The Use of Determinants of Length of Stay in the Post-anesthesia Care Unit (PACU) at the Philippine General Hospital among Postoperative Patients who Underwent Elective Surgeries to Create a Predictive Model for PACU Length of Stay

Background. The aims of this study were to determine the average length of stay in the Post-anesthesia CareUnit (PACU LOS) in the Philippine General Hospital (PGH) and to create a model that will predict the PACU LOSbased on the factors that significantly affect the LOS. Determination and prediction of PACU LOS is essential inresource utilization, and in cost containment and reduction. Addressing the modifiable variables that affect thePACU LOS may lead to an improvement in the LOS of patients in the PACU and, consequently, to better recoveryroom staffing and a reduced cost for the patients and the hospital. Methods. A prospective chart review of 400 postoperative patients admitted in the PGH PACU was done. Summarystatistics were presented. Using the set of variables found to be significant, a regression model was formulatedto estimate the PACU LOS. Results. The mean PACU LOS was 4.59 hours. There were significant differences in the mean PACU LOS basedon the occurrence of complications. There were also significant differences in the median PACU LOS based onthe type and duration of surgery, anesthetic technique, and duration of anesthesia. The multiple linear regressionmodel that best predicted PACU LOS included ASA-PS classification, type of surgery, duration of surgery, anesthetictechnique, and occurrence of intraoperative or postoperative complications. Conclusions. The mean PACU LOS of the Philippine Genera Hospital is higher than that of published data. Thefactors included in the model that best predicts PACU LOS may be studied to improve the PACU LOS.

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Weekend new patient reviews in psychiatry: evaluation of activity over 3 months

BJPsych Bulletin ◽

10.1192/pb.bp.117.056291 ◽

2017 ◽

Vol 41 (6) ◽

pp. 337-340

Author(s):

Michael Rutherford ◽

Mark Potter

Keyword(s):

Mental Health ◽

Length Of Stay ◽

Average Length ◽

Clinical Implications ◽

Out Of Hours ◽

Feasible Method ◽

Average Length Of Stay ◽

South West ◽

Before And After ◽

The Mean

Aims and methodSouth West London and St George's Mental Health NHS Trust developed a system of weekend new patient reviews by higher trainees to provide senior medical input 7 days a week. To evaluate the effectiveness of these reviews, the notes for all patients admitted over 3 months were examined. The mean length of stay for patients before and after the introduction of the weekend new patient reviews were compared via unpaired t-test.ResultsA total of 88 patients were seen: 84.4% of patients were seen within 24 h of admission. Higher trainees instituted some changes in 78.9% of patients. The most frequent action was to modify medication, in 47.8%. The average length of stay after the introduction of weekend reviews was not significantly different.Clinical implicationsWeekend reviews of newly admitted patients by higher trainees is a feasible method for providing senior input to patients admitted out of hours.

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MULTIDRUG-RESISTANT ACINETOBACTER BAUMANNII (MDRAB) PREVALENCE AND CHARACTERISTICS IN DR.WAHIDIN SUDIROHUSODO GENERAL HOSPITAL OF MAKASSAR

INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY ◽

10.24293/ijcpml.v25i2.1363 ◽

2019 ◽

Vol 25 (2) ◽

pp. 211

Author(s):

Dewi Tungadi ◽

Nurhayana Sennang ◽

Benny Rusli

Keyword(s):

