scholarly journals Identifying the Characteristics of Patients With Cervical Degenerative Disease for Surgical Treatment From 17-Year Real-World Data: Retrospective Study

10.2196/16076 ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. e16076 ◽  
Author(s):  
Si Zheng ◽  
Yun Xia Wu ◽  
Jia Yang Wang ◽  
Yan Li ◽  
Zhong Jun Liu ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Length Of Stay ◽  
Real World ◽  
Average Length ◽  
Real World Data ◽  
Female Patients ◽  
Average Length Of Stay ◽  
Age At Surgery ◽  
The Mean ◽  
Cervical Degenerative Disease

Background Real-world data (RWD) play important roles in evaluating treatment effectiveness in clinical research. In recent decades, with the development of more accurate diagnoses and better treatment options, inpatient surgery for cervical degenerative disease (CDD) has become increasingly more common, yet little is known about the variations in patient demographic characteristics associated with surgical treatment. Objective This study aimed to identify the characteristics of surgical patients with CDD using RWD collected from electronic medical records. Methods This study included 20,288 inpatient surgeries registered from January 1, 2000, to December 31, 2016, among patients aged 18 years or older, and demographic data (eg, age, sex, admission time, surgery type, treatment, discharge diagnosis, and discharge time) were collected at baseline. Regression modeling and time series analysis were conducted to analyze the trend in each variable (total number of inpatient surgeries, mean age at surgery, sex, and average length of stay). A P value <.01 was considered statistically significant. The RWD in this study were collected from the Orthopedic Department at Peking University Third Hospital, and the study was approved by the institutional review board. Results Over the last 17 years, the number of inpatient surgeries increased annually by an average of 11.13%, with some fluctuations. In total, 76.4% (15,496/20,288) of the surgeries were performed in patients with CDD aged 41 to 65 years, and there was no significant change in the mean age at surgery. More male patients were observed, and the proportions of male and female patients who underwent surgery were 64.7% (13,126/20,288) and 35.3% (7162/20,288), respectively. However, interestingly, the proportion of surgeries performed among female patients showed an increasing trend (P<.001), leading to a narrowing sex gap. The average length of stay for surgical treatment decreased from 21 days to 6 days and showed a steady decline from 2012 onward. Conclusions The RWD showed its capability in supporting clinical research. The mean age at surgery for CDD was consistent in the real-world population, the proportion of female patients increased, and the average length of stay decreased over time. These results may be valuable to guide resource allocation for the early prevention and diagnosis, as well as surgical treatment of CDD.

Short-acting antipsychotics or long-acting injectables? A treatment comparison in patients with schizophrenia

2020 ◽  
Vol 25 (03) ◽  
pp. 170-178 ◽  
Author(s):  
Helena Thiem ◽  
Here Folkerts ◽  
Lukas Völkel
Keyword(s):  
Length Of Stay ◽  
Average Length ◽  
Psychiatric Institute ◽  
Real World Data ◽  
Short Acting ◽  
Treatment Comparison ◽  
Average Length Of Stay ◽  
Before And After ◽  
Oral Antipsychotic ◽  
Long Acting

Abstract Aim This research aims to compare the efficacy and direct costs of short-acting oral antipsychotics and aripiprazole once-monthly (AOM) in the context of the treatment of patients with schizophrenia based on real-world data in Germany. Method Results are based on a single-armed, retrospective, non-interventional pre-post comparison study evaluating data from 132 patients with schizophrenia before and after switching from oral antipsychotics to AOM treatment (6 months each). Socio-demographics, as well as parameters of indication, efficacy and resource consumption were analyzed and statistically evaluated. Results The switch from an oral antipsychotic medication to AOM led to a distinct improvement in all clinically relevant parameters, including a reduction in hospitalization rates (55.1 % vs. 14.0 %), length of stay (43.5 d vs. 34.8 d) and percentage of patients with multiple hospitalizations (13.6 % vs. 3.8 %). There was also a reduction in schizophrenic episodes for patients with ≥ 1 episode (2.9 vs. 1.4) and of the percentage of patients with ≥ 1 (88.0 % vs. 29.3 %) as well as ≥ 2 (60.0 % vs. 8.1 %) schizophrenic episodes. The proportion of patients requiring a visit to day clinics or psychiatric institute outpatient clinics (PIA) decreased (39.5 % vs. 8.4 %) for patients with AOM treatment, as did the average length of stay in day clinics or PIAs (116.8 d vs. 86.4 d) for patients with ≥ 1 stay. The cost saving potential of AOM compared to the treatment with oral antipsychotics ranged between 1,729.32 € and 5,048.53 € per patient for a six-month observation period. Conclusion Our results suggest that AOM treatment of patients with schizophrenia is more effective (reduction in schizophrenic episodes, hospitalizations, stays in day clinics, psychiatrist visits, losses in productivity) and generates lower costs for the statutory health insurance (SHI) in Germany than treatment with oral antipsychotics and should therefore not be regarded as only a last-resort treatment option for schizophrenia.

