scholarly journals Factors affecting outcome of decompressive hemicraniectomy in malignant middle cerebral artery infarction

2021 ◽  
Vol 18 (3) ◽  
pp. 35-38
Author(s):  
Sagar Koirala ◽  
Shreeram Bhandari ◽  
Subash Lohani
Keyword(s):  
Hospital Stay ◽  
Primary Outcome ◽  
Length Of Hospital Stay ◽  
Primary Outcome Measure ◽  
Early Surgery ◽  
Brain Swelling ◽  
Middle Cerebral Artery Infarction ◽  
Factors Affecting ◽  
Decompressive Hemicraniectomy ◽  
Outcome Of Surgery

Introduction: Decompressive Hemicraniectomy (DHC) is a standard surgical management of malignant MCA (MMCA) infarction. This study was conducted to review the outcome of surgery and to find out factors associated with favorable outcomes at a tertiary level neurosurgery referral centre. Methods and Materials: This is a retrospective study conducted over a period of three years from 2017 to 2019. Patient charts were reviewed for variable like age, sex, timing of surgery, GCS at presentation, length of ventilation, length of ICU admission and length of hospital stay. Primary outcome measure was GOSE: favorable (<=4) and unfavorable (>=5). SPSS version 23 was used for analysis. Results:  A total of 28 patients underwent DHC out of which 21 patients were available for analysis. Mean age of patients was 58.62 years. Mean GCS on arrival was 11.86. Mean interval duration between event and surgery was 51.88 hours. Mean duration of ventilation was 4.43 days. Mean length of ICU stay was 5.95 days. Mean hospital stay was 22.33 days. Mean GOSE was 2. Mean age was significantly lower in patients with favorable GOSE. Early surgery had better mean GOSE which was not significant statistically. Conclusion: Patients with age less than 50 years have favorable GOSE despite MMCA infarction if decompressive hemicraniectomy is performed to accommodate brain swelling. Early surgery at presentation rather than waiting for deterioration might improve the outcome.

scholarly journals What are the Most Effective Factors in Determining Future Exacerbations, Morbidity Weight and Mortality In Patients Hospitalized wıth COPD Attack? A Prospective Study

2021 ◽  
Author(s):  
Çağla Koç ◽  
Füsun Şahin
Keyword(s):  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Blood Gases ◽  
Distribution Width ◽  
Factors Affecting ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Arterial Blood ◽  
Gold Stage ◽  
A Prospective Study

INTRODUCTION: The aim of this study was to investigate the important factors affecting the COPD prognosis. MATERIAL AND METHODS: We included 160 hospitalized patients with COPD exacerbation in the study. Hemoglobin-HB, hematocrit-HCT, leukocyte, red cell distribution width- RDW, mean platelet volume, platelet distribution width, plateletcrit, platelet, neutrophil / lymphocyte ratio, platelet / lymphocyte ratio, eosinophil, uric acid, albumin, CRP, procalcitonin, arterial blood gases (PO2, PCO2) pulmonary function test (FEV1, FVC), echocardiography (ejection fraction-EF) GOLD stage, MMRC and BORG scales, Charlson comorbidity index, body mass index-BMI, length of hospital stay were examined on the first day of hospitalization. Admission to the hospital with a new attack, hospitalization in the intensive care unit-ICU, and mortality during the 6 months after discharge were evaluated. RESULTS: High CRP and procalcitonin values were observed in the group with long hospital stay. In mortality group, HB, HCT, BMI and PO2 values were significantly lower than the group without mortality while age and GOLD stage were higher. The age, BORG and MMRC scores, number of exacerbations experienced in the previous 1 year, RDW, eosinophil count, PCO2 were significantly higher in the ICU group than without ICU. HCT, EF values were lower in the ICU group than without ICU. FEV1, FVC values were significantly lower in follow-up attack group than without attack; the duration of COPD and the number of experienced in the previous 1 year were high. CONCLUSION: It has been concluded that the scoring combining selected biomarkers and other factors will be stronger in determining the prognosis.

scholarly journals Factors affecting length of hospital stay for people with spinal cord injuries at Kanombe military hospital, Rwanda

2012 ◽  
Vol 68 (2) ◽  
Author(s):  
PB Bwanjugu ◽  
A. Rhoda
Keyword(s):  
Spinal Cord ◽  
Hospital Stay ◽  
Spinal Cord Injuries ◽  
Demographic Data ◽  
Linear Regression Analysis ◽  
Length Of Hospital Stay ◽  
Military Hospital ◽  
Pressure Sores ◽  
Rehabilitation Team ◽  
Factors Affecting

