A Descriptive Study of Length of Stay at an Intensive Care Unit

ABSTRACT Background and aims As intensive care units (ICUs) are very resource intensive, length of stay (LOS) is of prime importance. This study was done to analyze the LOS in different ICUs and analyze it against a set benchmark. Materials and methods This retrospective study was conducted from April to June 2013 on patients admitted during January to March 2013 in the neurosurgery ICU (NICU), medical ICU (MICU), high dependency unit (HDU) and isolation ICU of a large multispecialty hospital in Pune (India). As per the quality manual of the hospital, benchmark LOS was considered as 3.08 days for ICU. Mean and median LOS was analyzed through Student's t and Chi-square test; proportion of short (<2 days) and long stay (>4 days) patients was also computed. Results Out of 835 patients admitted to the NICU, MICU, HDU and Isolation ICU, the overall mean LOS was 3.37 ± 5.54 days which was statistically significant at a p-value <0.001 (t = 17.58, 95% CI 3-3.75). The overall mean LOS was higher than the benchmarked 3.08 days but still within the optimal range of 2 to 4 days. Mean LOS was statistically significant when tested for department-wise variations with a Chi-value of 173.56 (p-value < 0.001, LR = 113.75). Highest mean LOS was observed for isolation ICU and lowest for MICU. 360 (43.1%) were short stay, 141(16.8%) were long stay and remaining were optimal stay patients. Conclusion The mean LOS for the ICUs varied significantly across the type of ICUs which needs to be continuously monitored. Mean LOS variation across ICU type indicates need for separate benchmarks. How to cite this article Shukla K, Chandrashekhar P, Kumar N, Devade PK. A Descriptive Study of Length of Stay at an Intensive Care Unit. Int J Res Foundation Hosp Healthc Adm 2015;3(1):29-32.

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HUBUNGAN ANTARA LAMA RAWAT DENGAN TINGKAT KECEMASAN KELUARGA PASIEN DI RUANG INTENSIVE CARE UNIT RSUD DR SOEKARDJO KOTA TASIKMALAYA

JURNAL KEPERAWATAN MUHAMMADIYAH BENGKULU ◽

10.36085/jkmu.v7i1.308 ◽

2019 ◽

Vol 7 (1) ◽

pp. 33-38

Author(s):

Ida Rosidawati ◽

Siti Hodijah

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Length Of Stay ◽

Research Result ◽

P Value ◽

Chi Square ◽

Cross Sectional ◽

The Family ◽

Chi Square Test ◽

Chi Square Analysis

Intensive Care Unit (ICU) is a unit care of critical patients with mood in fast. The activity in an ICU is always busy and limited time visit, which find the family difficult to communicate with patient,while critically ill patients are usually treated for a long time, this can trigger families to experienced anxiety. The purpose of this research is to determine the relationship between length of stay and the level of anxiety family patients who being treated in dr. Soekardjo Tasikmalaya Hospital. This method of this research is used quantitative correlative with cross sectional approach. The sample of this research is family of patients who were waiting in the ICU room as many as 16 persons by using accidental sampling for two weeks. The data collected by using HARS scale and Chi Square analysis. The research result showed that patients with new length of stay (mean = 3.81) as many as 7 people, families of patients not experiencing anxiety as many as 5 people (71%) and families who experienced anxiety as many as 2 people (29%). While patients with long duration of care (≥ mean = 3.81) as many as 9 people, the patient's family all experienced anxiety (100%). Chi-square test result showed p-value of 0.005 α 0.05. The conclusion of the results of this study is that there is a relationship between length of stay with the level of anxiety of the patient's family, so it is recommended that the nurse or other medical team always coordinate with the family regarding the actions taken to the patient.Keywords: Intensive Care Unit (ICU), Long Care, Anxiety, Family Patients

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1412. The utility of respiratory viral panel testing for nosocomial fever in the neonatal intensive care unit

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.1594 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S713-S713

Author(s):

