scholarly journals Comparison Of Different Anesthetic Techniques Used For Geriatric Patients Who Underwent TUR-P Operation: Single Center Experience

2020 ◽  
Author(s):  
Ozge Gozcu ◽  
Elzem Sen ◽  
Haluk Sen ◽  
Omer Bayrak
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Anesthetic Techniques ◽  
Asa Score ◽  
Intensive Care Stay ◽  
Significant Difference ◽  
Operation Duration ◽  
The Cost

Abstract Objectives To investigate impacts that effect entrance to intensive care unit, mortality, and cost; according to demographical and clinical parameters of patients, and different anesthetic techniques performed on patients who underwent TUR-P operation. Methods Data of 234 patients aged 60 years and older who underwent TUR-P operations was evaluated retrospectively. The patients were examined in two groups as neuroaxial and general anesthesia groups. Charlson Comorbidity Index, preoperative laboratory parameters, presence of comorbidity, preoperative intensive care requirement, operation duration were obtained from hospital records. The cost calculation was based on the length of the patient's stay in hospital and intensive care unit. Results According to ASA score, no significant difference was observed among operation duration, length of hospital stay and intensive care unit stay. According to the CCI score, there was no significant difference among the operation time; however, when the patient's CCI was 3 and above 3, the duration of intensive care stay and hospital stay were significantly longer. The cost was increased significantly when CCI was 3 and above 3, but did not change according to the ASA score. Conclusions In our study, it was observed that the type of anesthesia did not affect the duration of surgery, rate of entrance to intensive care unit, length of intensive care stay, length of hospital stay, mortality and the cost. However, it was observed that the duration of hospitalization and rate of intensive care unit entrance increased in patients with CCI 3 and above, therefore the cost was increased.

scholarly journals Feasibility of Non-Rebreather Masks and Nasal Cannula as a Substitute for High Flow Nasal Oxygen in Patients with Severe COVID-19 Infection

2021 ◽  
Author(s):  
mehmet kabak ◽  
Baris Cil
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
High Flow ◽  
Nasal Cannula ◽  
Intensive Care Treatment ◽  
Mechanical Ventilators ◽  
Non Invasive ◽  
Significant Difference

Abstract Objective: Severe pneumonia and respiratory failure may develop in patients with coronavirus infection, placing a very significant burden on healthcare systems due to the need for both emergency and intensive care treatment. Therefore, treatment of hypoxemia is a clinical priority in the treatment of such patients. In this regard, newer strategies such as High Flow Nasal Oxygen (HFNO) and non-invasive mechanical ventilators that can provide non-invasive high fraction of inspired oxygen are gaining clinical significance. Our objective was to compare oxygen supply by HFNO with Non-Rebreather Masks and Nasal Cannula (NRMs + NC) in terms of treatment costs and mortality in a group of COVID-19 patients requiring intensive care unit admission. Material and Methods: This was a retrospective and single-center study involving 54 patients who were admitted to an Intensive Care Unit with a diagnosis of COVID-19 infection between July 2020 and August 2020. Results: HFNO was compared with NMRs + NC in terms of mortality and duration of hospital stay. The two groups were comparable in age (p=0.45), gender (p=0.33), and mortality (p=0.43). Also, there was no significant difference in oxygen saturation at admission (p=0.63), duration of intensive care (p=0.35), total length of hospital stay (p=0.057), and need for invasive mechanical ventilator (p=0.39) between the study groups. The levels of WBC (p=0.36), platelets (p=0.12), lymphocytes (p=0.98), CRP (p=0.11), pro-calcitonin (p=0.20), D-dimer (p=0.74), ferritin (p=0.14), urea (p=0.74), and creatinine (p=0.35) were also similar between the two groups. Conclusion: Oxygen support by NRMs + NC was comparable to HFNO in terms of mortality, need for invasive mechanic ventilation, length of intensive care, and length of hospital stay. We believe that NRMs + NC may represent an inexpensive and easily accessible therapeutic substitute for HFNO, particularly when the risk of transmission and costs related with HFNO use are considered.

The Impact of Resident Holdover Admissions on Length of Hospital Stay and Risk of Transfer to an Intensive Care Unit

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Deepshikha Charan Ashana ◽  
Vincent K. Chan ◽  
Sitaram Vangala ◽  
Douglas S. Bell
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
The Impact

scholarly journals Statin Use and COVID-19 Infectivity and Severity in South Korea: Two Population-Based Nationwide Cohort Studies (Preprint)

2021 ◽  
Author(s):  
Seung Won Lee ◽  
So Young Kim ◽  
Sung Yong Moon ◽  
In Kyung Yoo ◽  
Eun-Gyong Yoo ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hospital Stay ◽  
Clinical Outcomes ◽  
Length Of Hospital Stay ◽  
Population Based ◽  
Adjusted Relative Risk ◽  
Invasive Ventilation ◽  
Independent Population ◽  
Statin Use

