scholarly journals The effect of ERAS management in gastric cancer: assessment from the IMIGASTRIC study

2020 ◽  
Vol 2 (4) ◽  
pp. First
Author(s):  
Francesco Giovanardi ◽  
Francesco Falbo ◽  
Chiara Celano ◽  
Michele Casella ◽  
Marco Palisi
Keyword(s):  
Gastric Cancer ◽  
Propensity Score ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Total Sample ◽  
Control Group ◽  
Group Data ◽  
Complications Rate ◽  
And Control ◽  
The Impact

Background: Establish protocols to enhance the surgical management (ERAS) can improve outcomes, shortening hospital stay and save resources. Several studies have carried out for colorectal surgery, while a lack of evidence for gastrectomy remains.This study aims to evaluate the impact of ERAS strategies in a large series of patients underwent gastric cancer surgery. Methods: This is a propensity score-matched case-control study, comparing an ERAS group with a control group. Data were recorded through a tailored and protected web-based system. Primary outcomes: hospital stay, complications rate. Among the secondary outcomes, there are: POD of mobilization, POD of starting liquid diet and soft solid diet. Results: Patients in the ERAS and control groups were 1:1 matched by the closest propensity score on the logit scale and with a Caliber = 0.2. The successful matching resulted in a total sample of 440 patients. The two groups showed no differences in all baseline patients characteristics, type of surgery (P=0.31) and stage of the disease (P=0.61). A benefit in favor of the ERAS management was found in the length of hospital stay (P=0.0004) and complications rate (P=0.001). Conclusion: An ERAS program can safely be established in referral centers for gastric cancer, enabling to significantly improve the main clinical outcomes.

scholarly journals Impact of Vitamin C and Thiamine Administration on Delirium-Free Days in Patients with Septic Shock

2020 ◽  
Vol 9 (1) ◽  
pp. 193 ◽  
Author(s):  
Jong Eun Park ◽  
Tae Gun Shin ◽  
Ik Joon Jo ◽  
Kyeongman Jeon ◽  
Gee Young Suh ◽  
...  
Keyword(s):  
Septic Shock ◽  
Propensity Score ◽  
Vitamin C ◽  
Control Group ◽  
Matched Pairs ◽  
Control Groups ◽  
Icu Delirium ◽  
Definition Of ◽  
And Control ◽  
The Impact

Sepsis is a common cause of delirium in the intensive care unit (ICU). Recently, vitamin C and thiamine administration has been gaining interest as a potential adjunct therapy for sepsis. We investigated the impact of early vitamin C and thiamine administration on ICU delirium-free days among critically ill patients in septic shock. We performed a single-center, retrospective study of patients who visited the emergency department (ED) from January 2017 to July 2018. We categorized patients into a treatment (received vitamin C and thiamine) and control group. We compared delirium-free days within 14 days after ICU admission using propensity score matching. Of 435 patients with septic shock, we assigned 89 propensity score-matched pairs to the treatment and control groups. The median delirium-free days did not differ between treatment (11, interquartile range [IQR] 5–14 days) and control (12, IQR 6–14 days) groups (p = 0.894). Secondary outcomes were not different between the two groups, including delirium incidence and 28-day mortality. These findings were consistent after subgroup analysis for patients who met the sepsis-3 definition of septic shock. Vitamin C and thiamine administration showed no association with ICU delirium-free days among patients in septic shock.

scholarly journals Efficacy Evaluation of Thymosin Alpha 1 in Non-severe Patients With COVID-19: A Retrospective Cohort Study Based on Propensity Score Matching

2021 ◽  
Vol 8 ◽  
Author(s):  
ChenLu Huang ◽  
Ling Fei ◽  
Wei Xu ◽  
WeiXia Li ◽  
XuDong Xie ◽  
...  
Keyword(s):  
Propensity Score ◽  
Hospital Stay ◽  
Propensity Score Matching ◽  
Standard Therapy ◽  
Control Group ◽  
Thymosin Α1 ◽  
Significant Difference ◽  
Thymosin Alpha 1 ◽  
And Control ◽  
Related Mortality