Carlo Fopiano Palacios ◽

Eric Lemmon ◽

James Campbell

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Linear Regression ◽

Length Of Stay ◽

Neonatal Intensive Care Unit ◽

Neonatal Intensive Care ◽

P Value ◽

Fisher Exact Test ◽

The Mean ◽

Pcr Test

Abstract Background Patients in the neonatal intensive care unit (NICU) often develop fevers during their inpatient stay. Many neonates are empirically started on antibiotics due to their fragile clinical status. We sought to evaluate whether the respiratory viral panel (RVP) PCR test is associated with use of antibiotics in patients who develop a fever in the NICU. Methods We conducted a retrospective chart review on patients admitted to the Level 4 NICU of the University of Maryland Medical Center from November 2015 to June 2018. We included all neonates who developed a fever 48 hours into their admission. We collected demographic information and data on length of stay, fever work-up and diagnostics (including labs, cultures, RVP), and antibiotic use. Descriptive statistics, Fisher exact test, linear regression, and Welch’s ANOVA were performed. Results Among 347 fever episodes, the mean age of neonates was 72.8 ± 21.6 days, and 45.2% were female. Out of 30 total RVP samples analyzed, 2 were positive (6.7%). The most common causes of fever were post-procedural (5.7%), pneumonia (4.8%), urinary tract infection (3.5%), meningitis (2.6%), bacteremia (2.3%), or due to a viral infection (2.0%). Antibiotics were started in 208 patients (60%), while 61 neonates (17.6%) were already on antibiotics. The mean length of antibiotics was 7.5 ± 0.5 days. Neonates were more likely to get started on antibiotics if they had a negative RVP compared to those without a negative RVP (89% vs. 11%, p-value < 0.0001). Patients with a positive RVP had a decreased length of stay compared to those without a positive RVP (30.3 ± 8.7 vs. 96.8 ± 71.3, p-value 0.01). On multivariate linear regression, a positive RVP was not associated with length of stay. Conclusion Neonates with a negative respiratory viral PCR test were more likely to be started on antibiotics for fevers. Respiratory viral PCR testing can be used as a tool to promote antibiotic stewardship in the NICU. Disclosures All Authors: No reported disclosures

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Effect of ondansetron on spinal induced hypotension in caesarean deliveries

Journal of Kathmandu Medical College ◽

10.3126/jkmc.v8i4.32384 ◽

2020 ◽

Vol 8 (4) ◽

pp. 193-199

Author(s):

Pujan Balla ◽

Anil Shrestha ◽

Ninadini Shrestha ◽

Navindra Bista ◽

Moda Nath Marhatta

Keyword(s):

Spinal Anesthesia ◽

Elective Caesarean Section ◽

P Value ◽

Chi Square ◽

Induced Hypotension ◽

Intergroup Comparison ◽

Chi Square Test ◽

The Mean ◽

Student’S T ◽

Student’S T Test

Background: Spinal anesthesia is the preferred technique of anesthesia employed for caesarean sections. However, it is very often complicated by hypotension. Different drugs and techniques have been used to prevent the hypotension induced by spinal anesthesia. In this study, the effect of ondansetron on the prevention of hypotension after spinal anesthesia was evaluated. Objectives: To determine the effect of prophylactic ondansetron on prevention of spinal induced hypotension in elective caesarean section. Methodology: Eighty-six parturients planned for elective caesarean deliveries were randomized into two groups of 43 each. Group O received Ondansetron 4 mg (4 ml) and Group S received Normal Saline (4 ml) intravenously 10 minutes prior to spinal anesthesia. Blood pressure, heart rate, phenylephrine requirements, occurrence of nausea and vomiting and APGAR scores of neonates were compared between the groups. Hemodynamic data was analyzed using Student’s t-test for intergroup comparison and ANOVA was used for intragroup comparison. Categorical data was analyzed using Pearson Chi-Square test. For all determinants, p-value <0.05 was considered significant. Results: Occurrence of hypotension in Group O (20.9 %) was significantly lower than in Group S (72.1%) (p < 0.05). The mean arterial pressure was significantly higher in Group O at 2, 6, 8, 12 and 14 minutes (p < 0.05). The use of phenylephrine (37.21 mcg vs. 146.51 mcg, p < 0.05) and occurrence of nausea (11.6%, vs. 41.9% p < 0.002) was significantly lower in ondansetron group. Conclusion: Ondansetron is effective in preventing spinal induced hypotension in elective caesarean sections.