scholarly journals Weekend new patient reviews in psychiatry: evaluation of activity over 3 months

2017 ◽  
Vol 41 (6) ◽  
pp. 337-340
Author(s):  
Michael Rutherford ◽  
Mark Potter
Keyword(s):  
Mental Health ◽  
Length Of Stay ◽  
Average Length ◽  
Clinical Implications ◽  
Out Of Hours ◽  
Feasible Method ◽  
Average Length Of Stay ◽  
South West ◽  
Before And After ◽  
The Mean

Aims and methodSouth West London and St George's Mental Health NHS Trust developed a system of weekend new patient reviews by higher trainees to provide senior medical input 7 days a week. To evaluate the effectiveness of these reviews, the notes for all patients admitted over 3 months were examined. The mean length of stay for patients before and after the introduction of the weekend new patient reviews were compared via unpaired t-test.ResultsA total of 88 patients were seen: 84.4% of patients were seen within 24 h of admission. Higher trainees instituted some changes in 78.9% of patients. The most frequent action was to modify medication, in 47.8%. The average length of stay after the introduction of weekend reviews was not significantly different.Clinical implicationsWeekend reviews of newly admitted patients by higher trainees is a feasible method for providing senior input to patients admitted out of hours.

scholarly journals Contribution of the BioFire® FilmArray® Meningitis/Encephalitis Panel:

2019 ◽  
Vol 12 (1) ◽  
pp. 1-3 ◽  
Author(s):  
Kyle Dack ◽  
Stephanie Pankow ◽  
Elizabeth Ablah ◽  
Rosey Zackula ◽  
Maha Assi
Keyword(s):  
Length Of Stay ◽  
Average Length ◽  
Medical Center ◽  
Antiviral Treatment ◽  
Length Of Hospital Stay ◽  
Average Length Of Stay ◽  
Regional Medical ◽  
Regional Medical Center ◽  
The Mean ◽  
Hospital Stay Duration

Introduction. Traditional evaluation of meningitis includes cerebrospinalfluid (CSF) culture and gram stain to pinpoint specific causalorganisms. The BioFire® FilmArray® Meningitis/Encephalitis (ME)Panel has been implemented as a more timely evaluation method.This study sought to assess if the BioFire® ME Panel was associatedwith a decreased length of stay or decreased antimicrobial durationwhen used in the diagnosis of meningitis or encephalitis.Methods.xA case, historical-control, chart review was performed onpatients admitted to a regional medical center with CSF pleocytosisduring Cohort 1 (the year prior to BioFire® ME Panel implementation)and Cohort 2 (the year after BioFire® ME Panel implementation).Length of hospital stay, duration of antimicrobials, and BioFire® MEPanel result were gathered and analyzed.Results. Average length of stay for both cohorts was about fourhospital days. Approximately three-fourths of all patients receivedantibiotic/antiviral treatment with an average of three days duration.No significant differences were observed between groups. The mean(median) duration of antimicrobials in the year prior to and afterthe BioFire® ME Panel implementation was 3.6 (3) and 3.1 (2) days,respectively (p = 0.835). The mean (median) length of stay in the yearprior to and after the BioFire® ME Panel implementation was 5.8 (4)and 5.4 (4) days, respectively (p = 0.941). Among the patients admittedafter the implementation of the BioFire® ME Panel, 4.3 % (n =2) had a positive bacterial result, 38.3% (n = 18) had a positive viralresult, and 57.4% (n = 27) had a negative result. Of the 27 negativeresults, 77.8% (n = 21) were treated with antimicrobial medication.Conclusions. This study suggested there is no difference betweenlength of stay or antimicrobial duration in presumed meningitis casesassessed with traditional methods as compared to the BioFire® MEPanel. Kans J Med 2019;12(1):1-3.

