scholarly journals Analysis of stroke treatment outcomes in hospital setting in Brazil, between the years 2010 and 2019.

2021 ◽  
Author(s):  
Giovanna Carvalho Sousa ◽  
Gustavo Bomfim Barreto ◽  
Lanna Victória Loula ◽  
Louise Seixas Lordêllo ◽  
Gustavo Sampaio Vilas-Boas ◽  
...  
Keyword(s):  
Information System ◽  
Mortality Rate ◽  
Hospital Stay ◽  
Average Length ◽  
Hospital Setting ◽  
Length Of Hospital Stay ◽  
Secondary Data ◽  
Stroke Treatment ◽  
The World ◽  
Treatment Mortality

Background: Stroke is an important cause of death and is a major cause of serious disability in Brazil and in the world. Therefore, it is fundamental to analyze its treatment in the hospital setting in Brazil. Objectives: To describe the progression of the stroke treatment in the hospital setting in Brazil between the years 2010 and 2019 and the outcomes associated to the disease. Design and Setting: Transversal, retrospective and quantitative study, with secondary data collected in the Hospital Information System of SUS (SIH / SUS) between 2010 and 2019, in Brazil. Methods: Data from number of hospitalizations for stroke treatment, mortality rate and average length of hospital stay were collected and analyzed. A comparison has been made between these data over the selected years. Results: The number of hospitalizations for stroke treatment had a 16,83% growth between 2010 and 2019. In comparison, the average length of hospital stay was 7,7 days in 2010 and 7,6 days in 2019. The mortality rate had a reduction of 10,52% between these years. Conclusions: Despite the growth of hospitalization to stroke treatment, there was a reduction in the average length of hospital stay and in the mortality rate associated to the procedure. It is possible to infer an optimization in the stroke lead in intensive care units in Brazil.

scholarly journals RELATIONSHIP BETWEEN ICU WAITING AND MORTALITY RATE IN PATIENTS UNDER MECHANICAL VENTILATION ADMITTED IN EMERGENCY ROOM

2020 ◽  
Author(s):  
Layanna Alves da Silva Andrade ◽  
Monica Lucia Soares Borges ◽  
Geovane Rossone Reis ◽  
Aktor Hugo Teixeira ◽  
Rebeca Oliveira Crispim da Silva ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Mortality Rate ◽  
Hospital Stay ◽  
Average Length ◽  
Total Mortality ◽  
Length Of Hospital Stay ◽  
Field Research ◽  
Average Hospital ◽  
Number Of Patients ◽  
Using Data

Background: The number of patients who remain on prolonged mechanical ventilatory assistance has recently increased. The average length of hospital stay intervenes directly with the number of beds essential for assistance to a given population and is weighted as an indicator of service efficiency. Objective: To investigate the average time in which patients on mechanical ventilation admitted to the emergency department of a hospital remain waiting for a place in the ICU. Materials and Methods: Quantitative field research, where data collection was performed using data from medical records, admission books, death books / outcome of hospitalized patients and in line with pre-established criteria under mechanical ventilation. Mechanical ventilation patients admitted to the ER and the ICU, over 18 years old, were recruited. Results: The research comprises a sample of 67 patients. The average hospital stay was 334 hours and 36 minutes. The general ratio was for every 03 patients who entered for treatment, 01 was discharged and 02 died. The total mortality rate of the sample was 68.65%. Conclusion: The length of stay in ER and ICU in patients on mechanical ventilation is related to the high mortality rate.

scholarly journals Inequality in Health: Correlation Between Poverty and Injury – A Comprehensive Analysis Based on Income Level in Taiwan: A Cross-sectional Study

2020 ◽  
Author(s):  
Yi-Chang Lin ◽  
Chi-Hsiang Chung ◽  
Lu Pai ◽  
Chien-Sung Tsai ◽  
Wu-Chien Chien ◽  
...  
Keyword(s):  
Health Insurance ◽  
Mortality Rate ◽  
Hospital Stay ◽  
National Health Insurance ◽  
Health Inequality ◽  
Low Income ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Income Group ◽  
Accident Injury

