Preoperative anemia increases the risk of red blood cell transfusion and prolonged hospital length of stay in children undergoing spine arthrodesis surgery

Background: Acute pyelonephritis is a bacterial infection of the upper urinary tract. Patients can be admitted to a variety of wards for treatment. However, at the Prince of Wales Hospital in Hong Kong, they are managed initially in the emergency medicine ward. The aim of the study is to identify the risk factors that are associated with a prolonged hospital length of stay. Methods: This was a retrospective cohort study conducted in Prince of Wales Hospital. The study recruited patients who were admitted to the emergency medicine ward between 1 January 2014 and 31 December 2017. These patients presented with clinical features of pyelonephritis, received antibiotic treatment and had a discharge diagnosis of pyelonephritis. The length of stay was measured and any length of stay over 72 h was considered to be prolonged. Results: There were 271 patients admitted to the emergency medicine ward, and 118 (44%) had a prolonged hospital length of stay. Univariate and multivariate analyses showed that the only statistically significant predictor of prolonged length of stay was a raised C-reactive protein (odds ratio 1.01; 95% confidence 1.01–1.02; p < 0.0001). Out of 271 patients, 261 received antibiotics in the emergency department. All 10 patients (8.5%) who did not receive antibiotics in emergency department had a prolonged length of stay (p = 0.0002). Conclusion: In this series of acute pyelonephritis treated in the emergency medicine ward, raised C-reactive protein levels were predictive for prolonged length of stay. Patients who did not receive antibiotics in the emergency department prior to emergency medicine ward admission had prolonged length of stay.

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30-Day Outcomes for Total Ankle Arthroplasty in Patients With Anemia

Foot & Ankle International ◽

10.1177/10711007211017512 ◽

2021 ◽

pp. 107110072110175

Author(s):

Jordan R. Pollock ◽

Matt K. Doan ◽

M. Lane Moore ◽

Jeffrey D. Hassebrock ◽

Justin L. Makovicka ◽

...

Keyword(s):

Length Of Stay ◽

Univariate Analysis ◽

Hospital Length ◽

Total Ankle Arthroplasty ◽

Hospital Length Of Stay ◽

Preoperative Anemia ◽

Improvement Project ◽

Average Hospital ◽

Ankle Arthroplasty ◽

Reoperation Rates

Background: While anemia has been associated with poor surgical outcomes in total knee arthroplasty and total hip arthroplasty, the effects of anemia on total ankle arthroplasty remain unknown. This study examines how preoperative anemia affects postoperative outcomes in total ankle arthroplasty. Methods: A retrospective analysis was performed using the American College of Surgeons National Surgery Quality Improvement Project database from 2011 to 2018 for total ankle arthroplasty procedures. Hematocrit (HCT) levels were used to determine preoperative anemia. Results: Of the 1028 patients included in this study, 114 patients were found to be anemic. Univariate analysis demonstrated anemia was significantly associated with an increased average hospital length of stay (2.2 vs 1.8 days, P < .008), increased rate of 30-day readmission (3.5% vs 1.1%, P = .036), increased 30-day reoperation (2.6% vs 0.4%, P = .007), extended length of stay (64% vs 49.9%, P = .004), wound complication (1.75% vs 0.11%, P = .002), and surgical site infection (2.6% vs 0.6%, P = .017). Multivariate logistic regression analysis found anemia to be significantly associated with extended hospital length of stay (odds ratio [OR], 1.62; 95% CI, 1.07-2.45; P = .023) and increased reoperation rates (OR, 5.47; 95% CI, 1.15-26.00; P = .033). Anemia was not found to be a predictor of increased readmission rates (OR, 3.13; 95% CI, 0.93-10.56; P = .066) or postoperative complications (OR, 1.27; 95% CI, 0.35-4.56; P = .71). Conclusion: This study found increasing severity of anemia to be associated with extended hospital length of stay and increased reoperation rates. Providers and patients should be aware of the increased risks of total ankle arthroplasty with preoperative anemia. Level of Evidence: Level III, retrospective comparative study.

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Red Blood Cell Transfusion Practices

ICU Director ◽

10.1177/1944451612467534 ◽

2012 ◽

Vol 4 (1) ◽

pp. 11-14

Author(s):

Edwin Annan ◽

Kristin G. Fless ◽

Nirav Jasani ◽

Frantz Pierre-Louis ◽

Fariborz Rezai ◽

...

Keyword(s):

Length Of Stay ◽

Blood Cell ◽

Red Blood Cell ◽

High Intensity ◽

Retrospective Chart Review ◽

Red Blood Cell Transfusion ◽

Icu Length Of Stay ◽

Staffing Model ◽

One Year ◽

Rbc Transfusion

Background and Objectives. High-intensity ICU staffing model is associated with quality and outcome improvements. Restrictive red blood cell (RBC) transfusion strategies have been shown to have equivalent mortality to a more liberal strategy in the ICU. We examined the effect of high-intensity staffing on pretransfusion hemoglobin levels, RBC transfusion rates and length of ICU stay. Materials and Methods. The study was a retrospective chart review (n = 196) of all patients admitted to the adult medical/surgical ICU for more than 24 hours one year prior to and after institution of the high-intensity staffing model. Results. Matched for demographics and diagnosis, RBC transfusion rates pre- versus postinstitution of the high-intensity staffing model was 42% versus 27%, respectively, and pretransfusion hemoglobin levels were lower (8.94 to 7.39 g/dL). Length of stay was 4.1 days pre–high-intensity staffing and 4.0 days post–high-intensity staffing. Conclusions. High-intensity ICU staffing resulted in fewer RBC transfusions and lower transfusion thresholds. This restrictive RBC transfusion strategy had no adverse effects on patient ICU length of stay.

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Surgical sepsis and delays in social services and intervention services account for prolonged hospital length of stay in general and colorectal surgery

International Journal of Surgery ◽

10.1016/j.ijsu.2013.06.181 ◽

2013 ◽

Vol 11 (8) ◽

pp. 620-621

Author(s):

Carl Kotze

Keyword(s):

Colorectal Surgery ◽

Length Of Stay ◽

Social Services ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Intervention Services ◽

Prolonged Hospital

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Prolonged Length of Stay After Liver Transplantation

ICU Director ◽

10.1177/1944451612439315 ◽

2012 ◽

Vol 3 (2) ◽

pp. 75-79

Author(s):

Andrew T. Young ◽

Gebhard Wagener

Keyword(s):

Liver Transplantation ◽

Length Of Stay ◽

Hospital Stay ◽

Kidney Injury ◽

Hospital Length ◽

Meld Score ◽

Hospital Length Of Stay ◽

Prolonged Hospital Stay ◽

Prolonged Length ◽

Prolonged Hospital

Prolonged hospital length of stay after liver transplantation uses a large amount of hospital resources. The authors evaluated factors associated with prolonged hospital stay in a large single center series. Prolonged hospital stay was defined as more than 30 days. A total of 578 adult cadaveric liver transplants were included, and of these, 160 (27.7%) had a prolonged hospital stay. These patients had shorter waitlist time, higher preoperative MELD (model for end-stage liver disease) scores and received organs from donors with lower donor risk indices. In multivariate analysis, only preoperative MELD score remained significant. Postoperatively, there was no difference in the incidence of acute kidney injury; however, patients with prolonged hospital stay were more likely to have early allograft dysfunction and a higher 90-day mortality.

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