scholarly journals Clinical Characteristics of Liver Cirrhosis Patients in Internal Medicine Inpatient Ward of Fatmawati General Hospital and Factors Affecting Mortality during Hospitalization

2021 ◽  
Vol 22 (1) ◽  
pp. 3-8
Author(s):  
Nikko Darnindro ◽  
Annela Manurung ◽  
Edi Mulyana ◽  
Arnold Manurung
Keyword(s):  
Liver Cirrhosis ◽  
Mortality Rate ◽  
Hepatitis B ◽  
Creatinine Level ◽  
Mortality Risk ◽  
Average Length ◽  
Bivariate Analysis ◽  
Factors Affecting ◽  
Inpatient Ward ◽  
Average Length Of Stay

Background: liver cirrhosis is a global health problem. The mortality rate due to cirrhosis was estimated to achieve 1 million per year worldwide. The aim of this study is to elaborate the characteristics of patients  with liver cirrhosis and factors affecting mortality during hospitalization in Fatmawati General Hospital.Method: The design of this study was retrospective cohort involving patients admitted to the hospital between January and March 2019.Results: Among 41 liver cirrhosis patients, it was found that the average age was 52.9 ±13.8 years old and the percentage of male patients among participants was 75.6%. Patients who died during hospitalization was 12.2%. The average length of stay in hospital was 10.8±6.4 days. Patients were admitted to the hospital with various complaints; the most common complaint was gastrointestinal bleeding in 46.3%, decreased consciousness in 22% and massive ascites in 17.1% patients. Physical examination findings of anaemic conjunctiva, icteric sclera, and shifting dullness were found in 73.2%; 29.3% and 61% patients, respectively. Icteric condition during hospital admission has higher mortality risk with RR 9.6 (95% CI: 1.2-77.8). Approximately 53.7% cirrhosis patients were diagnosed with hepatitis B, while 22% of them  were diagnosed with hepatitis C. Coinfection of hepatitis B and C were found in 4.8% patients, while 29% patients were neither infected with hepatitis B nor C. Based on the laboratory examination, creatinine level 1.3 mg/dL had higher mortality risk with RR 8.3 (95% CI: 1.04-66.7), while natrium level ≤ 125 mmol/L had higher mortality risk with RR 26.4 (95% CI: 3.6-191). Based on Child-Pugh classification, 24.4% patients had Child-Pugh A, while 14.6% had Child Pugh C, and 39% patients could not be classified. The mean Child-Pugh score in this study was 8 ± 2.2. Through the bivariate analysis, we found the association between Child-Pugh classification and mortality; higher classification has higher mortality risk (p = 0.028). Child-Pugh C had mortality risk with RR = 9.5 (95% CI: 1.2-75.1).Conclusion: Liver cirrhosis patients were hospitalized due to the ongoing decompensation. The mortality rate during hospitalization in liver cirrhosis patients was high. Mortality in these patients was associated with icteric condition upon admission, high initial creatinine level, low sodium level, and high Child-Pugh classification.

scholarly journals INDICATORS OF MORBIDITY AND MORTALITY BY FEMUR FRACTURES IN OLDER PEOPLE: A DECADE-LONG STUDY IN BRAZILIAN HOSPITALS

2020 ◽  
Vol 28 (3) ◽  
pp. 142-148
Author(s):  
VIVIANE CRISTINA ULIANA PETERLE ◽  
JOÃO CARLOS GEBER JUNIOR ◽  
WILLIAN DARWIN JUNIOR ◽  
ALEXANDRE VASCONCELOS LIMA ◽  
PAULO EMILIANO BEZERRA JUNIOR ◽  
...  
Keyword(s):  
Older Adults ◽  
Mortality Rate ◽  
Average Length ◽  
Federal District ◽  
Population Based ◽  
Northern Region ◽  
Level Of Evidence ◽  
Average Length Of Stay ◽  
Femur Fractures ◽  
Unified Health System

