Transplante alogênico de medula óssea em crianças: experiência inicial do Hospital Santa Casa de Misericórdia de Belo Horizonte

OBJECTIVE: To report the clinical experience of a tertiary care hospital with allogeneic hematopoietic stem cell transplantation in children. METHODS: Data analysis of medical charts of the first 6 pediatric patients transplanted between April 2018 and December 2018. RESULTS: 6 patients (4 boys and 2 girls) with leukemia (5 ALL e 1 CML) received allogeneic transplants. The median age was 8 years. Donor sources were bone marrow (4 cases) and peripheral-blood stem cells (2 cases). All patients survived the first 100 days after transplantation and had a median clinical follow-up of 168 days. One patient developed acute GVHD and all patients developed at least one infection. Catheter-related bloodstream infections occurred in 66% of patients. Fever and mucositis were observed in all kids. The average length of stay at the hospital after transplantation was 38 days, 83% of the patients were admitted again due to infection or relapse. CONCLUSION: The obtained results are similar to others reported and make possible to know better all the factors that can influence the transplant success and survival in children and adolescents. However, Brazilian studies are still scarce. More studies should be encouraged, in order to increase the survive rate of our children.

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

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.1051 ◽

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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Percent Bed occupancy rate in a selected specialized tertiary care hospital in Dhaka city

Bangladesh Journal of Medical Science ◽

10.3329/bjms.v11i1.9817 ◽

1970 ◽

Vol 11 (1) ◽

pp. 18-24 ◽

Cited By ~ 1

Author(s):

H Rahman ◽

SME Haque ◽

MA Hafiz

Keyword(s):

Length Of Stay ◽

Tertiary Care Hospital ◽

Average Length ◽

Tertiary Care ◽

Calculated Data ◽

Care Hospital ◽

Dhaka City ◽

Occupancy Rate ◽

Bed Occupancy ◽

Average Length Of Stay

Background and Aims: Providing a necessary care for a sick person outside home 'in hospes or hospital' dates back to nearly 300 century BC. In the present day hospital care facilities has been taken an institutional shape both in public and private sector. A hospital bed is both a scarce and expensive commodity in healthcare. Administrators running hospitals are in a dire need of objective measures and methods for efficient management of their limited financial resources. Bed utilization rates can be of immense help in realistic and effective decision making. The present study was undertaken to explore utilization of bed in a specialized tertiary care hospital in the Dhaka city. Methods: Hospital records of the year were reviewed- age, gender, disease profile, duration of hospital stay, outcome of treatment were recorded and bed occupancy rate was calculated. Data were presented as number, percentage and/ or mean SD, as appropriate. The dada were managed by Statistical Package for Social Science (SPSS) for Windows Version 10. Results: The results showed in the year 2001 total number of admissions were 13,305 of which 9953 (74.8%) were male and 3352 (25.2%) female. Average monthly admission was 1109. Maximum number of admissions (1304) was observed in the month of September of that year. Male admission rate was higher than female admission throughout the year. Among all the admission 27.2% were of road traffic accident cases. Among the admitted patients there was 57.3% discharge with advice, 1.9% death, 14.6% discharge on request bond, 12.7% discharge on request. Of all the admission there 12.5% found to be absconded. Bed occupancy rate was 79.75% and average length of stay in the hospital 18.47 days. Conclusions: The present data suggest that (i) in terms of bed occupancy rate the NITOR found to run in optimal capacity which, however, might be attributed to the relative high rate of ascendance and discharges on requests; (ii) average length of stay of patients appeared to be relatively longer and (iii) the management need to look into the issue and take appropriate measures to reduce patients unwanted long duration of stay and make the tertiary care hospital improve the quality of services. DOI: http://dx.doi.org/10.3329/bjms.v11i1.9817 BJMS 2012; 11(1): 18-24

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Assessment of performance of services in a tertiary care Neuropsychiatric Institute using Pabon Lasso Model

Asian Journal of Medical Sciences ◽

10.3126/ajms.v7i6.15408 ◽

2016 ◽

Vol 7 (6) ◽

pp. 69-74 ◽

Cited By ~ 1

Author(s):

Chandra Bhushan Tripathi ◽

Rajesh Kumar ◽

Ramesh Chandra Sharma ◽

Rachna Agarwal

Keyword(s):

