Pre- and intra-operative predictors of postoperative hospital length of stay in patients undergoing radical prostatectomy for prostate cancer in China: a retrospective observational study

Abstract BackgroundDuring COVID-19 outbreak, with the increasing number of patients presenting with acute respiratory failure (ARF), a large use of non-invasive positive pressure ventilation (NIPPV) was done in the Emergency Departments (EDs) and medical wards despite the lack of recommendations. We aimed to assess the use of continuous positive airway pressure (CPAP) in the ED. The primary endpoint was the rate of CPAP failure and the need of endotracheal intubation (ETI). Secondary endpoints were in-hospital mortality and intensive care unit (ICU) and in-hospital length of stay. Study design and MethodsA retrospective observational study enrolling adult patients admitted to the ED of Niguarda Hospital, Milan, Italy, with ARF due to COVID-19 pneumonia from March 18th to April 18th 2020, was conducted. Only patients who strictly followed a local CPAP protocol were enrolled. ResultsA total of 52 patients were included in this study. 38 patients (73%) were judged eligible for ETI. 18 (34.6%) were intubated. 16 (30.8%) patients died: 7 (38.9%) and 9 (26.5%) in the ETI and non-ETI group respectively. The median hospital length of stay was different in ETI and non-ETI patients: 26 days [IQR 16-37] vs 15 days [IQR 9-17] (p=0.005). The median invasive mechanical ventilation time was 11 days [IQR 7-21] with an ICU length of stay of 14.5 days [IQR 10-28]. During the CPAP trial, variations between ETI and non-ETI patients over time were found for positive end-expiratory pressure (PEEP) (p=0.003) and respiratory rate (RR) (p=0.059).ConclusionsA short closed monitored CPAP trial could be considered for ARF due to COVID-19 pneumonia before considering ETI. A progressive PEEP titration should target patient’s SpO2 improvement and RR reduction. More studies are needed to evaluate the efficacy and predictors of failure of CPAP and NIPPV in patients with ARF due to COVID-19 pneumonia.

Download Full-text

CPAP Treatment In COVID-19 Patients: A Retrospective Observational Study In The Emergency Department

10.21203/rs.3.rs-113418/v1 ◽

2020 ◽

Author(s):

Nicolò Capsoni ◽

Daniele Privitera ◽

Annamaria Mazzone ◽

Chiara Airoldi ◽

Valentina Albertini ◽

...

Keyword(s):

Length Of Stay ◽

Observational Study ◽

Invasive Mechanical Ventilation ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Retrospective Observational Study ◽

Positive Pressure ◽

Number Of Patients ◽

Mechanical Ventilation Time ◽

Medical Wards

Abstract Background During COVID-19 outbreak, with the increasing number of patients presenting with acute respiratory failure (ARF), a large use of non-invasive positive pressure ventilation (NIPPV) was done in the Emergency Departments (EDs) and medical wards despite the lack of recommendations. We aimed to assess the use of continuous positive airway pressure (CPAP) in the ED. The primary endpoint was the rate of CPAP failure and the need of endotracheal intubation (ETI). Secondary endpoints were in-hospital mortality and intensive care unit (ICU) and in-hospital length of stay. Methods A retrospective observational study enrolling adult patients admitted to the ED of Niguarda Hospital, Milan, Italy, with ARF due to COVID-19 pneumonia from March 18th to April 18th 2020, was conducted. Only patients who strictly followed a local CPAP protocol were enrolled. Results A total of 52 patients were included in this study. 38 patients (73%) were judged eligible for ETI. 18 (34.6%) were intubated. 16 (30.8%) patients died: 7 (38.9%) and 9 (26.5%) in the ETI and non-ETI group respectively. The median hospital length of stay was different in ETI and non-ETI patients: 26 days [IQR 16–37] vs 15 days [IQR 9–17] (p = 0.005). The median invasive mechanical ventilation time was 11 days [IQR 7–21] with an ICU length of stay of 14.5 days [IQR 10–28]. During the CPAP trial, variations between ETI and non-ETI patients over time were found for positive end-expiratory pressure (PEEP) (p = 0.003) and respiratory rate (RR) (p = 0.059). Conclusionss A short closed monitored CPAP trial could be considered for ARF due to COVID-19 pneumonia before considering ETI. A progressive PEEP titration should target patient’s RR reduction. More studies are needed to evaluate the efficacy and predictors of failure of CPAP and NIPPV in patients with ARF due to COVID-19 pneumonia.

Download Full-text

Nursing Diagnoses as Predictors of Hospital Length of Stay: A Prospective Observational Study

Journal of Nursing Scholarship ◽

10.1111/jnu.12444 ◽

2018 ◽

Vol 51 (1) ◽

pp. 96-105 ◽

Cited By ~ 3

Author(s):

Fabio D'Agostino ◽

Ercole Vellone ◽

Antonello Cocchieri ◽

John Welton ◽

Massimo Maurici ◽

...

Keyword(s):

Length Of Stay ◽

Observational Study ◽

Prospective Observational Study ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Nursing Diagnoses

Download Full-text

Association of Guideline-concordant Acute Asthma Care in the Emergency Department With Shorter Hospital Length of Stay: A Multicenter Observational Study

Academic Emergency Medicine ◽

10.1111/acem.12920 ◽

2016 ◽

Vol 23 (5) ◽

pp. 616-622 ◽

Cited By ~ 8

Author(s):

Kohei Hasegawa ◽

Barry E. Brenner ◽

Richard M. Nowak ◽

Stacy A. Trent ◽

Vivian Herrera ◽

...

Keyword(s):

Emergency Department ◽

Length Of Stay ◽

Observational Study ◽

Acute Asthma ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Asthma Care ◽

Multicenter Observational Study

Download Full-text

The Relationship Between Preoperative Physical Activity With American Society of Anesthesiologists Score and Postoperative Length of Stay in Patients Undergoing Radical Prostatectomy

Journal of Physical Activity and Health ◽

10.1123/jpah.2021-0314 ◽

2021 ◽

pp. 1-8

Author(s):

Efthymios Papadopoulos ◽

Priya Brahmbhatt ◽

Shabbir M.H. Alibhai ◽

George A. Tomlinson ◽

Andrew G. Matthew ◽

...

Keyword(s):

Physical Activity ◽

Logistic Regression ◽

Radical Prostatectomy ◽

Length Of Stay ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Physical Status ◽

American Society ◽

American Society Of Anesthesiologists ◽

The Relationship

Background: The relationship between preoperative physical activity (PA) and hospital length of stay (LOS) following radical prostatectomy (RP) is poorly understood. In addition, the relationship between PA and the American Society of Anesthesiologists Physical Status score (ASA PS), an established prognosticator of surgical risk, has not been studied. The authors assessed the relationship between leisure-time PA (LTPA), ASA PS, and LOS in individuals undergoing RP. Methods: This retrospective cohort study was conducted using data from an institutional database. Ordinal logistic regression was used to assess the relationship between preoperative LTPA and physical status as indicated by the ASA PS. Binary logistic regression was used to assess the relationship between preoperative LTPA and LOS. Results: A sample of 1064 participants were included in the analyses. The participants in the highest preoperative LTPA quartile had 45% reduced odds (P = .015) of a worse ASA PS classification compared with participants in the lowest quartile. The participants engaging in vigorous LTPA preoperatively had 35% lower odds (P = .014) of a >2-day LOS following RP compared with participants who were not engaging in preoperative vigorous LTPA. Conclusions: Our findings suggest that total and vigorous preoperative LTPA is associated with improved preoperative American Society of Anesthesiologists scores and LOS following RP, respectively.

Download Full-text