scholarly journals Length of hospitalization is associated with selected biomarkers (albumin and lymphocytes) and with co-morbidities: study on 4000 patients

2017 ◽  
Vol 5 (1) ◽  
Author(s):  
Antonio E. Pontiroli ◽  
Lara Loreggian ◽  
Marco P. L. Rovati ◽  
Elena De Patto ◽  
Laura Folini ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Hospital Stay ◽  
Large Scale ◽  
Correlation Method ◽  
Length Of Hospital Stay ◽  
Emergency Admission ◽  
Negative Influence ◽  
Blood Levels ◽  
Essential Information ◽  
Length Of Hospitalization

Abstract Background Low albumin levels and low lymphocyte counts are intra hospital conditions that exert a negative influence on prognosis, healing and length of hospitalization. The study aimed to analyze the correlation between low blood levels of albumin, low lymphocytes, and length of stay. The secondary aim was to identify other co-morbidities associated with prolonged hospital stay. Methods Retrospective pilot study was conducted by analyzing anamnestic and biochemical data, related to 4038 patients admitted to ten wards of Hospital San Paolo (Milan), collected from July 1st 2012 to December 31st 2012. A statistical analysis was carried out using the Correlation method, Multivariate Analysis and Regression. Lymphocyte count and co-morbidities were evaluated in the whole cohort, albumin levels in 1437 patients. Results In the whole sample, low albumin levels and low lymphocyte counts were directly correlated to longer hospitalizations. The stratification of the results by department and diagnosis suggests that there is a higher correlation in certain subpopulations, and albumin shows a greater correlation with length of stay than lymphocytes. Also advanced age, high platelets, type of diagnosis, male gender and emergency admission led to longer hospitalizations. Conclusions A routine check of albumin, lymphocytes and a spectrum of significant variables can provide precious information which can eventually lead to a shorter hospital stay. Knowledge of the general health status of a patient and the possibility to estimate his/her length of hospital stay are essential information for Clinical Governance, and for the improvement of internal services of hospitals on a large scale.

Abstract WP386: Predictors of Length of Hospitalization in Patients Admitted With Intracerebral Hemorrhage in the United States

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Saqib A Chaudhry ◽  
Mohammad Rauf A Chaudhry ◽  
Iqra N Akhtar ◽  
Adnan I Qureshi ◽  
Werdah Zafar
Keyword(s):  
Logistic Regression ◽  
Length Of Stay ◽  
Intracerebral Hemorrhage ◽  
Hospital Stay ◽  
Multivariate Logistic Regression Analysis ◽  
Length Of Hospital Stay ◽  
The United States ◽  
Multivariate Logistic Regression ◽  
Median Length ◽  
Length Of Hospitalization

Background: We performed this study to determine the predictors of length of hospitalization in patients admitted with intracerebral hemorrhage using nationally representative data. Methods: We used the National Inpatient Sample (NIS) from 2010 to 2015 to assess the factors associated with length of stay in patients admitted with intracerebral hemorrhage using (ICD-9 CM diagnosis-related code 431). Patients who were transferred from another acute hospital or died within 2 days of admission were excluded. All variables pertaining to hospitalization were compared in 4 quartile groups on basis of length of hospital stay distribution (≤3, 4-6, 7-10 and ≥11 days) and median length of stay was calculated. The predictors of hospital stay exceeding the median length of stay were identified using multivariate logistic regression. Results: A total of 296,792patients were admitted with the diagnosis of intracerebral hemorrhage during the study period. The length of hospitalization was (≤3, 4-6, 7-10 and ≥11 days in 79,008 (26.5%), 89,019 (30.0%), 55,555 (18.7%) and 73,211 (24.6%) patients, respectively; median length of stay for the cohort was 6 days. In the multivariate logistic regression analysis, the following clinical factors were associated with length of hospitalization of ≥6 days (median): male (odds ratio [OR] 1.10), hypertension (OR 1.41 ), APRDRG severity (OR 2.87), history of alcohol use (OR 1.27 ), and in-hospital complications such as sepsis (OR 2.73), pneumonia (OR 2.30), urine tract infection (OR 2.34), pulmonary embolism (OR 1.42), and deep vein thrombosis (OR 5.06). Similarly in-hospital procedures such as craniotomy (OR 3.40), and transfusion (OR 2.09), were associated with length of hospitalization of ≥6 days. The excess hospitalization charges associated with length of hospitalization of ≥6 days was $107,915. Conclusion: Prolonged hospitalization is associated with significantly higher cost of hospitalization. The most important determinants being pre-existing medical comorbidities and potentially preventable in-hospital complications.