Tertiary Care Hospital ◽

Average Length ◽

Tertiary Care ◽

Cost Effective ◽

Care Hospital ◽

Bed Occupancy ◽

Medical Sciences ◽

Cross Sectional ◽

Average Length Of Stay ◽

Quantitative Performance

Background: The objective of the study to assess optimal utilisation of hospital facilities & evaluate their performance in a tertiary care hospital using Pabon Lasso Model using indicators- bed turnover (BTO), bed occupancy rate (BOR) and average length of stay (ALS).Aims and Objective: To assess optimal utilisation of hospital facilities various wards catering to psychiatric, neurological and neurosurgery services in a tertiary care hospital using Pabon Lasso model and to identify strategies for more efficient use of the existing health service resources.Materials and Methods: This cross-sectional descriptive study was carried out in 2015 at the Institute of Human Behaviour and Allied Sciences, Delhi, India. This study involved various wards catering to psychiatric, neurological and neurosurgery facilities in the institute. Their performance was evaluated over 8 year period (2007- 2014) using three performance indicators (BTO, BOR & ALS) to assess optimal utilisation of hospital facilities.Results: Psychiatry department was initially located in quadrant IV in 2007 & shifted to quadrant III in 2014 which suggests department’s good quantitative performance with small proportion of unused beds. Similarly Neurosurgery department was in quadrant I at its inception in 2010, but shifted to quadrant III in 2014. However, Neurology department was located in quadrant III initially (2007), but shifted to quadrant II indicating either excess bed supply or less need for utilisation.Conclusion: Pabon Lasso model can be used by hospital management for evaluating the performance of health services in cost effective manner.Asian Journal of Medical Sciences Vol.7(5) 2016 69-74

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Average length of stay in Level III and IV Care of Accident and Emergency Department of Tertiary care Hospital

JMS SKIMS ◽

10.33883/jms.v14i2.93 ◽

2011 ◽

Vol 14 (2) ◽

pp. 61-62

Author(s):

Reyaz A Rangrez ◽

Sheikh Mushtaq ◽

Shafa Deva ◽

Tanveer A Rather ◽

Sameena Mufti ◽

...

Keyword(s):

Length Of Stay ◽

Average Length ◽

Tertiary Care ◽

Care Hospital ◽

Emergency Admissions ◽

Prolonged Length ◽

Average Length Of Stay ◽

Accident And Emergency ◽

Time Gap

BACKGROUND: The scope of Accident and Emergency (A&E) Department is gradually broadening and in fact these are now becoming“mini hospitals within hospitals”.OBJECTIVE:To determine the average length of stay (LOS) in level III and level IV care and factors leading to prolonged length of stay.METHODS:A Hospital based study with follow up of patients received in level III and level IV of A&E Department and the patients were followed till transfer out to respective specialty wards,discharge or death.RESULTS: Emergency beds occupied 9.3% of the total hospital bed strength. Of the total emergency admissions studied, 71.1 % comprised of neurosurgical admissions followed by CVTS (21.4%), neurological (6.8%) and other admissions(1.2%). The average Length of Stay was greatest in CVTS followed by General Surgery i.e. 5.4 days and 4.6 days respectively. The time gap between investigations ordered and reports received was 1.04 days. 67% of the patients who attended A&E Department were of rural background and out of it 54% have read upto high school.CONCLUSIONS: Average Length of stay is 4.3 days which needs to be brought down to 24 hours as per international norms to provide equitable emergency care to wider population. Co-ordination between administration and cliniciansis needed to expedite theproblem.JMS2011;14(2):61-62

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Clinical Outcome of Patients Hospitalized in a Tertiary Care Hospital of Nepal with Confirmed Influenza A/pdm 09(H1N1) in 2018/2019

Journal of Nepal Health Research Council ◽

10.33314/jnhrc.v18i2.2380 ◽

2020 ◽

Vol 18 (2) ◽

pp. 196-200

Author(s):

Upasana Acharya ◽

Subhash Prasad Acharya

Keyword(s):

Influenza A ◽

Case Fatality Rate ◽

Tertiary Care Hospital ◽

Average Length ◽

Tertiary Care ◽

Case Fatality ◽

Care Hospital ◽

Fatality Rate ◽

Hospital System ◽

Average Length Of Stay

Background: It is important to monitor the cases affected by Influenza A/pdm09 as it is difficult to predict the behavior of Influenza A/pdm09 virus as a seasonal influenza. This study aimed to measure the clinical outcomes of patients with Influenza A/pdm 09 in a tertiary care hospital of Nepal in post pandemic period.Methods: A retrospective study was conducted in a tertiary care hospital of central Nepal to record the confirmed cases of Influenza A/pdm 09 from April 2018 to March 2019.The medical records of those patients whose throat sample had been sent to laboratory for testing Influenza A/pdm 09 were referred. The outcomes were then abstracted from the hospital system/medical record department.Results: Among 141 influenza suspected cases, 35.5%(N=50) were Influenza A/Pdm 09 positive. Both male and female were equal in distribution (N=25). Most positive cases were from the age group of 15-64 yrs. Out of total,72 %( N=36) with Influenza A/pdm 09 were discharged after treatment whereas case fatality rate was 22 %( N=11). Twenty-one positive cases were admitted in intensive care unit in which 52.4% expired. The average length of stay in I.C.U and mechanical ventilation were 6.4 days and 5.8 days respectively.Conclusions: This study in post pandemic period in Nepal shows the outcomes of patients with confirmed influenza A/pdm 09 in a year time period with comparably high case fatality rate. Keywords: Influenza A/pdm 09; Nepal; post pandemic, retrospective

