scholarly journals A Retrospective Study on the Factors Associated with Long-Stay Hospitalization in a Child Neuropsychiatry Unit

Healthcare ◽  
2021 ◽  
Vol 9 (9) ◽  
pp. 1241
Author(s):  
Silvia Zanato ◽  
Marina Miscioscia ◽  
Annalisa Traverso ◽  
Miriam Gatto ◽  
Mikael Poli ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Pediatric Patients ◽  
Suicide Attempts ◽  
Hospital Admissions ◽  
Psychiatric Symptoms ◽  
Length Of Hospital Stay ◽  
Discharge Diagnosis ◽  
Psychiatric Hospitalizations ◽  
Hospital Stays ◽  
Potential Factors

The past twenty years have seen a rapid increase in acute psychiatric symptoms in children and adolescents, with a subsequent rise in the number of psychiatric hospitalizations. This paper aims to: (a) describe the epidemiology of hospitalizations and some of the clinical and sociodemographic characteristics of pediatric patients admitted to a regional referral Complex Operative Child Neuropsychiatry Hospital Unit in Northeast Italy and (b) identify potential factors correlated with the length of hospital stay. Methods: 318 (M = 12.8 years; SD = 3.11; 72% Female) patients hospitalized for mental health disorders from 2013 to 2019. Results: Around 60% of hospital admissions occurred via the emergency room, mostly due to suicidal ideation and/or suicide attempts (24%). Affective disorders were the most frequent discharge diagnosis (40%). As for factors correlated with length of hospital stay, we found significant links with chronological age, way of hospital admission, cause of admission, discharge diagnosis, presence of psychiatric comorbidity, family conflict, and psychiatric family history. Conclusions: These results provide information about global characteristics associated with the length of psychiatric hospital stays in pediatric patients and provide a basis on which specific precautions can be hypothesized with the aim of developing more focused treatments.

Preventable hospitalizations among older patients with cognitive impairments and dementia

2018 ◽  
Vol 31 (3) ◽  
pp. 383-391 ◽  
Author(s):  
Dominik Wolf ◽  
Carolin Rhein ◽  
Katharina Geschke ◽  
Andreas Fellgiebel
Keyword(s):  
Cohort Study ◽  
Hospital Stay ◽  
Ambulatory Care ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Older Patients ◽  
Hospital Admissions ◽  
Cognitive Impairments ◽  
Length Of Hospital Stay ◽  
Complication Rates

ABSTRACTObjectives:Dementia and cognitive impairment are associated with higher rates of complications and mortality during hospitalization in older patients. Moreover, length of hospital stay and costs are increased. In this prospective cohort study, we investigated the frequency of hospitalizations caused by ambulatory care-sensitive conditions (ACSCs), for which proactive ambulatory care might prevent the need for a hospital stay, in older patients with and without cognitive impairments.Design:Prospective cohort study.Setting:Eight hospitals in Germany.Participants:A total of 1,320 patients aged 70 years and older.Measurements:The Mini-Cog test has been used to assess cognition and to categorize patients in the groups no/moderate cognitive impairments (probably no dementia) and severe cognitive impairments (probable dementia). Moreover, lengths of hospital stay and complication rates have been assessed, using a binary questionnaire (if occurred during hospital stay or not; behavioral symptoms were adapted from the Cohen-Mansfield Agitation Inventory). Data have been acquired by the nursing staff who received a special multi-day training.Results:Patients with severe cognitive impairments showed higher complication rates (including incontinence, disorientation, irritability/aggression, restlessness/anxiety, necessity of Tranquilizers and psychiatric consults, application of measures limiting freedom, and falls) and longer hospital stays (+1.4 days) than patients with no/moderate cognitive impairments. Both groups showed comparably high ACSC-caused admission rates of around 23%.Conclusions:The study indicates that about one-fourth of hospital admissions of cognitively normal and impaired older adults are caused by ACSCs, which are mostly treatable on an ambulatory basis. This implies that an improved ambulatory care might reduce the frequency of hospitalizations, which is of particular importance in cognitively impaired elderly due to increased complication rates.

