scholarly journals RELATIONSHIP BETWEEN ICU WAITING AND MORTALITY RATE IN PATIENTS UNDER MECHANICAL VENTILATION ADMITTED IN EMERGENCY ROOM

2020 ◽  
Author(s):  
Layanna Alves da Silva Andrade ◽  
Monica Lucia Soares Borges ◽  
Geovane Rossone Reis ◽  
Aktor Hugo Teixeira ◽  
Rebeca Oliveira Crispim da Silva ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Mortality Rate ◽  
Hospital Stay ◽  
Average Length ◽  
Total Mortality ◽  
Length Of Hospital Stay ◽  
Field Research ◽  
Average Hospital ◽  
Number Of Patients ◽  
Using Data

Background: The number of patients who remain on prolonged mechanical ventilatory assistance has recently increased. The average length of hospital stay intervenes directly with the number of beds essential for assistance to a given population and is weighted as an indicator of service efficiency. Objective: To investigate the average time in which patients on mechanical ventilation admitted to the emergency department of a hospital remain waiting for a place in the ICU. Materials and Methods: Quantitative field research, where data collection was performed using data from medical records, admission books, death books / outcome of hospitalized patients and in line with pre-established criteria under mechanical ventilation. Mechanical ventilation patients admitted to the ER and the ICU, over 18 years old, were recruited. Results: The research comprises a sample of 67 patients. The average hospital stay was 334 hours and 36 minutes. The general ratio was for every 03 patients who entered for treatment, 01 was discharged and 02 died. The total mortality rate of the sample was 68.65%. Conclusion: The length of stay in ER and ICU in patients on mechanical ventilation is related to the high mortality rate.

scholarly journals MO850OUTCOMES OF COVID-19 INFECTION IN DIALYSIS PATIENTS IN QATAR: A NATIONWIDE COHORT STUDY

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Tarek Abdellatif ◽  
Abdullah Hamad ◽  
Mohamad Alkadi ◽  
Essa Abuhelaiqa ◽  
Muftah Othman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Critical Care ◽  
Mortality Rate ◽  
General Population ◽  
Hospital Stay ◽  
Laboratory Tests ◽  
Length Of Hospital Stay ◽  
Dialysis Patients ◽  
Risk Of Death

Abstract Background and Aims Patients on maintenance dialysis are more susceptible to COVID-19 and its severe complications. We studied outcomes of COVID-19 infection in dialysis patients in the state of Qatar. Our primary outcome was to determine the mortality rate of dialysis patients with COVID-19 infection and associated risk factors. Our secondary outcomes were to assess the severity of COVID-19 in dialysis patients and its related complications such as the incidence of hypoxia, critical care unit admission, need for mechanical ventilation or inotropes, incidence of acute respiratory distress syndrome (ARDS), and length of hospital stay. Method This was an observational, analytical, retrospective, nationwide study. We included all adult patients on dialysis who tested positive for COVID-19 (PCR assay of nasopharyngeal swab) during the period from February 1, 2020 to July 19, 2020. Patient demographics and clinical features were collected from a national electronic medical record. Laboratory tests were evaluated upon diagnosis and on day 7. Results There were 76 out of 1068 dialysis patients who were diagnosed with COVID-19 (age 56±13.6, 56 hemodialysis and 20 peritoneal dialysis, 56 males). Eleven patients (15%) died during study period. Mortality due to COVID-19 among our dialysis cohort was 100 times higher than that in the general population for the same period (15% vs. 0.15%; OR 114.2 [95% CI: 1.53 to 2.44]; p<0.001). Univariate analysis for risk factors associated with COVID-19-related death in dialysis patients showed minor but statistically significant increases in risks with age (OR 1.07), peak WBC peak level (OR 1.189), AST level at day 7 (OR 1.04), fibrinogen level at day 7 (OR 1.4), D-dimer level on day 7 (OR 1.94), and peak CRP level (OR 1.01). A major increase in the risk of death was noted with atrial fibrillation (OR, 8.7; p=0.008) and hypoxia (OR: 28; p=0.001). High severity of COVID-19 illness in dialysis manifested as 25% of patients required admission to the intensive care unit, 18.4% had ARDS, 17.1% required mechanical ventilation, and 14.5% required inotropes for intractable hypotension or shock. The mean length of hospital stay was 19.2±10.4 days. Laboratory tests were remarkable for severely elevated ferritin, fibrinogen, CRP, and peak IL-6 levels and decreased albumin levels on day 7. Conclusion This is the first study to be conducted at a national level in Qatar exploring COVID-19 in a dialysis population. Dialysis patients had a high mortality rate of COVID-19 infection compared to the general population. Dialysis patients had severe COVID-19 course complicated by prolonged hospitalization and high need for critical care, mechanical ventilation and inotropes. Special care should be done to prevent COVID-19 in dialysis patients to avoid severe complications and mortality.

