scholarly journals Thyroidectomy with and without drains: a clinical comparative study

2019 ◽  
Vol 6 (5) ◽  
pp. 1584
Author(s):  
Shaileshkumar M. Emmi ◽  
M. Amarnath Reddy
Keyword(s):  
Comparative Study ◽  
Hospital Stay ◽  
Tertiary Care ◽  
Length Of Hospital Stay ◽  
Early Discharge ◽  
General Surgeon ◽  
Hematoma Formation ◽  
Closed Suction Drain ◽  
Drain Group ◽  
The Mean

Background: Thyroid surgery is one of the most commonly performed procedures by a general surgeon, and almost every surgeon tends to use closed suction drain at the end of surgery, with an intention of preventing the most dangerous complication i.e., suffocating haematoma, which may be not necessary as suggested by many studies. The objective of the study was to assess the benefit of drain use after thyroidectomy by determining; length of hospital stay, post operative pain and wound sepsis.Methods: This prospective clinical comparative study was undertaken at tertiary care teaching Hospital, for duration of one year from September 2017 to August 2018.Results: A total of 44 patients were evaluated. There were 29 females (65.90%) and 15 males (34.09%). The mean age for the drain group was 35.45 years and 33.79 years for the no drain group. Most participants were female. Mean duration of hospital stay after thyroidectomy was significantly higher among the drain arm as compared with the no drain arm. Seven patients developed complications in the drain group and one developed complication in the no drain group. The mean hospital stay of the drain group was 3.15 days which in the no drain group was 2.51 days.Conclusions: Thyroidectomy without drains causes less discomfort, early discharge, hence has lesser expenses, without increasing the risk of post operative including haemorrhage and hematoma formation. Meticulous haemostasis and an adequate surgical technique are the keys for avoiding haemorrhage and hematoma formation.

scholarly journals Comorbidity of COVID-19 related Fatalities in Tertiary Care Hospitals of Rawalpindi, Pakistan

2020 ◽  
Vol 24 (Supp-1) ◽  
pp. 32-36
Author(s):  
Rizwana Shahid ◽  
Muhammad Umar ◽  
Raja Bilal Zafar ◽  
Shazia Zeb ◽  
Saima Ambreen ◽  
...  
Keyword(s):  
Critical Illness ◽  
Hospital Stay ◽  
Tertiary Care ◽  
Length Of Hospital Stay ◽  
Hospital Data ◽  
Ventilator Support ◽  
Adverse Health Outcomes ◽  
The Mean ◽  
Medical University ◽  
Tertiary Care Hospitals

Objectives: To assess the COVID-19 associated fatalities with respect to demographics, comorbidity, critical illness, and length of hospital stay in tertiary care hospitals. Subjects & Methods: A retrospective hospital data-based research was done among 216 COVID-19 associated mortalities registered in 4 tertiary care hospitals Holy Family Hospital (HFH), Benazir Bhutto Hospital (BBH), District Head Quarters Hospital (DHQ) and Rawalpindi Institute of Urology & Transplantation (RIU & T) affiliated with Rawalpindi Medical University from 29th March-15th June 2020. The data was gathered by consecutive sampling pertinent to demographics, hospital stay, comorbidity, critical illness, and ventilator or oxygen support. The length of hospital stay among fatalities with and without comorbidity was compared by an independent sample z-test. Data were analyzed by using SPSS version 25.0. Results: Of the total 216 COVID-19 related mortalities, 150(69.4%) were males and 66(30.6%) were females. The mean age of fatalities was 55.66 ± 13.97 years. About 76.7% of dying males were 41-70 years old while 56.1% of females dying of COVID-19 were 41-60 years old. Most (60.8%) of study subjects had hypertension followed by diabetes (53.8%), Ischemic Heart Disease (17.5%), and respiratory disorders (12.3%). About 75% of the critically ill patients needed a ventilator for respiratory support. Length of hospital stay was determined to have a statistically insignificant association (P > 0.10) with the presence or absence of comorbidity among COVID-19 patients. Critical illness had a highly significant association (P < 0.000) with ventilator support among COVID-19 related mortalities. Conclusion: People 41-70 years should preferably adopt stringent precautions for protection against COVID-19. Comorbid states chiefly hypertension, diabetes, cardiac and respiratory diseases need special consideration amid COVID-19 pandemic to abstain from adverse health outcomes.