565 POST-OPERATIVE WEIGHT LOSS AND OUTCOMES FOLLOWING ESOPHAGECTOMY

2020 ◽  
Vol 33 (Supplement_1) ◽  
Author(s):  
R Khaw ◽  
S Munro ◽  
J Sturrock ◽  
H Jaretzke ◽  
S Kamarajah ◽  
...  
Keyword(s):  
Weight Loss ◽  
Length Of Stay ◽  
Hospital Stay ◽  
Enhanced Recovery ◽  
Length Of Hospital Stay ◽  
Failure To Thrive ◽  
Post Discharge ◽  
Postoperative Weight Loss ◽  
Poor Outcomes ◽  
The Impact

Abstract   Oesophageal cancer is the 11th most common cancer worldwide, with oesophagectomy remaining the mainstay curative treatment, despite significant associated morbidity and mortality. Postoperative weight loss remains a significant problem and is directly correlated to poor prognosis. Measures such as the Enhanced Recovery After Surgery (ERAS) programme and intraoperative jejunostomy feed have looked to tackle this. This study investigates the impact of these on mortality, length of hospital stay and postoperative weight loss. Methods Patients undergoing oesophagectomy between January 1st 2012—December 2014 and 28th October 2015–December 31st 2019 in a national tertiary oesophagogastric unit were included retrospectively. Variables measured included comorbidities, operation, histopathology, weights (pre- and post-operatively), length of hospital stay, postoperative complications and mortality. Pre-operative body weight was measured at elective admission, and further weights were identified from a prospectively maintained database, during further clinic appointments. Other data was collected through patient notes. Results 594 patients were included. Mean age at diagnosis was 65.9 years (13–65). Majority of cases were adenocarcinoma (63.3%), with varying stages of disease (TX-4, NX-3). Benign pathology accounted for 8.75% of cases. Mean weight loss post-oesophagectomy exceeded 10% at 6 months (SD 14.49). Majority (60.1%) of patients were discharged with feeding jejunostomy, and 5.22% of these required this feed to be restarted post-discharge. Length of stay was mean 16.5 days (SD 22.3). Complications occurred in 68.9% of patients, of which 13.8% were infection driven. Mortality occurred in 26.6% of patients, with 1.83% during hospital admission. 30-day mortality rate was 1.39%. Conclusion Failure to thrive and prolonged weight-loss following oesophagectomy can contribute to poor recovery, with associated complications and poor outcomes, including increased length of stay and mortality. Further analysis of data to investigate association between weight loss and poor outcomes for oesophagectomy patients will allow for personalised treatment of high-risk patients, in conjunction with members of the multidisciplinary team, including dieticians.

scholarly journals Palliative treatment for malignant gastrointestinal obstruction with peritoneal carcinomatosis: enteral stenting versus surgery

2020 ◽  
Vol 08 (10) ◽  
pp. E1487-E1494
Author(s):  
Veeravich Jaruvongvanich ◽  
FNU Chesta ◽  
Anushka Baruah ◽  
Meher Oberoi ◽  
Daniel Adamo ◽  
...  
Keyword(s):  
Adverse Events ◽  
Hospital Stay ◽  
Peritoneal Carcinomatosis ◽  
Large Scale ◽  
Clinical Success ◽  
Eastern Cooperative Oncology Group ◽  
Length Of Hospital Stay ◽  
Palliative Surgery ◽  
Gastrointestinal Obstruction ◽  
Malignant Gastrointestinal Obstruction

Abstract Background and study aims Management of malignant gastrointestinal obstruction (MGIO) is more challenging in the presence of peritoneal carcinomatosis (PC). Outcomes data to guide the management of MGIO with PC are lacking. We aimed to compare the clinical outcomes and adverse events between endoscopic and surgical palliation and identify predictors of stent success in patients with MGIO with PC. Patients and methods Consecutive inpatients with MGIO with PC between 2000 and 2018 who underwent palliative surgery or enteral stenting were included. Clinical success was defined as relief of obstructive symptoms. Results Fifty-seven patients with enteral stenting and 40 with palliative surgery were compared. The two groups did not differ in rates of technical success, 30-day mortality, or recurrence. Clinical success from a single intervention (63.2 % versus 95 %), luminal patency duration (27 days vs. 145 days), and survival length (148 days vs. 336 days) favored palliative surgery (all P < 0.05) but the patients in the surgery group had a trend toward better Eastern Cooperative Oncology Group (ECOG) status. The rate of adverse events (AEs) (10.5 % vs. 50 %), the severity of AEs, and length of hospital stay (4.5 days vs. 9 days) favored enteral stenting (P < 0.05). The need for more than one stent was associated with a higher likelihood of stent failure. Conclusions Our study suggests that enteral stenting is safer and associated with a shorter hospital stay than palliative surgery, although unlike other MGIOs, clinical success is lower in MGIO with PC. Identification of the right candidates and potential predictors of clinical success in ECOG-matched large-scale studies is needed to validate these results.

