scholarly journals An Early Screening Tool for Discharge Planning Shortened Length of Hospital Stay for Elderly Patients with Community-Acquired Pneumonia

2021 ◽  
Vol Volume 16 ◽  
pp. 443-450
Author(s):  
Hao Chen ◽  
Yu Hara ◽  
Nobuyuki Horita ◽  
Yusuke Saigusa ◽  
Takeshi Kaneko
Keyword(s):  
Elderly Patients ◽  
Hospital Stay ◽  
Screening Tool ◽  
Discharge Planning ◽  
Length Of Hospital Stay ◽  
Community Acquired Pneumonia ◽  
Early Screening

scholarly journals An Early Screening Tool for Discharge Planning Shortened Length of Hospital Stay for Elderly Patients with Community-Acquired Pneumonia

2020 ◽  
Author(s):  
Hao Chen ◽  
Yu Hara ◽  
Nobuyuki Horita ◽  
Yusuke Saigusa ◽  
Takeshi Kaneko
Keyword(s):  
Risk Factors ◽  
Length Of Stay ◽  
Hospital Stay ◽  
Screening Tool ◽  
Discharge Planning ◽  
Length Of Hospital Stay ◽  
Community Acquired Pneumonia ◽  
Early Screening ◽  
Delayed Discharge

Abstract Background: Community-acquired pneumonia is one of the most common diseases in elderly persons and usually results in a prolonged hospital stay. Discharge planning plays an important role in reducing the length of hospitalization. This study was designed to determine whether early screening for risk factors for delayed discharge could improve the quality of discharge planning.Methods: This retrospective, observational study was conducted in two medical facilities from January 2016 to December 2018. Hospital A used a screening tool on admission (screening group): screening for risk factors for delayed discharge and initiating discharge planning immediately for those for whom it was applicable, and discharge planning in the stable phase for those for whom it was not applicable; and Hospital B initiated discharge planning without screening (usual group). Propensity score-matched pneumonia patients in the two groups were then compared. The primary outcome was length of hospital stay.Results: A total of 648 patients were enrolled in this study. After adjusting for age, sex, aspiration, comorbidity, pneumonia severity index, and key person, 118 pairs underwent analysis. Length of stay was significantly different (20 days vs 13 days, p<0.001) between the groups. There were no differences in duration of antibiotic treatment, in-hospital mortality, and 30-day readmission (9 days vs 9 days, p=0.744; 10 (8.5%) vs 10 (8.5%), p=1.000; 10 (8.5%) vs 9 (7.6%), p=0.811, respectively).Conclusions: Early screening for delayed discharge improved the quality of discharge planning by reducing the length of stay in pneumonia patients.

Dexamethasone and length of hospital stay in patients with community-acquired pneumonia: a randomised, double-blind, placebo-controlled trial

The Lancet ◽  
2011 ◽  
Vol 377 (9782) ◽  
pp. 2023-2030 ◽  
Author(s):  
Sabine CA Meijvis ◽  
Hans Hardeman ◽  
Hilde HF Remmelts ◽  
Rik Heijligenberg ◽  
Ger T Rijkers ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Controlled Trial ◽  
Length Of Hospital Stay ◽  
Community Acquired Pneumonia ◽  
Double Blind ◽  
Double Blind Placebo

Community-acquired pneumonia: influence of management practices on length of hospital stay

2004 ◽  
Vol 34 (3) ◽  
pp. 91-97 ◽  
Author(s):  
R. Laing ◽  
C. Coles ◽  
S. Chambers ◽  
C. Frampton ◽  
L. Jennings ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Management Practices ◽  
Length Of Hospital Stay ◽  
Community Acquired Pneumonia

scholarly journals Markers of neutrophil extracellular traps predict adverse outcome in community-acquired pneumonia: secondary analysis of a randomised controlled trial

2018 ◽  
Vol 51 (4) ◽  
pp. 1701389 ◽  
Author(s):  
Fahim Ebrahimi ◽  
Stavros Giaglis ◽  
Sinuhe Hahn ◽  
Claudine A. Blum ◽  
Christine Baumgartner ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Secondary Analysis ◽  
Length Of Hospital Stay ◽  
Neutrophil Extracellular Traps ◽  
Community Acquired Pneumonia ◽  
Extracellular Traps ◽  
Clinical Instability ◽  
Randomised Controlled ◽  
The Impact ◽  
Clinical Stability

Neutrophil extracellular traps (NETs) are a hallmark of the immune response in inflammatory diseases. However, the role of NETs in community-acquired pneumonia (CAP) is unknown. This study aims to characterise the impact of NETs on clinical outcomes in pneumonia.This is a secondary analysis of a randomised controlled, multicentre trial. Patients with CAP were randomly assigned to either 50 mg prednisone or placebo for 7 days. The primary end-point was time to clinical stability; main secondary end-points were length of hospital stay and mortality.In total, 310 patients were included in the analysis. Levels of cell-free nucleosomes as surrogate markers of NETosis were significantly increased at admission and declined over 7 days. NETs were significantly associated with reduced hazards of clinical stability and hospital discharge in multivariate adjusted analyses. Moreover, NETs were associated with a 3.8-fold increased adjusted odds ratio of 30-day mortality. Prednisone treatment modified circulatory NET levels and was associated with beneficial outcome.CAP is accompanied by pronounced NET formation. Patients with elevated serum NET markers were at higher risk for clinical instability, prolonged length of hospital stay and 30-day all-cause mortality. NETs represent a novel marker for outcome and a possible target for adjunct treatments of pneumonia.

