scholarly journals Prevalence, Reasons, and Predisposing Factors Associated with 30-day Hospital Readmissions in Poland

2019 ◽  
Vol 16 (13) ◽  
pp. 2339 ◽  
Author(s):  
Jacek Kryś ◽  
Błażej Łyszczarz ◽  
Zofia Wyszkowska ◽  
Kornelia Kędziora-Kornatowska
Keyword(s):  
Hospital Readmissions ◽  
High Volume ◽  
Female Gender ◽  
University Hospital ◽  
Treatment Practice ◽  
Factors Associated ◽  
Pediatric Transplantation ◽  
High Volume Hospital ◽  
Quality Issues ◽  
Initial Hospitalization

There is a growing interest in quality issues associated with hospital care, with readmissions (rehospitalizations) being one of the main areas of interest. Retrospective data from a 914-bed university hospital in Bydgoszcz, Poland, was used to identify 30-day readmissions in 2015. We developed a catalogue of reasons for rehospitalization and differentiated between planned and unplanned readmissions, as well as those related and unrelated to index (initial) hospitalization. Multilevel logistic regression was used to determine factors associated with readmission risk. A total of 12.5% of patients were readmitted within 30 days of being discharged. The highest readmission rates were identified in pediatric, transplantation, and urology patients. The highest share of readmissions was due to the specific nature of a disease and its routine treatment practice. Almost two-thirds of readmission cases were classified as unplanned and related to the index hospitalization. The following characteristics were associated with a higher risk of rehospitalization: female gender, residing >35 km from the hospital, longer than average and very short stays at index admission, higher comorbidity score, and admission to a high-volume hospital sector. Due to the importance of quality issues in health policy, the topic should be further pursued to identify evidence-based practices that would improve hospitals’ performance.

scholarly journals Transvenous Lead Extraction SAFeTY Score for Risk Stratification and Proper Patient Selection for Removal Procedures Using Mechanical Tools

2020 ◽  
Vol 9 (2) ◽  
pp. 361 ◽  
Author(s):  
Wojciech Jacheć ◽  
Anna Polewczyk ◽  
Maciej Polewczyk ◽  
Andrzej Tomasik ◽  
Andrzej Kutarski
Keyword(s):  
Young Patients ◽  
High Volume ◽  
Female Gender ◽  
Lead Extraction ◽  
Factors Associated ◽  
Major Complications ◽  
Proper Patient Selection ◽  
Related Risk ◽  
Risk Patients ◽  
Selection For

Background: To ensure the safety and efficacy of the increasing number of transvenous lead extractions (TLEs), it is necessary to adequately assess the procedure-related risk. Methods: We analyzed potential clinical and procedural risk factors associated with 2049 TLE procedures. The TLEs were performed between 2006 and 2016 using only simple tools for lead extraction. Logistic regression analysis was used to develop a risk prediction scoring system for TLEs. Results: Multivariate analysis showed that the sum of lead dwell times, anemia, female gender, the number of procedures preceding TLE, and removal of leads implanted in patients under the age of 30 had a significant influence on the occurrence of major complications during a TLE. This information served as a basis for developing a predictive SAFeTY TLE score, where: S = sum of lead dwell times, A = anemia, Fe = female, T = treatment (previous procedures), Y = young patients, and TLE = transvenous lead extraction. In order to facilitate the use of the SAFeTY TLE Score, a simple calculator was constructed. Conclusion: The SAFeTY TLE score is easy to calculate and predicts the potential occurrence of procedure-related major complications. High-risk patients (scoring more than 10 on the SAFeTY TLE scale) must be treated at high-volume centers with surgical backup.

scholarly journals Spread of SARS-CoV-2 (COVID-19) in a High-Volume Hospital: Vascular Surgery Impact

2020 ◽  
pp. 1-4
Author(s):  
Andrea Ascoli Marchetti ◽  
Andrea Ascoli Marchetti ◽  
Ciattaglia Riccardo ◽  
Dauri Mario ◽  
Giuliano Ilaria ◽  
...  
Keyword(s):  
Vascular Surgery ◽  
High Volume ◽  
University Hospital ◽  
Future Perspective ◽  
Mortality And Morbidity ◽  
Vascular Activity ◽  
High Volume Hospital ◽  
The Future ◽  
The Impact

Increasing population rates of coronavirus disease 2019 (COVID-19) are occurring in several countries and continents. The impact regarding vascular activity, consequences and complication is scarce and makes the future perspective unclear. The aim of this report is to describe the changes in a high-volume University Hospital, relevant for future decisions. The mortality and morbidity should be higher not only in COVID+ patients but also in vascular patients.

