scholarly journals Are Only A Few Hours Adequate For Hospitalization Following Mini-Incision Open Appendectomy In Pediatric Patients?

2021 ◽  
Author(s):  
Paiboon Sookpotarom ◽  
Vichack Chakrapan Na Ayudhya ◽  
Vorapatu Tangsirapat
Keyword(s):  
Length Of Stay ◽  
Medical Records ◽  
Pediatric Patients ◽  
Open Appendectomy ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Open Technique ◽  
The Mean ◽  
Surgical Condition ◽  
Mini Incision

Abstract Purpose- A very short hospital length of stay following an open appendectomy in children with acute simple appendicitis has never been mentioned yet in literature. The authors reviewed the outcome of these pediatric patients who were treated with the open technique.Methods -We retrospectively reviewed the medical records of the 115 consecutive patients who underwent open appendectomy from June 2017 to July 2021.Results- There were 84 patients whose appendices were inflammatory or suppurative and appendectomies were done only through McBurney’s point. Of these, the average age was 9.11 ± 2.67 years. The mean length of the incision was 1.95 ± 0.48 centimeters. Nearly one-third (25/85) could be discharged with 3 hours following surgery. Of the remaining cases, 9 patients were discharged within the same day.Conclusion- There were increased percentages of patients who were eligible for our criteria in each year. The confidence of both parents and the therapeutic team on this concept is of paramount importance affecting a shift of paradigm of this treatment of this very common surgical condition.

scholarly journals Impact of a Positive Viral Polymerase Chain Reaction on Outcomes of Chronic Obstructive Pulmonary Disease (COPD) Exacerbations

2020 ◽  
Vol 17 (21) ◽  
pp. 8072 ◽  
Author(s):  
Kulothungan Gunasekaran ◽  
Mudassar Ahmad ◽  
Sana Rehman ◽  
Bright Thilagar ◽  
Kavitha Gopalratnam ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Length Of Stay ◽  
Pulmonary Disease ◽  
Respiratory Virus ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Exacerbations ◽  
The Mean

Introduction: More than 15 million adults in the USA have chronic obstructive pulmonary disease. Chronic obstructive pulmonary disease (COPD) places a high burden on the healthcare system. Many hospital admissions are due to an exacerbation, which is suspected to be from a viral cause. The purpose of this analysis was to compare the outcomes of patients with a positive and negative respiratory virus panel who were admitted to the hospital with COPD exacerbations. Methods: This retrospective cohort study was conducted in the Geisinger Healthcare System. The dataset included 2729 patient encounters between 1 January 2006 and 30 November 2017. Hospital length of stay was calculated as the discrete number of calendar days a patient was in the hospital. Patient encounters with a positive and negative respiratory virus panel were compared using Pearson’s chi-square or Fisher’s exact test for categorical variables and Student’s t-test or Wilcoxon rank-sum tests for continuous variables. Results: There were 1626 patients with a total of 2729 chronic obstructive pulmonary disease exacerbation encounters. Nineteen percent of those encounters (n = 524) had a respiratory virus panel performed during their admission. Among these encounters, 161 (30.7%) had positive results, and 363 (69.3%) had negative results. For encounters with the respiratory virus panel, the mean age was 64.5, 59.5% were female, 98.9% were white, and the mean body mass index was 26.6. Those with a negative respiratory virus panel had a higher median white blood cell count (11.1 vs. 9.9, p = 0.0076). There were no other statistically significant differences in characteristics between the two groups. Respiratory virus panel positive patients had a statistically significant longer hospital length of stay. There were no significant differences with respect to being on mechanical ventilation or ventilation-free days. Conclusion: This study shows that a positive respiratory virus panel is associated with increased length of hospital stay. Early diagnosis of chronic obstructive pulmonary disease exacerbation patients with positive viral panel would help identify patients with a longer length of stay.

scholarly journals Karydakis Flap Procedure in Patients with Sacrococcygeal Pilonidal Sinus Disease: Experience of a Single Centre in Istanbul

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
M. Kamil Yildiz ◽  
Erkan Ozkan ◽  
Hacı Mehmet Odabaşı ◽  
Bülent Kaya ◽  
Cengiz Eriş ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Pilonidal Sinus ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Sinus Surgery ◽  
Pilonidal Sinus Disease ◽  
Sinus Disease ◽  
Satisfaction Rate ◽  
Flap Procedure ◽  
The Mean