Objective: Thymosin alpha 1 (Thymosin-α1) is a potential treatment for patients with COVID-19. We aimed to determine the effect of Thymosin-α1 in non-severe patients with COVID-19.Methods: We retrospectively enrolled 1,388 non-severe patients with COVID-19. The primary and secondary clinical outcomes were evaluated with comparisons between patients treated with or without Thymosin-α1 therapy.Results: Among 1,388 enrolled patients, 232 patients (16.7%) received both Thymosin-α1 therapy and standard therapy (Thymosin-α1 group), and 1,156 patients (83.3%) received standard therapy (control group). After propensity score matching (1:1 ratio), baseline characteristics were well-balanced between the Thymosin-α1 group and control group. The proportion of patients that progressed to severe COVID-19 is 2.17% for the Thymosin-α1 group and 2.71% for the control group (p = 0.736). The COVID-19-related mortality is 0.54% for the Thymosin-α1 group and 0 for the control group (p = 0.317). Compared with the control group, the Thymosin-α1 group had significantly shorter SARS-CoV-2 RNA shedding duration (13 vs. 16 days, p = 0.025) and hospital stay (14 vs. 18 days, p < 0.001). No statistically significant difference was found between the Thymosin-α1 group and control group in duration of symptoms (median, 4 vs. 3 days, p = 0.843) and antibiotic utilization rate (14.1% vs. 15.2%, p = 0.768).Conclusion: For non-severe patients with COVID-19, Thymosin-α1 can shorten viral RNA shedding duration and hospital stay but did not prevent COVID-19 progression and reduce COVID-19-related mortality rate.

scholarly journals The Effect and Effectiveness Evaluation of Sit-up Training on Elderly Bedridden Patients with Severe Pneumonia

2018 ◽  
Vol 2 (5) ◽  
Author(s):  
Huashuang Chen ◽  
Yanling Luo
Keyword(s):  
Hospital Stay ◽  
Nursing Care ◽  
Length Of Hospital Stay ◽  
Severe Pneumonia ◽  
Control Group ◽  
Observation Group ◽  
Positive Effects ◽  
Care Satisfaction ◽  
The Difference ◽  
And Control

ABSTRACT】OBJECTIVE: To access the effect and the effectiveness of sit-up training on elderly bedridden patients with severe pneumonia. METHODS: A total of 150 elderly bedridden patients diagnosed with severe pneumonia were recruited for this study. They were divided equally into the observation group and control group i.e. 75 cases in each group. All patients were selected from January 2016 to April 2018. On this basis, both groups were treated with the same routine nursing care except with the addition of 30 to 60 minutes sit-up trainings twice daily for the control group under supervision. The clinical hospitalization outcomes, length of hospital stay, and patient care satisfaction of the two groups were compared. RESULTS: The clinical hospitalization outcomes, length of hospital stay, and patient satisfaction of the observation group were found to be superior to the control group, and the difference was significant. Conclusion: In bedridden elderly patients with severe pneumonia, sit-up training had positive effects and beneficial in improving the clinical outcomes and recovery rate.

scholarly journals Dexmedetomidine use and Mortality in Mechanically-Ventilated Patients with Severe Burns: A Cohort Study Using a National Inpatient Database in Japan

2020 ◽  
Author(s):  
Yuki Enomoto ◽  
Masao Iwagami ◽  
Asuka Tsuchiya ◽  
Kojiro Morita ◽  
Toshikazu Abe ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Control Group ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Severe Burns ◽  
And Control ◽  
Inpatient Database ◽  
Ventilated Patients

