Laparoscopic versus Open Colon Resections in California: A Cross-Sectional Analysis

2012 ◽  
Vol 78 (10) ◽  
pp. 1063-1065 ◽  
Author(s):  
Supriya S. Patel ◽  
Madhukar S. Patel ◽  
Sanjit Mahanti ◽  
Adrian Ortega ◽  
Glenn T. Ault ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Laparoscopic Colectomy ◽  
Laparoscopic Approach ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Case Volume ◽  
Cross Sectional ◽  
Perioperative Morbidity ◽  
Laparoscopic Techniques ◽  
Sectional Analysis

Laparoscopic surgery is associated with decreased hospital length of stay, improved perioperative morbidity, and faster return to work compared with open procedures. Despite these benefits, laparoscopy has not been universally adopted with recent implementation estimates ranging from 10 to 30 per cent. The purpose of this study was to analyze the adoption of laparoscopic techniques for colon resections in California in 2009 based on institutional colectomy volume status. A total of 14,736 patients from 320 hospitals was analyzed. The laparoscopic to open case ratios for the low (zero to 17 cases/year), medium (18 to 50 cases/year), and high (greater than 50 cases/year) volume centers were: 0.32, 0.50, and 0.92, respectively. Although the data confirmed that a laparoscopic approach reduced length of stay (LOS) regardless of volume, lower adopters of laparoscopic colectomy had a longer overall total LOS, likely related to preponderance of open cases. Therefore, the data show that higher-volume institutions appear to have implemented laparoscopic colectomy for more of their case volume, and this adoption may account for the better institutional outcomes observed in these centers.

scholarly journals The Correlation Between Patient Satisfaction Regarding Nutrition Service And Hospital Length Of Stay With Food Waste In Covid–19 Patients

2021 ◽  
Vol 14 (02) ◽  
pp. 147-152
Author(s):  
Budhi Setianto ◽  
Agus Aan Adriansyah ◽  
Umi Hanik ◽  
Difran Nobel Bistara
Keyword(s):  
Patient Satisfaction ◽  
Length Of Stay ◽  
Food Waste ◽  
Hospital Length ◽  
Food Delivery ◽  
Food Presentation ◽  
Hospital Length Of Stay ◽  
Cross Sectional ◽  
Isolation Room ◽  
Nutrition Service

Patient satisfaction is one indicator of the success of food delivery in the hospital. In the condition of the Covid-19 patient, there are several symptoms which will affect the length of stay in the hospital so that the patient’s nutrition greatly affects the patient’s improvement. This study aims to determine the relationship between food serving satisfaction and length of stay on leftover food in Covid-19 patients. This study used a quantitative method with observational and cross-sectional research method in the isolation room of RSI Surabaya in July-September. The data were processed using chi square test. The results showed that there was a relationship between the satisfaction of serving food and leftovers (P= 0,000), while the length of stay in Covid-19 patients had no relationship with food waste (P= 0,517). There is a relationship between the satisfaction of the patient’s food presentation and the food waste, this shows that the better the patient’s assessment of the assessment of the food presentation, the are no food waste. Meanwhile, the length of stay of patient in the Covid-19 isolation room did not have a relationship with food waste so that the length of stay did not affect the food waste.

scholarly journals Laparo-endoscopic Single Site Surgery in Pediatrics: Feasibility and surgical outcomes from a preliminary prospective Canadian experience.

2015 ◽  
Vol 9 (1-2) ◽  
pp. 48 ◽  
Author(s):  
Aziz M. Khambati ◽  
Elias Wehbi ◽  
Walid A. Farhat
Keyword(s):  
Length Of Stay ◽  
Surgical Outcomes ◽  
Laparoscopic Approach ◽  
Hospital Length ◽  
Single Site ◽  
Hospital Length Of Stay ◽  
Short Term ◽  
Tertiary Center ◽  
Single Site Surgery

