scholarly journals Impact of vaccination in reducing Hospital expenses, Mortality and Average length of stay among COVID 19 patients. A retrospective cohort study from India

2021 ◽  
Author(s):  
Madhumathi Ramakrishnan ◽  
Prakash Subbarayan
Keyword(s):  
Cohort Study ◽  
Relative Risk ◽  
Length Of Stay ◽  
Retrospective Cohort ◽  
Relative Risk Reduction ◽  
Average Length ◽  
Total Hospital ◽  
Average Length Of Stay ◽  
The Mean ◽  
Hospital Expenses

Background & Aim: WHO listed vaccine hesitancy among the top 10 global threats to health and there are very few reports highlighting vaccine benefits against COVID-19. The aim of this study was to study the impact of vaccination on reducing the average length of stay (ALOS), intensive care unit (ICU) requirement, mortality and cost of the treatment among COVID-19 patients. Methods: In this retrospective cohort study all the patients above 45 years who underwent treatment for COVID-19 were included. The data of patients treated pan India during the period March & April 2021 with the diagnosis of COVID-19, under health insurance cover, were extracted to study parameters like the ALOS, mortality, ICU requirement, total hospital expenses incurred and the vaccination status. Results: Among 3820 patients with COVID-19, 3301 (86.4%) were unvaccinated while 519 (13.6%) were vaccinated. Among the unvaccinated the mean (s.d) ALOS was 7 days. Fourteen days after second dose of vaccination this was significantly less (p=0.01) at 4.9. The mean total hospital expense among the unvaccinated was Rs. 277850. Fourteen days after second dose of vaccination this was further less (p=0.001) at Rs. 217850. Among the unvaccinated population 291/3301 (8.8%) required ICU and this was significantly less (p=0.03) at 31/519 (6%) among the vaccinated. Among those who received two doses of vaccination it was further less at 1/33 (3%). The mortality among unvaccinated patients was 16/3301 (0.5%) while there was no mortality among the vaccinated. Among those who received two doses of vaccination there was a 66% relative risk reduction in ICU stay and 81% relative risk reduction in mortality. Conclusions: There was a significant reduction in ALOS, ICU requirement, mortality & treatment cost in patients who had completed two doses of vaccination. These findings may be used in motivating public and promoting vaccination drive.

Total Population Estimate of Newborn Special-Care Bed Needs

PEDIATRICS ◽  
1985 ◽  
Vol 75 (6) ◽  
pp. 993-996
Author(s):  
August L. Jung ◽  
Nan Sherman Streeter
Keyword(s):  
Length Of Stay ◽  
Total Population ◽  
Average Length ◽  
Special Care ◽  
Care Hospital ◽  
Total Hospital ◽  
Live Births ◽  
Average Length Of Stay ◽  
Study Results ◽  
Hospital Days

In 1977, 7% of the 38,855 infants born in Utah were estimated to have required a total of 27,439 special-care hospital days. About half (53%) were mildly ill; their average length of stay was 4.6 days, or 24% of the total hospital-days. Another 20% of the infants had intermediate illness, with a 12-day average stay, or 23% of the total hospital-days. The remaining 27% of the infants required intensive care and used 53% of the total hospital-days; their average length of stay was 20 days. As a total population, the state's 38,855 births generated a need for two beds per 1,000 annual live births in special-care facilities. The estimated bed need was: mild illness (Level I), 0.5 beds per 1,000 annual live births; intermediate illness (Level II), 0.5 beds per 1,000 annual live births; and intense illness (Level III), one bed per 1,000 annual live births. Results are based on the assumption that nonstudy births, 30% of the total, have needs proportionate to study births. The following considerations are necessary to extrapolate these bed needs to other populations: (1) convalescence of intensely ill babies may require that up to 50% of their bed needs may be shifted to intermediate care; (2) compliance with criteria for transport to the next level of care may not be 100% as assumed in the study, thus redistributing bed needs; (3) census characteristically fluctuates in special-care nurseries (study results are reported for an unchanging daily census); and (4) the low birth rate of a population is intimately related to the bed needs.