scholarly journals Remdesivir Efficacy in COVID-19 Treatment: A Randomized Controlled Trial

2021 ◽  
Author(s):  
Sherief Abd-Elsalam ◽  
Ossama Ashraf Ahmed ◽  
Noha O. Mansour ◽  
Doaa H. Abdelaziz ◽  
Marwa Salama ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Mortality Rate ◽  
Hospital Stay ◽  
Standard Care ◽  
Controlled Trial ◽  
Length Of Hospital Stay ◽  
Final Analysis ◽  
Secondary Outcome ◽  
Control Group ◽  
Egyptian Patients

To date, no antiviral therapy has shown proven clinical effectiveness in treating patients with COVID-19. We assessed the efficacy of remdesivir in hospitalized Egyptian patients with COVID-19. Patients were randomly assigned at a 1:1 ratio to receive either remdesivir (200 mg on the first day followed by 100 mg daily for the next 9 days intravenously infused over 30–60 minutes) in addition to standard care or standard care alone. The primary outcomes were the length of hospital stay and mortality rate. The need for mechanical ventilation was assessed as a secondary outcome. Two hundred patients (100 in each group) completed the study and were included in the final analysis. The remdesivir group showed a significantly lower median duration of hospital stay (10 days) than the control group (16 days; P < 0.001). Eleven of the patients in the remdesivir group needed mechanical ventilation compared with eight patients in the control group (P = 0.469). The mortality rate was comparable between the two groups (P = 0.602). Mortality was significantly associated with older age, elevated C-reactive protein levels, elevated D-dimer, and the need for mechanical ventilation (P = 0.039, 0.003, 0.001, and < 0.001 respectively). Remdesivir had a positive influence on length of hospital stay, but it had no mortality benefit in Egyptian patients with COVID-19. Its use, in addition to standard care including dexamethasone, should be considered, particularly in low- and middle-income countries when other effective options are scarce.

scholarly journals Timing of Tracheostomy and Outcomes in Adults with Moderate and Severe Tetanus

2019 ◽  
Vol 34 (2) ◽  
pp. 20-23
Author(s):  
Wenrol Espinosa ◽  
Von Vinco
Keyword(s):  
Mechanical Ventilation ◽  
Mortality Rate ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Morbidity And Mortality ◽  
P Value ◽  
Early Tracheostomy ◽  
Severe Stage ◽  
Significant Difference ◽  
Severe Tetanus

Objective: This study aimed to evaluate the timing of tracheostomy and relationship to outcomes (length of hospital stay, length of mechanical ventilation, morbidity and mortality rate) in adults with moderate and severe tetanus.  Methods:             Design:           Cross-Sectional Study             Setting:           Tertiary Government Training Hospital             Patients:         All adult patients (19 years old and above) diagnosed with moderate and    severe stage tetanus from January 2015 to January 2018 were considered for inclusion. Results: There were 109 patients included in this study, majority were males (n=95) with a male to female ratio of 7:1. Most belonged to the 51-60 years age group (mean: 53.7 SD: +/-16.1). Based on Cole Tetanus staging, the majority presented with severe stage tetanus (67.9%; n=74). Only 35.8% (n=39) were admitted at the Intensive Care Unit. Early tracheostomy was performed in 56.0% (n=61) of the patients (mean 6.3 hours SD: +/- 4.61). Mortality rate was noted to be 52.3% (n=57). Overall, early tracheostomy among moderate to severe stage tetanus patients showed shorter length of hospital stay and length of mechanical ventilation than  late tracheostomy (tracheostomy >24 hours) (p-value < .05). However, no significant difference was noted for timing of tracheostomy in terms of morbidity and mortality rate (p-value > .05). Conclusion: Early tracheostomy within less than 24 hours from time of admission for moderate and severe tetanus is associated with shorter length of hospital stay and mechanical ventilation than late tracheostomy, and may play a role in tetanus management. Keywords: tracheostomy; tetanus; hospital stay; mechanical ventilation; morbidity; mortality

scholarly journals Phase I Clinical Research of Jejunal Interposition in Adenocarcinoma of the Esophagogastric Junction II/III Proximal Gastrectomy