Length Of Stay ◽

Acinetobacter Baumannii ◽

General Hospital ◽

Average Length ◽

Polymyxin B ◽

Multidrug Resistant ◽

Infection Prevention And Control ◽

Average Length Of Stay ◽

Improve Hospital ◽

And Control

BackgroundMultidrug-resistant Acinetobacter baumannii (MDRAB) is a strain of Acinetobacter baumannii which is resistant to three or more classes of antibiotics. As prevalence of MDRAB increases, the antibiotics of choice become limited. Identification of MDRAB is required to manage and control infection.MethodThis was a retrospective study, conducted in Dr. Wahidin Sudirohusodo General Hospital of Makassar, dated from January to December 2016. Bacterial identification and antimicrobial susceptibility testing (AST) were performed using VITEK 2. The patient data were obtained from electronic medical records.Results and DiscussionA total of 323 Acinetobacter baumannii isolates were obtained, consisted of 188 isolates in January-June 2016 and 36 of which was MDRAB (19.15%) with the average length-of-stay 33 days; and 135 isolates in July-December 2016 and 31 of which was MDRAB (22.96%) with the average length-of-stay 27 days. MDRAB was mostly discovered from patients using 3 or more medical devices and on single antibiotic therapy. MDRAB isolates were mostly obtained in sputum and pus specimens, and majority of patients had respiratory diseases. The result of AST showed 100% and 96% susceptibility to Polymyxin B; 71.43% and 54.84% susceptibility to Amikacin; 66.67% and 50% susceptibility to Trimethoprim/Sulfamethoxazole in January-June and July-December 2016, respectively.Conclusion and SuggestionsThe prevalence of MDRAB in our hospital in 2016 was high, suggesting the needs to improve hospital infection prevention and control. Polymyxin B, Amikacin, and Trimethoprim/Sulfamethoxazole are the antibiotics of choice to treat MDRAB.

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Contribution of the BioFire® FilmArray® Meningitis/Encephalitis Panel:

Kansas Journal of Medicine ◽

10.17161/kjm.v12i1.11695 ◽

2019 ◽

Vol 12 (1) ◽

pp. 1-3 ◽

Cited By ~ 7

Author(s):

Kyle Dack ◽

Stephanie Pankow ◽

Elizabeth Ablah ◽

Rosey Zackula ◽

Maha Assi

Keyword(s):

Length Of Stay ◽

Average Length ◽

Medical Center ◽

Antiviral Treatment ◽

Length Of Hospital Stay ◽

Average Length Of Stay ◽

Regional Medical ◽

Regional Medical Center ◽

The Mean ◽

Hospital Stay Duration

Introduction. Traditional evaluation of meningitis includes cerebrospinalfluid (CSF) culture and gram stain to pinpoint specific causalorganisms. The BioFire® FilmArray® Meningitis/Encephalitis (ME)Panel has been implemented as a more timely evaluation method.This study sought to assess if the BioFire® ME Panel was associatedwith a decreased length of stay or decreased antimicrobial durationwhen used in the diagnosis of meningitis or encephalitis.Methods.xA case, historical-control, chart review was performed onpatients admitted to a regional medical center with CSF pleocytosisduring Cohort 1 (the year prior to BioFire® ME Panel implementation)and Cohort 2 (the year after BioFire® ME Panel implementation).Length of hospital stay, duration of antimicrobials, and BioFire® MEPanel result were gathered and analyzed.Results. Average length of stay for both cohorts was about fourhospital days. Approximately three-fourths of all patients receivedantibiotic/antiviral treatment with an average of three days duration.No significant differences were observed between groups. The mean(median) duration of antimicrobials in the year prior to and afterthe BioFire® ME Panel implementation was 3.6 (3) and 3.1 (2) days,respectively (p = 0.835). The mean (median) length of stay in the yearprior to and after the BioFire® ME Panel implementation was 5.8 (4)and 5.4 (4) days, respectively (p = 0.941). Among the patients admittedafter the implementation of the BioFire® ME Panel, 4.3 % (n =2) had a positive bacterial result, 38.3% (n = 18) had a positive viralresult, and 57.4% (n = 27) had a negative result. Of the 27 negativeresults, 77.8% (n = 21) were treated with antimicrobial medication.Conclusions. This study suggested there is no difference betweenlength of stay or antimicrobial duration in presumed meningitis casesassessed with traditional methods as compared to the BioFire® MEPanel. Kans J Med 2019;12(1):1-3.