Background. The aim of this retrospective study was to evaluate the results of patients with sacrococcygeal pilonidal sinus who underwent surgery using the Karydakis technique.Methods. Two hundred fifty-seven patients with sacrococcygeal pilonidal sinus disease were treated by the Karydakis flap procedure between December 2003 and June 2011. Patients were evaluated with respect to age, gender, preoperative symptoms, duration of preoperative symptoms, history of pilonidal sinus surgery, early postoperative complications, recurrence rates, and cosmetic satisfaction.Results. There were 223 (86.8%) male and 34 (13.2%) female patients. The mean age of the patients was years. The most frequent symptom was seropurulent discharge (57.58%). Postoperative morbidity was noted in 24 patients (9.3%). The mean hospital length of stay was days. The cosmetic satisfaction rate was 91.06%. Recurrences were noted in 6 patients (2.3%).Conclusion. The Karydakis flap procedure is a safe treatment alternative for the surgical treatment of sacrococcygeal pilonidal sinus disease owing to the associated low complication rate, short hospital length of stay, rapid healing, and a high patient satisfaction rate.

scholarly journals Impact of a Hospitalist-Run Procedure Service on Time to Paracentesis and Length of Stay

2021 ◽  
Author(s):  
Evan Ritter ◽  
Manpreet Malik ◽  
Rehan Qayyum
Keyword(s):  
Length Of Stay ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Hospital Length ◽  
Resident Training ◽  
Hospital Length Of Stay ◽  
Patient Centered ◽  
Service Group ◽  
Radiology Service ◽  
Resident Group

Hospitals are establishing procedure services to address resident training and patient safety. We examined whether a hospitalist procedure service affects a patient’s hospital length of stay (LOS) and the time from admission to paracentesis (A2P). We queried our electronic medical records for all inpatient peritoneal fluid samples from July 1, 2016, to May 31, 2019. LOS and A2P time were compared among patients who had paracentesis by the procedure service, by residents, or by radiology. Of the 1,321 procedures, 509 (38.5%) were performed by the procedure service. In the adjusted analysis, as compared with procedure service, the group that underwent paracentesis by the radiology service had a 27% longer LOS (95% CI, 2%-58%) and 40% longer A2P time (95% CI, 5%-87%). The resident group had shorter A2P (–19%; 95% CI, –33% to 0.2%; P = .05) than the procedure service group but similar LOS. To our knowledge, this is the first study that suggests patient-centered benefits of a hospitalist procedure service.

Standardizing postoperative care for pediatric intradural Chiari decompressions to decrease length of stay

2021 ◽  
pp. 1-6
Author(s):  
David J. Mazur-Hart ◽  
Stephen G. Bowden ◽  
Brandi W. Pang ◽  
Nasser K. Yaghi ◽  
Joseph G. Nugent ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Hospital Stay ◽  
Postoperative Care ◽  
Pediatric Patients ◽  
Quality Care ◽  
Secondary Analysis ◽  
Hospital Length Of Stay ◽  
Hospital System ◽  
Care Protocol ◽  
The Mean

OBJECTIVE Amid national and local budget crises, cutting costs while maintaining quality care is a top priority. Chiari malformation is a relatively common pediatric neurosurgical pathology, and postoperative care varies widely. The postoperative course can be complicated by pain and nausea, which can extend the hospital stay. In this study, the authors aimed to examine whether instituting a standardized postoperative care protocol would decrease overall patient hospital length of stay (LOS) as well as cost to families and the hospital system. METHODS A retrospective study of pediatric patients who underwent an intradural Chiari decompression with expansile duraplasty at a single institution from January 2016 to September 2019 was performed. A standardized postoperative care protocol was instituted on May 17, 2018. Pre- and postprotocol groups were primarily analyzed for demographics, LOS, and the estimated financial expense of the hospital stay. Secondary analysis included readmissions, opioid consumption, and follow-up. RESULTS The analysis included 132 pediatric patients who underwent an intradural Chiari decompression with expansile duraplasty. The preprotocol group included 97 patients and the postprotocol group included 35 patients. Patient age ranged from 0.5 to 26 years (mean 9.5 years). The mean LOS preprotocol was 55.48 hours (range 25.90–127.77 hours), and the mean postprotocol LOS was 46.39 hours (range 27.58–77.38 hours). The comparison between means showed a statistically significant decrease following protocol initiation (95% CI 1.87–16.31 hours, p = 0.014). In the preprotocol group, 21 of 97 patients (22%) were discharged the first day after surgery compared with 14 of 35 patients (40%) in the postprotocol group (p = 0.045). The estimated cost of one night on the pediatric neurosurgical intermediate ward was approximately $4500, which gives overall cost estimates for 100 theoretical cases of $927,800 for the preprotocol group and $732,900 for the postprotocol group. CONCLUSIONS By instituting a Chiari protocol, postoperative LOS was significantly decreased, which resulted in decreased healthcare costs while maintaining high-quality and safe care.

