scholarly journals Clinical presentation and hospitalisation duration of 201 coronavirus disease 2019 patients in Abuja, Nigeria

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Isaac O. Akerele ◽  
Adaeze C. Oreh ◽  
Mohammed B. Kawu ◽  
Abubakar Ahmadu ◽  
Josephine N. Okechukwu ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Alcohol Intake ◽  
Health Workers ◽  
Tertiary Education ◽  
Length Of Hospital Stay ◽  
Patient Characteristics ◽  
Symptom Presentation ◽  
Early Presentation ◽  
Daily Alcohol Intake ◽  
Treatment Centre

Background: Knowledge of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is unfolding. Insights from patient features in different environments are therefore vital to understanding the disease and improving outcomes.Aim: This study aimed to describe patient characteristics associated with symptomatic presentation and duration of hospitalisation in coronavirus disease 2019 (COVID-19) patients managed in Abuja.Setting: The study was conducted in Abuja, the Federal Capital Territory, Nigeria.Methods: This was a retrospective study of 201 COVID-19 patients hospitalised in the Asokoro District Hospital COVID-19 Isolation and Treatment Centre between April 2020 and July 2020. Demographic and clinical data were obtained and outcomes assessed were symptom presentation and duration of hospitalisation.Results: Patients’ median age was 39.3 years (interquartile range [IQR]: 26–52); 65.7% were male and 33.8% were health workers. Up to 49.2% of the patients were overweight or obese, 68.2% had mild COVID-19 at presentation and the most common symptoms were cough (38.3%) and fever (33.8%). Hypertension (22.9%) and diabetes mellitus (7.5%) were the most common comorbidities. The median duration of hospitalisation was 14.4 days (IQR: 9.5–19). Individuals with secondary and tertiary education had higher percentage symptoms presentation (8.5% and 34%, respectively), whilst a history of daily alcohol intake increased the length of hospital stay by 129.0%.Conclusion: Higher educational levels were linked with symptom presentation in COVID-19 patients and that daily alcohol intake was significantly associated with longer hospital stay. These findings highlight the importance of public education on COVID-19 for symptom recognition, early presentation and improved outcomes.

scholarly journals Understanding variation in length of hospital stay for COPD exacerbation: European COPD audit

2016 ◽  
Vol 2 (1) ◽  
pp. 00034-2015 ◽  
Author(s):  
Mamta Ruparel ◽  
Jose Luis López-Campos ◽  
Ady Castro-Acosta ◽  
Sylvia Hartl ◽  
Francisco Pozo-Rodriguez ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Patient Characteristics ◽  
Clinical Severity ◽  
Chronic Obstructive ◽  
Cluster Effect ◽  
Obstructive Pulmonary Disease ◽  
Targeted Interventions ◽  
Hospitalised Patients ◽  
Patients At Risk

Chronic obstructive pulmonary disease (COPD) care across Europe has high heterogeneity with respect to cost and the services available. Variations in length of stay (LOS) may be attributed to patient characteristics, resource and organisational characteristics, and/or the so-called hospital cluster effect.The European COPD Audit in 13 countries included data from 16 018 hospitalised patients. The recorded variables included information on patient and disease characteristics, and resources available. Variables associated with LOS were evaluated by a multivariate, multilevel analysis.Mean±sd LOS was 8.7±8.3 days (median 7 days, interquartile range 4–11 days). Crude variability between countries was reduced after accounting for clinical factors and the clustering effect. The main factors associated with LOS being longer than the median were related to disease or exacerbation severity, including GOLD class IV (OR 1.77) and use of mechanical ventilation (OR 2.15). Few individual resource variables were associated with LOS after accounting for the hospital cluster effect.This study emphasises the importance of the patients' clinical severity at presentation in predicting LOS. Identifying patients at risk of a long hospital stay at admission and providing targeted interventions offers the potential to reduce LOS for these individuals. The complex interactions between factors and systems were more important that any single resource or organisational factor in determining differences in LOS between hospitals or countries.

scholarly journals Assessment of Computed Tomography-Defined Muscle and Adipose Tissue Features in Relation to Length of Hospital Stay and Recurrence of Hypertriglyceridemic Pancreatitis