BACKGROUND Basic studies suggest that statins as add-on therapy may benefit patients with COVID-19; however, real-world evidence of such a beneficial association is lacking. OBJECTIVE We investigated differences in SARS-CoV-2 test positivity and clinical outcomes of COVID-19 (composite endpoint: admission to intensive care unit, invasive ventilation, or death) between statin users and nonusers. METHODS Two independent population-based cohorts were analyzed, and we investigated the differences in SARS-CoV-2 test positivity and severe clinical outcomes of COVID-19, such as admission to the intensive care unit, invasive ventilation, or death, between statin users and nonusers. One group comprised an unmatched cohort of 214,207 patients who underwent SARS-CoV-2 testing from the Global Research Collaboration Project (GRCP)-COVID cohort, and the other group comprised an unmatched cohort of 74,866 patients who underwent SARS-CoV-2 testing from the National Health Insurance Service (NHIS)-COVID cohort. RESULTS The GRCP-COVID cohort with propensity score matching had 29,701 statin users and 29,701 matched nonusers. The SARS-CoV-2 test positivity rate was not associated with statin use (statin users, 2.82% [837/29,701]; nonusers, 2.65% [787/29,701]; adjusted relative risk [aRR] 0.97; 95% CI 0.88-1.07). Among patients with confirmed COVID-19 in the GRCP-COVID cohort, 804 were statin users and 1573 were matched nonusers. Statin users were associated with a decreased likelihood of severe clinical outcomes (statin users, 3.98% [32/804]; nonusers, 5.40% [85/1573]; aRR 0.62; 95% CI 0.41-0.91) and length of hospital stay (statin users, 23.8 days; nonusers, 26.3 days; adjusted mean difference –2.87; 95% CI –5.68 to –0.93) than nonusers. The results of the NHIS-COVID cohort were similar to the primary results of the GRCP-COVID cohort. CONCLUSIONS Our findings indicate that prior statin use is related to a decreased risk of worsening clinical outcomes of COVID-19 and length of hospital stay but not to that of SARS-CoV-2 infection.

scholarly journals Obesity May Not Be Associated with 28-Day Mortality, Duration of Invasive Mechanical Ventilation and Length of Intensive Care Unit and Hospital Stay in Critically Ill Patients with Severe Acute Respiratory Syndrome Coronavirus-2: A Retrospective Cohort Study

Medicina ◽  
2021 ◽  
Vol 57 (7) ◽  
pp. 674
Author(s):  
Sjaak Pouwels ◽  
Dharmanand Ramnarain ◽  
Emily Aupers ◽  
Laura Rutjes-Weurding ◽  
Jos van Oers
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Cohort Study ◽  
Intensive Care ◽  
Length Of Stay ◽  
Hospital Stay ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Invasive Mechanical Ventilation ◽  
Significant Difference

Background and Objectives: The aim of this study was to investigate the association between obesity and 28-day mortality, duration of invasive mechanical ventilation and length of stay at the Intensive Care Unit (ICU) and hospital in patients admitted to the ICU for SARS-CoV-2 pneumonia. Materials and Methods: This was a retrospective observational cohort study in patients admitted to the ICU for SARS-CoV-2 pneumonia, in a single Dutch center. The association between obesity (body mass index > 30 kg/m2) and 28-day mortality, duration of invasive mechanical ventilation and length of ICU and hospital stay was investigated. Results: In 121 critically ill patients, pneumonia due to SARS-CoV-2 was confirmed by RT-PCR. Forty-eight patients had obesity (33.5%). The 28-day all-cause mortality was 28.1%. Patients with obesity had no significant difference in 28-day survival in Kaplan–Meier curves (log rank p 0.545) compared with patients without obesity. Obesity made no significant contribution in a multivariate Cox regression model for prediction of 28-day mortality (p = 0.124), but age and the Sequential Organ Failure Assessment (SOFA) score were significant independent factors (p < 0.001 and 0.002, respectively). No statistically significant correlation was observed between obesity and duration of invasive mechanical ventilation and length of ICU and hospital stay. Conclusion: One-third of the patients admitted to the ICU for SARS-CoV-2 pneumonia had obesity. The present study showed no relationship between obesity and 28-day mortality, duration of invasive mechanical ventilation, ICU and hospital length of stay. Further studies are needed to substantiate these findings.

scholarly journals Clinical and prognostic significance of emergency MRI findings in neck infections

2021 ◽  
Author(s):  
Jaakko Heikkinen ◽  
Janne Nurminen ◽  
Jarno Velhonoja ◽  
Heikki Irjala ◽  
Tatu Happonen ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hospital Stay ◽  
Prognostic Significance ◽  
Length Of Hospital Stay ◽  
C Reactive Protein ◽  
Mri Findings ◽  
Neck Infection ◽  
Reactive Protein ◽  
Icu Treatment