Introduction: Laparo-endoscopic single-site surgery (LESS) is becoming an alternative to standard laparoscopic surgery. Proposed advantages include enhanced cosmesis and faster recovery. We assessed the early post-operative surgical outcomes of LESS surgery utilizing different instruments in the pediatric urological population in Canada.Methods: We prospectively captured data on all patients undergoing LESS at our institution between February 2011 and August 2012. This included patient age, operative time, length of stay, complications and short-term surgical outcomes. Different instruments/ devices were used to perform the procedures. Access was achieved through a transumbilical incision.Results: A total of 16 LESS procedures were performed, including seven pyeloplasties, four unilateral and one bilateral varicocelectomies, two simple nephrectomies, one renal cyst decortication and one pyelolithotomy. There was no statistical difference in the operative times, hospital length of stay and cost (pyeloplasty only) in patients undergoing pyeloplasty and varicocelectomy using the LESS technique when compared to an age matched cohort of patients managed with the traditional laparoscopic approach. One pyeloplasty in the LESS group required conversion to open due to a small intra-renal pelvis. There were no immediate or short term post-operative complications; however, one patient experienced a decrease in renal function status post LESS pyeloplasty. Since all procedures were performed by a vastly experienced surgeon at a tertiary center, the generalizability of the results cannot be assessed.Conclusions: There are only a few series that have assessed the role of LESS in pediatric urological surgery. Although our experience is limited by a heterogeneous group of patients with a short follow-up period, the present cohort demonstrates the safety and feasibility of LESS. Further evaluation with randomized studies is required to better assess the role of LESS in pediatric urology.

scholarly journals Postoperative cardiac surgery complications and hospital length of stay

2018 ◽  
Vol 12 (8) ◽  
pp. 2105
Author(s):  
Alexandre Lins Werneck ◽  
Ligia Marcia Contrin ◽  
Lucia Marinilza Beccaria ◽  
Gabriela Taparo De Castro ◽  
Carolina Varine Teixeira ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Intensive Care ◽  
Length Of Stay ◽  
Cross Sectional Study ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Cross Sectional ◽  
Cardiac Surgery Complications ◽  
Set Up ◽  
Previous Disease

RESUMOObjetivo: associar as principais complicações com pacientes submetidos à cirurgia cardíaca e o tempo de internação. Método: estudo quantitativo, transversal, descritivo e correlacional, para identificar os registros médicos de pacientes submetidos a cirurgias cardíacas e aqueles no pós-operatório na Unidade de Terapia Intensiva. O teste de Regressão Linear Multivariada foi utilizado para a análise e a previsão de independência entre as variáveis. Resultados: dos 103 pacientes submetidos a cirurgias cardíacas, 26 apresentaram complicações pós-operatórias. As complicações mais prevalentes foram cardíacas, pulmonares e infecciosas. Nove pacientes morreram. A doença anterior mais prevalente foi hipertensão arterial sistêmica. Em relação aos dias de hospitalização, o predomínio foi de um a três dias, seguido de três a seis dias. Conclusão: a revascularização miocárdica foi a principal cirurgia realizada, seguida de endarterectomia e as complicações observadas foram cardíacas, seguidas das pulmonares. A duração hospitalar dos pacientes variou de um a três dias. Este estudo mostrou que é imprescindível o planejamento da alta do paciente o mais precocemente possível para a diminuição do tempo de internação e possíveis complicações. Descritores: Complicações; Cirurgias Cardíacas; Pacientes; Tempo de Internação; Tempo de Internação; Alta do Paciente; Unidade de Terapia Intensiva.ABSTRACT Objective: to associate the main complications experienced by patients submitted to cardiac surgery and the length of stay in a Cardiac ICU. Method: this was a quantitative, cross-sectional study using descriptive and correlation designs. We identified medical records of patients undergoing cardiac surgeries and those who were in the postoperative period in the Intensive Care Unit. Multivariate Linear Regression test was used for THE analysis and THE prediction of independence between variables. Results: twenty-six out of 103 patients submitted to cardiac surgeries presented postoperative complications. The most prevalent complications were cardiac, pulmonary, and infectious ones. Nine patients died. The most prevalent previous disease was systemic arterial hypertension. Regarding the hospital length of stay, the predominance was ONE to THREE days, followed by THREE to six days. Conclusion: The hospital length of stay ranged from ONE to THREE days long. This STUDY showed that planning is essential to set up the patient’s discharge as early as possible, as well as to reduce the hospital length of stay and potential complications. Descriptor: Complications; Thoracic Surgery; Patients; Length of Stay; Discharge Plannings; Intensive Care Unit.RESUMENObjetivo: Asociar las principales complicaciones con pacientes sometidos a la cirugía y con el tempo de internación. Método: Estudio cuantitativo, transversal, descriptivo y correlacional del banco de datos del hospital para identificar los registros médicos de pacientes sometidos a cirugías torácicas y de aquellos en el postoperatorio en la Unidad de Cuidados Intensivos. Se utilizó la prueba de Regresión Lineal Múltiple para análisis y predicción de independencia entre las variables.  Resultados: De los 103 pacientes sometidos a cirugías torácicas, 26 presentaron complicaciones postoperatorias. Las complicaciones más prevalentes fueron las cardíacas, las pulmonares y las infecciosas. Nueve pacientes murieron. La enfermedad anterior más prevalente ha sido la hipertensión arterial sistémica. Acerca de los días de hospitalización, el período predominante fue de UNO a TRES días, seguido de TRES a SEIS días. Conclusión: La cirugía de revascularización coronaria ha sido la principal cirugía, seguida de la endarterectomía, y las complicaciones observadas fueron las cardíacas, seguidas de las pulmonares. El tiempo de internación de los pacientes varió de UNO a TRES días. Eso ESTUDIO ha mostrado que es imprescindible planificar el egreso del paciente lo más temprano posible, para reducción del tiempo de internación y de las posibles complicaciones. Descriptores: Complicaciones; Cirurgía Torácica; Pacientes; Tiempo de Internación; Alta del Paciente; Unidades de Cuidados Intensivos.