A Decade of Variation in the Surgical Treatment of Cervical Degenerative Disease: An Analysis of 20288 Inpatient Surgery Records from the Period of 2000-2016 (Preprint)

2018 ◽  
Author(s):  
Si Zheng ◽  
Yan Li ◽  
Yun Xia Wu ◽  
Jiao Li ◽  
Jia Yang Wang ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Hospital Stay ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Demographic Characteristics ◽  
Female Ratio ◽  
Age At Surgery ◽  
Cervical Degenerative Disease ◽  
Male To Female ◽  
Surgical Operations

BACKGROUND Cervical degenerative disease (CDD) refers to disease involving degenerative processes that occur in the cervical spine. In recent decades, with the development of more accurate diagnosis and better treatment options, inpatient surgery for CDD has become the mainstay when conservative treatment fails, yet little is known about variations in patient demographic characteristics associated with surgical treatment. OBJECTIVE This study assessed the number of surgical operations, variation in mean age at surgery, the male to female ratio and the average length of hospital stay for CDD patients. METHODS We conducted a real-world study using inpatient surgery data from the department of orthopedics in a hospital in northern China (2000-2016). Regression modeling and time series analysis were used. The length of hospital stay was used to measure improvement associated with treatment. RESULTS This study analyzed 20,288 inpatient surgery records. Over the last 17 years, the number of surgical operations increased (average annual increase of 11.13%), with some fluctuations. In total, 76.38% of surgeries occurred in patients aged 41 - 65 years (15,496), and there was no significant change in mean age at surgery for CDD patients during the study period. The male to female ratio of the patients was 1.83:1 (13,126 vs 7,162). Interestingly, the proportion of surgeries performed on female patients showed an increasing trend from 2000 to 2016 (P < .001). The average length of hospital stay for surgical treatment decreased from 23.21 days to 6.53 days, and showing a steady decline from 2012 onward. CONCLUSIONS This study investigated the demographic characteristics and trends over time among CDD patients who underwent surgical treatment. The mean age at surgery was stable during the 17-year study period, with an increased proportion of female patients and a decreased average length of hospital stay with time. These data may be valuable to guide resource allocation for early prevention, diagnosis and surgical treatment for CDD.

Impact of orthogeriatric management on the average length of stay of patients aged over seventy five years admitted to hospital after hip fractures

2021 ◽  
Author(s):  
Pierre-Sylvain Marcheix ◽  
Camille Collin ◽  
Jérémy Hardy ◽  
Christian Mabit ◽  
Achille Tchalla ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Hip Fracture ◽  
Mortality Rate ◽  
Length Of Stay ◽  
Average Length ◽  
Discharge Rate ◽  
Length Of Hospital Stay ◽  
Median Length ◽  
Average Length Of Stay ◽  
Significant Difference