Abstract Background For better health promotion in Taiwan, it needs an action to reduce health inequality; therefore a comprehensive monitoring on social determinants and health is urgent. Is income the obstacle to influence the health after Taiwan instituted national health insurance in 1995? We compared the characteristics of accident injuries for patients classified with low-income and non-low-income who required inpatient care. Methods We collected accident injury inpatient cases from 1998 to 2015 from the Health and Welfare Data Science Center, Ministry of Health and Welfare and categorized the patients as low-income and non-low-income. Chi-square tests, Fisher exact tests, an independent samples t-test, and percentages were used to identify differences in demographics, cause for hospitalization, and other hospital care variables. Results Between 1998 and 2015, there were 74,337 low-income accident injury inpatients, which represented 1.6% of all injury event inpatients. The hospitalization mortality rate for the low-income group was 1.9 times higher than that of the non-low-income group. Further, the average length of hospital stay (9.9 days), average medical expenses (1,681 USD), and mortality rate (3.6%) for the low-income inpatients were higher than those of the non-low-income group (7.6 days, 1,573 USD, and 2.1%, respectively). Among the common injury causes, the percentage of injuries from “medical malpractice,” “fall,” “suicide,” and “homicide” were higher for the low-income group than that for the non-low-income group. Conclusions Despite National Health Insurance coverage, we found a higher hospitalization rate, longer average length of hospital stay, and a higher mortality rate in the low-income group. These findings support our hypothesis that there is a correlation between health and income level, resulting in health inequality. Achieving health care equality may require collaboration between the government and private and nonprofit organizations to increase awareness of this phenomenon.

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.

scholarly journals Detection of influenza virus in rectal swabs of patients admitted in hospital for febrile illnesses in Thailand

2021 ◽  
Vol 9 ◽  
pp. 205031212198963
Author(s):  
Artit Sangkakam ◽  
Pasin Hemachudha ◽  
Abhinbhen W Saraya ◽  
Benjamard Thaweethee-Sukjai ◽  
Thaniwan Cheun-Arom ◽  
...  
Keyword(s):  
Influenza Virus ◽  
Gastrointestinal Tract ◽  
Hospital Stay ◽  
Rectal Swab ◽  
Average Length ◽  
Gastrointestinal Symptoms ◽  
Virus Detection ◽  
Length Of Hospital Stay ◽  
Nasopharyngeal Swab ◽  
Influenza Virus Detection

Introduction: Influenza virus favours the respiratory tract as its primary site of host entry and replication, and it is transmitted mainly via respiratory secretions. Nasopharyngeal swab is the gold standard specimen type for influenza detection, but several studies have also suggested that the virus replicates in the human gastrointestinal tract. Methods: A retrospective study was conducted on all patients positive for influenza virus and initially recruited as part of the PREDICT project from 2017 to 2018. The objectives of the study were to investigate whether rectal swab could aid in improving influenza detection, and if there was any correlation between gastrointestinal disturbances and severity of infection, using length of hospital stay as an indicator of severity. Results: Of the 51 influenza-positive patients, 12 had detectable influenza virus in their rectal swab. Among these 12 rectal swab positive patients, influenza virus was not detected in the nasopharyngeal swab of three of them. Gastrointestinal symptoms were observed for 28.2% patients with a negative rectal swab negative and 25.0% patients with a positive rectal swab. Average length of hospital stay was 4.2 days for rectal swab positive group and 3.7 days for rectal swab negative group. This difference was not statistically significant (p = 0.288). Conclusions: There is no correlation between influenza virus detection in rectal swab and gastrointestinal disturbances or disease severity, and there is currently insufficient evidence to support replicative ability in the gastrointestinal tract.

scholarly journals Critical Pathway and Hospital-Hospital Cooperation in Acute Stroke Reduction of the Length of Hospital Stay

2000 ◽  
Vol 6 (1_suppl) ◽  
pp. 251-255 ◽  
Author(s):  
Y. Hashimoto ◽  
T. Terasaki ◽  
T. Yonehara ◽  
M. Tokunaga ◽  
T. Hirano ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Hospital Stay ◽  
Acute Stroke ◽  
Neurological Disease ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Stroke Patients ◽  
Critical Pathway ◽  
Hospital Days ◽  
Other Neurological Disease

Stroke patients tend to stay longer in one hospital compared to patients with other neurological disease. After the introduction of 3 types of critical pathway dedicated for various severity of acute ischemic stroke in 1995, the average length of in-hospital days declined from 30.0 days (1993) to 15.3 days (1998), ie 49% reduction. This reduction was achieved by the use of critical pathway and the hospital-hospital cooperation.