Abstract Background: Dexmedetomidine is an alpha 2-adrenergic receptor agonist. Apart from its sedative effects, dexmedetomidine has the potential to reduce mortality through its anti-inflammatory effect. However, the impact of dexmedetomidine on in-hospital outcomes of patients with severe burns remains unclear. Therefore, we aimed to elucidate the association between dexmedetomidine and mortality in mechanically-ventilated patients with severe burns, using a Japanese nationwide database of in-hospital patients.Methods: We included adults with severe burns (burn index ≥ 10) who were registered in the Japanese Diagnosis Procedure Combination national inpatient database from 2010 to 2018, started mechanical ventilation within 3 days of admission, and received any sedative drug (dexmedetomidine, midazolam, or propofol). One-to-one propensity score matching was performed between patients who received dexmedetomidine on the day of mechanical ventilation initiation (dexmedetomidine group) and those who did not receive dexmedetomidine (control group). The primary outcome was all-cause 30-day in-hospital mortality. Secondary outcomes were length of hospital stay and duration of mechanical ventilation in all patients and survivors.Results: Eligible patients (n = 1,888) were classified into the dexmedetomidine group (n = 371) or the control group (n = 1,517). After one-to-one propensity score matching, we compared 329 patients from each of the two groups. No significant difference was observed in 30-day mortality between patients in the dexmedetomidine and control groups (22.8% vs. 22.5%, respectively; odds ratio, 1.02; 95% confidence interval, 0.71-1.46). Moreover, there were no significant differences between patients in the dexmedetomidine and control groups in terms of the length of hospital stay or the duration of mechanical ventilation.Conclusions: We found no significant association between dexmedetomidine use and in-hospital outcomes (mortality, length of hospital stay, and length of mechanical ventilation) in mechanically-ventilated patients with severe burns. Dexmedetomidine use may not improve the above-mentioned outcomes; therefore, its selection should be based on the patient’s general condition and the target level of sedation.

scholarly journals Clinical Pathways Based on Integrative Medicine in Chinese Hospitals Improve Treatment Outcomes for Patients with Acute Myocardial Infarction: A Multicentre, Nonrandomized Historically Controlled Trial

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Lei Wang ◽  
Minzhou Zhang ◽  
Liheng Guo ◽  
Jianyong Qi ◽  
Haiming Luo ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Hospital Stay ◽  
Integrative Medicine ◽  
Clinical Pathways ◽  
Controlled Trial ◽  
Length Of Hospital Stay ◽  
Control Group ◽  
Hospitalization Period ◽  
The Impact

Objective. To determine the impact of an integrative medicine clinical pathways (CPs) on the length of in-hospital stay and on outcomes for patients with acute myocardial infarction (AMI).Methods. A multicenter nonrandomized controlled trial enrolling 197 consecutive patients with AMI at eight urban TCM hospitals was conducted between 1 January 2010 and 31 October 2010. These patients were enrolled in the interventional group after the CPs had been implemented. The control group included 405 patients with AMI from eight hospitals; these patients were treated between 1 January 2008 and 31 December 2009, before the CPs were implemented. Outcome measures were the length of hospital stay costs of medical care, and major cardiovascular events (MACEs) during hospitalization.Results. Compared with the control group, the patients in intervention group had a shorter length of hospital stay (9.2±4.2days versus12.7±8.6days,P<0.05), and reduced healthcare costs in hospital (46365.7±18266.9versus52866.0±35404.4,P<0.05). There were statistically significant differences in MACE between the two groups during the hospitalization period (2.5% versus 6.9%,P=0.03).Conclusion. These data suggest that the development and implementation of the clinical pathways based in Integrative Medicine could further improve quality of care and outcome for patients with AMI.

scholarly journals PsychoeducationTo Increase Support Families of Pulmonary Tb Patients

2015 ◽  
Vol 2 (2) ◽  
pp. 126-129
Author(s):  
Bisepta Prayogi
Keyword(s):  
Total Sample ◽  
T Test ◽  
Control Group ◽  
Control Group Design ◽  
Test Analysis ◽  
Group Data ◽  
Immunodeficiency Virus ◽  
The Family ◽  
Post Test ◽  
And Control