scholarly journals The independent patient factors that affect length of stay following hip fractures

2018 ◽  
Vol 100 (7) ◽  
pp. 556-562 ◽  
Author(s):  
T Richards ◽  
A Glendenning ◽  
D Benson ◽  
S Alexander ◽  
S Thati
Keyword(s):  
Hip Fracture ◽  
Length Of Stay ◽  
Hospital Stay ◽  
Hip Fractures ◽  
Length Of Hospital Stay ◽  
Hospital Length ◽  
Acute Hospital ◽  
Hospital Length Of Stay ◽  
Patient Factors ◽  
Mobility Status

Introduction Management of hip fractures has evolved over recent years to drive better outcomes including length of hospital stay. We aimed to identify and quantify the effect that patient factors influence acute hospital and total health service length of stay. Methods A retrospective observational study based on National Hip Fracture Database data was conducted from 1 January 2014 to 31 December 2015. A multiple regression analysis of 330 patients was carried out to determine independent factors that affect acute hospital and total hospital length of stay. Results American Society of Anesthesiologists (ASA) grade 3 or above, Abbreviated Mental Test Score (AMTS) less than 8 and poor mobility status were independent factors, significantly increasing length of hospital stay in our population. Acute hospital length of stay can be predicted as 8.9 days longer when AMTS less than 8, 4.2 days longer when ASA grade was 3 or above and 20.4 days longer when unable to mobilise unaided (compared with independently mobile individuals). Other factors including total hip replacement compared with hemiarthroplasty did not independently affect length of stay. Conclusions Our analysis in a representative and generalisable population illustrates the importance of identifying these three patient characteristics in hip fracture patients. When recognised and targeted with orthogeriatric support, the length of hospital stay for these patients can be reduced and overall hip fracture care improved. Screening on admission for ASA grade, AMTS and mobility status allows prediction of length of stay and tailoring of care to match needs.

666 EARLY EXTUBATION AFTER ESOPHAGECTOMY IS SAFE. A SYSTEMATIC REVIEW AND META-ANALYSIS

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Maria Serafim ◽  
Clara Santos ◽  
Marina Orlandini ◽  
Letícia Datrino ◽  
Guilherme Tavares ◽  
...  
Keyword(s):  
Systematic Review ◽  
Length Of Stay ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Risk Difference ◽  
Pulmonary Complications ◽  
Mean Difference ◽  
Early Extubation ◽  
Icu Length Of Stay ◽  
Anastomotic Fistula

Abstract   Esophagectomy has high morbidity and mortality, mainly due to pulmonary complications. Consequently, ventilatory support is a cornerstone in postoperative management. However, there is still no consensus on the timing for extubation. There is a fear that untimely extubation would lead to a high risk for an urgent reintubation. On the other hand, there is a risk for pulmonary damage in prolonged intubation. Thus, the present study aimed to compare early and late extubation after esophagectomy. Methods A systematic review was carried out on PubMed, Lilacs, Cochrane Library Central, and Embase, comparing early and late extubation after esophagectomy. The primary outcome was reintubation. Secondary outcomes included mortality; complications; pulmonary complications; pneumonia; anastomotic fistula; length of hospital stay; and ICU length of stay. The inclusion criteria were: a) clinical trials and cohort studies; b) adult patients (&gt; 18 years); and c) patients with esophageal cancer undergoing esophagectomy. The results were summarized by risk difference and mean difference. 95% confidence interval and random model were applied. Results Four articles were selected, comprising 490 patients. Early extubation did not increase the risk for reintubation, with a risk difference of 0.01 (95%CI -0.03; 0.04). Also, there was no difference for mortality −0.01 (95%CI -0.04; 0.03); complications −0.09 (95%CI -0.22; 0.05); pulmonary complications −0.05 (95%CI -0.13; 0.03); pneumonia −0.06 (95% CI-0.18; 0.05); anastomotic fistula −0.01 (95% CI -0.09; 0.08). In addition, there was no significant mean difference for: length of hospital stay −0.10 (95%CI -0.38; 0.1); and ICU length of stay 0.00 (95%CI -0.22; 0.22). Conclusion Early extubation after esophagectomy does not increase the risk for reintubation, mortality, complications, and lenght of stay.

