Does preoperative mental health affect length of hospital stay and functional outcomes following arthroplasty surgery? A registry-based cohort study

All applications of s.5(2) of the Mental Health Act 1983, allowing the emergency detention of voluntary in-patients in North Cheshire between 1985 and 1995, were reviewed to examine general trends in its use and to assess variables likely to influence its outcome. Of the 877 applications implemented (4% of all admissions), 500 (57%) were converted to longer-term detention under the Act, 396 (45%) were converted to s.2 and 104 (12%) to s.3. The other 377 (43%) detained patients under s.5(2) regained informal status. The review found that time of application of section, length of hospital stay prior to application, medical officer's grade, use of s.5(4) and clinical diagnosis are best predictors of s.5(2) outcome. The results are similar to other published studies and seem to reflect a national pattern, possibly implying that patients detained under this short-term detention order have an almost equal chance of either regaining their voluntary status or being detained under another section by the end of the 72 hours. This may raise questions about the purpose of s.5(2) as expressed by the Mental Health Act Commission.

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Influence of Weekday of Admission and Level of Distress on Length of Hospital Stay in Patients With Low Back Pain: A Retrospective Cohort Study

10.21203/rs.3.rs-111329/v1 ◽

2020 ◽

Author(s):

Emanuel Brunner ◽

André Meichtry ◽

Davy Vancampfort ◽

Reinhard Imoberdorf ◽

David Gisi ◽

...

Keyword(s):

Primary Care ◽

Cohort Study ◽

Back Pain ◽

Hospital Stay ◽

Linear Model ◽

Length Of Hospital Stay ◽

Complex Problem ◽

Interdisciplinary Management ◽

Prolonged Length ◽

The Impact

Abstract BackgroundLow back pain (LBP) is often a complex problem requiring interdisciplinary management to address patients’ multidimensional needs. The inpatient care for patients with LBP in primary care hospitals is a challenge. In this setting, interdisciplinary LBP management is often unavailable during the weekend. Delays in therapeutic procedures may result in prolonged length of hospital stay (LoS). The impact of delays on LoS might be strongest in patients reporting high levels of psychological distress. Therefore, this study investigates which influence the weekday of admission and distress have on LoS of inpatients with LBP.MethodsRetrospective cohort study conducted between 1 February 2019 and 31 January 2020. ANOVA was used to test the hypothesized difference in mean effects of the weekday of admission on LoS. Further, a linear model was fitted for LoS with distress, categorical weekday of admission (Friday/Saturday vs. Sunday-Thursday), and their interactions.ResultsWe identified 173 patients with LBP. Mean LoS was 7.8 days (SD=5.59). Patients admitted on Friday (mean LoS=10.3) and Saturday (LoS=10.6) had longer stays but not those admitted on Sunday (LoS=7.1). Analysis of the weekday effect (Friday/Saturday vs. Sunday-Thursday) showed that admission on Friday or Saturday was associated with significant increase in LoS compared to admission on other weekdays (t=3.43, p=<0.001). 101 patients (58%) returned questionnaires, and complete data on distress was available from 86 patients (49%). According to a linear model for LoS, the effect of distress on LoS was significantly modified (t=2.51, p=0.014) by dichotomic weekdays of admission (Friday/Saturday vs. Sunday-Thursday).ConclusionsPatients with LBP are hospitalized significantly longer if they have to wait more than two days for interdisciplinary LBP management. This particularly affects patients reporting high distress. Our study provides a platform to further explore whether interdisciplinary LBP management addressing patients’ multidimensional needs reduces LoS in primary care hospitals.

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Preventable hospitalizations among older patients with cognitive impairments and dementia

International Psychogeriatrics ◽

10.1017/s1041610218000960 ◽

2018 ◽

Vol 31 (3) ◽

pp. 383-391 ◽

Cited By ~ 7

Author(s):

Dominik Wolf ◽

Carolin Rhein ◽

Katharina Geschke ◽

Andreas Fellgiebel

Keyword(s):

Cohort Study ◽

Hospital Stay ◽

Ambulatory Care ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Older Patients ◽