It is Not Just Cosmesis: Straight Laparoscopy with Stoma Site Extraction Improves Outcomes in Ulcerative Colitis Patients Undergoing Total Colectomy

2019 ◽  
Vol 85 (10) ◽  
pp. 1194-1197
Author(s):  
Ino Chough ◽  
Karen Zaghiyan ◽  
Gayane Ovsepyan ◽  
Phillip Fleshner
Keyword(s):  
Ulcerative Colitis ◽  
Length Of Stay ◽  
Group Versus ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Study Cohort ◽  
Class Iii ◽  
Total Abdominal Colectomy ◽  
Postoperative Length ◽  
The Mean

Minimally invasive approaches to total abdominal colectomy (TAC) in ulcerative colitis (UC) patients include straight laparoscopy (SL), hand-assisted laparoscopic surgery (HALS), and robotics. In this study, short-term outcomes of patients undergoing SL and HALS TAC were compared. Prospectively collected data on UC patients undergoing TAC were tabulated. The study cohort included 36 (27%) patients in the SL group and 95 (73%) patients in the HALS group. The groups were comparable in terms of preoperative characteristics and demographics. The mean operative time was 151 (range, 73–225) minutes in the SL group versus 164 (range, 103–295) minutes in the HALS group ( P = 0.09). Total 48-hour IV morphine use was 30 (range, 0–186) mg in the SL group compared with 56 (0–275) mg in the HALS group ( P < 0.01). Although overall morbidity was comparable between the groups, Clavien-Dindo Class III complications did not occur in any of the SL group patients versus 11 (11%) of the HALS group patients ( P = 0.03). The postoperative length of stay was 3 (3–21) days in the SL group versus 5 (3–15) days in the HALS group ( P < 0.01). Compared with HALS, SL is associated with lower postoperative narcotic use and hospital length of stay in UC patients undergoing TAC.

scholarly journals Perioperative Outcomes Of Laparoscopic Hysterectomy: Comparison With Abdominal, Vaginal, And Robot-Assisted Surgical Approaches

2015 ◽  
Vol 8 (1) ◽  
pp. 52-60
Author(s):  
Slavcho T. Tomov ◽  
Grigor A. Gortchev ◽  
Latchesar S. Tantchev ◽  
Todor I. Dimitrov ◽  
Chavdar A. Tzvetkov ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Vaginal Hysterectomy ◽  
Operative Time ◽  
Laparoscopic Hysterectomy ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Perioperative Outcomes ◽  
Surgical Approaches ◽  
Significant Linear Correlation ◽  
The Mean

SummarySelection of an appropriate surgical method for hysterectomy in an individual patient is currently an issue that remains open and debatable. This study aimed to analyze perioperative outcomes in gynecologic patients who underwent laparoscopic hysterectomy at a single institution during a 6-year period and to compare the data for simple hysterectomy patients treated with different surgical approaches. The study included a retrospective analysis of demographics, pre- and post-operative characteristics of 1,023 patients, operated on using four types of simple hysterectomy approaches: 635 laparoscopic hysterectomies (62.1%), 289 total abdominal hysterectomies (28.3%), 45 total vaginal hysterectomies (4.4%) and 54 robotic-assisted hysterectomies (5.3%). For the laparoscopic hysterectomy group, the mean operative time was shorter as compared to the abdominal and vaginal hysterectomy groups (p<0.05), as well as a significantly shorter hospital length-of-stay when compared to the abdominal, robotic or vaginal hysterectomy groups (p<0.05). Regression analysis revealed significant linear correlation between operative time and body-mass index of laparoscopic hysterectomy patients (R2 =0.008; p=0.026). Complications emergence and hemotransfusion often prolonged the mean operative time significantly by 17.8 min (p=0.002) and 15.5 min, respectively (p<0.001). The rate of major complications was significantly higher in the laparoscopic vs. abdominal groups (p<0.05). Clinical outcomes in patients operated on with laparoscopic hysterectomy were better than in those operated with total abdominal and vaginal hysterectomy in terms of operative time and hospital length-of-stay. Prospective randomized multi-center studies would be desirable to further define the place of the modern minimally invasive hysterectomy approaches.