Abstract Introduction Hip fracture is a frequent and serious condition in the elderly. We conducted a retrospective cohort study to answer the following questions: (1) Could treatment in an orthogeriatric unit help to reduce the average length of stay for patients aged over 75 years admitted to hospital for the treatment of a hip fracture?; and (2) Could such treatment influence the post-operative outcomes of patients with hip fracture? Methods and materials Our study included 534 patients admitted to hospital between January 2017 and December 2018 for surgical treatment of a hip fracture. We compared 246 patients who received traditional orthopaedic care with 288 patients treated in an orthogeriatric unit. Results Our cohort included 410 women (77%). The average age was 87.5 ± six years, and 366 patients (68%) were living at home prior to the fracture. A statistically significant difference in median length of stay (from 10 to 9 days) was observed between patients who did and did not receive orthogeriatric unit treatment (groups 1 and 2; 95% CI: 0.64; 2.59; p = 0.001). There was no difference in pre-operative delay, intra-hospital mortality rate, place of recovery, rate of institutionalisation after six months, or the number of new fractures at 6 months between the groups. The mortality rate after six months was 23.6% and 21.3% in groups 1 and 2, respectively; the difference was not significant. Discussion Orthogeriatric unit treatment reduced the median length of stay by one day, in line with most previous studies. According to Pablos-Hernandez et al., multifaceted orthogeriatric treatment is most effective. In our study, only 38% of the patients received surgical treatment within 48 hours, where early surgery is key for reducing the length of hospital stay. The intrahospital mortality rate was 2.6%, which is comparable to literature data. The discharge rate did not differ by orthogeriatric treatment status, which is also consistent with previous findings (e.g. Gregersen et al.). Lastly, the mortality rate after six months was slightly reduced by orthogeriatric care. In line with this, Boddaert et al. reported a difference in mortality rate after six months between groups who did and did not receive orthogeriatric treatment (15% vs. 24%).

Discharge destination of patients from a psychogeriatric unit

2011 ◽  
Vol 26 (S2) ◽  
pp. 845-845
Author(s):  
M. Ochuko-Emore
Keyword(s):  
Mental Illness ◽  
Length Of Stay ◽  
Average Length ◽  
Discharge Destination ◽  
Average Length Of Stay ◽  
The Mean ◽  
Time Of Admission ◽  
At Home

ObjectivesTo determine the discharge destination of patients admitted to a psychogeriatric unit.MethodsRecords of all patients discharged from an in-patient psychogeriatric unit between 1st July 2009 and 30th June 2010 were examined. The diagnosis, residence at admission, length of stay and discharge destination were recorded.ResultsThere were ninety-four discharges over the study period. Four of the patients were admitted and discharged twice. The mean age was 76.7 years (range 65–95 years). 52.1% (n = 49) were diagnosed with dementia and 47.9% (n = 45) with functional mental illness. The average length of stay was 67.4 days for dementia compare to 74.2 days for functional mental illness. 17.1% (n = 6/32) of patients with dementia and 84.2% (n = 32/38) of patients with functional mental illness resident at home at the time of admission were discharged home.ConclusionThis finding suggests that patients with functional mental illness are more likely to be discharge back to their homes compared with patients with dementia.

scholarly journals The Use of Determinants of Length of Stay in the Post-anesthesia Care Unit (PACU) at the Philippine General Hospital among Postoperative Patients who Underwent Elective Surgeries to Create a Predictive Model for PACU Length of Stay

2020 ◽  
Vol 54 (5) ◽  
Author(s):  
Maria Teresita B. Aspi ◽  
Evangeline Ko-Villa
Keyword(s):  
Length Of Stay ◽  
General Hospital ◽  
Chart Review ◽  
Average Length ◽  
Anesthetic Technique ◽  
Published Data ◽  
Post Anesthesia Care Unit ◽  
Average Length Of Stay ◽  
Duration Of Surgery ◽  
The Mean

Background. The aims of this study were to determine the average length of stay in the Post-anesthesia CareUnit (PACU LOS) in the Philippine General Hospital (PGH) and to create a model that will predict the PACU LOSbased on the factors that significantly affect the LOS. Determination and prediction of PACU LOS is essential inresource utilization, and in cost containment and reduction. Addressing the modifiable variables that affect thePACU LOS may lead to an improvement in the LOS of patients in the PACU and, consequently, to better recoveryroom staffing and a reduced cost for the patients and the hospital. Methods. A prospective chart review of 400 postoperative patients admitted in the PGH PACU was done. Summarystatistics were presented. Using the set of variables found to be significant, a regression model was formulatedto estimate the PACU LOS. Results. The mean PACU LOS was 4.59 hours. There were significant differences in the mean PACU LOS basedon the occurrence of complications. There were also significant differences in the median PACU LOS based onthe type and duration of surgery, anesthetic technique, and duration of anesthesia. The multiple linear regressionmodel that best predicted PACU LOS included ASA-PS classification, type of surgery, duration of surgery, anesthetictechnique, and occurrence of intraoperative or postoperative complications. Conclusions. The mean PACU LOS of the Philippine Genera Hospital is higher than that of published data. Thefactors included in the model that best predicts PACU LOS may be studied to improve the PACU LOS.