ABSTRACT Objective: To evaluate the profile of femur fractures in older adults in Brazil between 2008 and 2018. Methods: Population-based time series study with data from the Department of Informatics of the Unified Health System (Datasus), including 480,652 hospitalizations, of adults from 60 years and over, with hip fracture (ICD10-S72). Results: There was an increase of 76.9% in the hospitalization register (mean 5.87%/year) and an average incidence rate of 19.46 fractures for every 10,000 older adults. In total, 68% of hospitalizations were female, 28% from São Paulo. The average length of stay was 8.9 days, being higher in the Northern Region (11.8) and in the Federal District (18.7). Average mortality rate was 5%, being higher in men (5.45%) and over 80 years old. Northeast Region had the lowest mortality rate (3.54%). Southeast Region had the highest rate (5.53%). Total cost of hospitalizations was R$ 1.1 billion, with an average of R$ 100 million/year. Average cost per hospitalization was higher in the Southern Region (R$ 2,491.00). Conclusion: Femoral fracture is an important cause of mortality among older adults, with a higher incidence in women but higher mortality in men, with high cost to the system and regional differences. Level of Evidence II, Economic and decision analyses - developing an economic or decision model.

scholarly journals FAKTOR-FAKTOR YANG BERPENGARUH DALAM LUARAN KLINIS PASIEN TETANUS DI RSUP DR. MOHAMMAD HOESIN PALEMBANG

2018 ◽  
Vol 35 (3) ◽  
Author(s):  
Luther Theng ◽  
Theresia Christin ◽  
Erial Bahar
Keyword(s):  
Mortality Rate ◽  
Clinical Outcome ◽  
Incidence Rate ◽  
Medical Record ◽  
Case Fatality ◽  
Bivariate Analysis ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Isolation Room ◽  
Reduce Mortality Rate

FACTORS AFFECTING THE CLINICAL OUTCOME OF TETANUS PATIENTS IN MOHAMMAD HOESIN GENERAL HOSPITAL PALEMBANGABSTRACTIntroduction: Tetanus is a serious health problem with mortality rate up to 60% despite the decreasing incidence rate every year. Knowledge about factors affecting clinical outcome of tetanus patients may reduce mortality rate, better understanding on prevention and management of the disease. The clinical outcomeAim: To know the incidence and factors that affect the clinical outcome of tetanus patients.Method: Retrospective study with cross sectional analytic using hospital-based secondary data. Inclusion criteria were hospitalized tetanus patients within 3 years period (2013-2015) and complete medical record. Incidence, case fatality rate and other which other factors associated with clinical outcome were counted from medical record and analyzed by univariate and bivariate analysis, and logistic regression for multivariate analysis.Result: The incidence rate of tetanus patients in 2013 was (4.28%), 2014 (1.62%), 2015 (2.87%) and the mortality rate reaches 28.41%. From 41 subjects, univariate, bivariate and multivariate analyses were performed. The four selected variables were gender, port d’entrée, onset, and isolation room. Dsicussion: Mortality rate reached 28.41% despite the decreasing incidence every year. Sex, port d’entrée, onset, and isolation room treatment are factors that affect clinical outcome of tetanus patients.Keywords: Clinical outcome, mortality rate, tetanusABSTRAKPendahuluan: Tetanus merupakan masalah kesehatan serius dapat menyebabkan angka kematian mencapai 60% walaupun angka insiden semakin menurun setiap tahunnya. Pengetahuan mengenai faktor-faktor yang memengaruhi luaran klinis pasien dapat menurunkan angka kematian, upaya pencegahan penyakit dan keberhasilan penatalaksanaan.Tujuan: Mengetahui insiden serta faktor–faktor yang memengaruhi luaran klinis pasien tetanus.Metode: Studi bersifat retrospektif dengan metode potong lintang analitik dengan data sekunder berbasis RS. Kriteria inklusi adalah pasien tetanus yang dirawat sejak tiga periode 2013-2015 dan memiliki data rekam medis lengkap. Insiden, angka kematian dan hal-hal yang diperkirakan berhubungan dengan luaran ditelusuri dari rekam medis kemudian dilakukan analisis univariat, bivariat, dan multivariat menggunakan regresi logistik.Hasil: Angka insiden tetanus tahun 2013 (4,28%), 2014 (1,62%), 2015 (2,87%) dengan angka kematian rata-rata28,41%. Dari 41 subjek penelitian dilakukan analisis univariat, bivariat, dan multivariat. Empat variabel yang terpilih adalah jenis kelamin, port d’entrée, onset, dan perawatan pasien ruang isolasi.Diskusi: Angka kematian kasus tetanus masih mencapai 28,41% walaupun angka insiden semakin menurun setiap tahunnya. Jenis kelamin, port d’entry, onset, dan perawatan di ruang isolasi merupakan faktor-faktor berpengaruh terhadap luaran klinis pasien tetanus.Kata kunci: Angka kematian, luaran klinis, tetanus