Learning curve for hysterectomy in a high-volume-hospital after implementation of endoscopic procedure

2014 ◽  
Vol 74 (S 01) ◽  
Author(s):  
R Mavrova ◽  
JC Radosa ◽  
D Bardens ◽  
K Neis ◽  
S Wagenpfeil ◽  
...  
Keyword(s):  
Learning Curve ◽  
High Volume ◽  
Endoscopic Procedure ◽  
High Volume Hospital

scholarly journals Factors Associated with Clostridioides (Clostridium) Difficile Infection and Colonization: Ongoing Prospective Cohort Study in a French University Hospital

2021 ◽  
Vol 18 (14) ◽  
pp. 7528
Author(s):  
Nagham Khanafer ◽  
Philippe Vanhems ◽  
Sabrina Bennia ◽  
Géraldine Martin-Gaujard ◽  
Laurent Juillard ◽  
...  
Keyword(s):  
Cohort Study ◽  
Clostridium Difficile ◽  
Good Clinical Practice ◽  
University Hospital ◽  
Factors Associated ◽  
Contact Precautions ◽  
Institutional Review ◽  
Virulent Strains ◽  
Scientific Meetings ◽  
Hospital Acquired

Introduction: Clostridioides (Clostridium) difficile can be isolated from stool in 3% of healthy adults and in at least 10% of asymptomatic hospitalized patients. C. difficile, the most common cause of hospital-acquired infectious diarrhea in the developed world, has re-emerged in recent years with increasing incidence and severity. In an effort to reduce the spread of the pathogen, published recommendations suggest isolation and contact precautions for patients suffering from C. difficile infection (CDI). However, asymptomatic colonized patients are not targeted by infection control policies, and active surveillance for colonization is not routinely performed. Moreover, given the current changes in the epidemiology of CDI, particularly the emergence of new virulent strains either in the hospital or community settings, there is a need for identification of factors associated with colonization by C. difficile and CDI. Methods and analysis: We are carrying out a prospective, observational, cohort study in Edouard Herriot Hospital, Hospices Civils de Lyon, a 900-bed university hospital in Lyon, France. All consecutive adult patients admitted on selected units are eligible to participate in the study. Stool samples or rectal swabs for C. difficile testing are obtained on admission, every 3–5 days during hospitalization, at the onset of diarrhea (if applicable), and at discharge. Descriptive and logistic regression analyses will be completed to mainly estimate the proportion of asymptomatic colonization at admission, and to evaluate differences between factors associated with colonization and those related to CDI. Ethics: The study is conducted in accordance with the ethical principles of the Declaration of Helsinki, French law, and the Good Clinical Practice guidelines. The study protocol design was approved by the participating units, the ethics committee and the hospital institutional review board (Comité de protection des personnes et Comission Nationale de l’Informatique et des Libertés; N°: 00009118). Dissemination: The results of this study will be disseminated by presenting the findings locally at each participating ward, as well as national and international scientific meetings. Findings will be shared with interested national societies crafting guidelines in CDI.

Psychopathological Factors Associated With Burnout in Intensive Care Nurses: A Cross-Sectional Study

2021 ◽  
pp. 107839032199972
Author(s):  
Erman Yıldız
Keyword(s):  
Intensive Care ◽  
Emotional Exhaustion ◽  
Cross Sectional Study ◽  
Personal Accomplishment ◽  
University Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated ◽  
Anxiety Depression ◽  
The Relationship