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A Ten‐year Surveillance of P. aeruginosa Bloodstream Infections in a Tertiary Care Hospital: Trends and Risk Factors for Mortality

International Journal of Clinical Practice ◽

10.1111/ijcp.14409 ◽

2021 ◽

Author(s):

Mera A. Ababneh ◽

Abeer M Rababa'h ◽

Basima A. Almomani ◽

Abeer M. Ayoub ◽

Sayer I. Al‐Azzam¹

Keyword(s):

Risk Factors ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Bloodstream Infections ◽

Care Hospital

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Timing of Peripheral Blood Stem Cell Yield: Comparison of Alternative Methods with the Classic Method for CD34+Cell Determination

BioMed Research International ◽

10.1155/2014/575368 ◽

2014 ◽

Vol 2014 ◽

pp. 1-13 ◽

Cited By ~ 6

Author(s):

I. Fatorova ◽

M. Blaha ◽

M. Lanska ◽

D. Vokurkova ◽

V. Rezacova ◽

...

Keyword(s):

Stem Cells ◽

Peripheral Blood ◽

Reference Method ◽

Roc Curves ◽

Alternative Methods ◽

Optimal Timing ◽

Hematopoietic Tissue ◽

Peripheral Blood Stem Cells ◽

Hematopoietic Stem ◽

Blood Stem Cells

Hematopoietic stem cells (HSCs), still represent a certain mystery in biology, have a unique property of dividing into equal cells and repopulating the hematopoietic tissue. This potential enables their use in transplantation treatments. The quality of the HSC grafts for transplantation is evaluated by flow cytometric determination of the CD34+cells, which enables optimal timing of the first apheresis and the acquisition of maximal yield of the peripheral blood stem cells (PBSCs). To identify a more efficient method for evaluating CD34+cells, we compared the following alternative methods with the reference method: hematopoietic progenitor cells (HPC) enumeration (using the Sysmex XE-2100 analyser), detection of CD133+cells, and quantification of aldehyde dehydrogenase activity in the PBSCs. 266 aphereses (84 patients) were evaluated. In the preapheretic blood, the new methods produced data that were in agreement with the reference method. The ROC curves have shown that for the first-day apheresis target, the optimal predictive cut-off value was 0.032 cells/mL for the HPC method (sensitivity 73.4%, specificity 69.3%). HPC method exhibited a definite practical superiority as compared to other methods tested. HPC enumeration could serve as a supplementary method for the optimal timing of the first apheresis; it is simple, rapid, and cheap.

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Total Population Estimate of Newborn Special-Care Bed Needs

PEDIATRICS ◽

10.1542/peds.75.6.993 ◽

1985 ◽

Vol 75 (6) ◽

pp. 993-996

Author(s):

August L. Jung ◽

Nan Sherman Streeter

Keyword(s):

Length Of Stay ◽

Total Population ◽

Average Length ◽

Special Care ◽

Care Hospital ◽

Total Hospital ◽

Live Births ◽

Average Length Of Stay ◽

Study Results ◽

Hospital Days

In 1977, 7% of the 38,855 infants born in Utah were estimated to have required a total of 27,439 special-care hospital days. About half (53%) were mildly ill; their average length of stay was 4.6 days, or 24% of the total hospital-days. Another 20% of the infants had intermediate illness, with a 12-day average stay, or 23% of the total hospital-days. The remaining 27% of the infants required intensive care and used 53% of the total hospital-days; their average length of stay was 20 days. As a total population, the state's 38,855 births generated a need for two beds per 1,000 annual live births in special-care facilities. The estimated bed need was: mild illness (Level I), 0.5 beds per 1,000 annual live births; intermediate illness (Level II), 0.5 beds per 1,000 annual live births; and intense illness (Level III), one bed per 1,000 annual live births. Results are based on the assumption that nonstudy births, 30% of the total, have needs proportionate to study births. The following considerations are necessary to extrapolate these bed needs to other populations: (1) convalescence of intensely ill babies may require that up to 50% of their bed needs may be shifted to intermediate care; (2) compliance with criteria for transport to the next level of care may not be 100% as assumed in the study, thus redistributing bed needs; (3) census characteristically fluctuates in special-care nurseries (study results are reported for an unchanging daily census); and (4) the low birth rate of a population is intimately related to the bed needs.

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