In patients with spinal cord injuries increased length ofhospital stay is often as a result of secondary complications such as pressuresores, urinary tract infection and respiratory infection. An increased lengthof hospital stay was observed at Kanombe Military Hospital in Rwanda.The aim of this study was to determine specific factors affecting length ofhospital stay for individuals with spinal cord injuries at Kanombe MilitaryHospital in Rwanda. The records of 124 individuals with spinal cordinjuries who were discharged from the hospital between 1st January1996and 31st December 2007 were reviewed to collect data. Information collected and captured on a data gathering sheetincluded demographic data, information relating to the injury, occurrence of medical complications and length ofhospital stay. Linear regression analysis was computed in SPSS to determine factors affecting the length of stay.The necessary ethical considerations were adhered to during the implementation of the study. Current employmentstatus and the occurrence of pressure sores were significantly associated with the length of hospital stay (p=0.021 andp=0.000 respectively). A strong relationship was noted between pressure sores and length of stay (R= 0.703). There is aneed for all members of the rehabilitation team to devise and implement effective measures to prevent the developmentof pressure sores, in patients with spinal cord injuries in the study setting.

scholarly journals Factors affecting length of hospital stay.

BMJ ◽  
1978 ◽  
Vol 1 (6127) ◽  
pp. 1622-1623
Author(s):  
D Phillips-Miles
Keyword(s):  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Factors Affecting

Factors Affecting Length of Hospital Stay for Femoropopliteal Bypass

1986 ◽  
Vol 314 (3) ◽  
pp. 153-157 ◽  
Author(s):  
Robert S. Rhodes ◽  
Carl L. Krasniak ◽  
Paul K. Jones
Keyword(s):  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Femoropopliteal Bypass ◽  
Factors Affecting

Predicting length of hospital stay and cost by aneurysm grade on admission

1996 ◽  
Vol 85 (3) ◽  
pp. 388-391 ◽  
Author(s):  
J. Paul Elliott ◽  
Peter D. Le Roux ◽  
Galen Ransom ◽  
David W. Newell ◽  
M. Sean Grady ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Treatment Cost ◽  
Significant Proportion ◽  
Length Of Hospital Stay ◽  
Aneurysm Rupture ◽  
Clinical Grade ◽  
Content Type ◽  
Factors Affecting ◽  
Hospitalization Costs ◽  
The Cost

✓ To determine the relationship between clinical grade on admission and treatment cost after aneurysm rupture, the authors retrospectively examined the length of hospital stay (LOS) and total hospitalization costs (excluding professional fees) for 543 patients admitted for aneurysm surgery between 1983 and 1993. The overall median LOS was 18 days, with a range of 1 to 165 days. Increased median LOS correlated with Hunt and Hess Grades 0 to IV on admission (p< 0.001). Median LOS for Grade V patients was reduced, in part, because of early mortality. Increased treatment cost also correlated with worse admission clinical grade (p < 0.001). A significant proportion of total expenditures occurred early in the hospitalization for patients in all clinical grades. Identification of additional factors affecting the cost of aneurysm treatment is indicated to complement treatment outcome studies.

scholarly journals Factors affecting length of hospital stay.

BMJ ◽  
1978 ◽  
Vol 1 (6120) ◽  
pp. 1145-1145
Author(s):  
H B Chischick
Keyword(s):  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Factors Affecting

scholarly journals DOES PRESENCE OF DOWN SYNDROME INCREASE RESPIRATORY SYNCYTIAL VIRUS (RSV) RELATED HOSPITALIZATION IN CHILDREN LESS THAN 2 YEARS OF AGE? A SYSTEMATIC REVIEW AND META-ANALYSIS

2018 ◽  
Vol 23 (suppl_1) ◽  
pp. e45-e46
Author(s):  
Souvik Mitra ◽  
Helen McCord ◽  
Mohamed El Azrak ◽  
Bosco Paes
Keyword(s):  
Systematic Review ◽  
Sensitivity Analysis ◽  
Hospital Stay ◽  
Congenital Heart ◽  
Primary Outcome ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Assisted Ventilation ◽  
Inclusion Criteria ◽  
Syncytial Virus

