scholarly journals Delayed discharge for non-clinical reasons among stroke patients in a high-complexity hospital: A cross-sectional study

Author(s):  
Amada Pellico-López ◽  
Ana Fernández-Feito ◽  
David Cantarero ◽  
Manuel Herrero Montes ◽  
Joaquín Cayón- De las Cuevas ◽  
...  

Abstract Delayed discharge for non-clinical reasons (bed-blocking) is characteristic of pathologies associated with ageing, loss of functional capacity and dependence such as stroke. The aims of this study were to describe the costs and characteristics of cases of patients with stroke and delayed discharge for non-clinical reasons (bed-blocking) compared with cases of bed-blocking (BB) for other reasons and to assess the relationship between the length of total stay (LOS) with patient characteristics and the context of care. A descriptive cross-sectional study was conducted at a high complexity public hospital in Northern Spain (2007-2015). 443 stroke patients presented with BB. Delayed discharge increased LOS by approximately one week. The mean age was 80.22 years, significantly higher than in cases of BB for other reasons. Patients with stroke and BB are usually older patients, however, when younger patients are affected, their length of stay is longer in relation to the sudden onset of the problem and the lack of adequate functional recovery resources or residential facilities for intermediate care.

2021 ◽  
pp. 1-7
Author(s):  
Amélie Gabet ◽  
Clémence Grave ◽  
Edouard Chatignoux ◽  
Philippe Tuppin ◽  
Yannick Béjot ◽  
...  

<b><i>Introduction:</i></b> COVID-19 was found to be associated with an increased risk of stroke. This study aimed to compare characteristics, management, and outcomes of hospitalized stroke patients with or without a hospital diagnosis of CO­VID-19 at a nationwide scale. <b><i>Methods:</i></b> This is a cross-sectional study on all French hospitals covering the entire French population using the French national hospital discharge databases (<i>Programme de Médicalisation des Systèmes d’Information</i>, included in the <i>Système National des Données de Santé</i>). All patients hospitalized for stroke between 1 January and 14 June 2020 in France were selected. A diagnosis of COVID-19 was searched for during the index hospitalization for stroke or in a prior hospitalization that had occurred after 1 January 2020. <b><i>Results:</i></b> Among the 56,195 patients hospitalized for stroke, 800 (1.4%) had a concomitant COVID-19 diagnosis. Inhospital case-fatality rates were higher in stroke patients with COVID-19, particularly for patients with a primary diagnosis of COVID-19 (33.2%), as compared to patients hospitalized for stroke without CO­VID-19 diagnosis (14.1%). Similar findings were observed for 3-month case-fatality rates adjusted for age and sex that reached 41.7% in patients hospitalized for stroke with a concomitant primary diagnosis of COVID-19 versus 20.0% in strokes without COVID-19. <b><i>Conclusion:</i></b> Patients hospitalized for stroke with a concomitant COVID-19 diagnosis had a higher inhospital and 3 months case-fatality rates compared to patients hospitalized for stroke without a COVID-19 diagnosis. Further research is needed to better understand the excess of mortality related to these cases.


2021 ◽  
Vol 70 ◽  
pp. 102829
Author(s):  
Mohammad Al- zubi ◽  
Ammar Al Sleibi ◽  
Basel Mazen Elayan ◽  
Subhi Zahi Al-issawi ◽  
Morad Bani-hani ◽  
...  

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dania Jaber ◽  
Rafat Abu Ghannam ◽  
Waleed Rashed ◽  
Mohammad Shehadeh ◽  
Sa’ed H. Zyoud

