Blistering Diseases in a Tertiary Care Hospital: A 10-year Audit

Introduction: Cutaneous blisters can occur in variety of conditions. They are broadly classified as immunobullous or non-immunobullous. Immunobullous blistering diseases can further classify as intraepidermal or subepidermal. Non-immunobullous blistering disease are commonly due to infections, drugs among others. Some of the blistering disease carry significant mortality and morbidity. There are only limited data on blistering diseases from Nepal, so this study will provide details on the prevalence of this rare dermatological disease from one of the tertiary care referral hospital in the country. Objective: To assess the clinical pattern and prevalence of various blistering diseases in a tertiary care referral hospital. Materials and Methods: All of the data were obtained from the admission register maintained at department of dermatology and venereology, National Academy of Medical Sciences. All the patients admitted with blistering disease from year April 2008 till March 2018 were included. The details including age, sex, type of blistering disease and length of hospital stay were recorded. Results: A total of 710 patients were admitted in the dermatology ward over the period of 10 years. There were a total of 193 blistering disease admitted during this period. Autoimmune blistering disease was diagnosed in 59 patients whereas 100 patients had non-immunobullous disease. The age grouped range from 4- 93 years with the mean age of 43± 19.71 years. The average number of hospital stay of all blistering diseases was 11.73±11.36 days. Conclusion: Blistering diseases are one of the most common conditions requiring admission in dermatology ward. Some of these diseases carry a significant morbidity and mortality. So, prompt diagnosis and treatment is of utmost importance.

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A Study of Factors Affecting the Length of Hospital Stay of COVID-19 Patients by Cox-Proportional Hazard Model in a South Indian Tertiary Care Hospital

Journal of Primary Care & Community Health ◽

10.1177/21501327211000231 ◽

2021 ◽

Vol 12 ◽

pp. 215013272110002

Author(s):

Gayathri Thiruvengadam ◽

Marappa Lakshmi ◽

Ravanan Ramanujam

Keyword(s):

Hospital Stay ◽

Tertiary Care ◽

Length Of Hospital Stay ◽

Hazard Model ◽

Cox Proportional Hazard Model ◽

Care Hospital ◽

Proportional Hazard ◽

Proportional Hazard Model ◽

Cox Proportional Hazard ◽

South Indian

Background: The objective of the study was to identify the factors that alter the length of hospital stay of COVID-19 patients so we have an estimate of the duration of hospitalization of patients. To achieve this, we used a time to event analysis to arrive at factors that could alter the length of hospital stay, aiding in planning additional beds for any future rise in cases. Methods: Information about COVID-19 patients was collected between June and August 2020. The response variable was the time from admission to discharge of patients. Cox proportional hazard model was used to identify the factors that were associated with the length of hospital stay. Results: A total of 730 COVID-19 patients were included, of which 675 (92.5%) recovered and 55 (7.5%) were considered to be right-censored, that is, the patient died or was discharged against medical advice. The median length of hospital stay of COVID-19 patients who were hospitalized was found to be 7 days by the Kaplan Meier curve. The covariates that prolonged the length of hospital stay were found to be abnormalities in oxygen saturation (HR = 0.446, P < .001), neutrophil-lymphocyte ratio (HR = 0.742, P = .003), levels of D-dimer (HR = 0.60, P = .002), lactate dehydrogenase (HR = 0.717, P = .002), and ferritin (HR = 0.763, P = .037). Also, patients who had more than 2 chronic diseases had a significantly longer length of stay (HR = 0.586, P = .008) compared to those with no comorbidities. Conclusion: Factors that are associated with prolonged length of hospital stay of patients need to be considered in planning bed strength on a contingency basis.

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A Hospital based cross sectional study to find out factors associated with disease severity and length of hospital stay in COVID-19 patients in Tertiary Care Hospital of Ahmedabad city

Indian Journal of Community Health ◽

10.47203/ijch.2021.v33i02.006 ◽

2021 ◽

Vol 33 (2) ◽

pp. 256-259

Author(s):

Arpit Chelabhai Prajapati ◽

Mansi Maulik Patel ◽

Hardika Jamanadas Khanpara ◽

Rujul Pankajbhai Shukla ◽

Donald Shailendra Christian ◽

...