Tuberculosis (TB) remains a major global health problem. This leads to poor health among millions of people every year and is now ranked second leading cause of death from infectious disease worldwide, after the Human Immunodeficiency Virus (HIV). The objective of this study was to Analyze the influence of psycoeducation to support the family inan effort to increase support famillies of patients with pulmonary tuberculosis.Methods: This study used quasy experiment pre-post test control group design. Total sample was 32 respondents gotten by purposive sampling, divided into experiment and control group. Data were analyzed by Paired T Test, and Independent T Test with significance value of 0.05. Results: Independent T Test analysis showed there psychoeducation influence family to an increased support famillies (p =0,000) between thetreatment and control groups. Discussion: Psychoeducation can increased family support

scholarly journals Clinical and Economic Impact of Previous Bariatric Surgery on Liver Transplantation: a Nationwide, Population-Based Retrospective Study

2021 ◽  
Author(s):  
Antonio Iannelli ◽  
Julie Bulsei ◽  
Tarek Debs ◽  
Albert Tran ◽  
Andrea Lazzati ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Hospital Stay ◽  
Group Versus ◽  
Postoperative Mortality ◽  
Length Of Hospital Stay ◽  
Control Group ◽  
Study Group ◽  
Obese Patients ◽  
History Of ◽  
The Impact

Abstract Purpose The present study aims to determine the impact of previous bariatric surgery (BS) on the length of hospital stay; the incidence of mortality, re-transplantation, and re-hospitalization after LT; and the related economic costs, through the analysis of the French National Health Insurance Information System. Materials and Methods All patients aged > 18 years who underwent LT in France in the period from 2010 to 2019 were included. Thirty-nine patients with a history of BS (study group) were compared with 1798 obese patients without previous BS (control group). Results At the time of LT, patients with a history of BS were significantly younger than those of the control group and had lower Charlson comorbidity index. Female sex was significantly more represented in the study group. No significant differences were detected between the two groups regarding the postoperative mortality rate after LT (10.3% in the study group versus 8.0% in the control group), long-term mortality (0.038 versus 0.029 person-year of follow-up, respectively), re-transplantation (adjusted hazard ratio (HR) = 2.15, p = 0.2437), re-hospitalization (adjusted analysis, IRR = 0.93, p = 0.7517), and costs of LT hospitalization (73,515 € in the study group versus 65,878 € in the control group). After 1:2 propensity score matching, the duration of the LT hospital stay was significantly longer in the study group (58.3 versus 33.4 days, p = 0.0172). Conclusion No significant differences were detected between patients with previous BS versus obese patients without history of BS undergoing LT concerning the rates of mortality, re-LT, re-hospitalization after LT, and costs of hospitalization and re-hospitalizations. Graphical abstract

95 DIRECT ORAL FEEDING AFTER A MINIMALLY INVASIVE ESOPHAGECTOMY: A SINGLE-CENTER PROSPECTIVE COHORT STUDY

2020 ◽  
Vol 33 (Supplement_1) ◽  
Author(s):  
L Fransen ◽  
T Janssen ◽  
M Aarnoudse ◽  
G Nieuwenhuijzen ◽  
M Luyer
Keyword(s):  
Hospital Stay ◽  
Anastomotic Leakage ◽  
Functional Recovery ◽  
Complication Rate ◽  
Intervention Group ◽  
Length Of Hospital Stay ◽  
Oral Feeding ◽  
Control Group ◽  
Invasive Esophagectomy ◽  
And Control

Abstract   A recent randomized controlled trial showed the safety and feasibility of direct oral feeding following a minimally invasive esophagectomy (MIE). However, significant differences were found regarding complication rate between hospitals, potentially influencing the effect of direct oral feeding. This study aimed to investigate the effect of direct oral feeding compared to the standard of care in a center with low anastomotic leakage and overall complication rates following a MIE. Methods Patients in this single-center prospective cohort study received either direct oral feeding (intervention group) after a MIE with intrathoracic anastomosis or nil-by-mouth for 5 days postoperative and tube feeding (standard of care). Primary outcome was time to functional recovery—defined as adequate pain control with oral analgesics, recovery of mobility, sufficient caloric intake, no intravenous fluid therapy and no signs of active infection—and length of hospital stay. Secondary outcomes included anastomotic leakage, pneumonia, cardiopulmonary complications and other (surgical) complications. Results Baseline characteristics were similar in the intervention (n = 85) and control (n = 111) group. Median time to functional recovery was respectively 7 versus 9 days in the intervention and control group (p &lt; 0.001). Median length of hospital stay was respectively 8 versus 10 days in the intervention and control group (p &lt; 0.001). Thirty-day postoperative complications were significantly lower in the intervention group (p = 0.037). Anastomotic leakage and pneumonia rates did not differ between the intervention and control group (respectively 11.8% vs. 10.8%, p = 0.834; 27.1% vs. 33.3%, p = 0.651). Chyle leakage only occurred in the control group (18.9%, p &lt; 0.001). All other postoperative complications were similar between groups. Conclusion Direct oral feeding in a center with a low postoperative complication rate after a MIE results in a reduced time to functional recovery and a shorter length of hospital stay. Importantly, the 30-day postoperative complication rate was significantly lower in patients directly starting oral feeding.

