scholarly journals Admission Pattern and Outcome in a Pediatric High Dependency Care (PHDC) Unit of a Tertiary Care Children Hospital in Bangladesh

2015 ◽  
Vol 4 (2) ◽  
pp. 27-30
Author(s):  
Mohammed Reaz Mobarak ◽  
AKM Tajuddin Bhuyian ◽  
Md Rafiqul Islam ◽  
Ferdousi Begum ◽  
Md Atiqul Islam ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Very Low Birth Weight ◽  
Demographic Data ◽  
Tertiary Care ◽  
Case Fatality ◽  
Acute Bronchiolitis ◽  
Female Ratio ◽  
Dependency Care ◽  
High Dependency ◽  
High Dependency Care

Pediatric high dependency care (PHDC) is a care comprising of close observation, monitoring and management of children who are vulnerable to physiological instability. To determine the pattern of admission and register outcome of patients in the pediatric high dependency care (PHDC) of Dhaka Shishu( Children) Hospital, a tertiary level referral children hospital in Bangladesh. This is a retrospective study of the record of patients admitted to the PHDC unit at the Dhaka Shishu Hospital from May 2015 to February 2016. The information obtained from the admission/discharge record as well as the patients' case notes included demographic data, working diagnosis, type of management, length of stay (LOS) in the PHDC unit and outcome. A total of 140 children were admitted during the study period comprising of 80 (57.15%) males and 60 (42.85%) females, giving a male: female ratio of 1.33:1. The age ranged from one day to 12 years with a mean of 35.44±3.1 months. Meningitis (both bacterial and viral) accounted for 24 (17.14%) followed by encephalitis, 21 (15%) were the major indications for admission. Other indications included seizure disorders (both febrile and afebrile), 18 (12.85%); bronchopneumonia including acute bronchiolitis, 15 (10.71%); neonates with different indications 13(9.28%); typhoid fever with complications 5 (3.57%); mumps with complications, 4(2.85%); chickenpox with complications, 3(2.14%); surgical conditions, 7 (5%), and others, 30(21.42%). There were no post-operative surgical cases. The length of stay (LOS) in the unit ranged from 1 day to 34 days with mean of 7.9±0.5 days. The treatment expenses ranged from 1000 BDT to 50,000 BDT with a mean of 12297.14±888.69 BDT. Out of total 140 admissions, 82 (58.57%) were discharged in a satisfactory condition; discharge on request (DOR), 30 (21.42%); referred to intensive care unit (ICU), 7 (5%); left against medical advice (LAMA), 15(10.71%) and death, 6 (4.2%); case fatality rate (CFR), 4.2/100 admission. Among the death cases there were 2 meningitis, 2 encephalitis, 1 acute bronchiolitis and 1 preterm very low birth weight (VLBW). Meningitis, encephalitis, bronchopneumonia, seizure disorder were the major causes of admission in PHDC unit, while case fatality was the highest for meningitis and encephalitis. Therefore, awareness regarding prevention, early detection and management of meningitis and encephalitis should be emphasized. CBMJ 2015 July: Vol. 04 No. 02 P: 27-30

scholarly journals A study on length of stay and its predictors among dengue patients in a tertiary care institute in Lucknow

2019 ◽  
Vol 6 (11) ◽  
pp. 4870
Author(s):  
Sandhya Mishra ◽  
Deepak Chopra ◽  
Nidhi Jauhari ◽  
Ausaf Ahmad
Keyword(s):  
Occupational Exposure ◽  
Length Of Stay ◽  
Hospital Admissions ◽  
Tertiary Care ◽  
Case Fatality ◽  
Length Of Hospital Stay ◽  
Care Hospital ◽  
Age Group ◽  
Cross Sectional ◽  
Early Arrival

Background: Dengue virus infection is a growing health problem and is prevalent throughout India. Research focusing on length of hospital stay and its predictors is scarce from India. This is important considering the burden of the disease during epidemics and impact on hospital admissions. Hence the study was conducted with the objectives to find out the factors influencing the length of stay in hospital of dengue patients.Methods: A cross sectional retrospective observational study conducted at a tertiary care hospital from August 2016 to October 2016. Data was retrieved from case sheets at Medical Record Department of 350 lab confirmed adult dengue patients admitted in the hospital.Results: The majority of patients admitted were of economically productive age group of 18-45 years and males indicating the occupational exposure to the vector of dengue. The study found that majority had length of stay of less than a week and as age increases the length of stay also increases (statistically significant). The nil case fatality and lesser number of mean days of symptoms before admission possibly indicate that early arrival of patients to hospital can lead to very low fatality rates. Further research required to find out the other predictors of length of stay.Conclusions: The study concludes that the dengue affects the economically productive age group and more males thereby indicating occupational exposure to the vector. The age of the patient can be used as an indicator to the length of stay in the hospital.

scholarly journals P067: Factors associated with prolonged length of stay of admitted patients in a tertiary care emergency department

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S101
Author(s):  
K. Johns ◽  
S. Smith ◽  
E. Karreman ◽  
A. Kastelic
Keyword(s):  
Length Of Stay ◽  
Multiple Regression ◽  
Significant Relationship ◽  
Demographic Data ◽  
Healthcare Access ◽  
Tertiary Care ◽  
Outcome Variable ◽  
Prolonged Length ◽  
Patient Demographic Data ◽  
Major Predictor