Keyword(s):

Risk Factors ◽

Hospital Stay ◽

Disease Severity ◽

Tertiary Care Hospital ◽

Heart Diseases ◽

Tertiary Care ◽

Length Of Hospital Stay ◽

Care Hospital ◽

Factors Associated ◽

High Dependency

Background: Tertiary hospital care may vary from isolation bed ward care to high dependency units (HDUs) with oxygen support to intensive care unit (ICU) where patients may be intubated for mechanical ventilation The major risk factors for severe disease are age more than 60 years and underlying diseases like diabetes, hypertension. COVID-19 patients present at varying levels of severity. Understanding how long patients hospitalized with COVID-19 remain in hospital is critical for planning. Objectives: 1. To determine risk factors associated with disease severity 2. To determine risk factors associated with length of hospital stay in COVID-19 patients 3. To study the disease outcome Material & Methods: This was retrospective record-based study of inpatients with COVID-19 at Tertiary Care Hospital of Ahmedabad City. All patients admitted at tertiary care hospital diagnosed with COVID-19 between April 2020 to June, 2020, were included in present study. Inclusion criteria were all COVID-19 patients admitted at tertiary care hospital during the duration of April 2020 to June 2020. Results: A total of 916 COVID-19 patients were included in the study. Out of 916 total admitted patients 526 (57.4%) were male. 174 (19%) patients having one or more comorbidities like diabetes, hypertension, tuberculosis, heart diseases etc. Total 769 discharged (83.9%), 115 deaths (12.6%) and 32 transferred to other COVID-19 hospital (3.5%) out of total 916 patients admitted during study period. Conclusion: Severity of disease and deaths were associated with age and comorbidities. COVID-19 patients with comorbidities have more deteriorating outcomes compared with patients without.

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Convulsive status epilepticus in children: clinical profile and outcome in a tertiary care hospital

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20190093 ◽

2019 ◽

Vol 6 (2) ◽

pp. 280

Author(s):

Madhu P. K. ◽

Krithika R.

Keyword(s):

Status Epilepticus ◽

Hospital Stay ◽

Tertiary Care ◽

Significant Risk ◽

Significant Risk Factor ◽

Refractory Status Epilepticus ◽

Clinical Profile ◽

Convulsive Status Epilepticus ◽

Care Hospital ◽

Mortality And Morbidity

Background: The outcome of status epilepticus (SE) depends on various determinants such as age, type and duration of SE, etiology, management and associated comorbidities. This study was undertaken to describe the clinical profile and outcome of children with convulsive status epilepticus presenting to pediatric intensive care unit (PICU).Methods: Eighty-seven children between the age group 1 month to 12 years who at presentation or during the PICU stay had convulsive status epilepticus (CSE) were included in the study. Clinical profile, etiological spectrum and outcome at the end of hospital stay were analysed.Results: Median age of CSE was 4 years and 55 (63.2%) were below 5 years of age. Acute symptomatic etiology of CSE was a significant risk factor (p= 0.03) for refractory status epilepticus (RSE) which was seen in 31 patients (39%). Acute symptomatic etiology was the cause of CSE in 46 (59.2%) children. Remote symptomatic (26.4%), cryptogenic (18.4%) and progressive (2.3%) were other etiologies. Neuro-infection (29.8%) and febrile seizures (11.5%) were the most common acute symptomatic causes. Mortality and morbidity occurred in 23 (26.4%) and 8 (9.2%) patients respectively. Remaining 56 (64.6%) returned to baseline condition at the end of hospital stay. Longer duration (p= 0.03) and acute symptomatic etiology (p=0.049) were significant risk factors for mortality.Conclusions: Most common causes of CSE in children are acute symptomatic. Longer duration of status is associated with higher mortality. Hence, termination of seizure activity at the earliest, prudent management of respiratory or circulatory impairments in these children and improving the overall health care to prevent neuro-infections are important steps to improve outcome.

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Assessing frailty index and correlation with crp and serum albumin and clinical outcome in terms of length of hospital stay

Annals of Geriatric Education and Medical Sciences ◽

10.18231/j.agems.2021.005 ◽

2021 ◽

Vol 8 (1) ◽

pp. 15-21

Author(s):

Shilpa Avarebeel ◽

Akash Durgakar ◽

Pratibha Pereira ◽

Tandure Varsha ◽

Mahesh Poojari ◽

...

Keyword(s):