Abstract Objectives Due to its superior soft-tissue contrast and ability to delineate abscesses, MRI has high diagnostic accuracy in neck infections. Whether MRI findings can predict the clinical course in these patients is unknown. The purpose of this study was to determine the clinical and prognostic significance of various MRI findings in emergency patients with acute neck infections. Materials and methods We retrospectively reviewed the 3-T MRI findings of 371 patients with acute neck infections from a 5-year period in a single tertiary emergency radiology department. We correlated various MRI findings, including retropharyngeal (RPE) and mediastinal edema (ME) and abscess diameter, to clinical findings and outcomes, such as the need for intensive care unit (ICU) treatment and length of hospital stay (LOS). Results A total of 201 out of 371 patients (54%) with neck infections showed evidence of RPE, and 81 out of 314 patients (26%) had ME. Both RPE (OR = 9.5, p < 0.001) and ME (OR = 5.3, p < 0.001) were more prevalent among the patients who required ICU treatment than among those who did not. In a multivariate analysis, C-reactive protein (CRP) levels, RPE, and maximal abscess diameter were independent predictors of the need for ICU treatment, and CRP, ME, and maximal abscess diameter were independent predictors of LOS. Conclusion In patients with an acute neck infection that requires emergency imaging, RPE, ME, and abscess diameter, as shown by MRI, are significant predictors of a more severe illness. Key Points • Two hundred one out of 371 patients (54%) with neck infection showed evidence of retropharyngeal edema (RPE), and 81 out of 314 patients (26%) had mediastinal edema (ME). • Maximal abscess diameter, RPE, and C-reactive protein (CRP) were independent predictors of the need for intensive care unit (ICU) treatment, and maximal abscess diameter, ME, and CRP were independent predictors of length of hospital stay. • Prognostic significance of MRI findings was evident also while controlling for CRP values.

scholarly journals COVID in women in Brazil: length of stay and outcomes of first hospitalizations

Rev Rene ◽  
2021 ◽  
Vol 22 ◽  
pp. e61049
Author(s):  
Erica de Brito Pitilin ◽  
Maicon Henrique Lentsck ◽  
Vanessa Aparecida Gasparin ◽  
Larissa Pereira Falavina ◽  
Vander Monteiro da Conceição ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Length Of Stay ◽  
Hospital Stay ◽  
Ecological Study ◽  
Length Of Hospital Stay ◽  
Secondary Diagnosis ◽  
Chi Square ◽  
Hospital Stays ◽  
Underlying Diseases

Objective: to analyze the length of hospital stay and outcomes of the first hospitalizations due to COVID-19 of women at the beginning of the pandemic. Methods: ecological study with data on COVID-19 hospitalizations of women. Data classification was done by states, regions, age, length of hospital stay, main and secondary diagnosis (underlying diseases), and outcome. Kruskal-Wallis, Mann-Whitney, and chi-square tests were used for the analysis. Results: the Southeast region had the highest number of hospitalizations (0.6%). Of the total number of hospitalizations, 14.6% required an intensive care unit. The length of hospital stay of women over 50 years was significant for Brazil (p<0.001). There was an association between length of hospital stay and levels 2 and 3 of comorbidity. Deaths in women over 50 years old were significant in Brazil, Northeast, and Southeast (p<0.001). Conclusion: women over 50 years old with comorbidities are associated with longer hospital stays and deaths.

scholarly journals A retrospective examination of the effects of regional anesthesia methods applied for postoperative pain control on analgesic consumption after lower extremity surgery

2020 ◽  
Vol 7 (10) ◽  
pp. 659-662
Author(s):  
Mehmet Kenan Erol
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Postoperative Pain ◽  
Lower Extremity ◽  
Peripheral Nerve ◽  
Regional Anesthesia ◽  
Intensive Care Stay ◽  
Significant Difference ◽  
The Difference ◽  
Group 1

Objective: If preferable, the regional anesthesia is a more preferred method than general anesthesia. The preference for regional anesthesia increases as postoperative recovery is quicker, hospitalization is less and hospital costs are low. Material and methods: We retrospectively evaluated the hemodynamic findings, postoperative pain, hospital, and intensive care stay in patients aged 18-80 who underwent lower extremity surgery with regional anesthesia in the last 1 year. We divided the cases into 3 groups; Group 1 (n =114) patients with a peripheral nerve block, Group 2 (n =104) spinal anesthesia, and Group 3 (n =81) epidural anesthesia. Results: The difference between group 1 and 2, age hospitalization, and time of stay in intensive care was statistically significant. (P=0.021) (P=0.000). The difference between group 1 and 3 Intensive care unit stay was statistically significant (P = 0.003). The difference between the length of stay in the intensive care unit between groups 2 and 3 was found as statistically significant (P = 0.000). There was no significant difference in terms of hospital stay. Group 1 was found to have the shortest duration of intensive care stay. Conclusion: In lower extremity surgeries, peripheral nerve blocks may have provided more hemodynamic stability and longer analgesic effect compared to central blocks.

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