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HUBUNGAN STATUS GIZI DENGAN LAMA HARI RAWAT INAP PASIEN ANAK DIARE AKUT

Berkala Kedokteran ◽

10.20527/jbk.v12i2.1862 ◽

2016 ◽

Vol 12 (2) ◽

pp. 143

Author(s):

Muhammad Rizal Amin ◽

Edi Hartoyo ◽

Donna Marisa

Keyword(s):

Length Of Stay ◽

Nutritional Status ◽

General Hospital ◽

Pediatric Patient ◽

Acute Diarrhea ◽

Average Length ◽

Cross Sectional ◽

Purposive Sampling ◽

Average Length Of Stay ◽

Poor Nutritional Status

Abstract: Good nutritional status can reduce the risk of diarrhea, while children with less or poor nutritional status enables more frequent and more susceptible to diarrhea. The worse the nutrition of a children, the frequency of diarrhea increases. This situation may have a relationship with length of stay. Length of stay of childhood diarrhea is influenced by the child's physical condition (good nutritional status, less, or worse). The purpose of this study is analyzing the relationship between nutritional status and length of stay of pediatric patient on acute diarrhea in Ulin General Hospital Banjarmasin 2014. This study was done by observational analytic with cross sectional approach. Total of 50 samples were obtained by purposive sampling; 2 patients with excess nutritional status, 37 patients with good nutritional status, 8 patients with less nutritional status, and 3 patients with poor nutritional status. Data was analyzed using the Kruskal-Wallis test with a confidence level of 95% showed that the average length of stay in each nutritional status have no significant value difference (p=0,193). It was concluded that there is no relationship between nutritional status and length of stay of pediatric patient on acute diarrhea in Ulin General Hospital Banjarmasin 2014. Keywords: nutritional status, length of stay, acute diarrhea Abstrak: Status gizi anak yang baik dapat mengurangi risiko terkena penyakit diare, sedangkan anak dengan status gizi kurang atau buruk memungkinkan lebih sering dan lebih mudah terkena diare. Makin buruk gizi seorang anak, ternyata frekuensi diare semakin banyak. Keadaan ini mungkin memiliki hubungan dengan lama hari rawat inap. Hari rawat diare anak salah satunya dipengaruhi oleh kondisi fisik anak (status gizi baik, kurang, atau buruk). Tujuan penelitian ini adalah untuk menganalisis hubungan antara status gizi dengan lama hari rawat inap pasien anak diare akut di RSUD Ulin Banjarmasin tahun 2014. Penelitian ini bersifat observasional analitik dengan pendekatan cross sectional. Sebanyak 50 sampel didapat secara purposive sampling sesuai kriteria inklusi, 2 pasien status gizi lebih, 37 pasien status gizi baik, 8 pasien status gizi kurang, dan 3 pasien status gizi buruk. Analisis data menggunakan uji Kruskal Wallis dengan tingkat kepercayaan 95% menunjukkan bahwa rerata lama hari rawat inap di setiap status gizi tidak memiliki perbedaan nilai yang bermakna (p=0,193). Hal ini berarti bahwa tidak terdapat hubungan antara status gizi dengan lama hari rawat inap pasien anak diare akut di RSUD Ulin Banjarmasin Tahun 2014. Kata-kata kunci: status gizi, lama hari rawat inap, diare akut

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Associations between gender and outcome of acute psychiatric admission, looking specifically at length of stay and type of admission

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.1843 ◽

2017 ◽

Vol 41 (S1) ◽

pp. s901-s901

Author(s):

J. Beezhold ◽

U. Farooq ◽

J. Isaac ◽

A. Shepherd

Keyword(s):