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Kai Tao ◽  
Jian-Hong Dong
Keyword(s):  
Hospital Stay ◽  
Esophagogastric Junction ◽  
Average Length ◽  
Proximal Gastrectomy ◽  
Length Of Hospital Stay ◽  
Remnant Stomach ◽  
Jejunal Interposition ◽  
Average Hospital ◽  
Inflammatory Granuloma ◽  
Reconstruction Time

Objective.To investigate the feasibility and specific methods of single-tract jejunal interposition between esophagus and remnant stomach (ers-STJI) in adenocarcinoma of the esophagogastric junction (AEG) II/III proximal gastrectomy.Methods.15 AEG II/III gastric cancer (GC) patients in phase T1-3N0M0 with tumor size <5 cm were selected and they underwent proximal gastrectomy with ers-STJI from August 2013 to August 2014.Results.All of the 15 patients successfully completed GC R0 proximal gastrectomy with ers-STJI and no operative death or no significant complication occurred; one patient had anastomotic inflammatory granuloma. The digestive tract reconstruction time was 29.5 ± 5.7 min; the intraoperative blood loss was 96.7 ± 20.2 mL, and the number of lymph node dissections was 21.3 ± 3.0; the postoperative flatus time was 48.2 ± 11.9 h; the average length of hospital stay was 10.7 ± 2.3 d, and the average hospital stay cost was 60 ± 3 thousands. All of the patients were followed up for 12 months, and their postoperative single food intake, body weight, hemoglobin, and albumin were all recovered to the preoperative levels.Conclusions.The applications of ers-STJI in proximal gastrectomy were safe and feasible, and the length of jejunal interposition could be 15–25 cm.

Hospital admissions and direct costs: A comparative study between paliperidone palmitate and oral antipsychotics

2016 ◽  
Vol 33 (S1) ◽  
pp. s229-s229
Author(s):  
A. Soler Iborte ◽  
S. Galiano Rus ◽  
J.A. Ruíz Sánchez
Keyword(s):  
Hospital Stay ◽  
Hospital Admissions ◽  
Average Length ◽  
Direct Costs ◽  
Average Hospital Stay ◽  
Average Hospital ◽  
Number Of Patients ◽  
Icd 10 ◽  
Schizophrenic Patients ◽  
Competing Interest

IntroductionThe total costs of schizophrenia increased to 2576 million Euros in 2013 in Spain, or 2.7% of the annual cost of health services. The hospitalizations, along with other intermediate resources, such as Day Hospital, etc., significantly contribute to the increase of economic burden. In Spain, the average hospital stay of schizophrenic patients is 18.24 days, totalling to an average cost of 6,753 Euros/patient (370.23 Euros/patient/day).Material and methodsThe sample selected included patients from both sexes, aged between 18 and 65 years old, with diagnostic criteria of schizophrenia (according to DSM-IV and ICD-10), admitted in the Mental Health Hospital Unit (MHHU), Úbeda between 2012 and 2013, with registered visits of at least 2 outpatient visits or 1 hospitalization related to the schizophrenia diagnosis (n = 48).ResultsAfter the start of treatment with the injectable antipsychotic drug of prolonged duration, the number of patients that required hospitalization for any psychiatric motive went from 24 patients (49.7%) to 11 patients (22.4%; P < 0.001). The patients who started treatment with PAP during hospitalization had an average stay of 15.7 days, as compared to 18.24 days of average hospital stay due to schizophrenia in Spain. The direct costs of hospitalization stays due to psychiatric reasons decreased from 162,071.88 Euros to 74,282.95 Euros (P < 0.001).ConclusionsThis observational study shows us that the treatment with PAP reduced the average length of the hospital stay, and resulted in a decreased percentage of re-admissions as compared to oral treatments for schizophrenia. These data led to savings of more than 50% of the direct costs of hospitalization.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Triage in Mass-Casualty Events: The Haitian Experience