The Association between Prolonged Antibiotic Use in Culture Negative Infants and Length of Hospital Stay and Total Hospital Costs

2021 ◽  
Author(s):  
Wesam Sourour ◽  
Valeria Sanchez ◽  
Michel Sourour ◽  
Jordan Burdine ◽  
Elizabeth Rodriguez Lien ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Blood Culture ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Antibiotic Use ◽  
Hospital Length Of Stay ◽  
Control Group ◽  
Multivariate Linear Regression Analysis ◽  
Negative Blood Culture ◽  
Total Cost

Objective This study aimed to determine if prolonged antibiotic use at birth in neonates with a negative blood culture increases the total cost of hospital stay. Study design This was a retrospective study performed at a 60-bed level IV neonatal intensive care unit. Neonates born <30 weeks of gestation or <1,500 g between 2016 and 2018 who received antibiotics were included. A multivariate linear regression analysis was conducted to determine if clinical factors contributed to increased hospital cost or length of stay. Results In total, 190 patients met inclusion criteria with 94 infants in the prolonged antibiotic group and 96 in the control group. Prolonged antibiotic use was associated with an increase length of hospital stay of approximately 31.87 days, resulting in a $69,946 increase in total cost of hospitalization. Conclusion Prolonged antibiotics in neonates with negative blood culture were associated with significantly longer hospital length of stay and increased total cost of hospitalization. Key Points

scholarly journals EP.WE.782Retrospective analysis of acute surgical admissions during COVID-19 pandemic

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Shenbaga Rajamanikam ◽  
Suzzana Argyropoulos ◽  
Reza Arsalani Zadeh
Keyword(s):  
Length Of Stay ◽  
Hospital Stay ◽  
Surgical Procedures ◽  
Length Of Hospital Stay ◽  
Period Length ◽  
Surgical Patients ◽  
Surgical Team ◽  
Surgical Operations

Abstract Background COVID-19 pandemic has affected the number of surgical admissions and the number of emergency general surgical operations performed. COVID-19 pandemic has also led to changes in how some of the acute surgical patients were managed. Aim of the study was to compare acute surgical admissions and number of emergency general surgical procedures in this period. Material and Method We retrospectively analyzed acute surgical admissions during the pandemic from 20/3/20 to 19/4/20 and compared it with acute surgical admissions during pre-COVID-19 period from 1/11/2019 to 30/11/2019. Results During the COVID-19 pandemic 97 patients were assessed and admitted by the General surgical team, during the pre COVID-19 period 205 patients were assessed and admitted by the General surgical team. The number of acute surgical admissions during COVID-19 pandemic dropped by 53%. There were 46% less emergency surgeries performed during COVID 19 pandemic period. Length of stay during and before the COVID-19pandemic were 4.1 vs 4.4 days. Conclusion During the COVID-19 pandemic number of acute surgical admissions and the number of emergency surgeries were fewer than during pre COVID-19 pandemic. Length of hospital stay was less during COVID-19 pandemic.

Impact of postoperative haemoglobin on length of stay post fractured hip repair in patients with standardised perioperative management

2018 ◽  
Vol 29 (2) ◽  
pp. 172-176
Author(s):  
Siu-Wai Choi ◽  
Frankie K L Leung ◽  
Tak-Wing Lau ◽  
Gordon T C Wong
Keyword(s):  
Length Of Stay ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Postoperative Recovery ◽  
Medical Complications ◽  
Fractured Neck Of Femur ◽  
Neck Of Femur ◽  
Total Length ◽  
The Impact ◽  
Postoperative Haemoglobin

Introduction: Perioperative blood transfusion is not without risk and effort should be made to limit patients’ exposure to allogeneic blood. However, there is conflicting data regarding the impact of anaemia on postoperative recovery in patients with repaired hip fractures. It is hypothesised that for a given baseline functional status and fracture type, lower postoperative haemoglobin will increase rehabilitation time and prolong total length of hospital stay. Methods: This is a retrospective study on data collected prospectively on patients entered into the Clinical Pathway aged >65 years admitted to Queen Mary Hospital (QMH) with a fractured neck of femur during 2011–2013. Potential predictor variables were analysed with linear regression with respect to total length of stay and those that reached a significance level of 0.05 were included in further analysis. Results: 1092 patients were admitted to QMH with a suspected fractured neck of femur; data from 747 patients were analysed. The fracture sites were neck of femur (50%), intertrochanteric (48%) and subtrochanteric fracture (2%). Approximately 30% of patients received blood transfusions. Of these only the development of postoperative medical complications statistically prolonged hospital stay. No relationship was seen with haemoglobin levels cut-off above and below 10 g/dl with the result remaining non-significant down to a cut-off of above and below 8 g/dl. Discussion: This study revealed that post-surgical haemoglobin level of between 8 g/dl and 10 g/dL did not have an impact on the total length of hospital stay. The development of postoperative medical complications was the only factor that prolonged the total length of stay.