scholarly journals Impact of vaccination in reducing Hospital expenses, Mortality and Average length of stay among COVID 19 patients. A retrospective cohort study from India

2021 ◽  
Author(s):  
Madhumathi Ramakrishnan ◽  
Prakash Subbarayan
Keyword(s):  
Cohort Study ◽  
Relative Risk ◽  
Length Of Stay ◽  
Retrospective Cohort ◽  
Relative Risk Reduction ◽  
Average Length ◽  
Total Hospital ◽  
Average Length Of Stay ◽  
The Mean ◽  
Hospital Expenses

Background & Aim: WHO listed vaccine hesitancy among the top 10 global threats to health and there are very few reports highlighting vaccine benefits against COVID-19. The aim of this study was to study the impact of vaccination on reducing the average length of stay (ALOS), intensive care unit (ICU) requirement, mortality and cost of the treatment among COVID-19 patients. Methods: In this retrospective cohort study all the patients above 45 years who underwent treatment for COVID-19 were included. The data of patients treated pan India during the period March & April 2021 with the diagnosis of COVID-19, under health insurance cover, were extracted to study parameters like the ALOS, mortality, ICU requirement, total hospital expenses incurred and the vaccination status. Results: Among 3820 patients with COVID-19, 3301 (86.4%) were unvaccinated while 519 (13.6%) were vaccinated. Among the unvaccinated the mean (s.d) ALOS was 7 days. Fourteen days after second dose of vaccination this was significantly less (p=0.01) at 4.9. The mean total hospital expense among the unvaccinated was Rs. 277850. Fourteen days after second dose of vaccination this was further less (p=0.001) at Rs. 217850. Among the unvaccinated population 291/3301 (8.8%) required ICU and this was significantly less (p=0.03) at 31/519 (6%) among the vaccinated. Among those who received two doses of vaccination it was further less at 1/33 (3%). The mortality among unvaccinated patients was 16/3301 (0.5%) while there was no mortality among the vaccinated. Among those who received two doses of vaccination there was a 66% relative risk reduction in ICU stay and 81% relative risk reduction in mortality. Conclusions: There was a significant reduction in ALOS, ICU requirement, mortality & treatment cost in patients who had completed two doses of vaccination. These findings may be used in motivating public and promoting vaccination drive.

scholarly journals Colonization and Infection With MRSA and CRKP and Its Result in an Increased Mortality Rate Within the Intensive Care and High-Dependency Units in Barbados

2020 ◽  
Vol 41 (S1) ◽  
pp. s173-s174
Author(s):  
Keisha Gustave
Keyword(s):  
Intensive Care ◽  
Length Of Stay ◽  
High Mortality ◽  
Average Length ◽  
Cohort Analysis ◽  
Health Concern ◽  
Queen Elizabeth Hospital ◽  
Surveillance Program ◽  
Average Length Of Stay ◽  
High Dependency

