Correction: Risk factors associated with prolonged hospital length-of-stay: 18-year retrospective study of hospitalizations in a tertiary healthcare center in Mexico

Abstract Background The aim of our study was to identify the factors associated with unplanned reoperations among neonates who had undergone primary repair of gastrointestinal disorders. Methods A retrospective chart review was conducted for neonates who underwent primary gastrointestinal surgery between July 2018 and September 2020. The neonates were divided into two cohort, depending on whether they had an unplanned reoperation. The primary outcome was the occurrence of unplanned reoperation. The risk factors that associated the occurrence of unplanned reoperation were examined. Main results Two hundred ninety-six neonates fulfilled the eligibility criteria. The incidence of unplanned reoperation was 9.8%. Analyses of all patients with respect of developing unplanned reoperation showed that the length of operative time was an independent risk factor [Odds Ratio 1.02; 95% confidence interval 1.00, 1.04; p = 0.03]. Patients with unplanned reoperation had a longer postoperative hospital length-of-stay [19.9 ± 14.7 vs. 44.1 ± 32.1 days; p<0.01]. Conclusion The current study is the first analysis of risk factors associated with an unplanned reoperation in neonates undergoing primary repair of gastrointestinal disorders. The length of operative time is the only risk factor for an unplanned reoperation, and the unplanned reoperation can directly prolong the postoperative hospital length-of-stay. Trial registration This study was registered at http://www.chictr.org.cn/index.aspx with No. ChiCTR2000040260.

Download Full-text

Evidence Associated with the Use of Oxazolidinones for the Treatment of Skin and Skin Structure Infections: A Retrospective Study

Acta Médica Portuguesa ◽

10.20344/amp.11494 ◽

2019 ◽

Vol 32 (6) ◽

pp. 453

Author(s):

João Gonçalves-Pereira ◽

Filipe Froes ◽

Fernanda Paula Santos ◽

Helena Sofia Antão ◽

João Paulo Guimarães

Keyword(s):

Retrospective Study ◽

Length Of Stay ◽

Hospital Admissions ◽

Early Discharge ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Ambulatory Setting ◽

Skin Structure ◽

Clinically Significant ◽

Prolonged Hospital

Introduction: Skin and skin structure infections are an increasing cause of hospitalization. Although mortality is relatively low, skin and skin structure infections are associated with prolonged hospital length of stay and high costs. Oxazolidinones have been suggested as a tool to treat infected patients in the ambulatory setting in order to decrease hospital length of stay. We wanted to address the evidence associated with the use of oxazolidinones in the treatment of skin and skin structure infections.Material and Methods: In this observational retrospective study we analyzed the anonymized diagnosis related group coded information from the Portuguese database for hospital admissions, that included all adult patients with a diagnosis of oxazolidinone use and a SSSI, discharged between 2010 and 2015.Results: During the study period, a total of 5518 patients had a diagnosis of oxazolidinone treatment. We selected 483 of those who were also diagnosed with a skin and skin structure infections. Their mean age was 64.9 years and 62.7% were male. The median hospital length of stay was 27 days (Inter quartile range 13 – 56) and the mortality rate was 12.6%. The prevalence of secondary anemia and of thrombocytopenia in the whole group treated with oxazolidinones was 2.5% and 3%, respectively.Discussion: Despite the high bioavailability of oxazolidinones, we were not able to find evidence that its use was associated with a decrease of mortality or hospital length of stay (due to early discharge) of patients with skin and skin structure infections.Conclusion: In this study we were not able to find evidence that oxazolidinones had any clinically significant benefit. A structured approach, including antibiotics with favorable pharmacokinetic and safety profile as well as a carefully planned ambulatory follow up may be needed.

Download Full-text

CORRELATION BETWEEN POSTOPERATIVE CARDIAC RISKS FACTORS, FUNCTIONALITY AND LENGTH OF STAY

10.22541/au.160825475.57230649/v1 ◽

2020 ◽

Author(s):

Micaele Nascimento ◽

Beatriz York ◽

Milton Antonio Oliveira ◽

Katia Elizabete Galdino ◽

Ana Tereza Fernandes

Keyword(s):

Risk Factors ◽

Cardiac Surgery ◽

Length Of Stay ◽

Cardiac Risk ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Cardiovascular Risks ◽

