scholarly journals Early shunt complications in 46 children with hydrocephalus

2009 ◽  
Vol 67 (2a) ◽  
pp. 273-277 ◽  
Author(s):  
Moisés Heleno Vieira Braga ◽  
Gervásio Teles C. de Carvalho ◽  
Rafael Augusto Castro Santiago Brandão ◽  
Franklin Bernardes Faraj de Lima ◽  
Bruno Silva Costa
Keyword(s):  
Retrospective Study ◽  
Hospital Stay ◽  
Ventriculoperitoneal Shunt ◽  
Length Of Hospital Stay ◽  
Infectious Complications ◽  
Shunt Surgery ◽  
Common Complication ◽  
Shunt System ◽  
Shunt Complications ◽  
The Mean

OBJECTIVE: To determine the causes of early shunt complications in 46 children with hydrocephalus. METHOD: A retrospective study was conducted on 46 children submitted to ventriculoperitoneal shunt surgery between February 2005 and February 2007. RESULTS: Thirteen (28%) patients presented complications, which were due to infection in 9 (69%) and to malfunction of the shunt system in 4 (31%).The mean number of surgical procedures performed on patients who presented complications was 2.8 per patient, with a total of 46 surgeries in this group. All patients with infectious complications were identified during their hospital stay. CONCLUSIONS: Infection was the most common complication. The infection rate was proportional to the length of hospital stay. All patients with hydrocephalus due to tumors or myelomeningocele presented complications. A higher incidence of infections was observed in children older than 2 years.

Clinical improvement at Day 3 as factor influencing length of hospital stay and discharge of patients with schizophrenia

2011 ◽  
Vol 26 (S2) ◽  
pp. 1348-1348
Author(s):  
L. San-Molina ◽  
G. Rubio ◽  
I. Bernardo-Fernández ◽  
S. Miguélez-Fernández
Keyword(s):  
Retrospective Study ◽  
Length Of Stay ◽  
Hospital Stay ◽  
Hospital Discharge ◽  
Clinical Improvement ◽  
Length Of Hospital Stay ◽  
Medical Intervention ◽  
Symptom Improvement ◽  
The Mean ◽  
Symptom Outcome

IntroductionThe type of treatment used for patients with schizophrenia and an improvement at Day 3 can affect the length of stay and symptom outcome.ObjectivesTo determine the influence of improvement at Day 3 in the lenght of hospital stay and hospital discharge in the case of patients with schizophrenia admitted to acute units.MethodsA multicenter, naturalistic, retrospective study evaluating medical intervention in 1346 patients with schizophrenia in acute units in Spain.ResultsThe mean of hospital stay days was 23.3 (range 1–260 days). 49.5% of patients with improvement at Day 3 had a shorter length of hospital stay. 78.7% received treatment with antipsychotics prior to admission. The most common drugs were risperidone, olanzapine and quetiapine. 99.8% and 99.7% were treated during hospital stay and on discharge, respectively. The drugs most commonly used were paliperidone ER, risperidone and olanzapine. 99.8% of patients with improvement measured by GCI at Day 3 and 100% with improvement at Day 5 had improved at discharge. The percentage of patients requiring use of benzodiazepines or physical/mechanical restriction decreased as the days passed.ConclusionsThe three most commonly used drugs during admission were effective, but the action of paliperidone ER is to be noted (its use increased from 4% prior to admission to 43% and 44% during hospital stay and on discharge, respectively). The results of this study appear to confirm that symptom improvement should be obtained as early as the first week of treatment to achieve a shorter hospital stay.

scholarly journals Hem-o-lok clips are safe and efficacious for laparoscopic cholecystectomy: Preliminary results of a single center experience

2021 ◽  
Vol 1 (4) ◽  
Author(s):  
Gaetano Poillucci ◽  
◽  
Francesca Frangella ◽  
Piero Liberatore ◽  
Renato De Angelis ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Retrospective Study ◽  
Hospital Stay ◽  
Gallbladder Disease ◽  
Length Of Hospital Stay ◽  
Complication Rates ◽  
Biliary Leakage ◽  
Single Center Experience ◽  
The Mean ◽  
Titanium Clips

