scholarly journals Lama Hari Rawat Pasien Stroke

2020 ◽  
Vol 9 (2) ◽  
pp. 117-122
Author(s):  
Novita Nirmalasari ◽  
Muhamat Nofiyanto ◽  
Rizqi Wahyu Hidayati
Keyword(s):  
Length Of Stay ◽  
Hemorrhagic Stroke ◽  
Treatment Process ◽  
Clinical Signs ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Cerebral Function ◽  
Stroke Patients ◽  
Design Data

Background: Stroke has remained the leading cause of death globally in the last 15 years. Stroke is rapidly developing clinical signs of focal or global disturbance of cerebral function. Hospitalization is a treatment process which including patient to stay at the hospital. Length of stay is influenced by the type of stroke.  This  study aimed to know classification of stroke and length of stay of stroke patients. Methods: The study was a descriptive study with restrospective design. Data collected from medical record from May until December 2020 in RS PKU Muhammadiyah Yogyakarta. There were 207 patients with stroke. Descriptive data is then processed. Results: The results showed the highest percentage stroke patients male (50,24%), non hemorrhagic stroke (57,49%), length of stay hemorrhagic stroke 8 days. Conclusion: The result of this study may provide nursing research in patients with stroke.

In-Hospital Mortality and Related Outcomes for Elevated Risk Acute Pulmonary Embolism Treated With Mechanical Thrombectomy Versus Routine Care

2021 ◽  
pp. 088506662110364
Author(s):  
Jennifer R. Buckley ◽  
Brandt C. Wible
Keyword(s):  
Pulmonary Embolism ◽  
High Risk ◽  
Length Of Stay ◽  
Hospital Mortality ◽  
Routine Care ◽  
Hospital Length ◽  
Elevated Risk ◽  
Hospital Length Of Stay ◽  
Icu Length Of Stay

Purpose To compare in-hospital mortality and other hospitalization related outcomes of elevated risk patients (Pulmonary Embolism Severity Index [PESI] score of 4 or 5, and, European Society of Cardiology [ESC] classification of intermediate-high or high risk) with acute central pulmonary embolism (PE) treated with mechanical thrombectomy (MT) using the Inari FlowTriever device versus those treated with routine care (RC). Materials and Methods Retrospective data was collected of all patients with acute, central PE treated at a single institution over 2 concurrent 18-month periods. All collected patients were risk stratified using the PESI and ESC Guidelines. The comparison was made between patients with acute PE with PESI scores of 4 or 5, and, ESC classification of intermediate-high or high risk based on treatment type: MT and RC. The primary endpoint evaluated was in-hospital mortality. Secondary endpoints included intensive care unit (ICU) length of stay, total hospital length of stay, and 30-day readmission. Results Fifty-eight patients met inclusion criteria, 28 in the MT group and 30 in the RC group. Most RC patients were treated with systemic anticoagulation alone (24 of 30). In-hospital mortality was significantly lower for the MT group than for the RC group (3.6% vs 23.3%, P < .05), as was the average ICU length of stay (2.1 ± 1.2 vs 6.1 ± 8.6 days, P < .05). Total hospital length of stay and 30-day readmission rates were similar between MT and RC groups. Conclusion Initial retrospective comparison suggests MT can improve in-hospital mortality and decrease ICU length of stay for patients with acute, central PE of elevated risk (PESI 4 or 5, and, ESC intermediate-high or high risk).

scholarly journals The prediction of hospital length of stay using unstructured data

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jan Chrusciel ◽  
François Girardon ◽  
Lucien Roquette ◽  
David Laplanche ◽  
Antoine Duclos ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Traditional Approach ◽  
Secondary Analysis ◽  
Clinical Signs ◽  
Hospital Length ◽  
Structured Data ◽  
Unstructured Data ◽  
Hospital Length Of Stay ◽  
Postal Code ◽  
Exact Matching

Abstract Objective This study aimed to assess the performance improvement for machine learning-based hospital length of stay (LOS) predictions when clinical signs written in text are accounted for and compared to the traditional approach of solely considering structured information such as age, gender and major ICD diagnosis. Methods This study was an observational retrospective cohort study and analyzed patient stays admitted between 1 January to 24 September 2019. For each stay, a patient was admitted through the Emergency Department (ED) and stayed for more than two days in the subsequent service. LOS was predicted using two random forest models. The first included unstructured text extracted from electronic health records (EHRs). A word-embedding algorithm based on UMLS terminology with exact matching restricted to patient-centric affirmation sentences was used to assess the EHR data. The second model was primarily based on structured data in the form of diagnoses coded from the International Classification of Disease 10th Edition (ICD-10) and triage codes (CCMU/GEMSA classifications). Variables common to both models were: age, gender, zip/postal code, LOS in the ED, recent visit flag, assigned patient ward after the ED stay and short-term ED activity. Models were trained on 80% of data and performance was evaluated by accuracy on the remaining 20% test data. Results The model using unstructured data had a 75.0% accuracy compared to 74.1% for the model containing structured data. The two models produced a similar prediction in 86.6% of cases. In a secondary analysis restricted to intensive care patients, the accuracy of both models was also similar (76.3% vs 75.0%). Conclusions LOS prediction using unstructured data had similar accuracy to using structured data and can be considered of use to accurately model LOS.

