127 The Association of Preoperative Narcotic Use on Length of Hospital Stay and 1 Year Return to Work, Pain, Disability, and Quality of Life After Elective Surgery for Degenerative Spine Disease

Neurosurgery ◽  
2015 ◽  
Vol 62 ◽  
pp. 206 ◽  
Author(s):  
Scott L. Parker ◽  
Clinton J. Devin ◽  
Matthew J. McGirt
Keyword(s):  
Quality Of Life ◽  
Return To Work ◽  
Hospital Stay ◽  
Elective Surgery ◽  
Length Of Hospital Stay ◽  
Degenerative Spine ◽  
Degenerative Spine Disease ◽  
Pain Disability ◽  
Spine Disease

scholarly journals The Prevalence of Sarcopenia and Its Impact on Clinical Outcomes in Lumbar Degenerative Spine Disease—A Systematic Review and Meta-Analysis

2021 ◽  
Vol 10 (4) ◽  
pp. 773
Author(s):  
Wei-Ting Wu ◽  
Tsung-Min Lee ◽  
Der-Sheng Han ◽  
Ke-Vin Chang
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Clinical Outcomes ◽  
Meta Analysis ◽  
Clinical Manifestations ◽  
Current Evidence ◽  
Degenerative Spine ◽  
Degenerative Spine Disease ◽  
Spine Disease

The association of sarcopenia with poor clinical outcomes has been identified in various medical conditions, although there is a lack of quantitative analysis to validate the influence of sarcopenia on patients with lumbar degenerative spine disease (LDSD) from the available literature. Therefore, this systematic review and meta-analysis aimed to summarize the prevalence of sarcopenia in patients with LDSD and examine its impact on clinical outcomes. The electronic databases (PubMed and Embase) were systematically searched from inception through December 2020 for clinical studies investigating the association of sarcopenia with clinical outcomes in patients with LDSD. A random-effects model meta-analysis was carried out for data synthesis. This meta-analysis included 14 studies, comprising 1953 participants. The overall prevalence of sarcopenia among patients with LDSD was 24.8% (95% confidence interval [CI], 17.3%–34.3%). The relative risk of sarcopenia was not significantly increased in patients with LDSD compared with controls (risk ratio, 1.605; 95% CI, 0.321–8.022). The patients with sarcopenia did not experience an increase in low back and leg pain. However, lower quality of life (SMD, −0.627; 95% CI, −0.844–−0.410) were identified postoperatively. Sarcopenia did not lead to an elevated rate of complications after lumbar surgeries. Sarcopenia accounts for approximately one-quarter of the population with LDSD. The clinical manifestations are less influenced by sarcopenia, whereas sarcopenia is associated with poorer quality of life after lumbar surgeries. The current evidence is still insufficient to support sarcopenia as a predictor of postoperative complications.

scholarly journals Effectiveness of comprehensive geriatric assessment intervention on quality of life, caregiver burden and length of hospital stay: a systematic review and meta-analysis of randomised controlled trials

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhongyi Chen ◽  
Zhaosheng Ding ◽  
Caixia Chen ◽  
Yangfan Sun ◽  
Yuyu Jiang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Hospital Stay ◽  
Usual Care ◽  
Caregiver Burden ◽  
Length Of Hospital Stay ◽  
Sf 36 ◽  
Subgroup Analyses ◽  
Randomised Controlled ◽  
Meta Analyses