scholarly journals Mortality from liver cirrhosis in Espírito Santo State, Brazil

2014 ◽  
Vol 30 (6) ◽  
pp. 1335-1340
Author(s):  
Patricia Lofego Gonçalves ◽  
Carlos Sandoval Gonçalves ◽  
Fausto Edmundo Lima Pereira
Keyword(s):  
Liver Cirrhosis ◽  
Mortality Rate ◽  
Hepatitis B ◽  
Medical Records ◽  
Years Of Life Lost ◽  
Death Certificates ◽  
Espírito Santo ◽  
The Mean ◽  
Espirito Santo ◽  
Annual Mortality

To study mortality from liver cirrhosis in Espírito Santo State, Brazil, we reviewed death certificates (DC) from 2000-2010 and medical records of deceased patients with investigation of alcoholism and hepatitis B or C. From a total of 218,410 DC, 3,554 deaths from liver cirrhosis were retrieved. The annual mortality rate was 19.8/100,000 for men and 4.31/100,000 for women, without significant changes after correction for ICD-R98 and R99 and without a significant increase in the annual percentage change. In 49% of death certificates, the aetiology of cirrhosis was defined: of these alcoholism in 81.5% of cases and viral hepatitis in 15.7%. Aetiology was confirmed in 262 reviewed records, including alcoholism (40.5%); hepatitis B or C (26.7%); other (3.8%); and cryptogenic (10.6%). The mean annual potential years of life lost were 5,946 years and 1,739 years for men and women respectively. The mortality rate from cirrhosis in Espírito Santo State is intermediate in relationship to worldwide data; alcoholism and hepatitis B or C were the main aetiologies; probably alcoholism is overestimated and hepatitis B and C viruses are underestimated as causes of cirrhosis registered on death certificates.

Characteristics and factors affecting mortality of patients admitted for chemotherapy in the United States during the year 2017.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19025-e19025
Author(s):  
Arya Mariam Roy ◽  
Manojna Konda ◽  
Akshay Goel ◽  
Rashmi Verma
Keyword(s):  
Average Length ◽  
Private Insurance ◽  
Progression Free Survival ◽  
The United States ◽  
Factors Affecting ◽  
Beneficial Effects ◽  
Average Length Of Stay ◽  
Icd 10 ◽  
Life Threatening