scholarly journals Differentiated Instruction in a Calculus Curriculum for College Students in Taiwan

2017 ◽  
Vol 7 (1) ◽  
pp. 88
Author(s):  
Jing-Hua Chen ◽  
Yi-Chou Chen
Keyword(s):  
College Students ◽  
Differentiated Instruction ◽  
Teaching Method ◽  
Total Sample ◽  
Control Group ◽  
Significant Difference ◽  
Calculus Instruction ◽  
Quasi Experimental ◽  
And Control ◽  
The Impact

Objectives: To explore differentiated instruction within a calculus curriculum. For college students to learn concentration, motivation and the impact of academic achievement; explore the attitudes and ideas of students on differentiated instruction within a calculus curriculum; build up the diversity of mathematics education within varied educational settings. Participants: Sample data were collected from freshman students of the Army Academy: total sample = 60, experimental and control group each had 30. Methods: Quasi-experimental design. Study tested whether differentiated instruction would enhance calculus instruction, compared with a traditional teaching method. Results: As hypothesized, results showed a significant difference in calculus achievement between experimental and control groups. Conclusions: Results supported the effectiveness of differentiated instruction on calculus curriculum. Finally, depending on the research results, the researcher provided practical suggestions for the educational research.

scholarly journals Robotic versus laparoscopic distal gastrectomy in patients with gastric cancer: a propensity score-matched analysis

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Taro Isobe ◽  
Naotaka Murakami ◽  
Taizan Minami ◽  
Yuya Tanaka ◽  
Hideaki Kaku ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Propensity Score ◽  
Hospital Stay ◽  
Surgical Outcomes ◽  
Distal Gastrectomy ◽  
Length Of Hospital Stay ◽  
Operation Time ◽  
Laparoscopic Distal Gastrectomy ◽  
Safe Procedure ◽  
Clinical Advantage

Abstract Background Robotic distal gastrectomy (RDG) has been increasingly used for the treatment of gastric cancer (GC). However, whether RDG has a clinical advantage over laparoscopic distal gastrectomy (LDG) is yet to be determined. Thus, this study aimed to assess the feasibility and safety of RDG for the treatment of GC as compared with LDG. Methods In total, 157 patients were enrolled between February 2018 and August 2020 in this retrospective study. We then compared the surgical outcomes between RDG and LDG using propensity score-matching (PSM) analysis to reduce the confounding differences. Results After PSM, a clinicopathologically well-balanced cohort of 100 patients (50 in each group) was analyzed. The operation time for the RDG group (350.1 ± 58.1 min) was determined to be significantly longer than that for the LDG group (257.5 ± 63.7 min; P < 0.0001). Of interest, there was a decreased incidence of pancreatic fistulas and severe complications after RDG as compared with LDG (P = 0.092 and P = 0.061, respectively). In addition, postoperative hospital stay was statistically slightly shorter in the RDG group as compared with the LDG group (12.0 ± 5.6 vs. 13.0 ± 12.3 days; P = 0.038). Conclusions Our study confirmed that RDG is a feasible and safe procedure for GC in terms of short-term surgical outcomes. A surgical robot might reduce postoperative severe complications and length of hospital stay.

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