BACKGROUND: Although previous studies have separately revealed that parameters such as anxiety, depression, and secondary traumatic stress (STS) are associated with burnout, there is still a limited understanding of the relationship between anxiety, depression, and STS and burnout in intensive care unit (ICU) nurses. AIMS: To investigate the relationship between levels of burnout, anxiety, depression, and STS in ICU nurses. METHOD: A cross-sectional study was conducted with ICU nurses ( N = 164) from a university hospital in eastern Turkey. The participants completed the anxiety, depression, STS, and burnout scales along with the descriptive characteristics form. The data were analyzed using descriptive statistics, correlation, and logistic regression analysis. RESULTS: The mean scores for STS, anxiety, depression, and burnout were 40.60 ± 13.77, 17.14 ± 12.90, 13.28 ± 9.75 and 41.39 ± 14.87, respectively. The results showed that, in the ICU nurses, anxiety, depression, and STS components explained 61% of emotional exhaustion, 38% of depersonalization, and 13% of personal accomplishment. CONCLUSIONS: While the present findings supported the paradigm that burnout in ICU nurses is associated with STS, anxiety, and depression, they also revealed some details about the psychopathological factors associated with burnout. These details were as follows: (1) individuals who resorted to avoidance as a component of STS on a high level were more likely to experience emotional exhaustion and depersonalization, (2) individuals with severe depressive symptoms were more likely to experience a decrease in their personal accomplishment, and (3) individuals with anxiety symptoms were more likely to experience both emotional exhaustion and personal accomplishment.

scholarly journals Burnout Syndrome during Residency Training in Jordan: Prevalence, Risk Factors, and Implications

2021 ◽  
Vol 18 (4) ◽  
pp. 1557
Author(s):  
Abdullah Nimer ◽  
Suzan Naser ◽  
Nesrin Sultan ◽  
Rawand Said Alasad ◽  
Alexander Rabadi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Working Hours ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Burnout Syndrome ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Factors Associated ◽  
Resident Physicians ◽  
Healthcare Professions

Burnout syndrome is common among healthcare professions, including resident physicians. We aimed to assess the prevalence of burnout among resident physicians in Jordan, and a secondary aim was to evaluate the risk factors associated with the development of burnout syndrome in those residents, including gender, working hours, psychological distress, training sector, and specialty. In this cross-sectional study, 481 residents were recruited utilizing multistage stratified sampling to represent the four major health sectors in Jordan. Data were collected using an online questionnaire, where the Copenhagen Burnout Inventory (CBI) was used to assess the prevalence of burnout. The prevalence, group differences, and predictors of burnout were statistically analyzed using STATA 15. Overall, 373 (77.5%) residents were found to have burnout. Factors associated with higher levels of burnout were psychological stress (β = 2.34, CI = [1.88–2.81]), longer working hours (β = 4.07, CI = [0.52–7.62], for 51–75 h a week, β = 7.27, CI = [2.86–11.69], for 76–100 h a week and β = 7.27, CI = [0.06–14.49], for >100 h a week), and obstetrics/gynecology residents (β = 9.66, CI = [3.59–15.73]). Conversely, medical sub-specialty residents, as well as private and university hospital residents, had lower burnout levels. We concluded that decreasing the workload on residents, offering psychological counseling, and promoting a safety culture for residents might help in mitigating burnout consequences.

What Constitutes a “High-Volume” Hospital for Pancreatic Resection?

2008 ◽  
Vol 206 (4) ◽  
pp. 622.e1-622.e9 ◽  
Author(s):  
Robert A. Meguid ◽  
Nita Ahuja ◽  
David C. Chang
Keyword(s):  
Pancreatic Resection ◽  
High Volume ◽  
High Volume Hospital

scholarly journals Prevalence of anxiety in patients admitted to a university hospital in southern Brazil and associated factors

2013 ◽  
Vol 16 (3) ◽  
pp. 644-657 ◽  
Author(s):  
Inês Gullich ◽  
Andrews Barcellos Ramos ◽  
Tiago Rafael Anschau Zan ◽  
Cíntia Scherer ◽  
Raúl Andrés Mendoza-Sassi
Keyword(s):  
Health Care ◽  
Associated Factors ◽  
Depression Scale ◽  
Female Gender ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Cross Sectional ◽  
Clinical Ward ◽  
Long Time ◽  
Prevalence Ratios

Objective: To identify the prevalence of anxiety in adults hospitalized in the clinical ward of a university hospital and to analyze the possible associated factors. Method: A cross-sectional study was performed in a university hospital. All interviewees answered a specific questionnaire and the Hospital Anxiety and Depression Scale. A Poisson regression was used to calculate prevalence ratios with 95% confidence intervals. Results: 282 patients were enrolled. The prevalence of anxiety was 33.7% (95%CI 28.2 - 39.3). Characteristics associated with the outcome were female gender (RP 2.44), age ≥ 60 years (PR 0.65), consultation in primary health care (PR 2.37), estimated time of contact between patient and student > 30 min (RP 1.36), high blood pressure (PR 1.57), diabetes mellitus (PR 1.43), and obesity (RP 1.43). Conclusion: This study found prevalence of high anxiety. It may be associated with certain characteristics of the patients (gender, age, chronic diseases); the medical appointment in primary care and time (estimated by the patient) that the student remained with this patient. The need for a focused approach to mental health care within the hospital has been discussed for a long time. The particularity of this study refers to the environment of a university hospital and to what extent the environment and the patient's relationship with the student are associated with higher prevalence of anxiety.

