scholarly journals Retrospective evaluation of patients with and without 14-day readmissions following hospitalization for COVID-19

2021 ◽  
pp. jim-2021-001986
Author(s):  
Kavitha Subramoney ◽  
Omar Elsheikh ◽  
Saira Butt ◽  
Daniel Romano ◽  
Lindsey Reese ◽  
...  

Hospitalized patients with COVID-19 must have a safe discharge plan to prevent readmissions. We assessed patients with COVID-19 admitted to hospitals belonging to a single health system between April 2020 and June 2020. Demographics, vitals and laboratory data were obtained by electronic data query and discharge processes were reviewed by manual abstraction. Over the study period, 94 out of 912 (10.3%) patients were readmitted within 14 days of discharge. Readmitted patients were older and spent more time in the intensive care unit (p<0.01). Statistical differences were noted in discharge-day heart rates, temperatures, platelet counts, and neutrophil and lymphocyte percentages between the readmitted and non-readmitted groups. Readmitted patients were less likely to be discharged home and to receive complete discharge instructions or home oxygen (p<0.01). Age, duration of intensive care unit stay, disposition destinations other than home, incomplete discharge planning and no arrangement for home oxygen may be associated with 14-day readmissions in patients with COVID-19. Certain clinical parameters on discharge day, while statistically different, may not reach clinically discriminant thresholds. Structured discharge processes may improve outcomes.

2018 ◽  
Vol 2 (8) ◽  
Author(s):  
Bedih Balkan ◽  
Neziha Ates ◽  
Dondu Genç Moralar ◽  
Gulay Eren ◽  
Gulsum Oya Hergunsel ◽  
...  

2019 ◽  
Vol 38 ◽  
pp. S63
Author(s):  
D. Ebiloglu ◽  
C. Kaymak ◽  
H. Basar ◽  
A. Ozcan ◽  
N. Ozcan ◽  
...  

1993 ◽  
Vol 21 (2) ◽  
pp. 192-196 ◽  
Author(s):  
J. Lipman ◽  
W. Wilson ◽  
S. Kobilski ◽  
J. Scribante ◽  
C. Lee ◽  
...  

Forty intensive care unit patients requiring cardiopulmonary resuscitation were randomised to receive either the standard dose of adrenaline (1 mg every five minutes) or high-dose adrenaline (10 mg every five minutes). In the majority of patients, overwhelming sepsis was the major contributing factor leading to cardiac arrest. In this group of patients no difference could be detected in response to high-dose adrenaline compared with the standard dose. Although no side-effects were noted with this high dose of adrenaline, more investigation is required prior to its routine use in cardiopulmonary resuscitation.


2019 ◽  
Vol 15 (2) ◽  
pp. 79-89 ◽  
Author(s):  
Yamely Mendez ◽  
Francisco E. Ochoa-Martinez ◽  
Tatiana Ambrosii

Chronic obstructive lung disease is a common and preventable disease. One of its pathophysiological consequences is the presence of carbon dioxide retention due to hypoventilation and ventilation/perfusion mismatch, which in consequence will cause a decrease in the acid/base status of the patient. Whenever a patient develops an acute exacerbation, acute respiratory hypercapnic failure will appear and the necessity of a hospital ward is a must. However, current guidelines exist to better identify these patients and make an accurate diagnosis by using clinical skills and laboratory data such as arterial blood gases. Once the patient is identified, rapid treatment will help to diminish the hospital length and the avoidance of intensive care unit. On the other hand, if there is the existence of comorbidities such as cardiac failure, gastroesophageal reflux disease, pulmonary embolism or depression, it is likely that the patient will be admitted to the intensive care unit with the requirement of intubation and mechanical ventilation.


2017 ◽  
Vol 34 (6) ◽  
pp. 511-513 ◽  
Author(s):  
Ibrahim Karagoz ◽  
Gulali Aktas ◽  
Hamit Yoldas ◽  
Isa Yildiz ◽  
Muhammet Nur Ogun ◽  
...  

Aim: Recently, hemogram parameters, such as mean platelet volume (MPV), had been proposed as novel inflammatory and prognostic factors. In present retrospective analysis, we aimed to determine and compare MPV of survived and dead patients whom admitted to intensive care unit (ICU) of our institution. Methods: We recorded hemogram parameters and other laboratory data and demographic characteristics of patients treated in ICU. Patients are divided into 2 groups—dead patients and survived patients. Laboratory data of survived patients compared to those of dead patients. Results: Age, gender, and other laboratory variables were not significantly different between dead and survived patients. On the other hand, MPV of survived patients was significantly higher than that of the dead patients ( P = .001). Conclusion: We think that elevated MPV levels in an ICU patient should alert clinicians for worse outcome. Physicians should be more careful in the management of these patients.


2015 ◽  
Vol 20 (2) ◽  
pp. 112-118 ◽  
Author(s):  
Lauren M. Estkowski ◽  
Jennifer L. Morris ◽  
Elizabeth A. Sinclair

OBJECTIVES: To describe and compare off-label use and cardiovascular (CV) adverse effects of dexmedetomidine in neonates and infants in the pediatric intensive care unit (PICU). METHODS: Patients younger than 12 months with corrected gestational ages of at least 37 weeks who were receiving continuous infusion of dexmedetomidine at a tertiary pediatric referral center between October 2007 and August 2012 were assessed retrospectively. Patients were excluded if dexmedetomidine was used for procedural sedation, postoperative CV surgery, or if postanesthesia infusion weaning orders existed at the time of PICU admission. RESULTS: The median minimum dexmedetomidine dose was similar between infants and neonates at 0.2 mcg/kg/hr (IQR, 0.17–0.3) versus 0.29 mcg/kg/hr (IQR, 0.2–0.31), p = 0.35. The median maximum dose was higher for infants than neonates (0.6 mcg/kg/hr [IQR, 0.4–0.8] vs. 0.4 mcg/kg/hr [IQR, 0.26–0.6], p &lt; 0.01). Additional sedative use was more common in infants than neonates (75/99 [76%] vs. 15/28 [54%], p = 0.02). At least 1 episode of hypotension was noted in 34/127 (27%) patients and was similar between groups. An episode of bradycardia was identified more frequently in infants than neonates (55/99 [56%] vs. 2/28 [7%], p &lt; 0.01). Significant reduction in heart rate and systolic blood pressure was noted when comparing baseline vital signs to lowest heart rate and systolic blood pressure during infusion (p &lt; 0.01). CONCLUSIONS: Dexmedetomidine dose ranges were similar to US Food and Drug Administration–labeled dosages for intensive care unit sedation in adults. More infants than neonates experienced a bradycardia episode, but infants were also more likely to receive higher dosages of dexmedetomidine and additional sedatives.


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