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Antibiotic Surveillance in the Pediatric Intensive Care Unit (PICU) at Sanglah Hospital Denpasar in the Year of 2015-2017

The Open Microbiology Journal ◽

10.2174/1874285801913010146 ◽

2019 ◽

Vol 13 (1) ◽

pp. 146-153

Author(s):

Dyah Kanya Wati ◽

I Wayan Gustawan ◽

Ni Nengah Dwi Fatmawati ◽

I Ketut Tunas ◽

Putu Andrie Setiawan

Keyword(s):

Intensive Care Unit ◽

Multivariate Analysis ◽

Intensive Care ◽

Length Of Stay ◽

Pediatric Intensive Care Unit ◽

Antibiotic Sensitivity ◽

Pediatric Intensive Care ◽

Antibiotic Use ◽

Chi Square ◽

Chi Square Test

Background: Antibiotic surveillance in hospital settings is mandatory for optimal antibiotic therapy for the patient. Only a small number of studies have focused on antibiotic surveillance in hospitalized newborns, infants, and children. Objectives: The goal was to evaluate antibiotic use in our Pediatric Intensive Care Unit (PICU) and evaluate it for a possible association with the length of PICU stay. Methods: A retrospective, observational, cohort study was conducted from January 2015 to April 2017, involving subjects who were hospitalized in the PICU at Sanglah Hospital. The inclusion criteria were children aged between 1-month-12-years old, who had a blood culture and antibiotic sensitivity test result in their medical record. The exclusion criteria were incomplete medical records, blood cultures showing 2 types of bacteria at the same time (gram-positive and negative), or contaminated blood results. Factors associated with mortality were analyzed using a Chi-square test, with p < 0.05 considered to be statistically significant and the Risk Ratio (RR) of the associated factors was determined by 95% CI. Results: Multivariate analysis showed that the significant predictors of PICU length of stay were the appropriate continuation of antibiotics (RR 1.19; 95% CI 1.043 to 1.373; P = 0.047). There were also significant results for antibiotic compatibility and length of stay (RR 3.6; 95% CI 0.869 to 15.428; P = 0.049). Conclusion: Appropriate continuation of antibiotics and the compatibility of continuation antibiotics were significant predictors of length of PICU stay based on multivariate analysis.

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Fishery regulamentation or ethnoknowledge? The dilemma of the management of the mapará fisheries on the lower Tocantins river in northern Brazil

Research Society and Development ◽

10.33448/rsd-v10i11.18963 ◽

2021 ◽

Vol 10 (11) ◽

pp. e131101118963

Author(s):

Esther Mirian Cardoso ◽

Paulo Allison Costa da Mata ◽

Matheus dos Santos Souza ◽

Maria Clara Pinheiro de Souza ◽

Victoria Isaac

Keyword(s):

Socioeconomic Development ◽

Economic Importance ◽

Chi Square ◽

Great Economic Importance ◽

Chi Square Test ◽

Northern Brazil ◽

The Mean ◽

Tocantins River ◽

Student’S T ◽

Student’S T Test

The fishery of mapará (Hypophthalmus marginatus) is of great economic importance in the Amazon region. Despite this, it is observed that the current norms of management disagree with the ethnoknowledge of fishermen of the Tocantins river. Therefore, there are many seizures and fines in the Tocantins Low region. This work appeared as a demand of the fishermen of the region and had as purpose to test the pertinence of the fishing legislation on the capture of the species and to provide subsidies for the adaptation of the norms to the local reality. For this, a mapará fishery was taken on the Pindobal Grande river, in the municipality of Igarapé-Miri, in the state of Pará. A sample of the captured individuals was collected, and identification, sexing and biometry were done. Fishing was described, and the sex ratio tested with the Chi-Square test and the mean length differences between the sexes with the Student's t-test. The results were compared with current legislation and literature data. The captured mapará individuals were mostly above 30 cm, as determined by legislation. It is concluded that, despite using a network that is prohibited, the capture of the species in the region acts selectively, due to the ethno-cognition and the fisherman's action ("taleiro"). Therefore, it is necessary that the legislation be revised, seeking the reconciliation between the conservation of ecosystems, the traditional knowledge and the socioeconomic development of the region.

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INCIDENCE AND FACTORS RELATED TO THE APPEARANCE OF PRESSURE INJURIES IN AN INTENSIVE CARE UNIT

ESTIMA Brazilian Journal of Enterostomal Therapy ◽

10.30886/estima.v19.1014_in ◽

2021 ◽

Author(s):