Introduction: The aim of this retrospective study was to compare the outcomes after laparoscopic cholecystectomy using titanium clips or Hem-o-lok polymeric clips to close cystic artery and cystic duct. Methods: A total of 154 patients who underwent laparoscopic cholecystectomy for gallbladder disease from January 2019 to December 2019 at the Department of Surgery of the San Giovanni Addolorata Hospital in Rome (Italy) were studied retrospectively. In 100 patients, titanium clips were used, while Hem-o-lok clips were used in 54 patients. In the two groups, patients' demographic characteristics, laboratory tests and postoperative complications were analyzed. Results: The mean length of hospital stay was shorter in the Hem-o-lok group compared to the titanium clips group (2.0 SD0.7 vs. 3.6 SD5.5, p < 0.05). The overall complication rates for the titanium clips and the Hem-o-lock clips groups were 9% and 0% 7 days after surgery (p < 0.05), 10% and 9.3% 30 days after surgery, 13% and 16.7% 180 days after surgery. There were no statistically significant differences between the two groups in the typology of complications. Conclusion: Based on our results, Hem-o-lock have better postoperative outcomes after laparoscopic cholecystectomy for gallbladder disease in terms of complication rate 7 days after surgery and in terms of mean length of hospital stay. Keywords: laparoscopic cholecystectomy; Hem-O-Lok polymeric clips; titanium clips; biliary leakage; retrospective study.

Pilonidal Sinus: How to Choose Between Excision and Open Granulation Versus Excision and Primary Closure?

Swiss Surgery ◽  
2002 ◽  
Vol 8 (6) ◽  
pp. 255-258 ◽  
Author(s):  
Perruchoud ◽  
Vuilleumier ◽  
Givel
Keyword(s):  
Hospital Stay ◽  
Pilonidal Sinus ◽  
Primary Closure ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Healing Time ◽  
Incision And Drainage ◽  
The Mean ◽  
Primary Healing

Aims: The purpose of this study was to evaluate excision and open granulation versus excision and primary closure as treatments for pilonidal sinus. Subjects and methods: We evaluated a group of 141 patients operated on for a pilonidal sinus between 1991 and 1995. Ninety patients were treated by excision and open granulation, 34 patients by excision and primary closure and 17 patients by incision and drainage, as a unique treatment of an infected pilonidal sinus. Results: The first group, receiving treatment of excision and open granulation, experienced the following outcomes: average length of hospital stay, four days; average healing time; 72 days; average number of post-operative ambulatory visits, 40; average off-work delay, 38 days; and average follow-up time, 43 months. There were five recurrences (6%) in this group during the follow-up period. For the second group treated by excision and primary closure, the corresponding outcome measurements were as follows: average length of hospital stay, four days; average healing time, 23 days; primary healing failure rate, 9%; average number of post-operative ambulatory visits, 6; average off-work delay, 21 days. The average follow-up time was 34 months, and two recurrences (6%) were observed during the follow-up period. In the third group, seventeen patients benefited from an incision and drainage as unique treatment. The mean follow-up was 37 months. Five recurrences (29%) were noticed, requiring a new operation in all the cases. Discussion and conclusion: This series of 141 patients is too limited to permit final conclusions to be drawn concerning significant advantages of one form of treatment compared to the other. Nevertheless, primary closure offers the advantages of quicker healing time, fewer post-operative visits and shorter time off work. When a primary closure can be carried out, it should be routinely considered for socio-economical and comfort reasons.