Background: Methicillin-resistant Staphylococcus aureus(MRSA) and carbapenem-resistant Klebsiella pneumoniae (CRKP) are a growing public health concern in Barbados. Intensive care and critically ill patients are at a higher risk for MRSA and CRKP colonization and infection. MRSA and CRKP colonization and infection are associated with a high mortality and morbidly rate in the intensive care units (ICUs) and high-dependency units (HDUs). There is no concrete evidence in the literature regarding MRSA and CRKP colonization and infection in Barbados or the Caribbean. Objectives: We investigated the prevalence of MRSA and CRKP colonization and infection in the patients of the ICU and HDU units at the Queen Elizabeth Hospital from 2013 to 2017. Methods: We conducted a retrospective cohort analysis of patients admitted to the MICU, SICU, and HDU from January 2013 through December 2017. Data were collected as part of the surveillance program instituted by the IPC department. Admissions and weekly swabs for rectal, nasal, groin, and axilla were performed to screen for colonization with MRSA and CRKP. Follow-up was performed for positive cultures from sterile isolates, indicating infection. Positive MRSA and CRKP colonization or infection were identified, and patient notes were collected. Our exclusion criteria included patients with a of stay of <48 hours and patients with MRSA or CRKP before admission. Results: Of 3,641 of persons admitted 2,801 cases fit the study criteria. Overall, 161 (5.3%) were colonized or infected with MRSA alone, 215 (7.67%) were colonized or infected with CRKP alone, and 15 (0.53%) were colonized or infected with both MRSA and CRKP. In addition, 10 (66.6%) of patients colonized or infected with MRSA and CRKP died. Average length of stay of patients who died was 50 days. Conclusions: The results of this study demonstrate that MRSA and CRKP cocolonization and coinfection is associated with high mortality in patients within the ICU and HDU units. Patients admitted to the ICU and HDU with an average length of stay of 50 days are at a higher risk for cocolonization and coinfection with MRSA and CRKP. Stronger IPC measures must be implemented to reduce the spread and occurrence of MRSA and CRKP.Funding: NoneDisclosures: None

scholarly journals Temporal Changes in Central-Line–Associated Bloodstream Infection Time Between Events, 2017–2018 Versus 2015–2016

2020 ◽  
Vol 41 (S1) ◽  
pp. s403-s404
Author(s):  
Jonathan Edwards ◽  
Katherine Allen-Bridson ◽  
Daniel Pollock
Keyword(s):  
Length Of Stay ◽  
Patient Care ◽  
Average Length ◽  
Bloodstream Infections ◽  
Central Line ◽  
Significant Shift ◽  
Care Hospital ◽  
Average Length Of Stay ◽  
Period 2 ◽  
Hospital Bed

Background: The CDC NHSN surveillance coverage includes central-line–associated bloodstream infections (CLABSIs) in acute-care hospital intensive care units (ICUs) and select patient-care wards across all 50 states. This surveillance enables the use of CLABSI data to measure time between events (TBE) as a potential metric to complement traditional incidence measures such as the standardized infection ratio and prevention progress. Methods: The TBEs were calculated using 37,705 CLABSI events reported to the NHSN during 2015–2018 from medical, medical-surgical, and surgical ICUs as well as patient-care wards. The CLABSI TBE data were combined into 2 separate pairs of consecutive years of data for comparison, namely, 2015–2016 (period 1) and 2017–2018 (period 2). To reduce the length bias, CLABSI TBEs were truncated for period 2 at the maximum for period 1; thereby, 1,292 CLABSI events were excluded. The medians of the CLABSI TBE distributions were compared over the 2 periods for each patient care location. Quantile regression models stratified by location were used to account for factors independently associated with CLABSI TBE, such as hospital bed size and average length of stay, and were used to measure the adjusted shift in median CLABSI TBE. Results: The unadjusted median CLABSI TBE shifted significantly from period 1 to period 2 for the patient care locations studied. The shift ranged from 20 to 75.5 days, all with 95% CIs ranging from 10.2 to 32.8, respectively, and P < .0001 (Fig. 1). Accounting for independent associations of CLABSI TBE with hospital bed size and average length of stay, the adjusted shift in median CLABSI TBE remained significant for each patient care location that was reduced by ∼15% (Table 1). Conclusions: Differences in the unadjusted median CLABSI TBE between period 1 and period 2 for all patient care locations demonstrate the feasibility of using TBE for setting benchmarks and tracking prevention progress. Furthermore, after adjusting for hospital bed size and average length of stay, a significant shift in the median CLABSI TBE persisted among all patient care locations, indicating that differences in patient populations alone likely do not account for differences in TBE. These findings regarding CLABSI TBEs warrant further exploration of potential shifts at additional quantiles, which would provide additional evidence that TBE is a metric that can be used for setting benchmarks and can serve as a signal of CLABSI prevention progress.Funding: NoneDisclosures: None

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