scholarly journals Drain verus No Drain After Thyroidectomy: A Preliminary Prospective Randomized Controlled Trial

2014 ◽  
Vol 29 (1) ◽  
pp. 11-15
Author(s):  
Jefferson A. Alamani ◽  
Elias T. Reala ◽  
Samantha S. Castañeda ◽  
Antonio H. Chua
Keyword(s):  
Hospital Stay ◽  
Prevention And Control ◽  
Controlled Trial ◽  
Length Of Hospital Stay ◽  
Wound Dehiscence ◽  
Randomized Controlled ◽  
Prospective Randomized Controlled Trial ◽  
Drain Group ◽  
The Mean ◽  
And Control

Objective: To evaluate the necessity of placing a drain in post-thyroidectomy patients, we aimed to determine whether insertion of a passive drain, as compared to no drain, in post-thyroidectomy patients, would significantly affect hematoma formation, wound infection, wound dehiscence and length of hospital stay. Methods: Study Design:            Prospective randomized controlled trial Setting:                       Tertiary government training hospital Subjects:                     Patients who underwent thyroidectomy for various thyroid pathologies were divided into two postoperative treatment arms: one group with insertion of a passive drain, and another group without a drain. Hematoma, wound infection, wound dehiscence, and length of hospital stay were the outcomes measured per treatment arm.   Results: A total of 66 patients were evaluated. There were 54 females (81.81%) and 12 males (18.18%). The mean age for the drain group was 44.88 years and 43.67 years for the no drain group. Four patients developed complications in the drain group and 2 developed complications in the no drain group. The rate of complications between both groups was not statistically significant.  The mean hospital stay of the drain group was 3.15 days, which in the no drain group was 2.51 days. The difference in length of hospital stay was statistically significant.   Conclusion:   There was no difference in the development of complications among the drain and no drain group. Thyroidectomy without surgical drains was associated with a significant reduction in hospital stay compared to thyroidectomy with routine placement of drains.   Keywords: Surgical drainage / methods, hematoma / prevention and control, postoperative complications / prevention and control, thyroid disease / surgery, thyroidectomy / methods  

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.

Prevalence, Correlates and Management of Hyperglycemia in Diabetic Non-critically Ill Patients at a Tertiary Care Center in Lebanon

2019 ◽  
Vol 15 (2) ◽  
pp. 133-140 ◽  
Author(s):  
Ghada El Khoury ◽  
Hanine Mansour ◽  
Wissam K. Kabbara ◽  
Nibal Chamoun ◽  
Nadim Atallah ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Care Center ◽  
Descriptive Analysis ◽  
Tertiary Care ◽  
Multivariable Analysis ◽  
Length Of Hospital Stay ◽  
Retrospective Chart Review ◽  
Diabetic Patients

Background: Diabetes Mellitus is a chronic metabolic disease that affects 387 million people around the world. Episodes of hyperglycemia in hospitalized diabetic patients are associated with poor clinical outcomes and increased morbidity and mortality. Therefore, prevention of hyperglycemia is critical to decrease the length of hospital stay and to reduce complications and readmissions. Objective: The study aims to examine the prevalence of hyperglycemia and assess the correlates and management of hyperglycemia in diabetic non-critically ill patients. Methods: The study was conducted on the medical wards of a tertiary care teaching hospital in Lebanon. A retrospective chart review was conducted from January 2014 until September 2015. Diabetic patients admitted to Internal Medicine floors were identified. Descriptive analysis was first carried out, followed by a multivariable analysis to study the correlates of hyperglycemia occurrence. Results: A total of 235 medical charts were reviewed. Seventy percent of participants suffered from hyperglycemia during their hospital stay. The identified significant positive correlates for inpatient hyperglycemia, were the use of insulin sliding scale alone (OR=16.438 ± 6.765-39.941, p=0.001) and the low frequency of glucose monitoring. Measuring glucose every 8 hours (OR= 3.583 ± 1.506-8.524, p=0.004) and/or every 12 hours (OR=7.647 ± 0.704-79.231, p=0.0095) was associated with hyperglycemia. The major factor perceived by nurses as a barrier to successful hyperglycemia management was the lack of knowledge about appropriate insulin use (87.5%). Conclusion: Considerable mismanagement of hyperglycemia in diabetic non-critically ill patients exists; indicating a compelling need for the development and implementation of protocol-driven insulin order forms a comprehensive education plan on the appropriate use of insulin.