e19025 Background: Over the past two decades, there has been a tremendous increase in the chemotherapy options available to cancer patients. In terms of overall, progression-free survival, and temporary suppression of cancer-related symptoms, chemotherapy has shown beneficial effects. However, the side effects of chemotherapy are sometimes life threatening which affects an individual’s physical health, emotional state and quality of life. There is a considerable increase in the prevention, early identification and timely management of toxicities associated with chemotherapy; however, chemotherapy-related deaths still occur. Methods: We conducted a retrospective analysis of the National Inpatient Sample Database for the year 2017. Patients who were admitted for the administration of chemotherapy are identified using ICD- 10 codes. The epidemiology, the role of insurance providers in the treatment outcome were studied. Results: A total of 29,018 hospitalizations for the administration of chemotherapy were there in 2017. The median age of patients who received chemotherapy was 48. The overall mortality related to chemotherapy admissions was 0.80% (n = 233). The mortality of females who were admitted for chemotherapy did not vary much when compared to males admitted for chemotherapy (0.89% vs 0.73%, p = 0.132). It was found that admissions for chemotherapy during weekend had 85 % higher odds of dying as compared to admission during weekdays (1.6% vs 0.76%, OR = 1.85, p = 0.001, CI = 1.16 – 2.95). Patients who were admitted electively for chemotherapy were 74% less likely to die in hospital when compared to those who were admitted emergently for chemotherapy (1.4 % vs 0.49% OR = 0.36, p = 0.001, CI = 0.266 – 0.49). Interestingly, patients who had Medicare and Medicaid had higher mortality than those who had private insurance and self-pay when admitted for chemotherapy (2.08 % vs 0.58% vs 0.36%, p = 0.00). Those who had private insurance were 60% less likely to die in hospital while admitted for chemotherapy. The average length of stay for chemotherapy admissions were 5.92 ± 7.9%. Conclusions: Medicare and Medicaid patients, weekend admissions and emergent admissions were more likely to die in hospital while admitted for chemotherapy. Further studies are needed to reveal the disparities in the mortality of chemotherapy admissions, based on the socioeconomic status and the insurance payers.

516 Mortality from Inhalation Injury in Oxygen Dependent Patients Exceeds Prediction from Prognostic Models

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S95-S96
Author(s):  
Kathleen Singer ◽  
Jalen Harvey ◽  
Elizabeth Dale
Keyword(s):  
Mortality Rate ◽  
Length Of Stay ◽  
Average Length ◽  
Small Sample Size ◽  
Small Sample ◽  
Chi Square ◽  
Average Length Of Stay ◽  
Risk Of Mortality ◽  
Secondary Outcomes ◽  
Chi Square Analysis

Abstract Introduction The Boston Criteria and the Abbreviated Burn Severity Index (ABSI) are two widely accepted models for predicting mortality in burn patients. We aimed to elucidate whether these models are able to accurately predict risk of mortality in patients who sustain burns while smoking on home oxygen given their overall clinical fragility. Methods We conducted a retrospective chart review of 48 patients admitted to our burn center from November 2013 to September 2017 who sustained a burn while smoking on home oxygen. Yearlong mortality was the primary outcome of the investigation; secondary outcomes included discharge to facility, length of stay, and need for tracheostomy. We then calculated the expected mortality rate for each patient based on Boston Criteria and ABSI, respectively, and compared the mortality rate observed in our cohort. Results Patients in our cohort suffered a 54% mortality rate within a year of injury, compared to a 23.5% mortality predicted by Boston Criteria, which was found to be statistically significant by chi-square analysis (p < 0.05). ABSI predicted mortality was 19.7%. While the absolute value of difference in mortality was greater, this was not found to be significant on chi-square analysis due to the small sample size. Our secondary outcomes revealed 42% discharge to facility, average length of stay of 6.2 days, and 6.25% required tracheostomy. Patients in our cohort suffered a 54% mortality rate within a year of injury, compared to a 23.5% mortality predicted by Boston Criteria, which was found to be statistically significant by chi-square analysis (p < 0.05). ABSI predicted mortality was 19.7%. While the absolute value of difference in mortality was greater, this was not found to be significant on chi-square analysis due to the small sample size. Our secondary outcomes revealed 42% discharge to facility, average length of stay of 6.2 days, and 6.25% required tracheostomy. Conclusions Patients whose burns are attributable to smoking on home oxygen may have an increased risk of mortality than prognostication models, such as the Boston Criteria and ABSI, may suggest. This bears significant clinical impact, particularly regarding family and provider decision-making in pursuing aggressive management. Applicability of Research to Practice This data indicates that these injuries are direr than expected, which may have significant impact on family and provider decision-making.

scholarly journals 936 Outcomes of A Single Site Receiving Model for General Surgery During the COVID-19 Pandemic in A Scottish NHS Board

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
R Kilpatrick ◽  
A MacDonald
Keyword(s):  
Mortality Rate ◽  
General Surgery ◽  
Conservative Management ◽  
Average Length ◽  
Operative Management ◽  
Single Site ◽  
University Hospital ◽  
Average Length Of Stay ◽  
Time Period ◽  
Surgical Conditions