Jacqueline Marques Rodrigues ◽

Kemily Covre Gregório ◽

Ursula Marcondes Westin ◽

Danielle Garbuio

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Tertiary Hospital ◽

Chi Square ◽

Average Hospital ◽

Significance Level ◽

Sacral Region ◽

Adult Intensive Care Unit ◽

Pressure Injury ◽

Student’S T

Objectives: identify the incidence and characterize pressure injuries in an adult intensive care unit regarding the occurrence, locations and risk factors, and verify whether there is an association between these and the appearance of the injuries. Method: observational, cohort, prospective study, developed in an intensive care unit of a tertiary hospital, from October to December 2019. The population consists of adults on the first day of admission to the unit, without pressure injury at admission. Participants were monitored during hospitalization, sociodemographic and clinical variables, and risk assessment of developing a pressure injury, skin assessment and Braden scale were collected daily. Pearson’s chi-square tests and student’s t-test were used to assessing the relationship between variables and injuries. For the analyzes, a significance level (α) of 5% was considered. Results: 40 participants were included, 20% had pressure injuries with a predominance of stages 1 and 2; the main affected sites were the sacral region followed by the calcaneus. The average hospital stay was 23.38 days for the injured group and 5.77 days for the non-injured group; time showed a significant relationship with the appearance of lesions (p = 0.002). Conclusion: it was concluded that the most affected site was the sacral region and grade 1 was the most frequent staging; length of stay was the variable that influenced the appearance of injuries.

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The pattern of admission and outcome of neonates managed in the neonatal intensive care unit in a Sudanese hospital

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20211068 ◽

2021 ◽

Vol 8 (4) ◽

pp. 616

Author(s):

Safaa A. M. Ahmed ◽

Mohammed A. O. Ali ◽

Esraa A. A. Mahgoub ◽

Mohammed Nimir ◽

Elfatih M. Malik

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Birth Weight ◽

Neonatal Intensive Care Unit ◽

Medical Records ◽

Neonatal Intensive Care ◽

Binary Logistic Regression ◽

Neonatal Morbidity ◽

Chi Square ◽

Chi Square Test

Background: This study aimed to assess the admission pattern and outcome of neonates managed in the neonatal intensive care unit (NICU) in a Sudanese hospital.Methods: This hospital-based retrospective study was conducted in the NICU of Saad Abu Elella Teaching Hospital in Khartoum, Sudan. Data was collected from medical records of 207 neonates using an extraction form. Chi-square test and binary logistic regression were used in analysis.Results: Most of the neonates were term, and 43% of them had a birth weight less than 2.5 kg. Moreover, the most common morbidities among them were sepsis, respiratory distress syndrome, neonatal jaundice and asphyxia, and the mortality rate was 15%. Additionally, the birth weight, gestational age, the need for resuscitations, direct breast feeding and being beside mother were found to be significantly associated with the studied outcome.Conclusions: Majority of causes of neonatal morbidity and mortality in our study were preventable diseases. Therefore, interventions to improve services in the NICU are highly needed to improve the outcomes.

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(P2-94) How One Group of Physicians Helped a Busy Emergency Department

Prehospital and Disaster Medicine ◽

10.1017/s1049023x11005395 ◽

2011 ◽

Vol 26 (S1) ◽

pp. s167-s167

Author(s):

J. Hu ◽

J. Xu ◽

J. Botler ◽

S. Haydar

Keyword(s):

Intensive Care Unit ◽

Emergency Department ◽

Intensive Care ◽

Length Of Stay ◽

Medical Center ◽

Hospital Medicine ◽

Intermediate Care ◽

Physician Time ◽

The Mean ◽

Medical Telemetry

A pilot admission leadership physician (ALP) program was experimented within a 693-bed, tertiary medical center with a 60-bed emergency department. This trial was intended to investigate whether having a physician triage potential patients would shorten patients' length-of-stay in the emergency department. After a emergency physician evaluated patients, ALP triaged them. The ALP ordered the appropriate bed for the patients if they qualified for the inpatient criteria, choosing among medical, medical telemetry, cardiac telemetry, intermediate care, or intensive care bed. The mean patient door-to-bed order time (time between patients reaching the emergency department to time to bed ordered by ALP) is 330.7 minutes (n = 234, SD = 151.68, 95% CI = 310.21–351.28) with ALP involvement. Compared with the mean door-to-bed order time of 337.8 minutes (n = 827, SD = 149.71, 95%CI = 326.98–348.57) without ALP, ALP shortened the waiting time by 7.09 minutes. During the same period, the door-to-physician time was 41.38 minutes (SD = 38.87 95%CI = 36.38–46.39), compared with 39.52 minutes (SD = 40.32, 95%CI = 36.77–42.27) before ALP. The time for patients waiting in the emergency department for other services such as surgery, psychiatry, and pediatrics also have decreased accordingly. Incorrect medical admissions such as scrambling to get the patient to the intensive care unit right after seeing patients has decreased (data not provided). Identifying physicians as physicians in the emergency department who triage potential admissions also has improved efficiencies within the hospital medicine group and bonding with ER physicians.