2021 ◽  
Author(s):  
Huajun Yu ◽  
Yingbao Huang ◽  
Lifang Chen ◽  
Liuzhi Shi ◽  
Yunjun Yang ◽  
...  
Keyword(s):  
Body Composition ◽  
Hospital Stay ◽  
Subcutaneous Fat ◽  
Density Lipoprotein ◽  
Length Of Hospital Stay ◽  
Patient Characteristics ◽  
The Body ◽  
Hazard Ratios ◽  
Morphometric Assessment ◽  
The Relationship

Abstract Background: Analytic morphometric assessment has recently been proposed to be applied to the study of acute pancreatitis (AP). However, the relationship between body composition and the outcomes of hypertriglyceridemic pancreatitis (HTGP) is still unclear. The aim of this study was to evaluate body composition in relation to the length of hospital stay (LOS) and recurrence of HTGP.Methods: Patient characteristics, admission examination data, body composition parameters, LOS, and recurrence within 1 year were collected from the institutional pancreatitis database and follow-up records. Logistic regression analysis was used to identify risk factors for LOS and recurrence of HTGP.Results: Of the 196 included patients, 158 (80.6%) were men and 53 (27.0%) were sarcopenic. The average LOS was 15.83±10.02 days. The recurrence rate of HTGP was 36.7%. Multivariate analysis with multiple linear regression suggested that subcutaneous fat area (SFA) (p=0.019) and high-density lipoprotein-cholesterol (HDL-C) (p=0.001) were independently associated with the LOS for HTGP after adjusting for age and sex. The multivariate adjusted hazard ratios for SFA and HDL-C, with respect to the relationship between body parameters and LOS, were 1.008 (95% confidence interval [CI], 1.001–1.015) and 0.090 (95% CI, 0.022–0.361), respectively. No significant differences were observed between the AP and recurrent AP (RAP) groups in terms of characteristics, admission examination data, and body composition parameters.Conclusion: SFA and HDL-C are associated with LOS in patients with HTGP. The body composition of patients at the first symptom onset of HTGP cannot predict recurrence.

scholarly journals Laparoscopic Versusopen Appendectomy - Which One Is Better?

2019 ◽  
Vol 17 (1) ◽  
pp. 7-13
Author(s):  
Md Atiar Rahman ◽  
Md Shahadot Hossain Sheikh ◽  
Md Ibrahim Siddique ◽  
Md Shahidul Islam ◽  
AKM Ahsan Ullah ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Operative Time ◽  
Operative Procedure ◽  
Open Appendectomy ◽  
Length Of Hospital Stay ◽  
Laparoscopic Group ◽  
Patient Characteristics ◽  
Laparoscopic Technique ◽  
Analgesia Requirement ◽  
Initial Procedure

Objective: Appendectomy, being the most common surgical procedure performed in general surgery, is still being performed by both open and laparoscopic methods due to a lack of consensus as to which is the most appropriate method. Because further trials are necessary and few such studies have been performed in developing countries, we decided to evaluate the outcomes of the 2 procedures to share our experience with others. Methods: Prospectively collected data from 618 consecutive patients with appendicitis were studied. These comprised of 340 patients who underwent conventional open appendectomy and 260 patients treated laparoscoplcally&18 were excluded because of protocol violations. The two groups were compared with respect to operative time, length of hospital stay, postoperative pain, return to normal work, complication rate and cost. Results: There were no statistical differences regarding patient characteristics between the two groups. Conversion to laparotomy was necessary in 5 patients (1.88%). Laparoscopic appendectomy was associated with a shorter hospital stay (1.5 d vs 2.5 d), lower incidence of wound infection (3.07% vs 8.29%,) &less analgesia requirement. The operative time was more (45.6 vs 24.5 min) and the cost of treatment was higher in the laparoscopic group. Conclusion: The laparoscopic technique is a safe and clinically beneficial operative procedure. It provides certain advantages over open appendectomy, ·including short hospital stay, decreased requirement .of postoperative analgesia, early food tolerance, and earlier return to normal activities, Where feasible, laparoscopy should be undertaken as the initial procedure of choice for most cases of appendicitis. Journal of Surgical Sciences (2013) Vol. 17 (1) : 7-13

scholarly journals Clinical and functional patient characteristics predict medical needs in older patients at risk of functional decline