2011 ◽  
Vol 26 (5) ◽  
pp. 386-390 ◽  
Author(s):  
Ofer Merin ◽  
Ian N. Miskin ◽  
Guy Lin ◽  
Itay Wiser ◽  
Yitshak Kreiss
Keyword(s):  
Medical Care ◽  
Hospital Stay ◽  
Total Mortality ◽  
Length Of Hospital Stay ◽  
Mass Casualty ◽  
Limited Resources ◽  
Medical Attention ◽  
Field Hospital ◽  
Local Conditions ◽  
Number Of Patients

AbstractIntroduction: Mass-casualty triage is implemented when available resources are insufficient to meet the needs of all patients in a disaster situation. The basic principle is to do the maximum good for the most casualties with the least amount of resources. There are limited data to support the applicability of this principle in massive disasters such as the January 2010 earthquake in Haiti, in which the number of patients seeking medical attention overwhelmed the local resources.Objective: To analyze the application of a triage system developed for use in a mass-casualty setting with limited resources. The system was designed to admit only those patients who had medical conditions requiring urgent treatment that were within the capabilities of the hospital and had a good chance of survival after discharge. Priority was given to those whose treatment could be administered within a short hospital stay.Method: A retrospective, observational review of computerized registration forms of Haitian earthquake victims who sought medical care at a 72-bed field hospital within four to 14 days after the event. An analysis of the efficacy of the triage protocol that was used followed, using length of hospital stay to measure consumption of resources.Results: A total of 1,111 patients were triaged for treatment in the field hospital within 14 days of the earthquake. The median length of stay for all patients for whom data was available was 16 hours (mean = 29.7 hours). The majority of patients (n = 620, 65%) were discharged within 24 hours. Two hundred five patients underwent surgery and were discharged within a median of 39 hours (mean = 52.6 hours); of these, 124 (62%) were discharged within 48 hours. The total mortality of the treated patients was 1.5% (n = 17).Conclusions: Currently accepted triage principles for the most part are appropriate for efficiently providing medical care in a disaster area with extremely limited resources, but require extensive adaptation to local conditions.

scholarly journals Analysis of stroke treatment outcomes in hospital setting in Brazil, between the years 2010 and 2019.

2021 ◽  
Author(s):  
Giovanna Carvalho Sousa ◽  
Gustavo Bomfim Barreto ◽  
Lanna Victória Loula ◽  
Louise Seixas Lordêllo ◽  
Gustavo Sampaio Vilas-Boas ◽  
...  
Keyword(s):  
Information System ◽  
Mortality Rate ◽  
Hospital Stay ◽  
Average Length ◽  
Hospital Setting ◽  
Length Of Hospital Stay ◽  
Secondary Data ◽  
Stroke Treatment ◽  
The World ◽  
Treatment Mortality

Background: Stroke is an important cause of death and is a major cause of serious disability in Brazil and in the world. Therefore, it is fundamental to analyze its treatment in the hospital setting in Brazil. Objectives: To describe the progression of the stroke treatment in the hospital setting in Brazil between the years 2010 and 2019 and the outcomes associated to the disease. Design and Setting: Transversal, retrospective and quantitative study, with secondary data collected in the Hospital Information System of SUS (SIH / SUS) between 2010 and 2019, in Brazil. Methods: Data from number of hospitalizations for stroke treatment, mortality rate and average length of hospital stay were collected and analyzed. A comparison has been made between these data over the selected years. Results: The number of hospitalizations for stroke treatment had a 16,83% growth between 2010 and 2019. In comparison, the average length of hospital stay was 7,7 days in 2010 and 7,6 days in 2019. The mortality rate had a reduction of 10,52% between these years. Conclusions: Despite the growth of hospitalization to stroke treatment, there was a reduction in the average length of hospital stay and in the mortality rate associated to the procedure. It is possible to infer an optimization in the stroke lead in intensive care units in Brazil.