scholarly journals Weekend new patient reviews in psychiatry: evaluation of activity over 3 months

2017 ◽  
Vol 41 (6) ◽  
pp. 337-340
Author(s):  
Michael Rutherford ◽  
Mark Potter
Keyword(s):  
Mental Health ◽  
Length Of Stay ◽  
Average Length ◽  
Clinical Implications ◽  
Out Of Hours ◽  
Feasible Method ◽  
Average Length Of Stay ◽  
South West ◽  
Before And After ◽  
The Mean

Aims and methodSouth West London and St George's Mental Health NHS Trust developed a system of weekend new patient reviews by higher trainees to provide senior medical input 7 days a week. To evaluate the effectiveness of these reviews, the notes for all patients admitted over 3 months were examined. The mean length of stay for patients before and after the introduction of the weekend new patient reviews were compared via unpaired t-test.ResultsA total of 88 patients were seen: 84.4% of patients were seen within 24 h of admission. Higher trainees instituted some changes in 78.9% of patients. The most frequent action was to modify medication, in 47.8%. The average length of stay after the introduction of weekend reviews was not significantly different.Clinical implicationsWeekend reviews of newly admitted patients by higher trainees is a feasible method for providing senior input to patients admitted out of hours.

Abstract 368: Association of Atrial Fibrillation with In-hospital Outcomes in ST-Elevation Myocardial Infarction - A Propensity Matched Study

2015 ◽  
Vol 8 (suppl_2) ◽  
Author(s):  
Prakash Harikrishnan ◽  
Marjan Mujib ◽  
Tanush Gupta ◽  
Dhaval Kolte ◽  
Chandrasekar Palaniswamy ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Atrial Fibrillation ◽  
Length Of Stay ◽  
Hospital Mortality ◽  
Average Length ◽  
St Elevation Myocardial Infarction ◽  
Hospital Charges ◽  
Total Hospital ◽  
Average Length Of Stay ◽  
St Elevation

Background: Atrial fibrillation is a relatively common comorbid condition in patients with coronary artery disease. However, there are limited data on the association of atrial fibrillation (AF) with outcomes in ST-elevation myocardial infarction (STEMI). Methods: We queried the 2003-2011 Nationwide Inpatient Sample databases using the ICD-9 diagnosis codes, to identify all patients > 18 years admitted with a primary diagnosis of STEMI. We studied the association of AF with in-hospital outcomes in these patients both by regression analysis and propensity match to adjust for demographics, hospital characteristics and co-morbidities. Results: Of the total 452,772 (64.5% men) STEMI hospitalizations, AF was documented in 58,273 (12.9%) cases. Patients with AF were older (mean age 75±12 vs 64±14 years; p<0.001) and had a higher proportion of women (42.5% vs 34.5%; p<0.001) than patients without AF. STEMI patients with AF had a higher risk-adjusted in-hospital mortality (OR 1.15, 95% CI 1.12-1.19, p<0.001), longer average length of stay (7 days vs 4 days, P<0.001) and higher average total hospital charges ($74,082 vs $57,331, P<0.001) than those without AF. Using propensity matching, 57,388 STEMI patients with AF were compared with the same number of patients without AF. Within these matched cohorts, STEMI patients with AF had higher in-hospital mortality (16.7% vs 15.1%, OR 1.13, 95% CI 1.09-1.16; p<0.001), longer average length of stay (7 days vs 6 days, P<0.001), and higher average total hospital charges ($73,832 vs $65,201, P<0.001) than patients without AF. Conclusions: In patients hospitalized with STEMI, AF was independently associated with modestly higher in-hospital mortality, higher hospital charges, and longer length of stay.

scholarly journals Contribution of the BioFire® FilmArray® Meningitis/Encephalitis Panel:

2019 ◽  
Vol 12 (1) ◽  
pp. 1-3 ◽  
Author(s):  
Kyle Dack ◽  
Stephanie Pankow ◽  
Elizabeth Ablah ◽  
Rosey Zackula ◽  
Maha Assi
Keyword(s):  
Length Of Stay ◽  
Average Length ◽  
Medical Center ◽  
Antiviral Treatment ◽  
Length Of Hospital Stay ◽  
Average Length Of Stay ◽  
Regional Medical ◽  
Regional Medical Center ◽  
The Mean ◽  
Hospital Stay Duration

Introduction. Traditional evaluation of meningitis includes cerebrospinalfluid (CSF) culture and gram stain to pinpoint specific causalorganisms. The BioFire® FilmArray® Meningitis/Encephalitis (ME)Panel has been implemented as a more timely evaluation method.This study sought to assess if the BioFire® ME Panel was associatedwith a decreased length of stay or decreased antimicrobial durationwhen used in the diagnosis of meningitis or encephalitis.Methods.xA case, historical-control, chart review was performed onpatients admitted to a regional medical center with CSF pleocytosisduring Cohort 1 (the year prior to BioFire® ME Panel implementation)and Cohort 2 (the year after BioFire® ME Panel implementation).Length of hospital stay, duration of antimicrobials, and BioFire® MEPanel result were gathered and analyzed.Results. Average length of stay for both cohorts was about fourhospital days. Approximately three-fourths of all patients receivedantibiotic/antiviral treatment with an average of three days duration.No significant differences were observed between groups. The mean(median) duration of antimicrobials in the year prior to and afterthe BioFire® ME Panel implementation was 3.6 (3) and 3.1 (2) days,respectively (p = 0.835). The mean (median) length of stay in the yearprior to and after the BioFire® ME Panel implementation was 5.8 (4)and 5.4 (4) days, respectively (p = 0.941). Among the patients admittedafter the implementation of the BioFire® ME Panel, 4.3 % (n =2) had a positive bacterial result, 38.3% (n = 18) had a positive viralresult, and 57.4% (n = 27) had a negative result. Of the 27 negativeresults, 77.8% (n = 21) were treated with antimicrobial medication.Conclusions. This study suggested there is no difference betweenlength of stay or antimicrobial duration in presumed meningitis casesassessed with traditional methods as compared to the BioFire® MEPanel. Kans J Med 2019;12(1):1-3.

scholarly journals Identifying the Characteristics of Patients With Cervical Degenerative Disease for Surgical Treatment From 17-Year Real-World Data: Retrospective Study

10.2196/16076 ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. e16076 ◽  
Author(s):  
Si Zheng ◽  
Yun Xia Wu ◽  
Jia Yang Wang ◽  
Yan Li ◽  
Zhong Jun Liu ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Length Of Stay ◽  
Real World ◽  
Average Length ◽  
Real World Data ◽  
Female Patients ◽  
Average Length Of Stay ◽  
Age At Surgery ◽  
The Mean ◽  
Cervical Degenerative Disease

Background Real-world data (RWD) play important roles in evaluating treatment effectiveness in clinical research. In recent decades, with the development of more accurate diagnoses and better treatment options, inpatient surgery for cervical degenerative disease (CDD) has become increasingly more common, yet little is known about the variations in patient demographic characteristics associated with surgical treatment. Objective This study aimed to identify the characteristics of surgical patients with CDD using RWD collected from electronic medical records. Methods This study included 20,288 inpatient surgeries registered from January 1, 2000, to December 31, 2016, among patients aged 18 years or older, and demographic data (eg, age, sex, admission time, surgery type, treatment, discharge diagnosis, and discharge time) were collected at baseline. Regression modeling and time series analysis were conducted to analyze the trend in each variable (total number of inpatient surgeries, mean age at surgery, sex, and average length of stay). A P value <.01 was considered statistically significant. The RWD in this study were collected from the Orthopedic Department at Peking University Third Hospital, and the study was approved by the institutional review board. Results Over the last 17 years, the number of inpatient surgeries increased annually by an average of 11.13%, with some fluctuations. In total, 76.4% (15,496/20,288) of the surgeries were performed in patients with CDD aged 41 to 65 years, and there was no significant change in the mean age at surgery. More male patients were observed, and the proportions of male and female patients who underwent surgery were 64.7% (13,126/20,288) and 35.3% (7162/20,288), respectively. However, interestingly, the proportion of surgeries performed among female patients showed an increasing trend (P<.001), leading to a narrowing sex gap. The average length of stay for surgical treatment decreased from 21 days to 6 days and showed a steady decline from 2012 onward. Conclusions The RWD showed its capability in supporting clinical research. The mean age at surgery for CDD was consistent in the real-world population, the proportion of female patients increased, and the average length of stay decreased over time. These results may be valuable to guide resource allocation for the early prevention and diagnosis, as well as surgical treatment of CDD.