Abstract P312: Sensitivity to Mental Illness and Life Enjoyment (smile) After Stroke

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Matthew Wu ◽  
Laura Solano ◽  
Christopher Degiorgio ◽  
Neal M Rao
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Length Of Stay ◽  
Statistical Significance ◽  
Health Resources ◽  
Hospital Length ◽  
County Hospital ◽  
Hospital Length Of Stay ◽  
Stroke Patients

Background: After experiencing a life changing stroke, survivors are often faced with a challenging journey back to wellness. This is particularly trying for those with depression and poor access to healthcare. In this study, we seek to assess the degree of depression and health-related quality of life (QOL) in first-time ischemic stroke patients compared to post-myocardial infarction (MI) patients in a county hospital system. Methods: Consecutive patients admitted for stroke and MI at a Los Angeles County Hospital were reviewed. Patients who meet the inclusion criteria and consented for participation were assessed for quality of life with EQ-5D-3L, depression with Patient Health Questionnaire 9 (PHQ-9) and knowledge of mental health resources. Stroke and MI severity were ranked and compared by hospital length of stay and day 90 mRS. Dichotomized variables were computed via t-test for parametric and Wilcoxon for nonparametric values. Multivariate analysis of non-parametric values was computed via Spearman correlation. Results: 61 stroke patients (mean age 59.7±13.4) and 52 MI patients (mean age 60.5±9.9) were included. Hospital length of stay did not significantly differ (mean 3.9 vs 2.5 days p=0.11). Day 90 mRS was significantly higher in the stroke group (mean 1.62 vs 0.96, p=0.004). PHQ-9 (mean 5.97 vs 6.85 p=0.13) and EQ-5D-3L (mean 7.4 vs 6.60 p=0.06) scores did not significantly differ. Among stroke patients (mean NIHSS 4.8 ±5.7), age correlated with day 90 mRS (r s =0.36 p<0.01). Initial NIHSS and stroke subtype did not correlate with either PHQ-9 or EQ-5D scores. Day 90 mRS correlated with PHQ-9 scores (r s =0.76 p<0.01, r s =0.65 p<0.01) and EQ-5D scores (r s =0.74 p<0.01, r s =0.78 p<0.01) in both groups. Only 6.5% of stroke and 15.1% of MI patients sought mental health resources. Conclusions: Stroke patients trended towards worse QOL scores, but lower depression scores than MI patients, though this did not reach statistical significance. Day 90 mRS correlated with worse QOL and depression scores in both groups. Despite high rates of depressive symptoms, very few patients had sought out mental health resources. This highlights the need to support mental health outreach, especially for vulnerable county patient populations.

scholarly journals Gambaran length of stay pada pasien stroke rawat inap di RSUP Prof. Dr. R. D. Kandou Manado periode Juli 2015-Juni 2016

e-CliniC ◽  
2016 ◽  
Vol 4 (2) ◽  
Author(s):  
Reunita C. Amiman ◽  
Melke J. Tumboimbela ◽  
Mieke A.H.N. Kembuan
Keyword(s):  
Cardiovascular Disease ◽  
Length Of Stay ◽  
Medical Records ◽  
Hemorrhagic Stroke ◽  
Treatment Process ◽  
Secondary Data ◽  
Stroke Patients ◽  
Stroke Length ◽  
Dm Type 2