Cardiac Risk Factors ◽

Postoperative Risk ◽

Prolonged Hospital

Background: Cardiac surgery (CS) may be associated with several organic repercussions responsible for the appearance of cardiac risk factors during the postoperative period. These, associated with prolonged hospital length of stay (LoS), may trigger critical manifestations in individuals undergoing this surgical procedure. To investigate the relationships between postoperative cardiac risk factors, LoS, and changes in functioning state. Methods: Patients undergoing reconstructive, substitutive, or corrective cardiac surgeries were evaluated. The presence of postoperative cardiovascular risks was assessed using the InsCor score, while LoS and functionality were collected from medical records. Results: One-hundred patients with a mean age of 59.2±12.3 years were included. Significant correlations between functionality and both the hospital and Intensive Care Unit (ICU) LoS (p<0.0001, ρ= 0.56; p=0.002, ρ=0.29, respectively), as well as between hospital LoS and the number of comorbidities (p=0.003, ρ=0.28) were found. No significant relationships were observed between the number of postoperative risk factors and LoS. Conclusions: Functionality and comorbidities are associated with increased hospital and ICU LoS in patients undergoing cardiac surgery.

Download Full-text

Risk factors on admission associated with hospital length of stay in patients with COVID-19: a retrospective cohort study

Scientific Reports ◽

10.1038/s41598-021-86853-4 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Anping Guo ◽

Jin Lu ◽

Haizhu Tan ◽

Zejian Kuang ◽

Ying Luo ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Liver Disease ◽

Length Of Stay ◽

Regression Model ◽

Logistic Regression Model ◽

Hospital Length ◽

Clinical Treatment ◽

Hospital Length Of Stay ◽

Female Sex

AbstractTreating patients with COVID-19 is expensive, thus it is essential to identify factors on admission associated with hospital length of stay (LOS) and provide a risk assessment for clinical treatment. To address this, we conduct a retrospective study, which involved patients with laboratory-confirmed COVID-19 infection in Hefei, China and being discharged between January 20 2020 and March 16 2020. Demographic information, clinical treatment, and laboratory data for the participants were extracted from medical records. A prolonged LOS was defined as equal to or greater than the median length of hospitable stay. The median LOS for the 75 patients was 17 days (IQR 13–22). We used univariable and multivariable logistic regressions to explore the risk factors associated with a prolonged hospital LOS. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were estimated. The median age of the 75 patients was 47 years. Approximately 75% of the patients had mild or general disease. The univariate logistic regression model showed that female sex and having a fever on admission were significantly associated with longer duration of hospitalization. The multivariate logistic regression model enhances these associations. Odds of a prolonged LOS were associated with male sex (aOR 0.19, 95% CI 0.05–0.63, p = 0.01), having fever on admission (aOR 8.27, 95% CI 1.47–72.16, p = 0.028) and pre-existing chronic kidney or liver disease (aOR 13.73 95% CI 1.95–145.4, p = 0.015) as well as each 1-unit increase in creatinine level (aOR 0.94, 95% CI 0.9–0.98, p = 0.007). We also found that a prolonged LOS was associated with increased creatinine levels in patients with chronic kidney or liver disease (p < 0.001). In conclusion, female sex, fever, chronic kidney or liver disease before admission and increasing creatinine levels were associated with prolonged LOS in patients with COVID-19.

Download Full-text

Infections Acquired by Adults Who Receive Extracorporeal Membrane Oxygenation Risk Factors and Outcome

Infection Control and Hospital Epidemiology ◽

10.1086/668439 ◽

2013 ◽

Vol 34 (1) ◽

pp. 24-30 ◽

Cited By ~ 70

Author(s):

Cecile Aubron ◽

Allen C. Cheng ◽

David Pilcher ◽

Tim Leong ◽

Geoff Magrin ◽

...

Keyword(s):

Risk Factors ◽

Length Of Stay ◽

Extracorporeal Membrane Oxygenation ◽

Unit Length ◽

Severity Of Illness ◽

Infectious Complications ◽

Hospital Length ◽

Interquartile Range ◽

Hospital Length Of Stay ◽

Membrane Oxygenation

Objectives.To analyze infectious complications that occur in patients who receive extracorporeal membrane oxygenation (ECMO), associated risk factors, and consequences on patient outcome.Design.Retrospective observational survey from 2005 through 2011.Participants and Setting.Patients who required ECMO in an Australian referral center.Methods.Cases of bloodstream infection (BSI), catheter-associated urinary tract infection (CAUTI), and ventilator-associated pneumonia (YAP) that occurred in patients who received ECMO were analyzed.Results.A total of 146 ECMO procedures were performed for more than 48 hours in 139 patients, and 36 patients had a total of 46 infections (30.1 infectious episodes per 1,000 days of ECMO). They included 24 cases of BSI, 6 of them secondary to VAP; 23 cases of VAP; and 5 cases of CAUTI. The most frequent pathogens were Enterobacteriaceae (found in 16 of 46 cases), and Candida was the most common cause of BSI (in 9 of 24 cases). The Sequential Organ Failure Assessment score before ECMO initiation and the number of days of support were independenuy associated with a risk of BSI, with odds ratios of 1.23 (95% confidence interval [CI], 1.03-1.47; P = .019) and 1.08(95% CI, 1.03-1.19]; P = .006), respectively. Infected patients did not have a significantly higher mortality compared with uninfected patients (41.7% vs 32%; P = .315), but intensive care unit length of stay (16 days [interquartile range, 8-26 days] vs 11 days [IQR, 4-19 days]; P = .012) and hospital length of stay (33.5 days [interquartile range, 15.5-55.5] vs 24 days [interquartile range, 9-42 days]; P = .029) were longer.Conclusion.The probability of infection increased with the duration of support and the severity of illness before initiation of ECMO. Infections affected length of stay but did not have an impact on mortality.