2020 ◽  
Author(s):  
Anne-Carina Scharf ◽  
Janine Gronewold ◽  
Christian Dahlmann ◽  
Jeanina Schlitzer ◽  
Andreas Kribben ◽  
...  
Keyword(s):  
At Risk ◽  
Hospital Stay ◽  
Older Patients ◽  
Functional Decline ◽  
Length Of Hospital Stay ◽  
Patient Characteristics ◽  
Clinical Patient ◽  
Medical Needs ◽  
Patients At Risk ◽  
Cognition Impairment

Abstract Background: The rising number of older multimorbid in-patients has implications for medical care. There is a growing need for the identification of factors predicting the needs of older patients in hospital environments. Our aim was to evaluate the use of clinical and functional patient characteristics for the prediction of medical needs in older hospitalized patients. Methods: 242 in-patients (57.4% male) aged 78.4±6.4 years, who were consecutively admitted to internal medicine departments of the University Hospital Essen between July 2015 and February 2017, were prospectively enrolled. Patients were assessed upon admission using the Identification of Seniors at Risk (ISAR) screening followed by comprehensive geriatric assessment (CGA). The CGA included standardized instruments for the assessment of activities of daily living (ADL), cognition, mobility, and signs of depression upon admission. In multivariable regressions we evaluated the association of clinical patient characteristics, the ISAR score and CGA results with length of hospital stay, number of nursing hours and receiving physiotherapy as indicators for medical needs. We identified clinical characteristics and risk factors associated with higher medical needs. Results: The 242 patients spent [median(Q1;Q3)]:9.0(4.0;16.0) days in the hospital, needed 2.0(1.5;2.7) hours of nursing each day, and 34.3% received physiotherapy. In multivariable regression analyses including clinical patient characteristics, ISAR and CGA domains, the factors age (β=-0.19, 95% confidence interval (CI)=-0.66;-0.13), number of admission diagnoses (β=0.28, 95%CI=0.16;0.41), ADL impairment (B=6.66, 95%CI=3.312;10.01), and signs of depression (B=6.69, 95%CI=1.43;11.94) independently predicted length of hospital stay. ADL impairment (B=1.14, 95%CI=0.67;1.61), cognition impairment (B=0.57, 95%CI=0.07;1.07) and ISAR score (β =0.26, 95%CI=0.01;0.28) independently predicted nursing hours. The number of admission diagnoses (risk ratio (RR)=1.06, 95%CI=1.04;1.08), ADL impairment (RR=3.54, 95%CI=2.29;5.47), cognition impairment (RR=1.77, 95%CI=1.20;2.62) and signs of depression (RR=1.99, 95%CI=1.39;2.85) predicted receiving physiotherapy. Conclusion: Among older in-patients at risk for functional decline, the number of comorbidities, reduced ADL, cognition impairment and signs of depression are important predictors of length of hospital stay, nursing hours, and receiving physiotherapy during hospital stay.

scholarly journals Clinical and functional patient characteristics predict medical needs in older patients at risk of functional decline

2019 ◽  
Author(s):  
Anne-Carina Scharf ◽  
Janine Gronewold ◽  
Christian Dahlmann ◽  
Jeanina Schlitzer ◽  
Andreas Kribben ◽  
...  
Keyword(s):  
At Risk ◽  
Hospital Stay ◽  
Older Patients ◽  
Functional Decline ◽  
Length Of Hospital Stay ◽  
Patient Characteristics ◽  
Clinical Patient ◽  
Medical Needs ◽  
Patients At Risk ◽  
Cognition Impairment