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The assessment of clinical evaluation and treatment results of high-energy blunt polytrauma patients

Medicina ◽

10.3390/medicina43020017 ◽

2007 ◽

Vol 43 (2) ◽

pp. 137 ◽

Cited By ~ 2

Author(s):

Algimantas Pamerneckas ◽

Andrei Pijadin ◽

Giedrius Pilipavičius ◽

Gintaras Tamulaitis ◽

Vytautas Toliušis ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Length Of Stay ◽

Hospital Stay ◽

Injury Severity ◽

Motor Vehicle ◽

High Energy ◽

Ventilation Time ◽

Polytrauma Patients ◽

The Mean

The aim of this study was to evaluate the mechanism of high-energy blunt trauma, age and gender of patients, severity of regional and multiple injury, ventilation time, length of stay in intensive care unit and in-hospital stay, in-hospital complications, and treatment outcome. Materials and methods. Data on 159 patients with severe multiple injuries, meeting inclusion criteria, were collected prospectively and evaluated retrospectively. Results. The mean age of multiple trauma patients was 43.9±1.4 years; males were injured 2.5 times more often than females (P<0.001). More than half (66.7%) of patients were 17–64-year-old males. Majority (83%) of all patients were injured in motor vehicle crashes, and 52.2% of these patients were pedestrians. The mean Injury Severity Score was 29.5±0.8, and severe (Abbreviated Injury Scale score of 3 and more) injuries of extremities, head, and chest made up 69.1% of all injuries. The mean ventilation time, mean length of stay in intensive care unit, and mean in-hospital stay were 5.5±0.7, 7.0±0.8, and 23.6±1.6 days, respectively. Acute lung complications were the most common (25.2%). Systemic inflammatory response syndrome developed in 7.5% of patients, and sepsis in 3.8% of patients. More than one-fifth (20.8%) of polytrauma patients died. Conclusions. Working-age male pedestrians (17–64 years old) made up two-thirds of all polytrauma patients. Severe injuries of extremities, head, and chest were present in 69.1% of all cases. Lung complications were the most common.

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Effect of maternal underweight on fetal outcome

Biomedicine ◽

10.51248/.v39i3.174 ◽

2020 ◽

Vol 39 (3) ◽

pp. 480-483

Author(s):

Monteiro Geraldin ◽

N Anupama ◽

Rekha D. Kini ◽

Nayanatara A. K. ◽

Sneha Shetty ◽

...

Keyword(s):

Body Mass Index ◽

Intensive Care Unit ◽

Intensive Care ◽

Weight Gain ◽

Body Mass ◽

Neonatal Intensive Care ◽

Fetal Outcome ◽

Chi Square ◽

Chi Square Test ◽

Nicu Admission

Introduction and Aim: Nutritional state of the mother before and during pregnancy is one of the important determinants along with factors like pre-pregnancy BMI, weight gain during pregnancy and gestational age which determines pregnancy outcome. Adequate gestational weight gain contributes for better pregnancy outcomes in both mother and infants for short- and long-term health. Materials and Methods: This is an observational study conducted retrospectively over a year comprised 300 pregnant subjects in their second trimester. Incidence of anemia, preterm labour, intrauterine growth retardation (IUGR) and neonatal intensive care unit (NICU) admission were compared in women with various Body Mass index (BMI). Analysis of the data was done using SPSS version 13 using chi square test and p ? 0.05 was considered statistically significant. Results: Out of 300 subjects, 79 developed anemia, among these 64(81%) were in the underweight category. 49 cases had a preterm delivery, out of these 49 cases, about 37(75.5%) belonged to the underweight BMI category. 39 cases delivered an intra-uterine growth retarded baby. Out of these 39 cases, about 25 (64.1%) belonged to the underweight BMI category. 56 neonates required intensive care unit (NICU) admission, of which 41 (73.2%) neonates born for underweight BMI mothers. Conclusion: The high proportions of underweight pregnancies in this study reflects the poor nutritional status. Adverse effects of maternal low body mass index target the fetus. Adequate weight gain of pregnant woman is an extremely important factor for the fetal outcome.

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