scholarly journals Robotic adrenalectomy in the pediatric population: initial experience case series from a tertiary center

BMC Urology ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Anirban P. Mitra ◽  
Evalynn Vasquez ◽  
Paul Kokorowski ◽  
Andy Y. Chang
Keyword(s):  
Hospital Stay ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Operating Time ◽  
Case Series ◽  
Length Of Hospital Stay ◽  
Open Approach ◽  
Invasive Approach ◽  
Patients Âgés ◽  
Tertiary Center

Abstract Background Laparoscopic resection is the most well described minimally-invasive approach for adrenalectomy. While it allows for improved cosmesis, faster recovery and decreased length of hospital stay compared with the open approach, instrument articulation limitations can hamper surgical dexterity in pediatric patients. Use of robotic assistance can greatly enhance operative field visualization and instrument control, and is in the early stages of adoption in academic centers for pediatric populations. Case presentation We present a single-institution series of pediatric adrenalectomy cases. The da Vinci Xi surgical system was used to perform adrenalectomies on three consecutive patients (ages, 2–13 years) at our center. Final pathology revealed ganglioneuroblastoma (n = 2) and pheochromocytoma (n = 1). Median operating time was 244 min (range, 244–265 min); median blood loss was estimated at 100 ml (range, 15–175 ml). Specimens were delivered intact and all margins were negative. Median post-operative hospital stay was 2 days (range, 1–6 days). All patients remain disease-free at median follow-up of 19 months (range, 12–30 months). Conclusion Our experience continues to evolve, and suggests that robotic surgery is safe, feasible and oncologically effective for resection of adrenal masses in well-selected pediatric patients.

Analysis of Hospital Admissions for Psychiatric Care in Portugal: Results from the SMAILE Study

2017 ◽  
Vol 41 (S1) ◽  
pp. S250-S250
Author(s):  
M. Silva ◽  
A. Antunes ◽  
A. Loureiro ◽  
P. Santana ◽  
J. Caldas-de-Almeida ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Hospital Admission ◽  
Hospital Stay ◽  
Psychiatric Care ◽  
Hospital Admissions ◽  
Common Mental Disorders ◽  
Length Of Hospital Stay ◽  
Compulsory Admission ◽  
Clinical Factors ◽  
Psychiatric Admissions

IntroductionEvidence shows that the prevalence and severity of mental disorders and the need for psychiatric admission is influenced by socio-demographic and contextual factors.ObjectivesTo characterize the severity of hospital admissions for psychiatric care due to common mental disorders and psychosis in Portugal.AimsThis retrospective study analyses all acute psychiatric admissions for common mental disorders and psychosis in four Portuguese departments of psychiatry in the metropolitan areas of Lisbon and Porto, and investigates the association of their severity with socio-demographic and clinical factors.MethodsSocio-demographic and clinical variables were obtained from the clinical charts of psychiatric admissions in 2002, 2007 and 2012 (n = 2621). The number of hospital admissions per year (>1) and the length of hospital stay (31 days) were defined as measures of hospital admission severity. Logistic regression analysis was used to assess which socio-demographic and clinical factors were associated with both hospital admission severity outcomes.ResultsResults showed different predictors for each outcome. Being widowed, low level of education, being retired, having psychiatric co-morbidity, and a compulsory admission were statistically associated (P < 0.05) with a higher number of hospital admissions. Being single or widowed, being retired, a diagnosis of psychosis, and a compulsory admission were associated with higher length of hospital stay, while having suicidal ideation was associated with a lower length of hospital stay.ConclusionsSocio-demographic and clinical characteristics of the patients are determinants of hospital admissions for psychiatric care and of their severity.Funding Fundação para a Ciência e Tecnologia (FCT), Portugal.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The Effect of Anticipatory Discharge Orders on Length of Hospital Stay in Staff Pediatric Patients