Abstract Background : The rising number of older multimorbid in-patients has implications for medical care. There is a growing need for the identification of factors predicting the needs of older patients in hospital environments. Our aim was to evaluate the use of clinical and functional patient characteristics for the prediction of medical needs in older hospitalized patients. Methods : 242 in-patients (57.4% male) aged 78.4±6.4 years, who were consecutively admitted to internal medicine departments of the University Hospital Essen between July 2015 and February 2017, were prospectively enrolled. Patients were assessed upon admission using Identification of Seniors at Risk (ISAR) screening followed by comprehensive geriatric assessment (CGA). CGA included standardized instruments for the assessment of activities of daily living (ADL), cognition, mobility, and signs of depression upon admission. In multivariable regressions we evaluated the association of clinical patient characteristics, ISAR score and CGA results with length of hospital stay and number of nursing hours and receiving physiotherapy as indicators for medical needs. We identified clinical characteristics and risk factors associated with higher medical needs. Results: The 242 patients spent [median(Q1;Q3)]:9.0(4.0;16.0) days in the hospital, needed 2.0(1.5;2.7) hours of nursing each day, and 34.3% received physiotherapy. In multivariable regression analyses including clinical patient characteristics, ISAR and CGA domains, the factors age (β=-0.19, 95% confidence interval (CI)=-0.66;-0.13), number of admission diagnoses (β=0.28, 95%CI=0.16;0.41), ADL impairment (B=6.66, 95%CI=3.312;10.01), signs of depression (B=6.69, 95%CI=1.43;11.94) independently predicted length of hospital stay. ADL impairment (B=1.14, 95%CI=0.67;1.61) cognition impairment (B=0.57, 95%CI=0.07;1.07) and ISAR score (β =0.26, 95%CI=0.01;0.28) independently predicted nursing hours. The number of admission diagnoses (risk ratio (RR)=1.06, 95%CI=1.04;1.08), ADL impairment (RR=3.54, 95%CI=2.29;5.47), cognition impairment (RR=1.77, 95%CI=1.20;2.62) and signs of depression (RR=1.99, 95%CI=1.39;2.85) predicted receiving physiotherapy. Conclusion : Among older in-patients at risk for functional decline, the number of comorbidities, reduced ADL, cognition impairment and signs of depression are important predictors of length of hospital stay, nursing hours, and receiving physiotherapy during hospital stay.

scholarly journals Les Amputations Majeures Des Membres A L’hopital General De Reference Nationale De N’djamena, Tchad

2016 ◽  
Vol 12 (12) ◽  
pp. 270
Author(s):  
Choua Ouchemi ◽  
Touré Abdoul ◽  
Mbainguinam Dionadji ◽  
Mahamat Albichari Ahmat Chaib ◽  
Ahmat Malgnan Okim ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Road Traffic ◽  
Length Of Hospital Stay ◽  
Major Amputation ◽  
Early Presentation ◽  
Average Hospital ◽  
Prosthetic Devices ◽  
Tertiary Teaching ◽  
Limb Injuries ◽  
Study Population

The aim of this study was to describ major limb amputations in a tertiary teaching hospital in N’Djaména, Chad. Patients and Method We realized a both retrospective and prospective study from 01/08/2013 to 31/07/2015 in the General Surgery ward and Orthopedics and Traumatology ward of the National Reference General Hospital of N'Djamena, Chad. Data were collected from patient records, operating theater records and equipment center. Studied parameters: age, sex, indication and level of amputation, length of hospital stay, prosthetic devices and mortality. Results The study population included 155 patients divided into 118 men (70.1%) and 37 women (29.9%), a sex ratio of 2.3. The average age was 43.1 years. Severe limb injuries by road traffic crushes were the first major amputation indication in 74 cases (47.6%), followed by complications of diabetic ulcers in 33 cases (21.4%) and arterial occlusive disease in 21 cases (13.6%). The pelvic and thoracic limbs were affected respectively in 130 cases (84.9%) and 25 cases (16.1%). The levels of amputations were: the leg in 78 cases (50.3%), the thigh in 50 cases (32.3%) and the forearm in 9 cases (5.8%). The average hospital stay was 16 days. We noted wound suppuration in 28.4% of cases and psychiatric events in 4.6%. Mortality was 15.6%. Only 35 patients (22.6%) received a prosthetic device after amputation. Conclusion: road traffic trauma with irreversible vascular damage is the leading indication of major limb amputations in our setting. Complications of diabetic foot are increasing indication. Mostly, traditional bonesetters practiced on the patients before reaching to hospital care. The amputees face great prosthetic difficulties. Major limb amputations are preventable by education, early presentation and management of common indications.