scholarly journals Delirium and Associated Length of Stay and Costs in Critically Ill Patients

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Claudia Dziegielewski ◽  
Charlenn Skead ◽  
Toros Canturk ◽  
Colleen Webber ◽  
Shannon M. Fernando ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Hospital Costs ◽  
Hospital Length ◽  
Mean Difference ◽  
Hospital Length Of Stay ◽  
The Mean ◽  
The Impact

Purpose. Delirium frequently affects critically ill patients in the intensive care unit (ICU). The purpose of this study is to evaluate the impact of delirium on ICU and hospital length of stay (LOS) and perform a cost analysis. Materials and Methods. Prospective studies and randomized controlled trials of patients in the ICU with delirium published between January 1, 2015, and December 31, 2020, were evaluated. Outcome variables including ICU and hospital LOS were obtained, and ICU and hospital costs were derived from the respective LOS. Results. Forty-one studies met inclusion criteria. The mean difference of ICU LOS between patients with and without delirium was significant at 4.77 days ( p < 0.001 ); for hospital LOS, this was significant at 6.67 days ( p < 0.001 ). Cost data were extractable for 27 studies in which both ICU and hospital LOS were available. The mean difference of ICU costs between patients with and without delirium was significant at $3,921 ( p < 0.001 ); for hospital costs, the mean difference was $5,936 ( p < 0.001 ). Conclusion. ICU and hospital LOS and associated costs were significantly higher for patients with delirium, compared to those without delirium. Further research is necessary to elucidate other determinants of increased costs and cost-reducing strategies for critically ill patients with delirium. This can provide insight into the required resources for the prevention of delirium, which may contribute to decreasing healthcare expenditure while optimizing the quality of care.

scholarly journals Effect of length time to surgery on postoperative hospital length of stay among neurosurgical patients

2020 ◽  
Vol 11 ◽  
pp. 144
Author(s):  
Yahya H. Khormi ◽  
Andrew Nataraj
Keyword(s):  
Length Of Stay ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Outcome Variable ◽  
University Of Alberta ◽  
Postoperative Stay ◽  
Urgent Surgery ◽  
Neurosurgical Patients ◽  
Before And After ◽  
The Mean

Background: In most hospitals, inpatient urgent surgery is triaged based on the degree of urgency and time of surgical booking. A longer wait for semi-urgent surgery due to sharing resources between specialties might impact the postoperative course. The objective of this study is to determine the effect of length time to semi- urgent surgery on postoperative hospital length of stay among neurosurgical patients. Methods: A retrospective cohort study was conducted included all admitted adult patients placed on semi-urgent University of Alberta Hospital surgical list between 2008 and 2013. Linear and logistic regression analyses were performed. The main exposure variable was time from surgical booking to the time of surgery, and the outcome variable was time from surgery to discharge. Results: A total of 1367 neurosurgical cases were included in the study. The mean age was 54.3 years. The mean length of time in the hospital before and after surgery was 1.2 and 12.5 days, respectively. Overall, the time from booking to surgery did not affect the time from surgery to discharge. Increased age, higher ASA score, and surgeries performed after 24 h from booking in the group of patients who were discharged to another facility were associated with a longer postoperative stay. Conclusion: Neurosurgery patients booked for surgery to be done within 24 h waited longer to have their procedure completed. Overall, there was no significant association between length of time waiting for surgery and postoperative stay, although there was an increase in postoperative stays among patients who were discharged to another facility and had their surgeries performed after 24 h.

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