Clinical Outcome ◽

Elderly Patients ◽

Serum Albumin ◽

Hospital Stay ◽

Frailty Index ◽

Tertiary Care ◽

Age Groups ◽

Length Of Hospital Stay ◽

Care Hospital ◽

Cross Sectional

Frailty is defined as “a clinically recognizable state of increased vulnerability, resulting from aging associated decline in reserve and function across multiple A Hospital based descriptive cross-sectional study in tertiary care hospital. Atotal of 294 patients admitted in the Medicine/Geriatric Ward, were included in stressors is compromised”. It is a robust and powerful risk factor for disability. With this background, study was conducted at a tertiary centre with objectives to assess the frailty in elderly patients and to assess the correlation of frailty with Serum Albumin and CRP physiologic systems, such that the ability to cope with every day or acute and evaluate the clinical outcome in terms of length of hospital stay. The study. Demographic details and details of known comorbidities were recorded. Cognition score of all patients were assessed using mini mental scale examination. Investigations like Serum Albumin and CRP were done. The data was analyzed using statistical software.Our results show that in hospitalized patients frailty is seen in both gender. The presence of co-morbidities worsens the frailty. 30 second chair test is very good indicator for frailty and risk of fall and we observed reduced duration in the Pre-Frail group. The cognition score decreased along with the increase in age groups. When compared with the Frailty index, it was more in the Pre-Frail group. The duration of hospital stay was more in Frail group. The mean serum albumin level is important marker to identify early frailty.Assessment of frailty in elderly patients is necessary and identifying Pre-Frailgroup is very important. 30 second chair stand test and serum albumin are very important early markers in the assessment of frailty. Cognitive function is also very important to identify early frailty. Our study shows that the length of hospital stay is more in the Frail group. Frailty is important aspect of elderly. It should be included in routine clinical assessment of all elderly patients.

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Clinical Efficacy of Hydroxychloroquine in Patients with COVID-19: Findings from an Observational Comparative Study in Saudi Arabia

Antibiotics ◽

10.3390/antibiotics10040365 ◽

2021 ◽

Vol 10 (4) ◽

pp. 365

Author(s):

Saleh Alghamdi ◽

Bassant Barakat ◽

Ilhem Berrou ◽

Abdulhakim Alzahrani ◽

Abdul Haseeb ◽

...

Keyword(s):

Mechanical Ventilation ◽

Saudi Arabia ◽

Hospital Stay ◽

Tertiary Care ◽

Length Of Hospital Stay ◽

Clinical Effectiveness ◽

Treated Group ◽

Control Group ◽

Care Hospital ◽

Hospital Data

The aim of this study was to assess the clinical effectiveness of Hydroxychloroquine-based regimens versus standard treatment in patients with the coronavirus disease admitted in 2019 to a hospital in Saudi Arabia. A comparative observational study, using routine hospital data, was carried out in a large tertiary care hospital in Al Baha, Saudi Arabia, providing care to patients with COVID-19 between April 2019 and August 2019. Patients were categorized into two groups: the Hydroxychloroquine (HCQ) group, treated with HCQ in a dose of 400 mg twice daily on the first day, followed by 200 mg twice daily; the non HCQ group, treated with other antiviral or antibacterial treatments according to protocols recommended by the Ministry of Health (MOH) at the time. The primary outcomes were the length of hospital stay, need for admission to the intensive care unit (ICU), time in ICU, and need for mechanical ventilation. Overall survival was also assessed. 568 patients who received HCQ (treatment group) were compared with 207 patients who did not receive HCQ (control group). HCQ did not improve mortality in the treated group (7.7% vs. 7.2%). There were no significant differences in terms of duration of hospitalization, need for and time in ICU, and need for mechanical ventilation among the groups. Our study provides further evidence that HCQ treatment does not reduce mortality rates, length of hospital stay, admission and time in ICU, and need for mechanical ventilation in patients hospitalized with COVID-19.

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497. Moderate Versus High Dose Corticosteroids in Adult Patients with Severe COVID-19: Less Is More

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab466.696 ◽

2021 ◽

Vol 8 (Supplement_1) ◽

pp. S350-S350

Author(s):

Seema Joshi ◽

Sana Soman ◽

Saniya Jain ◽

Atheel Yako ◽

Marwa Hojeij ◽

...

Keyword(s):