scholarly journals Coinfection in SARS-CoV-2 Infected Children Patients

2021 ◽  
Vol 15 (06) ◽  
pp. 761-765
Author(s):  
Ayşe Karaaslan ◽  
Ceren Çetin ◽  
Yasemin Akın ◽  
Serap Demir Tekol ◽  
Elif Söbü ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Clinical Symptoms ◽  
Tertiary Education ◽  
Length Of Hospital Stay ◽  
The Other ◽  
Respiratory Pathogens ◽  
Rt Pcr ◽  
Laboratory Confirmation ◽  
Polymerase Chain ◽  
Coinfected Patient

Introduction: The aim of this study is to determine the coinfections with other respiratory pathogens in SARS-CoV-2 infected children patients in a pediatric unit in Istanbul. Methodology: This retrospective descriptive study was conducted in a 1000-bedded tertiary education and research hospital in Istanbul. All children hospitalized with the diagnosis of SARS-CoV-2 infection had been investigated for respiratory agents in nasopharyngeal secretions. Laboratory confirmation of SARS-CoV-2 and the other respiratory pathogens were performed using reverse transcriptase-polymerase chain reaction (RT-PCR). Results: A total of 209 hospitalized children with suspected SARS-CoV-2 infection between March 2020-May 2020 were enrolled in this study. Among 209 children, 93 (44.5%) were RT-PCR positive for SARS-CoV-2 infection, and 116 (55.5%) were RT-PCR negative. The most common clinical symptoms in all children with SARS-CoV-2 infection were fever (68.8%) and cough (57.0%). The other clinical symptoms in decreasing rates were headache (10.8%), myalgia (5.4%), sore throat (3.2%), shortness of breath (3.2%), diarrhea (2.2%) and abdominal pain in one child. In 7 (7.5%) patients with SARS-CoV-2 infection, coinfection was detected. Two were with rhinovirus/enterovirus, two were with Coronavirus NL63, one was with adenovirus, and one was with Mycoplasma pneumoniae. In one patient, two additional respiratory agents (rhinovirus/enterovirus and adenovirus) were detected. There was a significantly longer hospital stay in patients with coinfection (p = 0.028). Conclusions: Although the coinfection rate was low in SARS-CoV-2 infected patients in our study, we found coinfection as a risk factor for length of hospital stay in the coinfected patient group.

Pilonidal Sinus: How to Choose Between Excision and Open Granulation Versus Excision and Primary Closure?

Swiss Surgery ◽  
2002 ◽  
Vol 8 (6) ◽  
pp. 255-258 ◽  
Author(s):  
Perruchoud ◽  
Vuilleumier ◽  
Givel
Keyword(s):  
Hospital Stay ◽  
Pilonidal Sinus ◽  
Primary Closure ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Healing Time ◽  
Incision And Drainage ◽  
The Mean ◽  
Primary Healing

Aims: The purpose of this study was to evaluate excision and open granulation versus excision and primary closure as treatments for pilonidal sinus. Subjects and methods: We evaluated a group of 141 patients operated on for a pilonidal sinus between 1991 and 1995. Ninety patients were treated by excision and open granulation, 34 patients by excision and primary closure and 17 patients by incision and drainage, as a unique treatment of an infected pilonidal sinus. Results: The first group, receiving treatment of excision and open granulation, experienced the following outcomes: average length of hospital stay, four days; average healing time; 72 days; average number of post-operative ambulatory visits, 40; average off-work delay, 38 days; and average follow-up time, 43 months. There were five recurrences (6%) in this group during the follow-up period. For the second group treated by excision and primary closure, the corresponding outcome measurements were as follows: average length of hospital stay, four days; average healing time, 23 days; primary healing failure rate, 9%; average number of post-operative ambulatory visits, 6; average off-work delay, 21 days. The average follow-up time was 34 months, and two recurrences (6%) were observed during the follow-up period. In the third group, seventeen patients benefited from an incision and drainage as unique treatment. The mean follow-up was 37 months. Five recurrences (29%) were noticed, requiring a new operation in all the cases. Discussion and conclusion: This series of 141 patients is too limited to permit final conclusions to be drawn concerning significant advantages of one form of treatment compared to the other. Nevertheless, primary closure offers the advantages of quicker healing time, fewer post-operative visits and shorter time off work. When a primary closure can be carried out, it should be routinely considered for socio-economical and comfort reasons.

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