Length Of Stay ◽

Gender Bias ◽

Legal Status ◽

Average Length ◽

Psychiatric Inpatient ◽

Published Data ◽

Psychiatric Admission ◽

Average Length Of Stay ◽

Significant Difference ◽

Competing Interest

IntroductionThere is little published data regarding the association between gender and outcomes in acute inpatient psychiatry. We present outcomes from a study of 5601 acute psychiatric admissions.ObjectiveThe objective of this study was to identify associations between gender and outcome of acute psychiatric admission, looking specifically at length of stay and at whether they were detained in hospital.MethodsThe relationship between gender and acute psychiatric inpatient length of stay and detention status was analyzed for all admissions over 90 months from Sept 2002 to Feb 2010. There were 5601 consecutive admissions included in this study, 2862 of which were male and 2739 were female. There were no exclusions. Data was complete for more than 99% of subjects, and was extracted from part of routine service data on an anonymous- basis. The subjects were admitted into two acute inpatient wards in central Norfolk. Data was analyzed using SPSS. Ethics consent was granted by the research ethics committee.ResultsThe study showed no significant difference in average length of stay (female = 32.98, male = 32.11; P = 0.595). Additionally, no significant difference was found linking gender to detention status (26% female, 25% male; P = 0.517) as opposed to informal or voluntary admission.ConclusionThe study found no evidence of a gender bias regarding overall length of stay and legal status in acute admissions. Further research should be conducted in this area to examine whether there is any gender bias in outcomes relating to diagnosis.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Identifying the Characteristics of Patients With Cervical Degenerative Disease for Surgical Treatment From 17-Year Real-World Data: Retrospective Study

JMIR Medical Informatics ◽

10.2196/16076 ◽

2020 ◽

Vol 8 (4) ◽

pp. e16076 ◽

Cited By ~ 1

Author(s):

Si Zheng ◽

Yun Xia Wu ◽

Jia Yang Wang ◽

Yan Li ◽

Zhong Jun Liu ◽

...

Keyword(s):

Surgical Treatment ◽

Length Of Stay ◽

Real World ◽

Average Length ◽

Real World Data ◽

Female Patients ◽

Average Length Of Stay ◽

Age At Surgery ◽

The Mean ◽

Cervical Degenerative Disease

Background Real-world data (RWD) play important roles in evaluating treatment effectiveness in clinical research. In recent decades, with the development of more accurate diagnoses and better treatment options, inpatient surgery for cervical degenerative disease (CDD) has become increasingly more common, yet little is known about the variations in patient demographic characteristics associated with surgical treatment. Objective This study aimed to identify the characteristics of surgical patients with CDD using RWD collected from electronic medical records. Methods This study included 20,288 inpatient surgeries registered from January 1, 2000, to December 31, 2016, among patients aged 18 years or older, and demographic data (eg, age, sex, admission time, surgery type, treatment, discharge diagnosis, and discharge time) were collected at baseline. Regression modeling and time series analysis were conducted to analyze the trend in each variable (total number of inpatient surgeries, mean age at surgery, sex, and average length of stay). A P value <.01 was considered statistically significant. The RWD in this study were collected from the Orthopedic Department at Peking University Third Hospital, and the study was approved by the institutional review board. Results Over the last 17 years, the number of inpatient surgeries increased annually by an average of 11.13%, with some fluctuations. In total, 76.4% (15,496/20,288) of the surgeries were performed in patients with CDD aged 41 to 65 years, and there was no significant change in the mean age at surgery. More male patients were observed, and the proportions of male and female patients who underwent surgery were 64.7% (13,126/20,288) and 35.3% (7162/20,288), respectively. However, interestingly, the proportion of surgeries performed among female patients showed an increasing trend (P<.001), leading to a narrowing sex gap. The average length of stay for surgical treatment decreased from 21 days to 6 days and showed a steady decline from 2012 onward. Conclusions The RWD showed its capability in supporting clinical research. The mean age at surgery for CDD was consistent in the real-world population, the proportion of female patients increased, and the average length of stay decreased over time. These results may be valuable to guide resource allocation for the early prevention and diagnosis, as well as surgical treatment of CDD.

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Discharge destination of patients from a psychogeriatric unit

European Psychiatry ◽

10.1016/s0924-9338(11)72550-0 ◽

2011 ◽

Vol 26 (S2) ◽

pp. 845-845

Author(s):

M. Ochuko-Emore

Keyword(s):

Mental Illness ◽

Length Of Stay ◽

Average Length ◽

Discharge Destination ◽

Average Length Of Stay ◽

The Mean ◽

Time Of Admission ◽

At Home

ObjectivesTo determine the discharge destination of patients admitted to a psychogeriatric unit.MethodsRecords of all patients discharged from an in-patient psychogeriatric unit between 1st July 2009 and 30th June 2010 were examined. The diagnosis, residence at admission, length of stay and discharge destination were recorded.ResultsThere were ninety-four discharges over the study period. Four of the patients were admitted and discharged twice. The mean age was 76.7 years (range 65–95 years). 52.1% (n = 49) were diagnosed with dementia and 47.9% (n = 45) with functional mental illness. The average length of stay was 67.4 days for dementia compare to 74.2 days for functional mental illness. 17.1% (n = 6/32) of patients with dementia and 84.2% (n = 32/38) of patients with functional mental illness resident at home at the time of admission were discharged home.ConclusionThis finding suggests that patients with functional mental illness are more likely to be discharge back to their homes compared with patients with dementia.