Abstract Background Comprehensive geriatric assessment (CGA) interventions can improve functional ability and reduce mortality in older adults, but the effectiveness of CGA intervention on the quality of life, caregiver burden, and length of hospital stay remains unclear. The study aimed to determine the effectiveness of CGA intervention on the quality of life, length of hospital stay, and caregiver burden in older adults by conducting meta-analyses of randomised controlled trials (RCTs). Methods A literature search in PubMed, Embase, and Cochrane Library was conducted for papers published before February 29, 2020, based on inclusion criteria. Standardised mean difference (SMD) or mean difference (MD) with 95% confidence intervals (CIs) was calculated using the random-effects model. Subgroup analyses, sensitivity analyses, and publication bias analyses were also conducted. Results A total of 28 RCTs were included. Overall, the intervention components common in different CGA intervention models were interdisciplinary assessments and team meetings. Meta-analyses showed that CGA interventions improved the quality of life of older people (SMD = 0.12; 95% CI = 0.03 to 0.21; P = 0.009) compared to usual care, and subgroup analyses showed that CGA interventions improved the quality of life only in participants’ age > 80 years and at follow-up ≤3 months. The change value of quality of life in the CGA intervention group was better than that in the usual care group on six dimensions of the 36-Item Short-Form Health Survey questionnaire (SF-36). Also, compared to usual care, the CGA intervention reduced the caregiver burden (SMD = − 0.56; 95% CI = − 0.97 to − 0.15, P = 0.007), but had no significant effect on the length of hospital stay. Conclusions CGA intervention was effective in improving the quality of life and reducing caregiver burden, but did not affect the length of hospital stay. It is recommended that future studies apply the SF-36 to evaluate the impact of CGA interventions on the quality of life and provide supportive strategies for caregivers as an essential part of the CGA intervention, to find additional benefits of CGA interventions.

146 Where Does Potential for True Cost Savings Exist Following Elective Surgery for Degenerative Spine Disease?

Neurosurgery ◽  
2015 ◽  
Vol 62 ◽  
pp. 213
Author(s):  
Scott L. Parker ◽  
Silky Chotai ◽  
Ahilan Sivaganesan ◽  
Clinton J. Devin ◽  
Matthew J. McGirt
Keyword(s):  
Elective Surgery ◽  
Cost Savings ◽  
Degenerative Spine ◽  
Degenerative Spine Disease ◽  
True Cost ◽  
Spine Disease

Preoperative exercise halves the postoperative complication rate in patients with lung cancer: a systematic review of the effect of exercise on complications, length of stay and quality of life in patients with cancer

2018 ◽  
Vol 52 (5) ◽  
pp. 344-344 ◽  
Author(s):  
Daniel Steffens ◽  
Paula R Beckenkamp ◽  
Mark Hancock ◽  
Michael Solomon ◽  
Jane Young
Keyword(s):  
Quality Of Life ◽  
Lung Cancer ◽  
Systematic Review ◽  
Postoperative Complications ◽  
Hospital Stay ◽  
Postoperative Complication ◽  
Length Of Hospital Stay ◽  
Oncological Surgery ◽  
Preoperative Exercise

ObjectiveTo investigate the effectiveness of preoperative exercises interventions in patients undergoing oncological surgery, on postoperative complications, length of hospital stay and quality of life.DesignIntervention systematic review with meta-analysis.Data sourcesMEDLINE, Embase and PEDro.Eligibility criteria for selecting studiesTrials investigating the effectiveness of preoperative exercise for any oncological patient undergoing surgery were included. The outcomes of interest were postoperative complications, length of hospital stay and quality of life. Relative risks (RRs), mean differences (MDs) and 95% CI were calculated using random-effects models.ResultsSeventeen articles (reporting on 13 different trials) involving 806 individual participants and 6 tumour types were included. There was moderate-quality evidence that preoperative exercise significantly reduced postoperative complication rates (RR 0.52, 95% CI 0.36 to 0.74) and length of hospital stay (MD −2.86 days, 95% CI −5.40 to −0.33) in patients undergoing lung resection, compared with control. For patients with oesophageal cancer, preoperative exercise was not effective in reducing length of hospital stay (MD 2.00 days, 95% CI −2.35 to 6.35). Although only assessed in individual studies, preoperative exercise improved postoperative quality of life in patients with oral or prostate cancer. No effect was found in patients with colon and colorectal liver metastases.ConclusionsPreoperative exercise was effective in reducing postoperative complications and length of hospital stay in patients with lung cancer. Whether preoperative exercise reduces complications, length of hospital stay and improves quality of life in other groups of patients undergoing oncological surgery is uncertain as the quality of evidence is low.PROSPEROregistration number

scholarly journals Exercise Training for Patients Pre- and Postsurgically Treated for Non–Small Cell Lung Cancer: A Systematic Review and Meta-analysis