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.

scholarly journals Predictors of prolonged hospital stay in HIV-positive patients presenting to the emergency department

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249706
Author(s):  
Abdullah E. Laher ◽  
Fathima Paruk ◽  
Guy A. Richards ◽  
Willem D. F. Venter
Keyword(s):  
Emergency Department ◽  
Length Of Stay ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Hiv Positive ◽  
Cross Sectional ◽  
Prolonged Hospitalization ◽  
Prolonged Hospital

Background Prolonged hospitalization places a significant burden on healthcare resources. Compared to the general population, hospital length of stay (LOS) is generally longer in HIV-positive patients. We identified predictors of prolonged hospital length of stay (LOS) in HIV-positive patients presenting to an emergency department (ED). Methods In this cross-sectional study, HIV-positive patients presenting to the Charlotte Maxeke Johannesburg Academic Hospital adult ED were prospectively enrolled between 07 July 2017 and 18 October 2018. Data was subjected to univariate and multivariate logistic regression to determine parameters associated with a higher likelihood of prolonged hospital LOS, defined as ≥7 days. Results Among the 1224 participants that were enrolled, the median (IQR) LOS was 4.6 (2.6–8.2) days, while the mean (SD) LOS was 6.9 (8.2) days. On multivariate analysis of the data, hemoglobin <11 g/dL (OR 1.37, p = 0.032), Glasgow coma scale (GCS) <15 (OR 1.80, p = 0.001), creatinine >120 μmol/L (OR 1.85, p = 0.000), cryptococcal meningitis (OR 2.45, p = 0.015) and bacterial meningitis (OR 4.83, p = 0.002) were significantly associated with a higher likelihood of LOS ≥7 days, while bacterial pneumonia (OR 0.35, p = 0.000) and acute gastroenteritis (OR 0.40, p = 0.025) were significantly associated with a lower likelihood of LOS ≥7 days. Conclusion Various clinical and laboratory parameters are useful in predicting prolonged hospitalization among HIV-positive patients presenting to the ED. These parameters may be useful in guiding clinical decision making and directing the allocation of resources.

scholarly journals Utility and impact of inpatient pediatric physiologic monitoring

2020 ◽  
Author(s):  
Anand Gourishankar ◽  
Monaliza S Evangelista ◽  
Misti Ellsworth ◽  
Jean Hsu
Keyword(s):  
Length Of Stay ◽  
Pulse Oximeter ◽  
Pediatric Patients ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Cross Sectional ◽  
Cardiac Monitor ◽  
Cardiac Pulse ◽  
Prolonged Hospital ◽  
Time Of Admission

Objective: To study the practice and effect of monitoring pediatric patients on the hospital length of stay (LOS). Methods: We conducted a cross-sectional observational study of pediatric patients in the general ward from October to December 2016. We recorded the use of cardiac, pulse-oximeter, or both, and physician order at the time of admission. We studied the proportions of monitoring on different patient groups. The median length of stay assessed for various modes of monitoring. We did regression analysis for the effect of cardiopulmonary monitoring, orders, and medical complexity on hospital length of stay. Results: Among 398 patients, patients with cardiac monitor and pulse oximeter with orders were 68 % and 82%, respectively. The pulmonary group of patients had more monitoring than the neurology group of patients. LOS was shorter in patients without monitors; the median difference for the cardiac monitor was 1 day, and pulse oximeter was 0.5 days. Cardiac monitor order increased LOS by 22% (95% CI, 0.5% to 48%) and complex past medical history increased it by 25% (95% CI, 4% to 51%). Conclusion: Our study highlights the variable practice in using monitors, demanding a standardized approach. The judicious use of monitoring reduces prolonged hospital stay.

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