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Impact of vaccination in reducing Hospital expenses, Mortality and Average length of stay among COVID 19 patients. A retrospective cohort study from India

10.1101/2021.06.18.21258798 ◽

2021 ◽

Author(s):

Madhumathi Ramakrishnan ◽

Prakash Subbarayan

Keyword(s):

Cohort Study ◽

Relative Risk ◽

Length Of Stay ◽

Retrospective Cohort ◽

Relative Risk Reduction ◽

Average Length ◽

Total Hospital ◽

Average Length Of Stay ◽

The Mean ◽

Hospital Expenses

Background & Aim: WHO listed vaccine hesitancy among the top 10 global threats to health and there are very few reports highlighting vaccine benefits against COVID-19. The aim of this study was to study the impact of vaccination on reducing the average length of stay (ALOS), intensive care unit (ICU) requirement, mortality and cost of the treatment among COVID-19 patients. Methods: In this retrospective cohort study all the patients above 45 years who underwent treatment for COVID-19 were included. The data of patients treated pan India during the period March & April 2021 with the diagnosis of COVID-19, under health insurance cover, were extracted to study parameters like the ALOS, mortality, ICU requirement, total hospital expenses incurred and the vaccination status. Results: Among 3820 patients with COVID-19, 3301 (86.4%) were unvaccinated while 519 (13.6%) were vaccinated. Among the unvaccinated the mean (s.d) ALOS was 7 days. Fourteen days after second dose of vaccination this was significantly less (p=0.01) at 4.9. The mean total hospital expense among the unvaccinated was Rs. 277850. Fourteen days after second dose of vaccination this was further less (p=0.001) at Rs. 217850. Among the unvaccinated population 291/3301 (8.8%) required ICU and this was significantly less (p=0.03) at 31/519 (6%) among the vaccinated. Among those who received two doses of vaccination it was further less at 1/33 (3%). The mortality among unvaccinated patients was 16/3301 (0.5%) while there was no mortality among the vaccinated. Among those who received two doses of vaccination there was a 66% relative risk reduction in ICU stay and 81% relative risk reduction in mortality. Conclusions: There was a significant reduction in ALOS, ICU requirement, mortality & treatment cost in patients who had completed two doses of vaccination. These findings may be used in motivating public and promoting vaccination drive.

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Colonization and Infection With MRSA and CRKP and Its Result in an Increased Mortality Rate Within the Intensive Care and High-Dependency Units in Barbados

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.703 ◽

2020 ◽

Vol 41 (S1) ◽

pp. s173-s174

Author(s):

Keisha Gustave

Keyword(s):