Hospital Admissions ◽

Cognitive Impairments ◽

Length Of Hospital Stay ◽

Complication Rates

ABSTRACTObjectives:Dementia and cognitive impairment are associated with higher rates of complications and mortality during hospitalization in older patients. Moreover, length of hospital stay and costs are increased. In this prospective cohort study, we investigated the frequency of hospitalizations caused by ambulatory care-sensitive conditions (ACSCs), for which proactive ambulatory care might prevent the need for a hospital stay, in older patients with and without cognitive impairments.Design:Prospective cohort study.Setting:Eight hospitals in Germany.Participants:A total of 1,320 patients aged 70 years and older.Measurements:The Mini-Cog test has been used to assess cognition and to categorize patients in the groups no/moderate cognitive impairments (probably no dementia) and severe cognitive impairments (probable dementia). Moreover, lengths of hospital stay and complication rates have been assessed, using a binary questionnaire (if occurred during hospital stay or not; behavioral symptoms were adapted from the Cohen-Mansfield Agitation Inventory). Data have been acquired by the nursing staff who received a special multi-day training.Results:Patients with severe cognitive impairments showed higher complication rates (including incontinence, disorientation, irritability/aggression, restlessness/anxiety, necessity of Tranquilizers and psychiatric consults, application of measures limiting freedom, and falls) and longer hospital stays (+1.4 days) than patients with no/moderate cognitive impairments. Both groups showed comparably high ACSC-caused admission rates of around 23%.Conclusions:The study indicates that about one-fourth of hospital admissions of cognitively normal and impaired older adults are caused by ACSCs, which are mostly treatable on an ambulatory basis. This implies that an improved ambulatory care might reduce the frequency of hospitalizations, which is of particular importance in cognitively impaired elderly due to increased complication rates.

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Early Oral Switch to Linezolid for Low-risk Patients With Staphylococcus aureus Bloodstream Infections: A Propensity-matched Cohort Study

Clinical Infectious Diseases ◽

10.1093/cid/ciy916 ◽

2018 ◽

Vol 69 (3) ◽

pp. 381-387 ◽

Cited By ~ 15

Author(s):

Rein Willekens ◽

Mireia Puig-Asensio ◽

Isabel Ruiz-Camps ◽

Maria N Larrosa ◽

Juan J González-López ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Cohort Study ◽

Propensity Score ◽

Hospital Stay ◽

Propensity Score Matching ◽

Length Of Hospital Stay ◽

Low Risk ◽

Significant Difference ◽

Risk Patients ◽

Oral Switch

Abstract Background Oral switch to linezolid is a promising alternative to standard parenteral therapy (SPT) in Staphylococcus aureus bacteremia (SAB). Methods We conducted a prospective cohort study of all adult cases of SAB between 2013 and 2017 in a Spanish university hospital. We compared the efﬁcacy, safety, and length of hospital stay of patients receiving SPT and those where SPT was switched to oral linezolid between days 3 and 9 of treatment until completion. We excluded complicated SAB and osteoarticular infections. A k-nearest neighbor algorithm was used for propensity score matching with a 2:1 ratio. Results After propensity score matching, we included 45 patients from the linezolid group and 90 patients from the SPT group. Leading SAB sources were catheter related (49.6%), unknown origin (20.0%), and skin and soft tissue (17.0%). We observed no difference in 90-day relapse between the linezolid group and the SPT group (2.2% vs 4.4% respectively; P = .87). No statistically significant difference was observed in 30-day all-cause mortality between the linezolid group and the SPT group (2.2% vs 13.3%; P = .08). The median length of hospital stay after onset was 8 days in the linezolid group and 19 days in the SPT group (P < .01). No drug-related events leading to discontinuation were noted in the linezolid group. Conclusions Treatment of SAB in selected low-risk patients with an oral switch to linezolid between days 3 and 9 of treatment until completion yielded similar clinical outcomes as SPT, allowing earlier discharge from the hospital.

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Early Ambulation Decreases Length of Hospital Stay, Perioperative Complications and Improves Functional Outcomes in Elderly Patients Undergoing Surgery for Correction of Adult Degenerative Scoliosis

Spine ◽

10.1097/brs.0000000000002189 ◽

2017 ◽

Vol 42 (18) ◽

pp. 1420-1425 ◽

Cited By ~ 19

Author(s):

Owoicho Adogwa ◽

Aladine A. Elsamadicy ◽

Jared Fialkoff ◽

Joseph Cheng ◽

Isaac O. Karikari ◽

...

Keyword(s):

Elderly Patients ◽

Hospital Stay ◽

Functional Outcomes ◽

Perioperative Complications ◽

Length Of Hospital Stay ◽

Degenerative Scoliosis ◽

Early Ambulation ◽

Adult Degenerative Scoliosis

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An Investigation Into the Length of Hospital Stay for Deaf Mental Health Service Users

The Journal of Deaf Studies and Deaf Education ◽

10.1093/deafed/enq003 ◽

2010 ◽

Vol 15 (2) ◽

pp. 179-184 ◽

Cited By ~ 8

Author(s):

D. Baines ◽

N. Patterson ◽

S. Austen

Keyword(s):

Mental Health ◽

Mental Health Service ◽

Health Service ◽

Hospital Stay ◽

Length Of Hospital Stay ◽

Service Users

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Ethnic variations in unplanned readmissions and excess length of hospital stay: a nationwide record-linked cohort study

European Journal of Public Health ◽

10.1093/eurpub/ckt005 ◽

2013 ◽

Vol 23 (6) ◽

pp. 964-971 ◽

Cited By ~ 18

Author(s):

Martine C. de Bruijne ◽

Floor van Rosse ◽

Ellen Uiters ◽

Mariël Droomers ◽

Jeanine Suurmond ◽

...