The GRIM2005 Study of Migraine Consultation in France II. Psychological Factors Associated with Treatment Response to Acute Headache Therapy and Satisfaction in Migraine

Cephalalgia ◽  
2007 ◽  
Vol 27 (12) ◽  
pp. 1398-1407 ◽  
Author(s):  
C Lucas ◽  
M Lantéri-Minet ◽  
H Massiou ◽  
F Nachit-Ouinekh ◽  
A Pradalier ◽  
...  
Keyword(s):  
Treatment Response ◽  
Female Gender ◽  
Psychological Variables ◽  
Behavioural Interventions ◽  
Factors Associated ◽  
Brief Cope ◽  
Positive Reinterpretation ◽  
Headache Therapy ◽  
Ihs Criteria ◽  
Acute Headache

The objective of this analysis was to identify variables associated with treatment response in subjects with migraine. Data were collected from a sample of 10 000 subjects. A battery of questionnaires assessing clinical and psychological variables was completed. Migraine diagnosis was attributed using an algorithm based on the IHS criteria and treatment response using the ANAES criteria. We identified 1534 subjects, of whom 1443 were treated. For 54.2%, at least one ANAES criterion for treatment response was unfulfilled. Non-response was associated with female gender, high HIT-6 impact scores and high HAD psychological distress scores. The strongest associations with non-response were identified for four psychological variables: elevated scores on the CSQ catastrophization subscale and the ‘Consequences’ and ‘Acceptance’ dimensions of the Brief COPE, and low scores on the ‘Positive Reinterpretation’ Brief COPE dimension. In conclusion, many individuals with migraine respond inadequately to treatment. Behavioural interventions aimed at modifying coping strategies may improve outcome.

Primary Uterine Cancer in Maryland: Impact of Distance on Access to Surgical Care at High-Volume Hospitals

2013 ◽  
Vol 23 (7) ◽  
pp. 1244-1251 ◽  
Author(s):  
Camille C. Gunderson ◽  
Ana I. Tergas ◽  
Aimee C. Fleury ◽  
Teresa P. Diaz-Montes ◽  
Robert L. Giuntoli
Keyword(s):  
Confidence Interval ◽  
Odds Ratio ◽  
Uterine Cancer ◽  
Multivariable Analysis ◽  
Community Setting ◽  
Surgical Care ◽  
High Volume ◽  
High Volume Hospital ◽  
To Receive ◽  
Zip Code

ObjectiveTo evaluate the influence of distance on access to high-volume surgical treatment for patients with uterine cancer in Maryland.MethodsThe Maryland Health Services Cost Review Commission database was retrospectively searched to identify primary uterine cancer surgical cases from 1994 to 2010. Race, type of insurance, year of surgery, community setting, and both surgeon and hospital volume were collected. Geographical coordinates of hospital and patient’s zip code were used to calculate primary independent outcomes of distance traveled and distance from nearest high-volume hospital (HVH). Logistic regression was used to calculate odds ratios and confidence intervals.ResultsFrom 1994 to 2010, 8529 women underwent primary surgical management of uterine cancer in Maryland. Multivariable analysis demonstrated white race, rural residence, surgery by a high-volume surgeon and surgery from 2003 to 2010 to be associated with both travel 50 miles or more to the treating hospital and residence 50 miles or more from the nearest HVH (allP< 0.05). Patients who travel 50 miles or more to the treating hospital are more likely to have surgery at a HVH (odds ratio, 6.03; 95% confidence interval, 4.67–7.79) In contrast, patients, who reside ≥50 miles from a HVH, are less likely to have their surgery at an HVH. (odds ratio, 0.37; 95% confidence interval, 0.32–0.42).ConclusionIn Maryland, 50 miles or more from residence to the nearest HVH is a barrier to high-volume care. However, patients who travel 50 miles or more seem to do so to receive care by a high-volume surgeon at an HVH. In Maryland, Nonwhites are more likely to live closer to an HVH and more likely to use these services.

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