scholarly journals The Effects of Early Rehabilitation in the Intensive Care Unit for Patients with Severe COVID-19 Pneumonia: A Retrospective Cohort Study

2022 ◽  
Vol 11 (2) ◽  
pp. 357
Author(s):  
Tokio Kinoshita ◽  
Yukihide Nishimura ◽  
Yasunori Umemoto ◽  
Yasuhisa Fujita ◽  
Ken Kouda ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cohort Study ◽  
Intensive Care ◽  
Length Of Stay ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Small Sample ◽  
Icu Length Of Stay ◽  
The Mean ◽  
Mean Time

This retrospective cohort study aimed to examine the rehabilitation effect of patients with coronavirus disease 2019 (COVID-19) in the intensive care unit (ICU) under mechanical ventilation and included ICU patients from a university hospital who received rehabilitation under ventilator control until 31 May 2021. Seven patients were included, and three of them died; thus, the results of the four survivors were examined. The rehabilitation program comprised the extremity range-of-motion training and sitting on the bed’s edge. The Sequential Organ Failure Assessment score (median (25–75th percentiles)) at admission was 7.5 (5.75–8.5), and the activities of daily living (ADLs) were bedridden, the lowest in the Functional Independence Measure (FIM) and Barthel Index (BI) surveys. Data on the mean time to extubation, ICU length of stay, and ADLs improvement (FIM and BI) during ICU admission were obtained. Inferential analyses were not performed considering the small sample size. The mean time to extubation was 4.9 ± 1.1 days, and the ICU length of stay was 11.8 ± 5.0 days. ΔFIM was 36.5 (28.0–40.5), and the ΔBI was 22.5 (3.75–40.0). Moreover, no serious adverse events occurred in the patients during rehabilitation. Early mobilization of patients with COVID-19 may be useful in ADLs improvement during ICU stay.

Discharge destination of patients from a psychogeriatric unit

2011 ◽  
Vol 26 (S2) ◽  
pp. 845-845
Author(s):  
M. Ochuko-Emore
Keyword(s):  
Mental Illness ◽  
Length Of Stay ◽  
Average Length ◽  
Discharge Destination ◽  
Average Length Of Stay ◽  
The Mean ◽  
Time Of Admission ◽  
At Home

ObjectivesTo determine the discharge destination of patients admitted to a psychogeriatric unit.MethodsRecords of all patients discharged from an in-patient psychogeriatric unit between 1st July 2009 and 30th June 2010 were examined. The diagnosis, residence at admission, length of stay and discharge destination were recorded.ResultsThere were ninety-four discharges over the study period. Four of the patients were admitted and discharged twice. The mean age was 76.7 years (range 65–95 years). 52.1% (n = 49) were diagnosed with dementia and 47.9% (n = 45) with functional mental illness. The average length of stay was 67.4 days for dementia compare to 74.2 days for functional mental illness. 17.1% (n = 6/32) of patients with dementia and 84.2% (n = 32/38) of patients with functional mental illness resident at home at the time of admission were discharged home.ConclusionThis finding suggests that patients with functional mental illness are more likely to be discharge back to their homes compared with patients with dementia.