1997 ◽  
Vol 12 (1) ◽  
pp. 48-50 ◽  
Author(s):  
Timur Sumer ◽  
D. Kay Taylor ◽  
Marney McDonald ◽  
Vicki McKinney ◽  
Margaret Gillard ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Pediatric Patients ◽  
Length Of Hospital Stay

scholarly journals Staged Bilateral Hip or Knee Arthroplasties

2007 ◽  
Vol 15 (2) ◽  
pp. 159-162 ◽  
Author(s):  
FR Hashmi ◽  
K Barlas ◽  
CF Mann ◽  
FR Howell
Keyword(s):  
Hospital Admission ◽  
Hospital Stay ◽  
Operating Time ◽  
Length Of Hospital Stay ◽  
Mean Difference ◽  
Complication Rates ◽  
Early Complication ◽  
Early Complications ◽  
Hospital Stays ◽  
The Mean

Purpose. To compare the operating time, amount of blood transfused, length of hospital stay, and early complications (within 6 months) between 2-week staged bilateral arthroplasties and matched randomised controls undergoing unilateral arthroplasties. Methods. From October 1992 to October 2000, 90 patients who underwent bilateral hip or knee arthroplasties with a 2-week interval were compared with matched randomised controls undergoing unilateral arthroplasties. A single surgeon performed all procedures. Results. After the match-up process, 30 pairs of patients were included in the analysis. There were no significant differences in the operating times, amount of blood transfused, and early complication rates. The mean difference in length of hospital stay was significant ( t= −3.552, df=29, p<0.001). Conclusion. Compared to staged procedures with an interval months apart, staged sequential arthroplasty with a 7- to 10-day interval during one hospital admission is more efficient, as it facilitates earlier rehabilitation without higher complication rates, and entails shorter hospital stays.

scholarly journals Influence of Orthogeriatrics on the Morbidity and Mortality of Patients with Hip Fracture.

2020 ◽  
Author(s):  
Patricia Balvís ◽  
Diego Matias Dominguez-Prado ◽  
Lucia Ferradas-Garcia ◽  
Marta Perez-Garcia ◽  
Alejandro Garcia-Reza ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Hospital Stay ◽  
Clinical Care ◽  
Length Of Hospital Stay ◽  
Cost Benefit ◽  
Perioperative Period ◽  
Morbidity And Mortality ◽  
Economic Saving ◽  
Hospital Stays ◽  
One Year

Abstract BACKGROUND: Osteoporotic hip fractures often occur in fragile, elderly patients and are associated with a significant morbidity and mortality. The objective of this study is to evaluate the morbidity and mortality together with the length of hospital stay in patients with hip fracture in two non-consecutive years and to compare their evolution with the involvement of a specialist in orthogeriatric care.MATERIAL AND METHODS: Retrospective study that reviewed a total of 633 patients with an average age of 85.5 years who suffered a hip fracture and were treated in the same service of Trauma and Orthopaedics in two different years (2012 and 2017). We have analysed mortality, morbidity during their hospital stay, the length of hospital stays and the cost-benefit after the implication of a specialist in orthogeriatric care in 2017.RESULTS: Mortality during their hospital stay decreased significantly from 10% in 2012 to 3.6% in 2017. We have also observed a decrease in mortality at 30 days (10.5% versus 7%) and after one year (28.9% versus 24.9%) between both groups, although these differences were not statistically significant. The length of hospital stays decreased significantly between both periods observed. The average stay decreased by 4.8 days, the surgical delay decreased by 1.1 days and the postoperative hospital stay decreased by 3.4 days. The total annual economic savings estimated due to the involvement of a geriatrician in the follow-up of patients with hip fracture was 1,017.084.94€.CONCLUSIONS: The multidisciplinary approach of patients with hip fracture results in a more effective and more efficient care model. The quality of care and the clinical care optimisation of patients in the perioperative period improve and both hospital stay and mortality during hospital stay decrease significantly. A significant economic saving is also obtained in the treatment of this pathology.