Intensive Care ◽

Length Of Stay ◽

High Mortality ◽

Average Length ◽

Cohort Analysis ◽

Health Concern ◽

Queen Elizabeth Hospital ◽

Surveillance Program ◽

Average Length Of Stay ◽

High Dependency

Background: Methicillin-resistant Staphylococcus aureus(MRSA) and carbapenem-resistant Klebsiella pneumoniae (CRKP) are a growing public health concern in Barbados. Intensive care and critically ill patients are at a higher risk for MRSA and CRKP colonization and infection. MRSA and CRKP colonization and infection are associated with a high mortality and morbidly rate in the intensive care units (ICUs) and high-dependency units (HDUs). There is no concrete evidence in the literature regarding MRSA and CRKP colonization and infection in Barbados or the Caribbean. Objectives: We investigated the prevalence of MRSA and CRKP colonization and infection in the patients of the ICU and HDU units at the Queen Elizabeth Hospital from 2013 to 2017. Methods: We conducted a retrospective cohort analysis of patients admitted to the MICU, SICU, and HDU from January 2013 through December 2017. Data were collected as part of the surveillance program instituted by the IPC department. Admissions and weekly swabs for rectal, nasal, groin, and axilla were performed to screen for colonization with MRSA and CRKP. Follow-up was performed for positive cultures from sterile isolates, indicating infection. Positive MRSA and CRKP colonization or infection were identified, and patient notes were collected. Our exclusion criteria included patients with a of stay of <48 hours and patients with MRSA or CRKP before admission. Results: Of 3,641 of persons admitted 2,801 cases fit the study criteria. Overall, 161 (5.3%) were colonized or infected with MRSA alone, 215 (7.67%) were colonized or infected with CRKP alone, and 15 (0.53%) were colonized or infected with both MRSA and CRKP. In addition, 10 (66.6%) of patients colonized or infected with MRSA and CRKP died. Average length of stay of patients who died was 50 days. Conclusions: The results of this study demonstrate that MRSA and CRKP cocolonization and coinfection is associated with high mortality in patients within the ICU and HDU units. Patients admitted to the ICU and HDU with an average length of stay of 50 days are at a higher risk for cocolonization and coinfection with MRSA and CRKP. Stronger IPC measures must be implemented to reduce the spread and occurrence of MRSA and CRKP.Funding: NoneDisclosures: None

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Temporal Changes in Central-Line–Associated Bloodstream Infection Time Between Events, 2017–2018 Versus 2015–2016

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.1051 ◽

2020 ◽

Vol 41 (S1) ◽

pp. s403-s404

Author(s):

Jonathan Edwards ◽

Katherine Allen-Bridson ◽

Daniel Pollock

Keyword(s):

Length Of Stay ◽

Patient Care ◽

Average Length ◽

Bloodstream Infections ◽

Central Line ◽

Significant Shift ◽

Care Hospital ◽

Average Length Of Stay ◽

Period 2 ◽

Hospital Bed

Background: The CDC NHSN surveillance coverage includes central-line–associated bloodstream infections (CLABSIs) in acute-care hospital intensive care units (ICUs) and select patient-care wards across all 50 states. This surveillance enables the use of CLABSI data to measure time between events (TBE) as a potential metric to complement traditional incidence measures such as the standardized infection ratio and prevention progress. Methods: The TBEs were calculated using 37,705 CLABSI events reported to the NHSN during 2015–2018 from medical, medical-surgical, and surgical ICUs as well as patient-care wards. The CLABSI TBE data were combined into 2 separate pairs of consecutive years of data for comparison, namely, 2015–2016 (period 1) and 2017–2018 (period 2). To reduce the length bias, CLABSI TBEs were truncated for period 2 at the maximum for period 1; thereby, 1,292 CLABSI events were excluded. The medians of the CLABSI TBE distributions were compared over the 2 periods for each patient care location. Quantile regression models stratified by location were used to account for factors independently associated with CLABSI TBE, such as hospital bed size and average length of stay, and were used to measure the adjusted shift in median CLABSI TBE. Results: The unadjusted median CLABSI TBE shifted significantly from period 1 to period 2 for the patient care locations studied. The shift ranged from 20 to 75.5 days, all with 95% CIs ranging from 10.2 to 32.8, respectively, and P < .0001 (Fig. 1). Accounting for independent associations of CLABSI TBE with hospital bed size and average length of stay, the adjusted shift in median CLABSI TBE remained significant for each patient care location that was reduced by ∼15% (Table 1). Conclusions: Differences in the unadjusted median CLABSI TBE between period 1 and period 2 for all patient care locations demonstrate the feasibility of using TBE for setting benchmarks and tracking prevention progress. Furthermore, after adjusting for hospital bed size and average length of stay, a significant shift in the median CLABSI TBE persisted among all patient care locations, indicating that differences in patient populations alone likely do not account for differences in TBE. These findings regarding CLABSI TBEs warrant further exploration of potential shifts at additional quantiles, which would provide additional evidence that TBE is a metric that can be used for setting benchmarks and can serve as a signal of CLABSI prevention progress.Funding: NoneDisclosures: None

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