2016 ◽  
Vol 16 (1) ◽  
pp. 63-73 ◽  
Author(s):  
Hui-Juan Ni ◽  
Bigyan Pudasaini ◽  
Xun-Tao Yuan ◽  
He-Fang Li ◽  
Lei Shi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Postoperative Complications ◽  
Exercise Training ◽  
Hospital Stay ◽  
Exercise Capacity ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Small Cell Lung ◽  
Preoperative Exercise

Background. This meta-analysis examined the effects of exercise training on length of hospital stay, postoperative complications, exercise capacity, 6-minute walking distance (6MWD), and health-related quality of life (HRQoL) in patients following resection of non–small cell lung cancer (NSCLC). Methods. This review searched PubMed, EMBASE, and the Cochrane Collaboration data base up to August 16, 2015. It includes 15 studies comparing exercise endurance and quality of life before versus after exercise training in patients undergoing lung resection for NSCLC. Results. This review identified 15 studies, 8 of which are randomized controlled trials including 350 patients. Preoperative exercise training shortened length of hospital stay; mean difference (MD): −4.98 days (95% CI = −6.22 to −3.74, P < .00001) and also decreased postoperative complications for which the odds ratio was 0.33 (95% CI = 0.15 to 0.74, P = .007). Four weeks of preoperative exercise training improved exercise capacity; 6MWD was increased to 39.95 m (95% CI = 5.31 to 74.6, P = .02) .While postoperative exercise training can also effectively improve exercise capacity, it required a longer training period; 6MWD was increased to 62.83 m (95% CI = 57.94 to 67.72) after 12 weeks of training ( P < .00001). For HRQoL, on the EORTC-QLQ-30, there were no differences in patients’ global health after exercise, but dyspnea score was decreased −14.31 points (95% CI = −20.03 to −8.58, P < .00001). On the SF-36 score, physical health was better after exercise training (MD = 3 points, 95% CI = 0.81 to 5.2, P = .007) while there was no difference with regard to mental health. The I2 statistics of all statistically pooled data were lower than 30%. There was a low amount of heterogeneity among these studies. Conclusions. Evidence from this review suggests that preoperative exercise training may shorten length of hospital stay, decrease postoperative complications and increase 6MWD. Postoperative exercise training can also effectively improve both the 6MWD and quality of life in surgical patients with NSCLC, but requiring a longer training period.

scholarly journals Mind It: Increasing Rate of Mental Health Disorders in Hospitalized Sickle Cell Patients

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 4689-4689
Author(s):  
Nauman Siddiqui ◽  
Amandeep Godara ◽  
Amber Afzal ◽  
Mohammad Saud Khan ◽  
Satish Munigala ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Hospital Stay ◽  
Sickle Cell ◽  
Length Of Hospital Stay ◽  
Mental Health Disorders ◽  
National Inpatient Sample ◽  
Median Length ◽  
Health Disorders