scholarly journals Inequality in Health: Correlation Between Poverty and Injury – A Comprehensive Analysis Based on Income Level in Taiwan: A Cross-sectional Study

2020 ◽  
Author(s):  
Yi-Chang Lin ◽  
Chi-Hsiang Chung ◽  
Lu Pai ◽  
Chien-Sung Tsai ◽  
Wu-Chien Chien ◽  
...  
Keyword(s):  
Health Insurance ◽  
Mortality Rate ◽  
Hospital Stay ◽  
National Health Insurance ◽  
Health Inequality ◽  
Low Income ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Income Group ◽  
Accident Injury

Abstract Background For better health promotion in Taiwan, it needs an action to reduce health inequality; therefore a comprehensive monitoring on social determinants and health is urgent. Is income the obstacle to influence the health after Taiwan instituted national health insurance in 1995? We compared the characteristics of accident injuries for patients classified with low-income and non-low-income who required inpatient care. Methods We collected accident injury inpatient cases from 1998 to 2015 from the Health and Welfare Data Science Center, Ministry of Health and Welfare and categorized the patients as low-income and non-low-income. Chi-square tests, Fisher exact tests, an independent samples t-test, and percentages were used to identify differences in demographics, cause for hospitalization, and other hospital care variables. Results Between 1998 and 2015, there were 74,337 low-income accident injury inpatients, which represented 1.6% of all injury event inpatients. The hospitalization mortality rate for the low-income group was 1.9 times higher than that of the non-low-income group. Further, the average length of hospital stay (9.9 days), average medical expenses (1,681 USD), and mortality rate (3.6%) for the low-income inpatients were higher than those of the non-low-income group (7.6 days, 1,573 USD, and 2.1%, respectively). Among the common injury causes, the percentage of injuries from “medical malpractice,” “fall,” “suicide,” and “homicide” were higher for the low-income group than that for the non-low-income group. Conclusions Despite National Health Insurance coverage, we found a higher hospitalization rate, longer average length of hospital stay, and a higher mortality rate in the low-income group. These findings support our hypothesis that there is a correlation between health and income level, resulting in health inequality. Achieving health care equality may require collaboration between the government and private and nonprofit organizations to increase awareness of this phenomenon.

Hypomethylating agents as first-line therapy in acute myeloid leukemia (AML).

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 7084-7084
Author(s):  
Samuel D Bailey ◽  
Zartash Gul ◽  
Stacey A. Slone ◽  
Emily Marie Van Meter ◽  
Amber Lawson ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Hospital Admissions ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Median Number ◽  
Cancer Center ◽  
Hypomethylating Agents ◽  
Average Hospital Stay ◽  
Average Hospital ◽  
First Line Therapy

7084 Background: Hypomethylating agents are used in older AML patients (pts) who are not considered candidates for standard induction therapy. However, data regarding their efficacy remains unclear. Methods: We retrospectively evaluated a cohort of 24 consecutive AML pts who were placed on hypomethylation therapy at diagnosis between October 2010 and June 2012 at Markey Cancer Center. Results: Baseline characteristics of the patients are described in table 1. Response rate (CR+PR) was 45.8%. Median number of infections were 1 (8 pts), 2 (5 pts), 3 (4 pts).Median hospital admissions required were 1 (10 pts), 2 (4 pts), 3 (5 pts), 4 or greater (2 pts). Average length of hospital stay was 10.3 days (0-37 days). Median units of packed red cell and platelet transfusions were 10 and 11 units (Range=0-64 and 0-78) respectively. After a median follow up of 145.5 days, 13 pts had died. Cause of death was AML (6 pts), infection and end organ failure (7pts).Median overall survival (OS) was 9.7 months (95%CI: 3.2-16.5 months). On multivariate analysis, blast count less than 30% was borderline significantly associated with better OS (P=0.05). However after addition of average hospital stay in the model only age (HR=1.3, CI=1.06- 1.67), gender (HR=11.5, CI=1.2, 110.5), and average hospital stay were significantly associated with OS (HR=1.2, CI = 1.04- 1.32). Conclusions: In this cohort of pts the median OS was 9.7 months. Older pts and those with longer average hospital stay had a higher mortality. Better selection of pts in a larger cohort who are likely to gain more benefit from these agents may impact outcomes. [Table: see text]

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