Comparison of specialist and generalist care

2018 ◽  
Vol 42 (5) ◽  
pp. 579 ◽  
Author(s):  
C. M. Horwood ◽  
P. Hakendorf ◽  
C. H. Thompson
Keyword(s):  
Hospital Stay ◽  
Readmission Rate ◽  
General Medicine ◽  
Length Of Hospital Stay ◽  
Community Acquired Pneumonia ◽  
Public Hospitals ◽  
Unplanned Readmission ◽  
Specialist Service ◽  
Safe Alternative ◽  
Comorbidity Burden

Objective The choice of whether to admit under a specialist or a generalist unit is often made with neither clear rationale nor understanding of its consequences. The present study compared the characteristics and outcomes of patients admitted with community-acquired pneumonia to either a general medicine or respiratory unit. Methods This study was a retrospective cross-sectional study using data from public hospitals in Adelaide, South Australia. Over 5 years there were 9775 overnight, unplanned appropriate adult admissions. Patient length of hospital stay, in-patient mortality rate and 30-day unplanned readmission rate were calculated, with and without adjustment for patient age and comorbidity burden. Results Over 80% of these patients were cared for by a general medicine unit rather than a specialist unit. Patients admitted to a general medicine unit were, on average, 4 years older than those admitted to a respiratory unit. Comorbidity burdens were similar between units at the same hospital. Length of in-patient stay was >1 day shorter for those admitted to a general medicine unit, without significant compromise in mortality or readmission rates. Between each hospital, general medicine units showed a range of mortality rates and length of hospital stay, for which there was no obvious explanation. Conclusions Compared with speciality care, general medicine units can safely and efficiently care for patients presenting to hospital with community-acquired pneumonia. What is known about the topic? Within the narrow range of any specific disease, generalist medical services are often cited as inferior in performance compared with a speciality service. This has implications for hospital resourcing, including both staffing and ward allocation. What does this paper add? This paper demonstrates that most patients admitted with a principal diagnosis of community-acquired pneumonia were admitted to a generalist unit and did not apparently fare worse than patients admitted to a specialist service; patients admitted to a generalist unit spent less time in hospital and there was no difference in mortality or readmission rate compared with patients admitted to a specialist service. What are the implications for practitioners? The provision of generalist services at urban hospitals in Australia provides a safe alternative admission option for patients presenting with pneumonia, and possibly for other common acute medical conditions.

PS01.218: MORBIDITY AND MORTALITY IN ELDERLY PATIENTS AFTER MINIMALLY INVASIVE ESOPHAGECTOMY

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 112-112
Author(s):  
Jeroen Hol ◽  
Joos Heisterkamp ◽  
Barbara Langenhoff
Keyword(s):  
Minimally Invasive ◽  
Elderly Patients ◽  
Hospital Stay ◽  
Minimally Invasive Esophagectomy ◽  
Length Of Hospital Stay ◽  
Morbidity And Mortality ◽  
Tumor Type ◽  
Invasive Esophagectomy ◽  
Group 2 ◽  
Group 1

Abstract Background Elderly patients undergoing gastrointestinal surgery are at higher risk for postoperative complications and mortality. Currently available literature on elderly patients undergoing an esophagectomy is inconclusive and dates back from the time before minimally invasive techniques were implemented. Methods Length of hospital stay, 90-day morbidity and mortality were analyzed from patients undergoing minimally invasive esophagectomy (MIE) between 2014 and 2017 in a single center. Data from patients aged 76 years or older was compared to the cohort of patients aged 71 to 75 years old. Results From a consecutive series of in total 187 patients two cohorts were retrieved: 19 patients 76 years or older (group 1) were compared to 41 patients 71 to 75 years old (group 2). Median age was 77 years (76–83) in group 1 and 72 years (71–75) in group 2 (P < 0.05). There were no significant differences in sex, Charlson comorbidity score, number of patients undergoing neoadjuvant chemoradiaton, histological tumor type, tumor stage, number of lymph nodes harvested and type of anastomosis. There were no significant differences in length of hospital stay, 90-day morbidity and mortality. The percentage of anastomotic leakage was 21.2% in group 1 and 14.6% in group 2. Mortality was 10.5% and 4.9% respectively. Conclusion No difference was seen in morbidity and mortality after MIE comparing the eldest old to younger old patients. Therefore, patient selection should not be based on calendar age alone. Disclosure All authors have declared no conflicts of interest.

Community-Acquired Pneumonia in Patients With Diabetes Mellitus: Predictors of Complications and Length of Hospital Stay

2016 ◽  
Vol 352 (1) ◽  
pp. 30-35 ◽  
Author(s):  
Mazen S. Bader ◽  
Yanqing Yi ◽  
Kassem Abouchehade ◽  
Babar Haroon ◽  
Lisa D. Bishop ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Community Acquired Pneumonia ◽  
Patients With Diabetes
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