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 A Study of Factors Affecting the Length of Hospital Stay of COVID-19 Patients by Cox-Proportional Hazard Model in a South Indian Tertiary Care Hospital

2021 ◽  
Vol 12 ◽  
pp. 215013272110002
Author(s):  
Gayathri Thiruvengadam ◽  
Marappa Lakshmi ◽  
Ravanan Ramanujam
Keyword(s):  
Hospital Stay ◽  
Tertiary Care ◽  
Length Of Hospital Stay ◽  
Hazard Model ◽  
Cox Proportional Hazard Model ◽  
Care Hospital ◽  
Proportional Hazard ◽  
Proportional Hazard Model ◽  
Cox Proportional Hazard ◽  
South Indian

Background: The objective of the study was to identify the factors that alter the length of hospital stay of COVID-19 patients so we have an estimate of the duration of hospitalization of patients. To achieve this, we used a time to event analysis to arrive at factors that could alter the length of hospital stay, aiding in planning additional beds for any future rise in cases. Methods: Information about COVID-19 patients was collected between June and August 2020. The response variable was the time from admission to discharge of patients. Cox proportional hazard model was used to identify the factors that were associated with the length of hospital stay. Results: A total of 730 COVID-19 patients were included, of which 675 (92.5%) recovered and 55 (7.5%) were considered to be right-censored, that is, the patient died or was discharged against medical advice. The median length of hospital stay of COVID-19 patients who were hospitalized was found to be 7 days by the Kaplan Meier curve. The covariates that prolonged the length of hospital stay were found to be abnormalities in oxygen saturation (HR = 0.446, P < .001), neutrophil-lymphocyte ratio (HR = 0.742, P = .003), levels of D-dimer (HR = 0.60, P = .002), lactate dehydrogenase (HR = 0.717, P = .002), and ferritin (HR = 0.763, P = .037). Also, patients who had more than 2 chronic diseases had a significantly longer length of stay (HR = 0.586, P = .008) compared to those with no comorbidities. Conclusion: Factors that are associated with prolonged length of hospital stay of patients need to be considered in planning bed strength on a contingency basis.

Trend of Hospital Admission and Outcome Study of Patients Admitted in a Neurology Unit at a Tertiary Care Neuroscience Hospital in Bangladesh

2018 ◽  
Vol 4 (2) ◽  
pp. 69-74
Author(s):  
Md Tauhidul Islam Chowdhury ◽  
Mohammad Shah Jahirul Hoque Choudhury ◽  
KM Ahasan Ahmed ◽  
Mohammad Sadekur Rahman Sarkar ◽  
Md Abdullah Yusuf ◽  
...  
Keyword(s):  
Neurological Disorders ◽  
Neurological Diseases ◽  
Tertiary Care ◽  
Length Of Hospital Stay ◽  
Retrospective Chart Review ◽  
Total Death ◽  
Neurological Patients ◽  
Study Population ◽  
The Mean ◽  
Day By Day

Background: Neurological disorders is becoming a growing concern both for developed and developing countries. Magnitude of the problem is increasing day by day. Among all neurological disorders, stroke is the leading cause of morbidity and mortality globally.Objectives: The purpose of the study was to see the trend of admission of patients with neurological diseases and to study the outcome of patients at referral neurology hospital in Bangladesh.Methodology: This retrospective chart review was conducted in the blue unit of the Department of Neurology at National Institute of Neurosciences and Hospital, Dhaka, Bangladesh from 1st January to 31st December 2016 for a period of one (01) year. All the admitted patients with both sexes were selected as study population. The outcome was observed among the study population.Result: A total number of 1044 patients were admitted during the study period. Majority of the patients were in the age group of the 41 to 50 years which was 417(39.9%) cases. Both male and female were in highest number in the month of May which was 63 and 48 cases respectively. The total death of the study population was 146(14.0%) cases. The mean length of hospital stay was 8.4±2.31 days.Conclusion: Middle aged male is the main bulk of the neurological patients, admitted in a referral neurology hospital in Bangladesh. Highest admission and mortality was observed in stroke patients.Journal of National Institute of Neurosciences Bangladesh, 2018;4(2): 69-74

Nosocomial Methicillin-Resistant and Methicillin-SusceptibleStaphylococcus AureusPrimary Bacteremia: At What Costs?