Download Full-text

Predictive factors for prolonged hospitalisation in acute pyelonephritis patients admitted to the emergency medicine ward

Hong Kong Journal of Emergency Medicine ◽

10.1177/10249079211000976 ◽

2021 ◽

pp. 102490792110009

Author(s):

Howard Tat Chun Chan ◽

Ling Yan Leung ◽

Alex Kwok Keung Law ◽

Chi Hung Cheng ◽

Colin A Graham

Keyword(s):

Emergency Department ◽

Emergency Medicine ◽

Length Of Stay ◽

Acute Pyelonephritis ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Prolonged Length ◽

Reactive Protein ◽

Prolonged Hospital ◽

Emergency Medicine Ward

Background: Acute pyelonephritis is a bacterial infection of the upper urinary tract. Patients can be admitted to a variety of wards for treatment. However, at the Prince of Wales Hospital in Hong Kong, they are managed initially in the emergency medicine ward. The aim of the study is to identify the risk factors that are associated with a prolonged hospital length of stay. Methods: This was a retrospective cohort study conducted in Prince of Wales Hospital. The study recruited patients who were admitted to the emergency medicine ward between 1 January 2014 and 31 December 2017. These patients presented with clinical features of pyelonephritis, received antibiotic treatment and had a discharge diagnosis of pyelonephritis. The length of stay was measured and any length of stay over 72 h was considered to be prolonged. Results: There were 271 patients admitted to the emergency medicine ward, and 118 (44%) had a prolonged hospital length of stay. Univariate and multivariate analyses showed that the only statistically significant predictor of prolonged length of stay was a raised C-reactive protein (odds ratio 1.01; 95% confidence 1.01–1.02; p < 0.0001). Out of 271 patients, 261 received antibiotics in the emergency department. All 10 patients (8.5%) who did not receive antibiotics in emergency department had a prolonged length of stay (p = 0.0002). Conclusion: In this series of acute pyelonephritis treated in the emergency medicine ward, raised C-reactive protein levels were predictive for prolonged length of stay. Patients who did not receive antibiotics in the emergency department prior to emergency medicine ward admission had prolonged length of stay.

Download Full-text

Effects of statins on clinical outcomes in hospitalized patients with community-acquired pneumonia

Journal of International Medical Research ◽

10.1177/0300060520938586 ◽

2020 ◽

Vol 48 (8) ◽

pp. 030006052093858

Author(s):

Rony M. Zeenny ◽

Hanine Mansour ◽

Wissam K Kabbara ◽

Nibal Chamoun ◽

Myriam Audi ◽

...

Keyword(s):

Retrospective Study ◽

Length Of Stay ◽

Hospital Length ◽

Community Acquired Pneumonia ◽

Hospital Length Of Stay ◽

Comorbid Conditions ◽

C Reactive Protein ◽

Reactive Protein ◽

Significant Difference ◽

Chronic Use

Objective We evaluated the effect of chronic use of statins based on C-reactive protein (CRP) levels and hospital length of stay (LOS) in patients admitted with community-acquired pneumonia (CAP). Methods We conducted a retrospective study over 12 months at a teaching hospital in Lebanon comparing patients with CAP taking chronic statins with patients not taking statins. Included patients with CAP were older than age 18 years and had two CRP level measures during hospitalization. CURB-65 criteria were used to assess the severity of pneumonia. A decrease in CRP levels on days 1 and 3, LOS, and normalization of fever were used to assess the response to antibiotics. Results Sixty-one patients were taking statins and 90 patients were not taking statins. Patients on statins had significantly more comorbid conditions; both groups had comparable CURB-65 scores. In both groups, no statistically significant difference was seen for the decrease in CRP level on days 1 and 3 and LOS. No difference in days to normalization of fever was detected in either group. Conclusion No association was found between the chronic use of statins and CRP levels, LOS, or days to fever normalization in patients with CAP.

Download Full-text