Abstract BACKGROUND Down syndrome (DS) is associated with a number of immunologic abnormalities and congenital heart disease (CHD) which increase susceptibility to respiratory syncytial virus (RSV). However current position statements from the American Academy of Pediatrics and the Canadian Paediatric Society do not recommend routine RSV prophylaxis with Palivizumab to all infants with DS, OBJECTIVES To conduct a systematic reviewand meta-analysis of observational studies to compare RSV-related hospitalization (RSVH) rates, length of hospital stay(LOS), need for intensive care and assisted ventilation in DS children <2 years of age compared with children without DS. DESIGN/METHODS Data Sources: The authors searched MEDLINE, Embase, CINAHL, reference lists of relevant articles, abstracts and conference proceedings, results of unpublished trials, and contacted the primary authors of relevant studies. Studies were included if data was provided on RSV-related hospitalization in children <2yr of age with and without DS. Data extraction & Synthesis: Two reviewers independently screened the search results, applied inclusion criteria and assessed methodological quality using the Newcastle-Ottawa Scale. Data was extracted and checked in duplicate. Main outcomes & measures: The primary outcome was RSV-related hospitalization. Secondary outcomes included length of hospital stay, need for intensive care and assisted ventilation. Sensitivity analysis was conducted for the primary outcome comparing DS infants without congenital heart disease (CHD) with non-DS infants. RESULTS 19 cohort studies met the inclusion criteria. Ten studies involving 1,390,380 children were analyzed. DS-children had significantly higher RSVH compared to non-DS children (Relative Risk, 6.97; 95% CI, 6.01 to 8.08; I2=0%; Figure 1a). Among children hospitalized with RSV, need for assisted ventilation (RR, 5.82; 95% CI, 1.81 to 18.69; I2=84%; Figure 1b) and LOS (Mean difference, 2.28 days; 95% CI, 1.61 to 2.96 days; I2=0%; Figure 1c) were significantly higher in DS-children. The sensitivity analysis also confirmed that DS children without CHD had a significantly higher RSVH rate compared to non-DS children (RR, 6.31; 95% CI, 4.83 to 8.23;I2=0%; Figure 1d). CONCLUSION Compared to children without DS, RSV-related hospitalization, need for assisted ventilation and length of RSV-related hospital stay is significantly higher in children with DS in the first 2 years of life. The results of this systematic review should prompt a favorable recommendation for routine RSV prophylaxis in both healthy and medically compromised DS children aged <2years.

Urinary [TIMP-2]·[IGFBP7]-guided randomized controlled intervention trial to prevent acute kidney injury in the emergency department

2018 ◽  
Vol 34 (11) ◽  
pp. 1902-1909 ◽  
Author(s):  
Moritz Schanz ◽  
Christoph Wasser ◽  
Sebastian Allgaeuer ◽  
Severin Schricker ◽  
Juergen Dippon ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Early Detection ◽  
Hospital Stay ◽  
Primary Outcome ◽  
Intervention Group ◽  
Kidney Injury ◽  
Length Of Hospital Stay ◽  
Intervention Trial ◽  
Randomized Controlled ◽  
Early Biomarker

Abstract Background Early detection and prevention of acute kidney injury (AKI) is important to reduce morbidity and mortality. Discovery of early-detection biomarkers has enabled early preventive approaches. There are no data on early biomarker-guided intervention with nephrological consultation in emergency departments (EDs). Methods In this prospective randomized controlled intervention trial, patients at high risk for AKI were screened with urinary [TIMP-2]·[IGFBP7] in the ED of Robert-Bosch-Hospital (Stuttgart, Germany). We screened 257 eligible patients of whom 100 met the inclusion criteria, with urinary [TIMP-2]·[IGFBP7] >0.3, and were included. The intervention group received immediate one-time nephrological consultation after randomization, implementing Kidney Disease: Improving Global Outcomes (KDIGO) 2012 recommendations on AKI. The primary outcome was the incidence of moderate to severe AKI within the first day after admission. Secondary outcomes were AKI occurrence within 3 days after admission, need for renal replacement therapy (RRT), length of hospital stay and death. Results The primary outcome did not differ significantly (P = 0.9) between the groups, neither within the first day nor within the first 3 days after admission. The intervention group had significantly (P < 0.05) lower serum creatinine (SCr) on Day 2 and lower maximum SCr and tended (P = 0.08) to have higher urine output (UOP) at Day 3 than the non-intervention group. No patient in the intervention group needed RRT (0 versus 3) during the hospital stay (P = 0.09). Conclusions One-time routine nephrologist-guided application of the KDIGO bundle in ED patients with a risk for AKI cannot currently be recommended. However, due to the uniform trend of study endpoints in favour of intervention, further trials to investigate larger cohorts of more severely ill patients are warranted. Trial registration www.ClinicalTrials.gov, study number NCT02730637.

Sign in / Sign up

Export Citation Format

Share Document