scholarly journals Lumboperitoneal Shunt Surgery Under Rachianesthesia

2022 ◽  
Author(s):  
Yukihiro Goto ◽  
Shinji Nozuchi ◽  
Takuro Inoue
Keyword(s):  
Elderly Patients ◽  
Hospital Stay ◽  
General Anesthesia ◽  
Postoperative Delirium ◽  
Length Of Hospital Stay ◽  
Normal Pressure ◽  
Respiratory Complications ◽  
General Anesthesia Group ◽  
Lumboperitoneal Shunt ◽  
Hospital Stays

Abstract Purpose: In the very elderly, complications such as postoperative pneumonia or delirium, which are directly associated with longer hospitalization, are more frequent. In order to overcome these drawbacks, we switched from general anesthesia to rachianesthesia for the lumboperitoneal shunt (LPS) procedure in idiopathic normal pressure hydrocephalus (iNPH) patients. This is because iNPH suffers particularly elderly patients, and neuraxial anesthesia techniques such as rachianesthesia reportedly decrease postoperative complications in patients of very advanced age as compared with general anesthesia. Methods: We retrospectively analyzed 45 patients who underwent LPS in our institution, and divided them into two groups based on the anesthetic approach; 1) general anesthesia, 2) rachianesthesia. We analyzed these two groups with regard to postoperative delirium score and the hospital stay.Results: In the general anesthesia group, two patients had respiratory complications after the surgery. The mean postoperative delirium score using the intensive care delirium screening checklist (ICDSC) was 1.3 (1.4) and the length of hospital stay was 13.9 (4.7) days. In the rachianesthesia group, no patients had respiratory complications. The postoperative mean ICDSC was 1.3 (1.4), and the length of hospital stay was 10.8 (2.1) days. The statistical analysis showed the rachianesthesia group to have significantly shorter hospital stays.Conclusions: LPS under rachianesthesia is an alternative to performing this procedure under general anesthesia in elderly patients.

scholarly journals Length of Hospital Stay for Hip Fracture and 30-Day Mortality in People With Alzheimer’s Disease: A Cohort Study in Finland

2020 ◽  
Vol 75 (11) ◽  
pp. 2184-2192
Author(s):  
Piia Lavikainen ◽  
Marjaana Koponen ◽  
Heidi Taipale ◽  
Antti Tanskanen ◽  
Jari Tiihonen ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Hospital Stay ◽  
Older Persons ◽  
Length Of Hospital Stay ◽  
Inpatient Rehabilitation ◽  
Risk Of Death ◽  
Increased Risk ◽  
Hospital Stays ◽  
Worse Prognosis

Abstract Background Persons with Alzheimer’s disease (AD) are at higher risk of hip fractures (HFs) than general older population and have worse prognosis after HF. Hospital stays after HF have shortened along time. We investigated the association between length of hospital stay after HF and mortality after discharge among persons with AD. Method The MEDALZ cohort includes all Finnish community dwellers who received clinically verified AD diagnosis in 2005–2011 (N = 70 718). Patients who experienced first HF after AD diagnosis in 2005‒2015 (n = 6999) were selected. Length of hospital stay for HF was measured as a sum of the consecutive days spent in hospital after HF until discharge. Outcome was defined as death within 30 days after hospital discharge. Results Mean of overall length of hospital stay after a HF decreased from 52.6 (SD 62.9) days in 2005 to 19.6 (SD 23.1) days in 2015. Shortest treatment decile (1‒4 days) had the highest risk of death within 30 days after discharge (adjusted hazard ratio [aHR] 2.76; 95% confidence interval [CI] 1.66–4.60) in addition to second (5‒6 days; aHR 2.52; 95% CI 1.50–4.23) and third (7‒10 days; aHR 2.22; 95% CI 1.34–3.69) deciles when compared to the sixth decile of length of stays (21‒26 days). Conclusions Among persons with AD, shorter length of hospital stay after HF was associated with an increased risk of death after discharge. After acute HF treatment, inpatient rehabilitation or proper care and services in home need to be organized to older persons with AD.

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