Introduction: Extended length of stay (LOS) in emergency departments (EDs) and overcrowding are a problems for the Canadian healthcare system, which can lead to the creation of a healthcare access block, a reduced health outcome for acute care patients, and decreased satisfaction with the health care system. The goal of this study is to identify and assess specific factors that predict length of stay in EDs for those patients who fall in the highest LOS category. Methods: A total of 130 patient charts from EDs in Regina were reviewed. Charts included in this study were from the 90th-100th percentile of time-users, who were registered during February 2016, and were admitted to hospital from the ED. Patient demographic data and ED visit data were collected. T-tests and multiple regression analyses were conducted to identify any significant predictors of our outcome variable, LOS. Results: None of the demographic variables showed a significant relationship with LOS (age: p=.36; sex: p=.92, CTAS: p=.48), nor did most of the included ED visit data such as door to doctor time (p=.34) and time for imaging studies (X-ray: p=.56; ultrasound: p=.50; CT p=.45). However, the time between the request for consult until the decision to admit did show a significant relationship with LOS (p<.01).Potential confounding variables analyzed were social work consult requests (p=.14), number of emergency visits on day of registration (p=.62), and hour of registration (00-12 or 12-24-p<.01). After adjustment for time of registration, using hierarchical multiple regression, time from consult request to admit decision maintained a significant predictor (p<.01) of LOS. Conclusion: After adjusting for the influence of confounding factors, “consult request to admit decision” was by far the strongest predictor of LOS of all included variables in our study. The results of this study were limited to some extent by inconsistencies in the documentation of some of the analyzed metrics. Establishing standardized documentation could reduce this issue in future studies of this nature. Future areas of interest include establishing a standard reference for our variables, a further analysis into why consult requests are a major predictor, and how to alleviate this in the future.

Delay in time from diagnosis to treatment in metastatic melanoma, lung, and colon cancer.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e23186-e23186
Author(s):  
Muhammad Salman Faisal ◽  
Ahmed Khattab ◽  
Vida Jahangiri ◽  
Hira Shaikh ◽  
Soorih Shaikh ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Colon Cancer ◽  
Demographic Data ◽  
Tertiary Care ◽  
The United States ◽  
Definitive Treatment ◽  
Metastatic Colon Cancer ◽  
Female Ratio ◽  
Number Of Patients ◽  
Delay In Treatment

e23186 Background: Delay in cancer treatment is anxiety provoking both for the patient and clinician. We conducted the study to evaluate the patterns of delay in treatment of patients with metastatic colon cancer, lung cancer and melanoma from diagnosis to the initiation of the treatment, and to identify the causes of delay. Methods: In this retrospective study, patients with metastatic colon cancer, lung cancer and melanoma diagnosed between 01/01/2016 to 12/31/2016 in a tertiary care network in the United States were studied. Data was collected from electronic health record (EHR) database, ‘Epic’. Variables such as demographic data, including patient age and gender, and type of cancer, and treatment received were analyzed. The causes of the delay were also evaluated when available. Results: Total number of patients in the study was 288. Mean age was 68.3 years (median 69 years) and 36% were alive at the time of data analysis. Male to female ratio was 1.4:1. 66.7% people had lung cancer, 30% had colon cancer and 3% had melanoma. 67 (23.6%) of total analyzed patients had denied definitive treatment and chose to undergo palliative management. Of the rest, most started treatment with chemotherapy (39.5%), followed by surgery (22.6%) and then radiation (14.6%). With the time of pathological diagnosis of the tumor taken as the date of diagnosis, mean delay from the day of diagnosis to the start of treatment in this study population observed was 27.7 days. 67 patients (23.3%) had a delay of more than 30 days, with the most common reason being systemic factors in 39 patients (58.2%), followed by patient factors in 23 patients (34.3%) and physician factors in 5 patients (7.5%). On logistic regression analysis, time from diagnosis to treatment didn’t predict mortality (OR = 0.99, 95% CI P = 0.10(0.97-1.002). Conclusions: Delay in treatment is common and the system factors one of the common reasons as exhibited by our study. Time from diagnosis to treatment didn’t predict mortality.

scholarly journals Sepsis biomarkers in unselected patients on admission to intensive or high-dependency care

Critical Care ◽  
2013 ◽  
Vol 17 (2) ◽  
pp. R60 ◽  
Author(s):  
Martin J Llewelyn ◽  
Mario Berger ◽  
Mark Gregory ◽  
Ravi Ramaiah ◽  
Amanda L Taylor ◽  
...  
Keyword(s):  
Dependency Care ◽  
High Dependency ◽  
High Dependency Care

Respiratory Care for Spinal Cord Injury

2013 ◽  
Vol 749 ◽  
pp. 258-261
Author(s):  
Yan Chun Zhu ◽  
Jun Chang ◽  
Zhi Gang Sheng
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Acute Spinal Cord Injury ◽  
Therapeutic Interventions ◽  
Respiratory Care ◽  
Respiratory Complications ◽  
Dependency Care ◽  
High Dependency ◽  
Cord Injury ◽  
High Dependency Care

In this paper the issue of respiratory complications following acute spinal cord injury with reference to the area of high dependency care is considered. It will deal with the pathophysiology behind acute spinal cord injury and its effect on the respiratory system, while discussing the interventions used to prevent these complications. A multitude of therapeutic interventions in the care of respiratory complications has been identified. And positioning, chest physiotherapy and assisted coughing techniques will be considered in this paper.

Impact of a high-dependency care area on the nutritional management of patients with acute uremia

2002 ◽  
Vol 12 (2) ◽  
pp. 126-133
Author(s):  
Neil Maredia ◽  
Diane Green ◽  
Heather Jayasekera ◽  
Hilary Robinson ◽  
Anne Jones ◽  
...  
Keyword(s):  
Nutritional Management ◽  
Dependency Care ◽  
High Dependency ◽  
High Dependency Care
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