Length of hospital stay in aneurysmal subarachnoid hemorrhage patients without vasospasm on angiography: potential for a fast-track discharge cohort

2021 ◽  
pp. neurintsurg-2021-017424
Author(s):  
Joshua S Catapano ◽  
Visish M Srinivasan ◽  
Kavelin Rumalla ◽  
Mohamed A Labib ◽  
Candice L Nguyen ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Length Of Stay ◽  
Hospital Stay ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Length Of Hospital Stay ◽  
Hospital Length Of Stay ◽  
Neurologic Outcome ◽  
Angiographic Vasospasm ◽  
Fisher Grade ◽  
Tertiary Center

BackgroundPatients with aneurysmal subarachnoid hemorrhage (aSAH) frequently suffer from vasospasm. We analyzed the association between absence of early angiographic vasospasm and early discharge.MethodsAll aSAH patients treated from August 1, 2007, to July 31, 2019, at a single tertiary center were reviewed. Patients undergoing diagnostic digital subtraction angiography (DSA) on post-aSAH days 5 to 7 were analyzed; cohorts with and without angiographic vasospasm (angiographic reports by attending neurovascular surgeons) were compared. Primary outcome was hospital length of stay; secondary outcomes were intensive care unit length of stay, 30 day return to the emergency department (ED), and poor neurologic outcome, defined as a modified Rankin Scale (mRS) score >2.ResultsA total of 298 patients underwent DSA on post-aSAH day 5, 6, or 7. Most patients (n=188, 63%) had angiographic vasospasm; 110 patients (37%) did not. Patients without vasospasm had a significantly lower mean length of hospital stay than vasospasm patients (18.0±7.1 days vs 22.4±8.6 days; p<0.001). The two cohorts did not differ significantly in the proportion of patients with mRS scores >2 at last follow-up or those returning to the ED before 30 days. After adjustment for Hunt and Hess scores, Fisher grade, admission Glasgow Coma Scale score, and age, logistic regression analysis showed that the absence of vasospasm on post-aSAH days 5–7 predicted discharge on or before hospital day 14 (OR 3.4, 95% CI 1.8 to 6.4, p<0.001).ConclusionLack of angiographic vasospasm 5 to 7 days after aSAH is associated with shorter hospitalization, with no increase in 30 day ED visits or poor neurologic outcome.

scholarly journals Impact of a poison control center on the length of hospital stay of poisoned patients: retrospective cohort

2011 ◽  
Vol 129 (1) ◽  
pp. 23-29 ◽  
Author(s):  
Taís Freire Galvão ◽  
Marcus Tolentino Silva ◽  
Carolina Dalene Silva ◽  
Adriana Melo Barotto ◽  
Izabela Lucchese Gavioli ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Hospital Stay ◽  
Retrospective Cohort ◽  
Length Of Hospital Stay ◽  
Poison Control ◽  
Poison Control Center ◽  
Toxic Agent ◽  
Control Center ◽  
Set Up ◽  
Remote Assistance

CONTEXT AND OBJECTIVE: Poison control centers play an essential role in caring for poisoned patients, albeit without secure funding for their activities. The aim here was to investigate differences in length of hospital stay among poisoned patients, between those who received remote assistance from a poison control center and those who did not. DESIGN AND SETTING: A retrospective cohort including all poisoned patients hospitalized at an emergency service in Manaus between 2005 and 2007 was set up, and the local poison control center database was checked to see whether they received such assistance. METHODS: Patients presenting a known toxic agent, with less than 12 hours since exposure and without severe comorbidities, were selected. Their severity of poisoning was evaluated by two independent reviewers and divergences were resolved by another reviewer. RESULTS: One hundred and ninety-eight patients were included. Those who received remote assistance from a poison control center stayed in hospital on average for 3.43 days less than those without poison control center assistance (95% confidence interval, CI: -6.10 to -0.77). Severity was assessed in the cases of 90 patients: there was no statistical difference in severity between the patients with and without poison control center assistance (P > 0.5). CONCLUSION: Patients with remote assistance from a poison control center had a shorter length of stay then patients without this aid. The poison control center may have reduced the length of stay of the poisoned patients

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