scholarly journals The Use of Determinants of Length of Stay in the Post-anesthesia Care Unit (PACU) at the Philippine General Hospital among Postoperative Patients who Underwent Elective Surgeries to Create a Predictive Model for PACU Length of Stay

2020 ◽  
Vol 54 (5) ◽  
Author(s):  
Maria Teresita B. Aspi ◽  
Evangeline Ko-Villa
Keyword(s):  
Length Of Stay ◽  
General Hospital ◽  
Chart Review ◽  
Average Length ◽  
Anesthetic Technique ◽  
Published Data ◽  
Post Anesthesia Care Unit ◽  
Average Length Of Stay ◽  
Duration Of Surgery ◽  
The Mean

Background. The aims of this study were to determine the average length of stay in the Post-anesthesia CareUnit (PACU LOS) in the Philippine General Hospital (PGH) and to create a model that will predict the PACU LOSbased on the factors that significantly affect the LOS. Determination and prediction of PACU LOS is essential inresource utilization, and in cost containment and reduction. Addressing the modifiable variables that affect thePACU LOS may lead to an improvement in the LOS of patients in the PACU and, consequently, to better recoveryroom staffing and a reduced cost for the patients and the hospital. Methods. A prospective chart review of 400 postoperative patients admitted in the PGH PACU was done. Summarystatistics were presented. Using the set of variables found to be significant, a regression model was formulatedto estimate the PACU LOS. Results. The mean PACU LOS was 4.59 hours. There were significant differences in the mean PACU LOS basedon the occurrence of complications. There were also significant differences in the median PACU LOS based onthe type and duration of surgery, anesthetic technique, and duration of anesthesia. The multiple linear regressionmodel that best predicted PACU LOS included ASA-PS classification, type of surgery, duration of surgery, anesthetictechnique, and occurrence of intraoperative or postoperative complications. Conclusions. The mean PACU LOS of the Philippine Genera Hospital is higher than that of published data. Thefactors included in the model that best predicts PACU LOS may be studied to improve the PACU LOS.

Nonunion Rates in Hind- and Midfoot Arthrodesis in Current, Ex-, and Nonsmokers

2020 ◽  
pp. 107110072097126
Author(s):  
Jack Allport ◽  
Jayasree Ramaskandhan ◽  
Malik S. Siddique
Keyword(s):  
Risk Factor ◽  
Cohort Study ◽  
Relative Risk ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Smoking Status ◽  
Time Frame ◽  
Modifiable Risk Factor ◽  
Level Of Evidence ◽  
Significant Difference

Background: Nonunion rates in hind or midfoot arthrodesis have been reported as high as 41%. The most notable and readily modifiable risk factor that has been identified is smoking. In 2018, 14.4% of the UK population were active smokers. We examined the effect of smoking status on union rates for a large cohort of patients undergoing hind- or midfoot arthrodesis. Methods: In total, 381 consecutive primary joint arthrodeses were identified from a single surgeon’s logbook (analysis performed on a per joint basis, with a triple fusion reported as 3 separate joints). Patients were divided based on self-reported smoking status. Primary outcome was clinical union. Delayed union, infection, and the need for ultrasound bone stimulation were secondary outcomes. Results: Smoking prevalence was 14.0%, and 32.2% were ex-smokers. Groups were comparable for sex, diabetes, and body mass index. Smokers were younger and had fewer comorbidities. Nonunion rates were higher in smokers (relative risk, 5.81; 95% CI, 2.54-13.29; P < .001) with no statistically significant difference between ex-smokers and nonsmokers. Smokers had higher rates of infection ( P = .05) and bone stimulator use ( P < .001). Among smokers, there was a trend toward slower union with heavier smoking ( P = .004). Conclusion: This large retrospective cohort study confirmed previous evidence that smoking has a considerable negative effect on union in arthrodesis. The 5.81 relative risk in a modifiable risk factor is extremely high. Arthrodesis surgery should be undertaken with extreme caution in smokers. Our study shows that after cessation of smoking, the risk returns to normal, but we were unable to quantify the time frame. Level of Evidence: Level III, retrospective cohort study.

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