1999 ◽  
Vol 20 (6) ◽  
pp. 408-411 ◽  
Author(s):  
Murray A. Abramson ◽  
Daniel J. Sexton
Keyword(s):  
Hospital Stay ◽  
Medical Center ◽  
A Priori ◽  
Tertiary Care ◽  
Length Of Hospital Stay ◽  
Bloodstream Infections ◽  
Methicillin Resistant ◽  
Tertiary Care Medical Center ◽  
Matching Criteria ◽  
Nested Case Control

Objective:To determine the attributable hospital stay and costs for nosocomial methicillin-sensitive Staphylococcus aureus (MSSA) and methicillin-resistantS aureus(MRSA) primary bloodstream infections (BSIs).Design:Pairwise-matched (1:1) nested case-control study.Setting:University-based tertiary-care medical center.Patients:Patients admitted between December 1993 and March 1995 were eligible. Cases were defined as patients with a primary nosocomialS aureusBSI; controls were selected according to a priori matching criteria.Measurements:Length of hospital stay and total and variable direct costs of hospitalization.Results:The median hospital stay attributable to primary nosocomial MSSA BSI was 4 days, compared with 12 days for MRSA (P=.023). Attributable median total cost for MSSA primary nosocomial BSIs was $9,661 versus $27,083 for MRSA nosocomial infections (P=.043).Conclusion:Nosocomial primary BSI due toS aureussignificantly prolongs the hospital stay. Primary nosocomial BSIs due to MRSA result in an approximate threefold increase in direct cost, compared with those due to MSSA.

A Comparative Study of Endoscopic Coblation Adenoidectomy and Regular Curettage Adenoidectomy in a Tertiary Care Hospital in Kerala

2021 ◽  
Vol 8 (41) ◽  
pp. 3559-3566
Author(s):  
Abdul Salam R. T. ◽  
Shahul Hameed A. ◽  
Meera Rajan
Keyword(s):  
Blood Loss ◽  
Comparative Study ◽  
Tertiary Care ◽  
Operation Time ◽  
Care Hospital ◽  
Adenoid Tissue ◽  
Significant Difference ◽  
Tube Function ◽  
Prospective Comparative Study ◽  
The Mean

BACKGROUND An ideal surgery to remove hypertrophied adenoid mass should be safe, with less bleeding and operation time along with post-operative improvement in the eustachian tubal ventilation and normal respiration. It should also have low morbidity and mortality. Among the various methods described for its removal, the two commonly used methods are conventional cold curettage method and coblation technique. The purpose of this study was to collate the safety and efficacy of endoscopic coblation adenoidectomy with the conventional curettage adenoidectomy. METHODS A prospective comparative study with fifty patients was studied who underwent adenoidectomy. Twenty five patients underwent endoscopy assisted coblation adenoidectomy and twenty five patients underwent regular adenoidectomy by curettage. RESULTS Patients who underwent coblation adenoidectomy showed better results during follow up in terms of completeness of removal. 80 % of children undergoing regular adenoidectomy by curettage method showed remnant adenoid tissue in the nasopharynx at the end of the procedure. But it was 6 % among the children undergoing endoscopic assisted coblation adenoidectomy. The mean duration of operation was higher for endoscopic assisted coblation adenoidectomy which was significant statistically. The mean blood loss was 30.36 ml in regular curettage adenoidectomy; 10.6 ml with endoscopic coblation adenoidectomy. The grading of pain was significantly lower in endoscopic assisted coblation adenoidectomy. There was no significant difference between two groups in terms of eustachian tube function after surgery. CONCLUSIONS Coblation adenoidectomy has significant advantages over conventional adenoidectomy in terms of completeness of removal, reduced blood loss, and lower post-operative pain grade. KEYWORDS Coblation, Adenoidectomy, Curettage, Haemorrhage and Complications

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