schmitt ◽  
Andrea Kirfel ◽  
Marie-Therese Schmitz ◽  
Hendrik Kohlhof ◽  
Tobias Weisbarth ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Drug Interactions ◽  
Negative Binomial ◽  
Negative Binomial Regression ◽  
Hospital Length ◽  
Community Acquired Pneumonia ◽  
Assessment Tools ◽  
Hospital Length Of Stay ◽  
Increased Risk ◽  
The Impact

(1) Background: An aging society is frequently affected by multimorbidity and polypharmacy, which, in turn, leads to an increased risk for drug interaction. The aim of this study was to evaluate the influence of drug interactions on the length of stay (LOS) in hospitals. (2) Methods: This retrospective, single-centre study is based on patients treated for community-acquired pneumonia in the hospital. Negative binomial regression was used to analyse the association between drug interactions and the LOS in the hospital. (3) Results: The total cohort contained 503 patients, yet 46 inpatients (9%) that died were not included in the analyses. The mean age was 74 (±15.3) years, 35% of patients older than 65 years were found to have more than two drug interactions, and 55% had a moderate, severe, or contraindicated adverse drug reaction. The regression model revealed a significant association between the number of drug interactions (rate ratio (RR) 1.02; 95%-CI 1.01–1.04) and the severity of drug interactions (RR 1.22; 95%-CI 1.09–1.37) on the LOS for the overall cohort as well as for the subgroup of patients aged 80 years and older. (4) Conclusion: Drug interactions are an independent risk factor for prolonged hospitalisation. Standardised assessment tools to avoid drug interactions should be implemented in clinical routines.

scholarly journals S63 Telehealth in acute community acquired pneumonia: proof of concept and provisional evaluation of impact on hospital length of stay

Thorax ◽  
2011 ◽  
Vol 66 (Suppl 4) ◽  
pp. A31-A31
Author(s):  
S. Selvaraj ◽  
E. Davies ◽  
C. Humphries ◽  
K. S. Srinivasan ◽  
H. Moudgil
Keyword(s):  
Length Of Stay ◽  
Hospital Length ◽  
Community Acquired Pneumonia ◽  
Hospital Length Of Stay ◽  
Proof Of Concept

scholarly journals Hospital Admission Patterns in Adult Patients with Community-Acquired Pneumonia Who Received Ceftriaxone and a Macrolide by Disease Severity across United States Hospitals

Antibiotics ◽  
2020 ◽  
Vol 9 (9) ◽  
pp. 577 ◽  
Author(s):  
Thomas P. Lodise ◽  
Hoa Van Le ◽  
Kenneth LaPensee
Keyword(s):  
Length Of Stay ◽  
Healthcare Delivery ◽  
Pneumonia Severity Index ◽  
Severity Index ◽  
Primary Diagnosis ◽  
Hospital Length ◽  
Community Acquired Pneumonia ◽  
Hospital Length Of Stay ◽  
Cross Sectional ◽  
Risk Class

(1) Objective: There are limited data regarding community-acquired pneumonia (CAP) admissions patterns in US hospitals. Current expert CAP guidelines advocate for outpatient treatment or an abbreviated hospital stay for CAP patients in pneumonia severity index (PSI) risk classes I–III (low risk); however, the extent of compliance with this recommendation is unclear. This study sought to estimate the proportion of admissions among CAP patients who received ceftriaxone and macrolide therapy, one of the most commonly prescribed guideline-concordant CAP regimens, by PSI risk class and Charlson comorbidity index (CCI) score. (2) Methods: A retrospective cross-sectional study of patients in the Vizient® (MedAssets, Irving, Texas) database between 2012 and 2015 was performed. Patients were included if they were aged ≥ 18 years, had a primary diagnosis for CAP, and received ceftriaxone and a macrolide on hospital day 1 or 2. Baseline demographics and admitting diagnoses were used to calculate the PSI score. Patients in the final study population were grouped into categories by their PSI risk class and CCI score. Hospital length of stay, 30-day mortality rates, and 30-day CAP-related readmissions were calculated across resulting PSI–CCI strata. (3) Results: Overall, 32,917 patients met the study criteria. Approximately 70% patients were in PSI risk classes I–III and length of stay ranged between 4.9 and 6.2 days, based on CCI score. The 30-day mortality rate was <0.5% and <1.4% in patients with PSI risk classes I and II, respectively. (4) Conclusions: Over two-thirds of hospitalized patients with CAP who received ceftriaxone and a macrolide were in PSI risk classes I–III. Although the findings should be interpreted with caution, they suggest that there is a potential opportunity to improve the efficiency of healthcare delivery for CAP patients by shifting inpatient care to the outpatient setting in appropriate patients.

Intervention to Discontinue Parenteral Antimicrobial Therapy in Patients Hospitalized with Pulmonary Infections: Effect on Shortening Patient Stay

1992 ◽  
Vol 13 (1) ◽  
pp. 21-32 ◽  
Author(s):  
N. Joel Ehrenkranz ◽  
Debra E. Nerenberg ◽  
James M. Shultz ◽  
Kenneth C. Slater
Keyword(s):  
Length Of Stay ◽  
Antimicrobial Therapy ◽  
Cost Savings ◽  
Severity Of Illness ◽  
Cost Effective ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Patient Specific ◽  
Practice Characteristics ◽  
Alternative Drug

AbstractObjectives:Current efforts to contain antimicrobial costs in hospitals are based on restricting drugs. We explored the effects of unsolicited case-specific recommendations to physicians to discontinue parenteral antimicrobial therapy in medically stable patients with pneumonia, in order to shorten hospital length of stayMethods:A nurse-interventionist, working as an emissary of an appropriate committee in 3 nonteaching community hospitals, presented randomly assigned physicians withnonconfrontational suggestions to substitute comparable oral antimicrobials for parenteral antimicrobials. Blinded observers evaluated in-hospital and30-day postdischarge courses of patients of physicianswhohad been contacted by the nurse (cases) and those who had not (controls).Results:Eighty-two patient episodes (47 physicians) met study criteria. There were 53 cases and 29 controls. In 42 of 53 (79%) case episodes, physicians discontinued parenteral antimicrobials; patients' mean length of stay was 2.4 days less than for 29 control episodes (estimated cost savings was$884/patient). In 11 (21%) episodes, case physicians continuedparenteraltherapy; patients' mean length of stay was 1.9 days longer than for controls (estimated cost excess was$704/patient). Education, training and practice characteristics were comparable in physician groups. Severity of illness indicators and postdischarge outcomes were comparable in patient groups.Conclusions:The major cost-saving potential for shifting from par-enter-al to oral antimicrobial therapy is shortened length of stay. Timely information about alternative drug therapies, offered on a patient-specific basis, appears to modify the treating behavior of physicians. The program as currently conducted is cost-effective, with an estimated net savings of $50,000 per 100 interventions.

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