223 Procedural Safety of Stereotactic Laser Ablation (SLA) and Associated Hospital Stay: Outcome from the First Hundred Patient from LAANTERN Prospective Registry

Neurosurgery ◽  
2017 ◽  
Vol 64 (CN_suppl_1) ◽  
pp. 261-261
Author(s):  
Clark C Chen ◽  
Robert Rennert ◽  
Usman Khan ◽  
Stephen B Tatter ◽  
Melvin Field ◽  
...  
Keyword(s):  
Laser Ablation ◽  
Hospital Stay ◽  
Radiation Treatment ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Invasive Procedure ◽  
Patient Discharge ◽  
Target Lesion ◽  
Hospital Length ◽  
Hospital Length Of Stay

Abstract INTRODUCTION We examined the procedural safety and length of hospital stay for patients who underwent stereotactic laser ablation (SLA). METHODS Patients undergoing stereotactic laser ablation were prospectively enrolled in the Laser Ablation of Abnormal Neurological Tissue using Robotic Neuroblate System (LAANTERN) registry. Data from the first 100 enrolled patients are presented. RESULTS >The demographic of the patient cohort consisted of 58% females and 42% males. The mean age and KPS of the cohort were 51 (±17) years and 83 (±15), respectively. 87% of the SLA-treated patients had undergone prior surgical or radiation treatment. In terms of indications, 84% of the SLAs were performed as treatment for brain tumor and 16% were performed as treatment for epilepsy. In terms of the procedure, 79% of the SLA patients underwent treatment of a single lesion. In 72% of the SLA treated patients, >90% of the target lesion was ablated. The average procedural time was 188.2 minutes (range: 48–368 minutes). The average blood loss per procedure was 17.7 cc (range: 0–300cc). In terms of hospitalization, the average length of Intensive Care stay was 38.1 hours (range 0335). The number of hours post-procedure before patient discharge was 61.1 hours (range 6–612). 85% of the patients were discharged home. There were 15 adverse events at the one-month follow-up (12%), with two events definitively related to the procedure (2%), including one patient with post-operative intraventricular hemorrhage and another with post-procedural gait compromise. CONCLUSION SLA is a minimally invasive procedure with favorable profile in terms of safety and hospital length of stay.

scholarly journals Trends in the incidence and outcome of sepsis using data from a Japanese nationwide medical claims database-the Japan Sepsis Alliance (JaSA) study group-

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Taro Imaeda ◽  
Taka-aki Nakada ◽  
Nozomi Takahashi ◽  
Yasuo Yamao ◽  
Satoshi Nakagawa ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Hospital Mortality ◽  
Hospital Stay ◽  
Organ Dysfunction ◽  
Length Of Hospital Stay ◽  
Annual Incidence ◽  
Claim Database ◽  
Antibiotic Administration ◽  
Electronic Health Record Data ◽  
Acute Organ Dysfunction

Abstract Background Trends in the incidence and outcomes of sepsis using a Japanese nationwide database were investigated. Methods This was a retrospective cohort study. Adult patients, who had both presumed serious infections and acute organ dysfunction, between 2010 and 2017 were extracted using a combined method of administrative and electronic health record data from the Japanese nationwide medical claim database, which covered 71.5% of all acute care hospitals in 2017. Presumed serious infection was defined using blood culture test records and antibiotic administration. Acute organ dysfunction was defined using records of diagnosis according to the international statistical classification of diseases and related health problems, 10th revision, and records of organ support. The primary outcomes were the annual incidence of sepsis and death in sepsis per 1000 inpatients. The secondary outcomes were in-hospital mortality rate and length of hospital stay in patients with sepsis. Results The analyzed dataset included 50,490,128 adult inpatients admitted between 2010 and 2017. Of these, 2,043,073 (4.0%) patients had sepsis. During the 8-year period, the annual proportion of patients with sepsis across inpatients significantly increased (slope = + 0.30%/year, P < 0.0001), accounting for 4.9% of the total inpatients in 2017. The annual death rate of sepsis per 1000 inpatients significantly increased (slope = + 1.8/1000 inpatients year, P = 0.0001), accounting for 7.8 deaths per 1000 inpatients in 2017. The in-hospital mortality rate and median (interquartile range) length of hospital stay significantly decreased (P < 0.001) over the study period and were 18.3% and 27 (15–50) days in 2017, respectively. Conclusions The Japanese nationwide data indicate that the annual incidence of sepsis and death in inpatients with sepsis significantly increased; however, the annual mortality rates and length of hospital stay in patients with sepsis significantly decreased. The increasing incidence of sepsis and death in sepsis appear to be a significant and ongoing issue.