Abstract Aim: To assess overall patient outcomes of converting to a single-site receiving unit for general surgery during the height of the covid-19 pandemic. Method Prospective study of all general surgery inpatients, who would normally be looked after at University Hospital Monklands, between 17/04/20-06/06/20, the beginning and end of a single-site receiving model within NHS Lanarkshire. Results There was a 32% reduction in admissions from 278 to 188, from the same time period in 2019. The 30-day mortality rate was 3.2% in comparison to 2.8% in 2019. Of 59 patients (31.4%) who had surgery, 13.5% had a complication of varying degree. The post-operative 30-day mortality rate was 0%. Only 4 patients (2%) were diagnosed with covid-19, none of which died. Laparoscopic appendicectomy was favoured over conservative management, with average length of stay (LoS) being 3.2 days and 5 days respectively. Acute cholecystitis was overall managed conservatively with average LoS being 8.8 days for operative management, compared to 4.1 days for conservative management. Conclusions Overall outcomes during this time were not found to be significantly worse when compared to the previous year. The rate of contracting covid-19 in the unit was low. Laparoscopic surgery can still be carried out safely for selected acute surgical conditions.

scholarly journals 55 A Review of Stroke Demographics and Outcomes at a Regional Hospital without a Stroke Unit

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Lushen Pillay ◽  
Kushan Galav ◽  
Deeptish Tulsi ◽  
Joanna McGlynn ◽  
John Doherty ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Length Of Stay ◽  
Stroke Unit ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Local Analysis ◽  
Stroke Patients ◽  
Stroke Units ◽  
Average Length Of Stay ◽  
Stroke Register

Abstract Background According to the 2017 National Stroke Register Report; 75% of strokes occur in patients aged 65 years and older. Within the audit 19 stroke units reported that 70.6% of stroke patients were admitted to a stroke unit and their median length of stay of 9 days. Numerous studies have shown better outcomes in patients admitted to a stroke unit versus a medical unit leading to national stroke networks and bypass protocols for patients. However, stroke patients can still be found in non-stroke unit hospitals such as our own. Methods Demographics from HIPE data was collected on all stroke patients admitted to our hospital between January 1st and December 31st 2017. Basic statistical methods were used to analyse the data. Results We analyzed 103 patient records. The average age at presentation was 73 years (range: 35-97) and 60.1% were males. The average length of hospital stay was 16.1 days (range 1- 130 days). Ischemic (77%) events were more common than haemorrhagic events (23%). The three most common co-morbidities were hypertension (45%), hyperlipidemia (30%) and atrial fibrillation (19%). Discharge destination was home (66%), nursing home (14%), national rehabilitation (2%) and an 18% mortality rate within 3 months. The mortality rate was higher in the hemorrhagic (42%) compared to ischemic (11%). Conclusion The average length of stay was 16.1 days, considerably higher than the national stroke unit average of 9. The overall mortality rate was 5% higher than the national of 13%. Limited rehabilitation services and time awaiting national rehabilitation beds contributed to the long LOS. There is a definite need for a dedicated stroke service at our hospital, local analysis suggests that 6 beds would meet the needs of our catchment area; and this would lead to better outcomes for stroke patients. A further locally dedicated stroke audit is needed.

scholarly journals Emergency Department Overcrowding in Turkey: Reasons, Facts and Solutions

2014 ◽  
Vol 52 (195) ◽  
pp. 878-885 ◽  
Author(s):  
Oya Durmus Cakir ◽  
Sebnem Eren Cevik ◽  
Mehtap Bulut ◽  
Ozlem Guneyses ◽  
Sule Akkose Aydin
Keyword(s):  
Emergency Department ◽  
Length Of Stay ◽  
Average Length ◽  
Waiting Times ◽  
Pediatric Trauma ◽  
University Hospital ◽  
Trauma Patients ◽  
Factors Affecting ◽  
Average Length Of Stay ◽  
Bed Capacity