Keyword(s):

Cohort Study ◽

Hospital Stay ◽

Length Of Hospital Stay ◽

Ethnic Variations

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Tocilizumab shortens time on mechanical ventilation and length of hospital stay in patients with severe COVID‐19: a retrospective cohort study

Journal of Internal Medicine ◽

10.1111/joim.13162 ◽

2020 ◽

Cited By ~ 9

Author(s):

J. Eimer ◽

J. Vesterbacka ◽

A.‐K. Svensson ◽

B. Stojanovic ◽

C. Wagrell ◽

...

Keyword(s):

Mechanical Ventilation ◽

Cohort Study ◽

Hospital Stay ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Length Of Hospital Stay

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Psychiatric and substance abuse disorder diagnoses as predictors of length of hospital stay

Australian Health Review ◽

10.1071/ah960020 ◽

1996 ◽

Vol 19 (4) ◽

pp. 20 ◽

Cited By ~ 1

Author(s):

David I Ben-Tovim ◽

Rob Elzinga ◽

Phillip Burgess

Keyword(s):

Mental Health ◽

Substance Abuse ◽

Hospital Stay ◽

Average Length ◽

Diagnosis Related Groups ◽

Length Of Hospital Stay ◽

Classification Systems ◽

Substance Abuse Disorder ◽

Average Length Of Stay ◽

Related Group

The mental health and substance abuse components of AN-DRG 3 were examinedusing data from all inpatient separations in two Australian States over a two-yearperiod. Assignment to a mental health or a substance abuse diagnosis related group(DRG) predicted about 20- per cent of the variability in average length of stay ofpatients treated for such conditions. Assignment to a substance abuse DRG was amuch less robust predictor of length of hospital stay than assignment to a mental healthDRG. There was little variation between years or States. Day-only intent patientswere excluded, as were long-stay outliers identified using an inter-quartile rangetrimming process. Psychiatric DRGs are similar to a number of other non-surgicallyfocused diagnosis related groups in their capacity to predict length of hospital stay. Theyare likely to remain an important component of casemix classification systems.

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A Nomogram Prediction of Length of Hospital Stay in Patients with COVID-19 Pneumonia: A Retrospective Cohort Study

Disease Markers ◽

10.1155/2021/5598824 ◽

2021 ◽

Vol 2021 ◽

pp. 1-9

Author(s):

Kang Li ◽

Chi Zhang ◽

Ling Qin ◽

Chaoran Zang ◽

Ang Li ◽

...

Keyword(s):

Cohort Study ◽

Hospital Stay ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Proportional Hazards ◽

Characteristic Curve ◽

Length Of Hospital Stay ◽

Cox Proportional Hazards ◽

Brier Score ◽

Rank Test

Assessing the length of hospital stay (LOS) in patients with coronavirus disease 2019 (COVID-19) pneumonia is helpful in optimizing the use efficiency of hospital beds and medical resources and relieving medical resource shortages. This retrospective cohort study of 97 patients was conducted at Beijing You’An Hospital between January 21, 2020, and March 21, 2020. A multivariate Cox proportional hazards regression based on the smallest Akaike information criterion value was used to select demographic and clinical variables to construct a nomogram. Discrimination, area under the receiver operating characteristic curve (AUC), calibration, and Kaplan–Meier curves with the log-rank test were used to assess the nomogram model. The median LOS was 13 days (interquartile range [IQR]: 10–18). Age, alanine aminotransferase, pneumonia, platelet count, and PF ratio (PaO2/FiO2) were included in the final model. The C-index of the nomogram was 0.76 ( 95 % confidence interval CI = 0.69 – 0.83 ), and the AUC was 0.88 ( 95 % CI = 0.82 – 0.95 ). The adjusted C-index was 0.75 ( 95 % CI = 0.67 – 0.82 ) and adjusted AUC 0.86 ( 95 % CI = 0.73 – 0.95 ), both after 1000 bootstrap cross internal validations. A Brier score of 0.11 ( 95 % CI = 0.07 – 0.15 ) and adjusted Brier score of 0.130 ( 95 % CI = 0.07 – 0.20 ) for the calibration curve showed good agreement. The AUC values for the nomogram at LOS of 10, 20, and 30 days were 0.79 ( 95 % CI = 0.69 – 0.89 ), 0.89 ( 95 % CI = 0.83 – 0.96 ), and 0.96 ( 95 % CI = 0.92 – 1.00 ), respectively, and the high fit score of the nomogram model indicated a high probability of hospital stay. These results confirmed that the nomogram model accurately predicted the LOS of patients with COVID-19. We developed and validated a nomogram that incorporated five independent predictors of LOS. If validated in a future large cohort study, the model may help to optimize discharge strategies and, thus, shorten LOS in patients with COVID-19.

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