Adverse Events ◽

Hospital Stay ◽

Primary Outcome ◽

Tertiary Care ◽

Length Of Hospital Stay ◽

Supplemental Oxygen ◽

Multivariable Logistic Regression Analysis ◽

High Dose ◽

Care Hospital ◽

Less Is More

Abstract Background The early administration of corticosteroids (CS) in patients with severe COVID-19 (hospitalized with need for supplemental oxygen) has been the only therapy to improve survival. However, the optimal dosing of CS remains unclear. Beginning March 2020 methylprednisolone (MP) in a dose of 40mg twice daily (high dose CS - HDC) was adopted at our institution. Based on emerging trials, this dose of MP was reduced to 16mg twice daily (moderate dose CS – MDC) in November 2020. The study aims to evaluate the outcome difference in patients receiving HDC versus MDC. Methods This pre-post quasi-experimental study was done at Henry Ford Hospital, an 877-bed tertiary care hospital in Detroit, Michigan. Consecutive patients in the HDC group from September 1, 2020 to November 15, 2020 were compared to the MDC group from November 30, 2020 to January 20, 2021. Only hospitalized patients with severe COVID-19 were included. The primary outcome was 28-day mortality. Secondary outcomes included progression to mechanical ventilation, length of hospital stay, discharge on supplemental oxygen and CS-associated adverse events. Patient demographics were evaluated using descriptive statistics. Bivariate and multivariable logistic regression analysis was planned to test the association between primary outcome and exposure. Results 470 patients were evaluated, 218 and 252 in the HDC and MDC groups respectively. Clinical characteristics and severity of illness on admission were comparable in both groups (Table 1). Among comorbidities - lung disease, cardiovascular disease and hypertension were higher in MDC. Antibiotic and tocilizumab use were lower in MDC. Significantly more patients in MDC group received oral CS. There was no difference in mortality between HDC and MDC through bivariate and multivariate analysis (14.7% and 13.5%, p < 0.712, adjusted OR 0.913 [0.514-1.619]) (Table 2,3). Median length of hospital stay was 5 and 6 days in HDC and MDC respectively (p < 0.001). There was no difference in CS-associated adverse events. Conclusion The survival in severe COVID-19 patients treated with MDC is comparable to HDC. Oral corticosteroids are an equally effective option. Disclosures Rachel Kenney, PharmD, Medtronic, Inc. (Other Financial or Material Support, spouse is an employee and shareholder)

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The audit of traumatic head injuries in a tertiary care hospital in Mumbai: a retrospective study

International Surgery Journal ◽

10.18203/2349-2902.isj20204672 ◽

2020 ◽

Vol 7 (11) ◽

pp. 3678

Author(s):

Snehal Deotale ◽

Vivek Mukhamale ◽

Bhushankumar A. Thakur ◽

Rajas Mudgerikar

Keyword(s):

Hospital Stay ◽

Tertiary Care Hospital ◽

Average Length ◽

Head Injuries ◽

Tertiary Care ◽

Total Mortality ◽

Care Hospital ◽

Mortality And Morbidity ◽

Severity Of Injury ◽

Traumatic Head

Background: Trauma and trauma related deaths are a major health concerns in any country of which half of the deaths are due to head injuries. Yet reliable statistics are difficult to discover from routinely collected data. This study helps to analyse the epidemiology, mortality and morbidity of traumatic head injury patients in a tertiary care hospital in Mumbai.Methods: Retrospective data of one year (1st January 2019 to 31st December 2019) was collected from Medical records department. Demographic data, mode of injury, severity of injury, interventions done, duration of hospital stay, mortality and morbidity were recorded.Results: Of the total 944 cases recorded, 785 (83%) were males. More than half of the patients were below 40 years of age. The leading cause of trauma was RTA (79%) followed by accidental fall (18%). Of all the trauma patients 110 (11%) were found to be under influence of alcohol. 77 patients (8%) on admission had poor GCS (0-3), while 766 (81%) on admission had good GCS (8 and above). 153 patients (16%) underwent neurosurgical intervention. Average length of hospital stay of most patients (545) was 4 to 7 days. Total mortality was 111 (12%). Mortality was high in patients with poor GCS on admission.Conclusions: The above study gives statistics regarding the epidemiology, morbidity and mortality of patients of traumatic head injuries in a tertiary care hospital which can be used for future references in designing management policies to prevent traumatic head injuries.

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Hospital Stay of Orthopedic Cases in a Tertiary Care Hospital: A Descriptive Cross-sectional Study

Journal of Nepal Medical Association ◽

10.31729/jnma.6400 ◽

2021 ◽

Vol 59 (236) ◽

Author(s):

Pramod Joshi

Keyword(s):

Hospital Stay ◽

Chronic Back Pain ◽

Tertiary Care ◽

Length Of Hospital Stay ◽

Cross Sectional Study ◽

Care Hospital ◽

Sectional Study ◽

Cross Sectional ◽

Provincial Hospital ◽

Co Morbidity

Introduction: Orthopedic conditions includes a range of condition varying from traumatic injuries, congenital anomalies, chronic back pain, arthritis, rheumatologic conditions, and other. Length of hospital stay is determined by a number of factors such as symptom severity, patient co morbidity and hospital availability. Our study aims to study the length of hospital stay of the patients admitted in a provincial hospital. Methods: A descriptive cross-sectional study was conducted in Seti Provincial Hospital in the month of January among 800 cases. The record of each orthopedic cases admitted in the hospital was retrospectively collected from the medical record section after receiving ethical approval from Institutional Review Committee of Seti Provincial Hospital. Whole sampling technique was used. Data were analyzed by Statistical Package for the Social Sciences version 20. The descriptive statistical analysis was done. Results: The average length of hospital stay was 2.87 days with the maximum length of the stay of 10 days and the minimum stay of zero days (discharged on the same day). Forearm bone fracture was the main reason for admission in the hospital 325 (40.62%). Conclusions: Length of the hospital stay was found to shorter than the previous study done in similar settings.

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