Propensity-adjusted cost analysis of radial versus femoral access for neuroendovascular procedures

2020 ◽  
pp. neurintsurg-2020-016728
Author(s):  
Joshua S Catapano ◽  
Andrew F Ducruet ◽  
Stefan W Koester ◽  
Tyler S Cole ◽  
Jacob F Baranoski ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Hospital Costs ◽  
Length Of Hospital Stay ◽  
Diagnostic Procedures ◽  
Femoral Access ◽  
Catheter Size ◽  
The Mean ◽  
The Difference ◽  
Procedure Type ◽  
Angiographic Findings

BackgroundTransradial artery (TRA) access for neuroendovascular procedures is associated with fewer complications than transfemoral artery (TFA) access. This study compares hospital costs associated with TRA access to those associated with TFA access for neurointerventions.MethodsElective neuroendovascular procedures at a single center were retrospectively analyzed from October 1, 2018 to May 31, 2019. Hospital costs for each procedure were obtained from the hospital financial department. The primary outcome was the difference in the mean hospital costs after propensity adjustment between patients who underwent TRA compared with TFA access.ResultsOf the 338 elective procedures included, 63 (19%) were performed through TRA versus 275 (81%) through TFA access. Diagnostic procedures were more common in the TRA cohort (51 of 63, 81%) compared with the TFA cohort (197 of 275, 72%), but the difference was not significant (p=0.48). The TRA cohort had a shorter length of hospital stay (mean (SD) 0.3 (0.5) days) compared with the TFA cohort (mean 0.7 (1.3) days; p=0.02) and lower hospital costs (mean $12 968 ($6518) compared with the TFA cohort (mean $17 150 ($10 946); p=0.004). After propensity adjustment for age, sex, symptoms, angiographic findings, procedure type, sheath size, and catheter size, TRA access was associated with a mean hospital cost of $2514 less than that for TFA access (95% CI −$4931 to −$97; p=0.04).ConclusionNeuroendovascular procedures performed through TRA access are associated with lower hospital costs than TFA procedures. The lower cost is likely due to a decreased length of hospital stay for TRA.

scholarly journals Is Obesity a Risk Factor for Spinal Surgeries? A Retrospective Study in a Specialized Orthopedic Spine Center

2021 ◽  
Vol 8 (1) ◽  
pp. 37-42
Author(s):  
Hasan Ghandhari ◽  
◽  
Ebrahim Ameri ◽  
Mohsen Motalebi ◽  
Mohamad-Mahdi Azizi ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Postoperative Complications ◽  
Blood Loss ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Obese Group ◽  
Obese Patients ◽  
Number Of Patients ◽  
Significant Difference ◽  
Duration Of Surgery

Background: Various studies have shown the effects of morbid obesity on the adverse consequences of various surgeries, especially postoperative infections. However, some studies have shown that the complications of spinal surgery in obese and non-obese patients are not significantly different. Objectives: This study investigated and compared the duration of surgery, length of hospital stay, and complications after common spinal surgeries by orthopedic spine fellowship in obese and non-obese patients in a specialized spine center in Iran. Methods: All patients who underwent decompression with or without lumbar fusion were included in this retrospective study. These patients were classified into two groups: non-obese (BMI <30 kg/m2) and obese (BMI ≥30 kg/m2). The data related to type and levels of surgery, 30-day hospital complications, length of hospital stay, rate of postoperative wound infection, blood loss, and need for transfusion were all extracted and compared between the two groups. Results: A total of 148 patients (74%) were in the non-obese group and 52 patients (26%) in the obese group. The number of patients that need packed cells was significantly higher in the obese group (51.8% vs 32.6%) (P=0.01). Otherwise, there were not a significant difference between type of treatment (fusion or only decompression) (P=0.78), interbody fusion (P=0.26), osteotomy (P=0.56), duration of surgery (P=0.25), length of hospital stay (P=0.72), mean amount of blood loss (P=0.09), and postoperative complications (P=0.68) between the two groups. Conclusion: Our results suggest that duration of surgery, length of hospital stay, and postoperative complications are not associated with the BMI of the patients.

