Comparison of Statistical Models of Predict the Factors Affecting the Length of Stay (LOS) in the Intensive Care Unit (ICU) of a Teaching Hospital

Neonatal intensive care is associated with high costs world-wide and remains a matter of financial stress for families. This is an issue of great importance in a developing country like ours as financial burden may have a negative impact in the overall outcome of a newborn. The objective of this study was to evaluate the direct cost of treating newborns by family members in a neonatal intensive care unit (NICU). This was a prospective cross sectional study carried out in the NICU of Manipal Teaching Hospital, Pokhara, Nepal. There were 96 neonates included in this study over a period of 3 months from September to November 2020. The average cost per neonate per day was NRs. 5858 (USD 50). The highest health expenditure was incurred in neonates of gestational age of 32 to less than 37 weeks, and it was also significantly higher in neonates having birth weights less than 1.5kg. Preterms with hyaline membrane disease, followed by newborns with meconium aspiration syndrome resulted in maximum health costs. Maximum expenditure of the total bill was due to the cost of the bed charges. The median length of stay in the study was 5 days and the length of stay was directly and significantly related to the treatment costs.

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Use of Penalized Count Regression to Determine Factors Affecting the Length of Stay of Trauma Patients in the Intensive Care Unit

10.32592/ircmj.2021.23.11.1278 ◽

2021 ◽

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Length Of Stay ◽

Variable Selection ◽

Oxygen Saturation ◽

Chest Trauma ◽

Trauma Patients ◽

Selection Methods ◽

Factors Affecting ◽

The Mean

Background: Trauma is considered an important issue in most countries. Identification of the factors affecting the length of stay (LOS) in the intensive care unit (ICU) plays a crucial role in controlling the costs and complications of prolonged hospitalization. Objectives: This study aimed to identify the factors affecting the LOS of trauma patients in the ICU using stepwise and new penalized variable selection methods in count data regression. Methods: The patients’ information was evaluated in Emtiaz Hospital and Shahid Rajaee trauma center in Shiraz from March 2016 to September 2017. Count regression model was used to determine the factors affecting the LOS of patients in the ICU using penalized variable selection including, Enet, Snet, and Mnet. Results: The mean age of the patients (n=382) was obtained at 36.7±16.7 years, and the majority (88.4%) of the patients were male. The mean LOS in the ICU was determined at 6.2±6.6 days. Mnet with a negative binomial distribution outperformed the other penalized variable selection methods. A Glasgow Coma Scale (GCS) of less than 9 (IRR=1.7), blunt brain trauma (IRR=1.8), chest trauma (IRR=2.2), and oxygen saturation of less than 90 (IRR=1.2) increased the LOS of trauma patients in the ICU. Conclusions: Penalized variable selection methods effectively ignore or control the existing correlations between predictors. Amongst the penalized models, Mnet provided more acceptable results with smaller Akaike information criterion and fewer predictors. According to this penalty, the most important factors affecting the length of stay were chest trauma, blunt brain trauma, GCS, and oxygen saturation rate. Most clinical studies on trauma have also shown the importance of these factors.

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Factors Affecting the Length of Stay in the Intensive Care Unit: Our Clinical Experience

BioMed Research International ◽

10.1155/2018/9438046 ◽

2018 ◽

Vol 2018 ◽

pp. 1-4 ◽

Cited By ~ 5

Author(s):

Mehmet Toptas ◽

Nilay Sengul Samanci ◽

İbrahim Akkoc ◽

Esma Yucetas ◽

Egemen Cebeci ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Length Of Stay ◽

Average Length ◽

Cerebrovascular Diseases ◽

Factors Affecting ◽

Average Length Of Stay ◽

Lengths Of Stay ◽

Life Threatening ◽

Hospital Days

Background and Aim. Long hospital days in intensive care unit (ICU) due to life-threatening diseases are increasing in the world. The primary goal in ICU is to decrease length of stay in order to improve the quality of medical care and reduce cost. The aim of our study is to identify and categorize the factors associated with prolonged stays in ICU.Materials and Method. We retrospectively analyzed 3925 patients. We obtained the patients’ demographic, clinical, diagnostic, and physiologic variables; mortality; lengths of stay by examining the intensive care unit database records.Results. The mean age of the study was 61.6 ± 18.9 years. The average length of stay in intensive care unit was 10.2 ± 25.2 days. The most common cause of hospitalization was because of multiple diseases (19.5%). The length of stay was positively correlated with urea, creatinine, and sodium. It was negatively correlated with uric acid and hematocrit levels. Length of stay was significantly higher in patients not operated on than in patients operated on (p<0.001).Conclusion. Our study showed a significantly increased length of stay in patients with cardiovascular system diseases, multiple diseases, nervous system diseases, and cerebrovascular diseases. Moreover we showed that when urea, creatinine, and sodium values increase, in parallel the length of stay increases.