Abstract Background Generally, complementary and alternative therapies (CAT) are accepted methods of treatment by patients with various types of conditions. Their use is becoming especially prevalent among patients with eye problems even in developed countries. Thus, we aimed to determine the pattern of use of CAT in this patient population, to identify the patient characteristics associated with the use of CAT, and to assess the types of CAT used. Methods A descriptive, cross-sectional study was conducted in Palestine at An-Najah National University Hospital between the time periods of October 2019 to May 2020, using questionnaire-based face to face interviews. Data were collected through convenience sampling. Patients responded to the questionnaire, which was focused on information adapted from previous research in this area, covering socio-demographic and clinical characteristics, types of CAT, source of information, and side effects on CAT use. Results A total of 86 patients were interviewed for our study. Over two thirds, 67% reported using CAT for the specific purpose of improving their eye condition, and about one third (29.1%) received more than one therapy. The most common therapies reported were duea’ (i.e. supplication) (47.1%) and herbal therapies (24.1%). It was shown that patients with bilateral involvement of their eyes were almost twice more likely to describe using CAT than patients with unilateral eye pathology (p = 0.006). Also, patients who underwent surgery as their route of treatment were significantly less likely to use CAT (p = 0.043). Most of our study participants mentioned a non-physician source as their source of information regarding CAT with family members being the most frequently mentioned (30.2%) followed by the internet (25.6%) and friends (19.8%). Conclusions The prevalence of CAT use among patients with eye disease is somewhat high in our study population. Because CAT may trigger adverse reactions, influence the progression of the disease, and interfere with conventional treatment, the ophthalmologist should frequently be asked patients with such diagnostics regarding the use of these therapies. Further work is required to analyze the mechanisms of action and to establish realistic guidelines for the use of these modalities.


BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e041917
Author(s):  
Fei Shao ◽  
Haibin Li ◽  
Shengkui Ma ◽  
Dou Li ◽  
Chunsheng Li

ObjectiveThe purpose of this study was to assess the trends in outcomes of out-of-hospital cardiac arrest (OHCA) in Beijing over 5 years.DesignCross-sectional study.MethodsAdult patients with OHCA of all aetiologies who were treated by the Beijing emergency medical service (EMS) between January 2013 and December 2017 were analysed. Data were collected using the Utstein Style. Cases were followed up for 1 year. Descriptive statistics were used to characterise the sample and logistic regression was performed.ResultsOverall, 5016 patients with OHCA underwent attempted resuscitation by the EMS in urban areas of Beijing during the study period. Survival to hospital discharge was 1.2% in 2013 and 1.6% in 2017 (adjusted rate ratio=1.0, p for trend=0.60). Survival to admission and neurological outcome at discharge did not significantly improve from 2013 to 2017. Patient characteristics and the aetiology and location of cardiac arrest were consistent, but there was a decrease in the initial shockable rhythm (from 6.5% to 5.6%) over the 5 years. The rate of bystander cardiopulmonary resuscitation (CPR) increased steadily over the years (from 10.4% to 19.4%).ConclusionSurvival after OHCA in urban areas of Beijing did not improve significantly over 5 years, with long-term survival being unchanged, although the rate of bystander CPR increased steadily, which enhanced the outcomes of patients who underwent bystander CPR.


1969 ◽  
Vol 2 (2) ◽  
pp. 187-191
Author(s):  
Sahibzada Saeed Jan ◽  
Taj Muhammad Khan ◽  
Alamzeb ◽  
Izaz-urrahman ◽  
Amanullah ◽  
...  

Background: As hypertension is the most important risk factor for stroke, it is generally considered to beasymptomatic condition and require lifetime therapy which may include chemotherapy and lifestylechanges. Hypertension also clearly contributes to the risk of macrovascular disease in patients with type-IIdiabetes mellitus. Therefore, the present study was conducted to evaluate the prevalence of hypertension indiabetic and non-diabetic stroke patients in community hospital district Swat. Methodology: This was a cross-sectional study, comprised of 100 subjects, 50 were diabetic and 50 werenon-diabetic stroke patients of ages between 28 to 90 years. The blood sugar (random and fasting), bloodpressure (systolic and diastolic) of Diabetic stroke subjects were compared with Non-diabetic strokesubjects. Results: The prevalence of hypertension was significantly high in diabetic stroke subject as compared tonon-diabetic stroke subjects. Conclusion: Diabetic patients with persistently elevated blood pressure are more prone to develop stroke ascompared to non diabetic with hypertension KEYWORDS:Stroke, Diabetes mellitus, hypertension.


2020 ◽  
Vol 7 (4) ◽  
pp. 723-735
Author(s):  
Christy Pu ◽  
◽  
Jiun-Yu Guo ◽  
Yu-Hua-Yeh ◽  
Placide Sankara ◽  
...  

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