Neurogenic claudication associated with posterior vertebral rim fractures in children

2012 ◽  
Vol 10 (3) ◽  
pp. 241-245 ◽  
Author(s):  
Jonathan G. Thomas ◽  
Jerome Boatey ◽  
Alison Brayton ◽  
Andrew Jea
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Signs And Symptoms ◽  
Leg Pain ◽  
Neurogenic Claudication ◽  
Pediatric Age Group ◽  
Fractures In Children ◽  
The Mean

Object Outside of the patient population with achondroplasia, neurogenic claudication is rare in the pediatric age group. Neurogenic claudication associated with posterior vertebral rim fracture is even more uncommon but nonetheless causes pain and disability in affected children and adolescents. The purpose of this study was to describe the surgical results of 3 adolescents presenting with neurogenic claudication and posterior vertebral rim fracture when treated with laminectomy alone. Methods The medical and operative records of the 3 pediatric patients were retrospectively reviewed. Presenting signs and symptoms and CT findings, such as the interpedicular distances between T-12 and L-5, were obtained. Perioperative results were assessed, including operative time, blood loss, length of hospital stay, and complications. Findings at latest follow-up were also recorded, including a patient satisfaction survey. Results The 3 patients (1 girl and 2 boys) had a mean age of 14.7 years (range 14–15 years) and underwent follow-up for a mean of 11.3 months (range 5–18 months). Notable preoperative signs and symptoms included back pain (all patients), leg pain (all patients), leg numbness (1 patient), and leg weakness (1 patient). No patient presented with bowel and/or bladder dysfunction. The mean blood loss during laminectomy was 123 ml (range 20–300 ml), and the mean length of hospital stay was 4.3 days (range 3–6 days). On average, decompression was performed at 2.2 levels (range 2–2.5 levels). All 3 patients reported at most recent follow-up that they were “satisfied” with the surgery. There was 1 complication of instability from an iatrogenic pars fracture, which required reoperation and posterior instrumented fusion. Conclusions To the best of the authors' knowledge, this report represents the first surgical series of pediatric neurogenic claudication associated with posterior vertebral rim fractures. Pediatric neurosurgeons may infrequently encounter neurogenic claudication associated with a posterior vertebral rim fracture in children. To treat children with neurogenic claudication associated with posterior vertebral rim fractures, a simple laminectomy may be a safe and efficacious alternative to discectomy and removal of fracture fragments.

scholarly journals Thirty-Day Postoperative Outcomes Following Sugammadex Use in Colorectal Surgery Patients; Retrospective Study

2019 ◽  
Vol 8 (1) ◽  
pp. 97 ◽  
Author(s):  
Yun Chae ◽  
Han Joe ◽  
Juyeon Oh ◽  
Eunyoung Lee ◽  
In Yi
Keyword(s):  
Retrospective Study ◽  
Colorectal Surgery ◽  
Hospital Stay ◽  
Acetylcholinesterase Inhibitor ◽  
Length Of Hospital Stay ◽  
Postoperative Hospital Stay ◽  
Postoperative Outcomes ◽  
Total Length ◽  
Delayed Discharge ◽  
Postanesthetic Care Unit

Purpose: Sugammadex rapidly reverses muscle relaxation compared to acetylcholinesterase inhibitors. The long-term outcomes of sugammadex, however, are not well known. We compared 30-day postoperative outcomes following sugammadex and acetylcholinesterase inhibitor use in colorectal surgery patients. Patients and methods: Colorectal surgical patients older than 21 were included in this retrospective study, and were dichotomized according to use of reversal agents, sugammadex (group S), and acetylcholinesterase inhibitor (group A). We assessed 30-day postoperative outcomes, including total length of hospital stay, length of postoperative hospital stay, readmission rate, and delayed discharge rate. Additional parameters included postanesthetic care unit stay time, time to first successful oral intake, unforeseen intensive care unit (ICU) admission rate, postoperative pulmonary complications, and mortality. Results: Among a total of 585 patients, 157 patients remained in each group after propensity score matching. Total length of hospital stay, length of postoperative hospital stay, and readmission rates did not differ between the two groups, while the incidence of delayed discharge was significantly lower in group S (23 (15%) vs. 40 (25%), p = 0.017). Other outcomes did not differ between the two groups. Conclusion: We found no difference in 30-day postoperative outcomes following sugammadex and acetylcholinesterase inhibitor use. The only difference between these treatments was the associated incidence of delayed discharge, which was lower in group S.

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