Introduction: The purpose of this study was to determine the factors affecting the long waiting times of the patients in a university hospital. Methods: This study included 3000 of the adults above 18 years and pediatric trauma patients under 18 years who applied to emergency department between February 2009 and April 2009. The examination period of the physician, length of stay, length of hospitalization, waiting times for hospitalization and follow up times in the emergency department were recorded. Moreover, the patients were divided into four groups according to the reasons for waiting. Results: In our study, the time period between 4 pm-12 pm was determined as the busiest time for the applications. Average length of stay in the emergency department for 3000 patients was 146.7±160.2 minutes. The length of stay for the patients consulted was longer than the length of stay for the ones who were not consulted. Because of the fact that our hospital did not have appropriate bed capacity, 41.1% of the patients waited less than two hours, 13. 4% of the patients waited more than 8 hours. It was also found that the waiting times of the Group two patients (206,7±145,2 minutes) was longer than Group one (95,5±73,9 minutes) patients and the waiting times of Group three patients (470,7±364,7 minutes) was longer than Group one patients. Conclusions: In conclusion, cooperation of the managers, relevant departments and a multidisciplinary approach are necessary to achieve the goals to reduce overcrowding in the emergency departments.  Keywords: bed capacity; crowding; emergency department; length of stay.  

scholarly journals 839. Examining the Effects of HIV Infection on Severity of Outcomes in Those with COVID-19

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S511-S511
Author(s):  
Melissa Parkinson ◽  
Rebecca Gerrity ◽  
Rachel Strength ◽  
Christian J Fuchs ◽  
Christopher Jackson ◽  
...  
Keyword(s):  
Viral Load ◽  
Charlson Comorbidity Index ◽  
Average Length ◽  
Cd4 Count ◽  
Large Hospital ◽  
Factors Affecting ◽  
Average Length Of Stay ◽  
Chi Squared ◽  
Icd 10 ◽  
Comorbidity Index

Abstract Background Throughout the SARS-CoV-2 pandemic, there have been many questions about how COVID-19 affects patients living with HIV (PLWH). We examined the clinical courses of 45 PLWH who required hospitalization with SARS-CoV-2 infection. Methods This is a retrospective cohort study in which ICD-10 codes were used to identify PLWH who were admitted to three large hospital systems in Memphis, TN with COVID-19. We included all patients ≥ 18 years of age with HIV and a documented positive SARS-CoV-2 PCR test. After manual abstraction from the electronic health records, chi-squared and T-tests were performed to evaluate associations between patient-level factors and outcomes. Results A total of 45 patients with HIV who tested positive for SARS-CoV-2 were admitted to Memphis, TN area hospitals between March 2020 and October 2020. 18 (40%) were female, 43 (95.6%) were Black, and the average age was 50.3 years (SD 12.6). The average BMI was 30.2 (SD 8.6). 40 (88.9%) patients admitted had at least one comorbidity with the most common being hypertension (28 patients, 62.2%) and diabetes (14 patients, 31.1%). 24 (46.7%) patients had a Charlson Comorbidity Index > 3. 15/43 (48.4%) patients had a CD4 count < 200, and 35 (77.8%) were on ART. 30 (66.7%) patients met SIRS criteria within 24 hours of admission, and 27 (60%) required some form of oxygen supplementation during hospitalization, including 4 (8.9%) who required intubation. The average length of stay was 10.4 days (SD 12.5). 9 (20%) patients required an ICU stay, and 3 (6.7%) died. BMI > 30, CD4 count < 200, and viral load > 1000 were not associated with worse outcomes. Both a Charlson Comorbidity Index > 3 and the absence of ART were associated with need for ICU-level care. Conclusion Viral load, CD4 count, and BMI were not correlated with differences in mortality or oxygen use in our study. Patients with higher Charlson Comorbidity Indices and patients who were not on ART at presentation were significantly more likely to require the ICU. Further study is needed to definitively determine factors affecting the outcomes of PLWH with SARS-CoV-2 infection. Disclosures All Authors: No reported disclosures

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