Abstract: Stroke is a cardiovascular disease which is the second rank of worldwide disease leading to death. Hospitalization is a treatment process which including patient to stay at hospital and length of stay (LOS) is a calculated time periode when patient admitted until discharged. This studywas aimed to obtain the profile of hospitalized stroke patients’ LOS at Prof. Dr. R. D. Kandou Hospital Manado from July 2015 to Juni 2016. This was a descriptive retrospective study using secondary data of the medical records. Samples consisted of 293 patients.The results presented ischemic stroke in 58.02% with LOS 6.84 days and hemorrhagic stroke in 41.98% with LOS 10.84 days. Patients with the highest LOS were females with hemorrhagic stroke (11.04 days); age 45-54 years (9.47 days); hemorrhagic stroke with hypertension (11.26 days); hemorrhagic stroke without dyslipidemia (10.67 days); hemorrhagic stroke with DM type 2 (12.67 days); and hemorrhagic stroke with tuberculosis (23.50 days). Conclusion: In this study, hemorrhagic stroke patients had higher LOS.Keywords: stroke, length of stay. Abstrak: Stroke adalah penyakit kardiovaskular yang menempati peringkat kedua sebagai penyakit yang menyebabkan kematian di dunia. Pelayanan rawat inap merupakan proses perawatan pasien dengan menginap di rumah sakit dan length of stay (LOS) merupakan periode yang dihitung ketika pasien masuk hingga keluar dari rumah sakit. Penelitian ini bertujuan untuk mengetahui gambaran LOS pada pasien stroke rawat inap di RSUP Prof. Dr. R. D. Kandou Manado periode Juli 2015-Juni 2016. Jenis penelitian ialah deskriptif retrospektif dengan menggunakan data sekunder pasien stroke periode Juli 2015-Juni 2016 dari bagian rekam medik. Sampel penelitian berjumlah 293 pasien. Hasil penelitian menunjukkan persentase jumlah pasien stroke iskemik 58,02% dengan LOS 6,84 hari dan persentase jumlah pasien stroke hemoragik 41,98% dengan LOS 10,64 hari. Pasien stroke dengan LOS tertinggi terdapat pada jenis kelamin perempuan dengan stroke hemoragik, 11,04 hari; usia 45-54 tahun, 9,47 hari; stroke hemoragik dengan hipertensi, 11,26 hari; stroke hemoragik tanpa dislipidemia, 10,67 hari; stroke hemoragik dengan DM tipe 2, 12,67 hari; stroke dengan komplikasi, 9,33 hari; stroke hemoragik dengan pneumonia, 10,65 hari; dan stroke hemoragik dengan tuberculosis, 23,50 hari. Simpulan: Pasien stroke hemoragik memiliki LOS yang lebih tinggi.Kata kunci: stroke, lama rawat

scholarly journals 182. Missed Opportunities to Discontinue Unnecessary Vancomycin During Pharmacist Therapeutic Monitoring

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S98-S98
Author(s):  
Corey J Medler ◽  
Mary Whitney ◽  
Juan Galvan-Cruz ◽  
Ron Kendall ◽  
Rachel Kenney ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Adverse Drug Events ◽  
Academic Medical Center ◽  
Total Duration ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Therapeutic Monitoring ◽  
Resistant Bacteria ◽  
Therapeutic Drug ◽  
Missed Opportunities

Abstract Background Unnecessary and prolonged IV vancomycin exposure increases risk of adverse drug events, notably nephrotoxicity, which may result in prolonged hospital length of stay. The purpose of this study is to identify areas of improvement in antimicrobial stewardship for vancomycin appropriateness by clinical pharmacists at the time of therapeutic drug monitoring (TDM). Methods Retrospective, observational cohort study at an academic medical center and a community hospital. Inclusion: patient over 18 years, received at least three days of IV vancomycin where the clinical pharmacy TDM service assessed for appropriate continuation for hospital admission between June 19, 2019 and June 30, 2019. Exclusion: vancomycin prophylaxis or administered by routes other than IV. Primary outcome was to determine the frequency and clinical components of inappropriate vancomycin continuation at the time of TDM. Inappropriate vancomycin continuation was defined as cultures positive for methicillin-susceptible Staphylococcus aureus (MRSA), vancomycin-resistant bacteria, and non-purulent skin and soft tissue infection (SSTI) in the absence of vasopressors. Data was reported using descriptive statistics and measures of central tendency. Results 167 patients met inclusion criteria with 38.3% from the ICU. SSTIs were most common indication 39 (23.4%) cases, followed by pneumonia and blood with 34 (20.4%) cases each. At time of vancomycin TDM assessment, vancomycin continuation was appropriate 59.3% of the time. Mean of 4.22 ± 2.69 days of appropriate vancomycin use, 2.18 ± 2.47 days of inappropriate use, and total duration 5.42 ± 2.94. 16.4% patients developed an AKI. Majority of missed opportunities were attributed to non-purulent SSTI (28.2%) and missed MRSA nares swabs in 21% pneumonia cases (table 1). Conclusion Vancomycin is used extensively for empiric treatment of presumed infections. Appropriate de-escalation of vancomycin therapy is important to decrease the incidence of adverse effects, decreasing hospital length of stay, and reduce development of resistance. According to the mean duration of inappropriate therapy, there are opportunities for pharmacy and antibiotic stewardship involvement at the time of TDM to optimize patient care (table 1). Missed opportunities for vancomycin de-escalation Disclosures All Authors: No reported disclosures

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