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Outcome analysis of a newly setup pediatric intensive care unit in a teaching hospital of northern India

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20193742 ◽

2019 ◽

Vol 6 (5) ◽

pp. 2147

Author(s):

Aparna Chakravarty ◽

Jagannath Mohapatra ◽

Richa Garg ◽

Shaurya Kumar

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Length Of Stay ◽

Teaching Hospital ◽

Indian Subcontinent ◽

Pediatric Intensive Care ◽

Critically Ill Children ◽

Outcome Analysis ◽

P Value ◽

Significant Relation

Background: Pediatric intensive care units (PICU) have brought about dramatic increase in the survival of critically ill children. The aim of pediatric intensive care is not just to save lives but also to maximise the quality of those lives. Evaluation of the outcome of an intensive care unit is necessary as a measure of quality improvement in patient care.Methods: A retrospective observational study was done in a PICU of a teaching hospital between February 2017 to August 2018. Records of all admissions, transfer outs, discharges and deaths were collected along with age, sex, diagnosis, length of stay, and outcome.Results: Mean age of the 601 patients admitted over a period of nineteen months was 4 years. 36% patients were between 1-5 year and 32% were infants. Major indication for admission to the PICU was respiratory (30%) followed by neurological illnesses (25%) and infections (22%). Increased length of stay (LOS) (>5 days) was seen in respiratory, neurological diseases and infections. A significant relation (p value <0.05) was found between outcome and patients admitted with sepsis and the group classified as others. Patients admitted with involvement of nephrology system had a significant relation with LOS (p value <0.05). The mortality rate was 2%.Conclusion: The outcome analysis of our newly setup PICU is comparable with other studies in the Indian subcontinent. Active surveillance or audit of PICU admissions help capture lapses in management and bring a better outcome with available resources.

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Factors modifying the length of stay in the Medical Intensive Care Unit of a tertiary care teaching hospital in India

Proceedings for Annual Meeting of The Japanese Pharmacological Society ◽

10.1254/jpssuppl.wcp2018.0_po1-10-4 ◽

2018 ◽

Vol WCP2018 (0) ◽

pp. PO1-10-4

Author(s):

Manish Bajpai ◽

Sartaj Hussain ◽

Suraj Yadav ◽

Sanjay Khattri ◽

Kamal K Sawlani

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Length Of Stay ◽

Teaching Hospital ◽

Medical Intensive Care Unit ◽

Tertiary Care ◽

Tertiary Care Teaching Hospital ◽

Care Teaching ◽

Medical Intensive Care

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Determinants of gait independence after mechanical ventilation in the intensive care unit: a Japanese multicenter retrospective exploratory cohort study

Journal of Intensive Care ◽

10.1186/s40560-019-0404-2 ◽

2019 ◽

Vol 7 (1) ◽

Cited By ~ 1

Author(s):

Shinichi Watanabe ◽

Toru Kotani ◽

Shunsuke Taito ◽

Kohei Ota ◽

Kenzo Ishii ◽

...

Keyword(s):

Intensive Care Unit ◽

Mechanical Ventilation ◽

Intensive Care ◽

Length Of Stay ◽

Hospital Discharge ◽

Early Mobilization ◽

Factors Affecting ◽

Icu Length Of Stay ◽

Sum Score ◽

Icu Discharge

Abstract Purpose Gait independence is one of the most important factors related to returning home from the hospital for patients treated in the intensive care unit (ICU), but the factors affecting gait independence have not been clarified. This study aimed to determine the factors affecting gait independence at hospital discharge using a standardized early mobilization protocol that was shared by participating hospitals. Materials and methods Patients who entered the ICU from January 2017 to March 2018 were screened. The exclusion criteria were mechanical ventilation < 48 hours, age < 18, loss of gait independence before hospitalization, being treated for neurological issues, unrecoverable disease, unavailability of continuous data, and death during ICU stay. Basic attributes, such as age, ICU length of stay, information on early mobilization while in the ICU, Medical Research Council (MRC) sum-score at ICU discharge, incidence of ICU-acquired weakness (ICU-AW) and delirium, and the degree of gait independence at hospital discharge, were collected. Gait independence was determined using a mobility scale of the Barthel Index, and the factors that impaired gait independence at hospital discharge were investigated using a Cox proportional hazard regression analysis. Results One hundred thirty-two patients were analyzed. In the univariate analysis, age, APACHE II score, duration of mechanical ventilation, ICU length of stay, incidence of delirium, and MRC sum-score at ICU discharge were extracted as significant. In the multivariate analysis, age (p = 0.014), MRC sum-score < 48 (p = 0.021), and delirium at discharge from ICU (p < 0.0001) were extracted as significant variables. Conclusions We found that age and incidence of ICU-AW and delirium were significantly related to impaired gait independence at hospital discharge.

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