Abstract Introduction: The number of patients with sickle cell disease (SCD) approaches 100,000 in US after adjusting for early mortality (Hassell Am J Prev Med 2010). Management of SCD and its complications require frequent access to healthcare system lifelong, thus impacting patients' quality of life and cost of healthcare. Chronic pain inducing illnesses are known to increase susceptibility to mental health disorders (Rayner Pain 2016). Psychosocial disorders are common in this population and impact the course of hospitalization, however we have limited published data in this area. Hence, we performed a large retrospective study utilizing the National Inpatient Sample (NIS) data to evaluate the prevalence of mental health disorders in hospitalized sickle cell patients, and their influence on length of hospitalization. Methods: We identified hospitalized sickle cell patients using ICD 9 codes (282.5,282.6X -282.6X ) in the National Inpatient Sample (NIS) database. Similarly, ICD-9 codes were used to identify patients with mental health disorders of interest. The demographics and length of hospital stay of patients with and without mental health disorders were then compared. Surveyfreq was used to calculate proportions and surveymeans was used to calculate median length of stay and hospital charges. Cochran-Armitage test was used for analyzing trends. We used chi-square for categorical data frequency, P value of < 0.05 was considered statistically significant. All analysis was performed using SAS 9.4. Results: We identified a total of 1,349,701 hospitalizations for sickle cell patients between 2003-2014, of which 221,279 (16%) had associated mental health disorders. Mood disorders were most common (40%), followed by substance abuse (28%) and anxiety disorder (16%) (Table 1). Over the timeline of our study, we found a longitudinal trend towards higher prevalence of mental health disorders in hospitalized sickle cell patients (Figure 1). There was higher prevalence of mental health disorders among patients aged between 21-40 years (24%). No difference in the rate of mental health disorders was noted in patients admitted with or without acute sickle cell pain episode. Median length of hospital stay (LOS) was 4 days in patients with mental health disorders (95% CI 4.04-4.12) compared to 3 days in those without (95% CI 3.17-3.20). Conclusion: The prevalence of mental health disorders in hospitalized sickle cell patients has been gradually increasing from 2003 to 2014 and approaches 16% overall. The length of hospital stay is longer for the individuals with these disorders than those without hence, increasing the cost of health care and reducing patient satisfaction. Therefore, early recognition and intervention for mental health disorders is paramount to promote quality of life and reduce health care costs. This demands for a multidisciplinary approach to provide better access to mental health resources to this population in the outpatient setting. Disclosures No relevant conflicts of interest to declare.

scholarly journals The impact of physical training on length of hospital stay and physical function in patients hospitalized with community-acquired pneumonia: protocol for a randomized controlled trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Camilla Koch Ryrsø ◽  
Daniel Faurholt-Jepsen ◽  
Christian Ritz ◽  
Bente Klarlund Pedersen ◽  
Maria Hein Hegelund ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Hospital Stay ◽  
Usual Care ◽  
Physical Training ◽  
Length Of Hospital Stay ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

Abstract Background Community-acquired pneumonia (CAP) is a leading cause of hospitalization worldwide. Bed rest with low levels of physical activity is common during periods of hospitalization and leads to functional decline as well as increased risk of complications. The aim of this study is to assess the effect of supervised physical training during hospitalization with CAP compared with standard usual care for CAP on length of hospital stay, risk of readmission, mortality risk, physical capacity, muscle and fat mass, muscle strength, metabolic function, systemic inflammation, health-related quality of life, and physical activity level. Methods This study is a randomized controlled trial with three parallel experimental arms. Based on a sample size calculation, a total of 210 patients admitted with CAP at Nordsjællands Hospital, Hillerød, Denmark, will be recruited. Patients will be randomly allocated (1:1:1) to either (1) standard usual care, (2) standard usual care combined with in-bed cycling, or (3) standard usual care combined with exercises from a booklet. The primary outcome is differences in length of hospital stay between groups, with secondary outcomes being differences between groups in time to (1) 90-day readmission and (2) 180-day mortality. Further secondary outcomes are differences in changes from baseline between groups in (3) lean mass, (4) fat mass, (5) fat-free mass, (6) physical capacity, (7) health-related quality of life, (8) systemic inflammation, and (9) physical activity level after discharge. Data on length of hospital stay, readmission, and mortality will be collected from patient files, while total lean, fat, and fat-free mass will be quantitated by dual-energy x-ray absorptiometry and bioelectrical impedance analysis. Physical function will be assessed using grip strength, 30-s chair stand tests, and Barthel Index-100. Health-related quality of life will be assessed with the EQ-5D-5L questionnaire. Systemic inflammation will be assessed in blood samples, while accelerometers are used for measuring physical activity. Discussion If a simple physical training program appears to diminish the impact of critical illness and hospitalization on clinical outcome, mobility, and health-related quality of life, it may lead to novel therapeutic approaches in the treatment of patients hospitalized with CAP. Trial registration ClinicalTrials.gov NCT04094636. Registered on 1 April 2019

Sign in / Sign up

Export Citation Format

Share Document