scholarly journals Consent for the discontinuation of life-prolonging treatment in cancer patients: a retrospective comparative analysis before and after the enforcement of the Life Extension Medical Decision law

2020 ◽  
Author(s):  
YuJin Chung ◽  
JinHo Beom ◽  
JiEun Lee ◽  
Incheol Park ◽  
Junho Cho
Keyword(s):  
Emergency Room ◽  
Hospital Stay ◽  
Cancer Patients ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Life Extension ◽  
Medical Decision ◽  
Patient Consent ◽  
Before And After ◽  
The Law

Abstract Background The Life Extension Medical Decision law enacted on February 4, 2018 in South Korea was the first to consider the suspension of nonsensical life-prolonging treatment, and its enactment raised big controversy in Korean society. However, there is no study on whether the actual life-prolonging treatment for patients has decreased after enforcing the law. This study aimed to compare the provision of patient consent before and after the enforcement of the law among cancer patients who visited a tertiary university hospital's emergency room to understand the effects of the law on cancer patients' clinical care. Methods This retrospective single cohort study included advanced cancer patients over 19 years of age who visited the emergency room at a tertiary university hospital. The two study periods were as follows: from February 2017 to January 2018 (before) and from May 2018 to April 2019 (after). The primary outcome was the average length of hospital stay. The consent rate for cardiopulmonary resuscitation (CPR), intubation, continuous renal replacement therapy (CRRT), and intensive care unit (ICU) admission were the secondary outcomes. Results The average length of hospital stay decreased after the law was enforced, from 4 days to 2 days (p= 0.001). The rates of direct transfers to secondary and nursing hospitals increased from 8.2% to 21.2% (p=0.001) and from 1.0% to 9.7%, respectively (p<0.001). The rate of provision of consent for admission to the ICU decreased from 6.7% to 2.3% (p=0.032). For CPR and CRRT, the rate of provision of consent decreased from 1.0% to 0.0% and from 13.9% to 8.8%, respectively, but the differences were not significant (p=0.226 and p=0.109, respectively). Conclusion According to previous research, for patients wishing only conservative treatment, the reduction in hospital stays at tertiary hospitals ultimately reduces the physical, emotional, financial burdens and also improves the quality of end-of-life at home or in a hospice facility. In this context, this research ultimately show that the purpose of the LEMD law has been achieved. Further research in several hospitals including those patients who completed the consent after hospitalization is needed to generalize the clinical implication of the LEMD law.

scholarly journals Prevalence and costs of hospitalizations for poisoning and accidental intoxication in Brazilian elderly

2013 ◽  
Vol 49 (4) ◽  
pp. 679-687
Author(s):  
Marcelle Silva de Abreu ◽  
Silvandro Diego de Albuquerque Ferreira ◽  
Larissa Pelágia de Lima Ferreira ◽  
José Ferreira Toneo Júnior ◽  
Wamberto Vieira Maciel ◽  
...  
Keyword(s):  
Hospital Admissions ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Secondary Data ◽  
Mortality Rates ◽  
Cross Sectional Study ◽  
Microsoft Excel ◽  
Cross Sectional ◽  
Alcohol And Drugs ◽  
Elderly Males

A cross-sectional study of secondary data/information obtained from the Hospital Information System (HIS) spanning the years 2008 - 2009 was performed. The distribution of the main hospital admissions by gender, age, color/race, region and federal unit of residence, average expenditure and average length of hospital stay, year of hospitalization and mortality rates (MR) were studied. The data collected were tabulated by TabNet and keyed into Microsoft Excel 2007. It was verified that elderly males (54.3%), from 60 to 69 years old (50.6%), nonwhites (36.3%) and residents of Southeast and North regions of the country had the highest rates of hospitalization. Seniors were hospitalized for an average of 4.8 days, and the major causes were exposure to alcohol (43.7%) and to drugs (33.9%). Expenses related to hospital admissions were, on average, R$ 529,817.70. The highest mortality rates were recorded among females (MR = 4.34), in elderly, 80 years or older (MR = 10.16) and Caucasians (MR = 3.95), where pharmacological substances with action on the Autonomic Nervous System were the leading cause of death. There are demographic differences in morbi-mortality of these elderly since, although men and younger elderly were the main victims, women and elderly of advanced age have greater mortality. The leading causes of hospitalization were alcohol and drugs.

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