Multivariable Analysis of Factors Affecting Length of Stay and Hospital Charges After Atlantoaxial Fusion

AbstractObjective:To evaluate the impact of methicillin resistance in Staphylococcus aureus on mortality, length of hospitalization, and hospital charges.Design:A cohort study of patients admitted to the hospital between July 1, 1997, and June 1, 2000, who had clinically significant S. aureus bloodstream infections.Setting:A 630-bed, urban, tertiary-care teaching hospital in Boston, Massachusetts.Patients:Three hundred forty-eight patients with S. aureus bacteremia were studied; 96 patients had methicillin-resistant S. aureus (MRSA). Patients with methicillin-susceptible S. aureus (MSSA) and MRSA were similar regarding gender, percentage of nosocomial acquisition, length of hospitalization, ICU admission, and surgery before S. aureus bacteremia. They differed regarding age, comorbidities, and illness severity score.Results:Similar numbers of MRSA and MSSA patients died (22.9% vs 19.8%; P = .53). Both the median length of hospitalization after S. aureus bacteremia for patients who survived and the median hospital charges after S. aureus bacteremia were significantly increased in MRSA patients (7 vs 9 days, P = .045; $19,212 vs $26,424, P = .008). After multivariable analysis, compared with MSSA bacteremia, MRSA bacteremia remained associated with increased length of hospitalization (1.29 fold; P = .016) and hospital charges (1.36 fold; P = .017). MRSA bacteremia had a median attributable length of stay of 2 days and a median attributable hospital charge of $6,916.Conclusion:Methicillin resistance in S. aureus bacteremia is associated with significant increases in length of hospitalization and hospital charges.

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Factors affecting hospital length of stay and hospital charges associated with road traffic-related injuries in Iran

BMC Health Services Research ◽

10.1186/1472-6963-13-281 ◽

2013 ◽

Vol 13 (1) ◽

Cited By ~ 22

Author(s):

Hassan Haghparast-Bidgoli ◽

Soheil Saadat ◽

Lennart Bogg ◽

Mohammad Hossein Yarmohammadian ◽

Marie Hasselberg

Keyword(s):

Length Of Stay ◽

Road Traffic ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Hospital Charges ◽

Factors Affecting

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Factors affecting hospital charges and length of stay from teenage motor vehicle crash-related hospitalizations among United States teenagers, 2002–2007

Accident Analysis & Prevention ◽

10.1016/j.aap.2010.07.019 ◽

2011 ◽

Vol 43 (3) ◽

pp. 595-600 ◽

Cited By ~ 18

Author(s):

Corinne Peek-Asa ◽

Jingzhen Yang ◽

Marizen Ramirez ◽

Cara Hamann ◽

Gang Cheng

Keyword(s):

United States ◽

Length Of Stay ◽

Motor Vehicle ◽

Motor Vehicle Crash ◽

Hospital Charges ◽

Factors Affecting ◽

Vehicle Crash

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Relationship of hospital volume on outcomes in patients with acute pulmonary embolism: Analysis of a 70,000 patient database

Vascular Medicine ◽

10.1177/1358863x20970263 ◽

2020 ◽

pp. 1358863X2097026

Author(s):

Mark Finkelstein ◽

Mario A Cedillo ◽

David C Kestenbaum ◽

Obaib S Shoaib ◽

Aaron M Fischman ◽

...

Keyword(s):

New York ◽

Pulmonary Embolism ◽

Length Of Stay ◽

New York State ◽

Multivariable Analysis ◽

High Volume ◽

Categorical Variables ◽

Patient Database ◽

Very High ◽

Total Charges

Positive relationships between volume and outcome have been seen in several surgical and medical conditions, resulting in more centralized and specialized care structures. Currently, there is a scarcity of literature involving the volume–outcome relationship in pulmonary embolism (PE). Using a state-wide dataset that encapsulates all non-federal admissions in New York State, we performed a retrospective cohort study on admitted patients with a diagnosis of PE. A total of 70,443 cases were separated into volume groups stratified by hospital quartile. Continuous and categorical variables were compared between cohorts. Multivariable regression analysis was conducted to assess predictors of 1-year mortality, 30-day all-cause readmission, 30-day PE-related readmission, length of stay, and total charges. Of the 205 facilities that were included, 128 (62%) were labeled low volume, 39 (19%) medium volume, 23 (11%) high volume, and 15 (7%) very high volume. Multivariable analysis showed that very high volume was associated with decreased 30-day PE-related readmission (OR 0.64; 95% CI, 0.55 to 0.73), decreased 30-day all-cause readmission (OR 0.84; 95% CI, 0.79 to 0.89), decreased 1-year mortality (OR 0.85; 95% CI, 0.80 to 0.91), decreased total charges (OR 0.96; 95% CI, 0.94 to 0.98), and decreased length of stay (OR 0.94; 95% CI, 0.92 to 0.96). In summary, facilities with higher volumes of acute PE were found to have less 30-day PE-related readmissions, less all-cause readmissions, shorter length of stay, decreased 1-year mortality, and decreased total charges.

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Recurrence after Curative Resection for Intrahepatic Cholangiocarcinoma: How to Predict the Chance of Repeat Hepatectomy?

Journal of Clinical Medicine ◽

10.3390/jcm10132820 ◽

2021 ◽

Vol 10 (13) ◽

pp. 2820

Author(s):

Serena Langella ◽

Nadia Russolillo ◽

Paolo Ossola ◽

Andrea-Pierre Luzzi ◽

Michele Casella ◽

...

Keyword(s):

Liver Resection ◽

Intrahepatic Cholangiocarcinoma ◽

Major Hepatectomy ◽

Multivariable Analysis ◽

Study Data ◽

Good Survival ◽

Lower Probability ◽

Factors Affecting ◽

Time To Recurrence ◽

Second Resection

(1) Background: Tumor recurrence after liver resection (LR) for intrahepatic cholangiocarcinoma (ICC) is common. Repeat liver resection (RLR) for recurrent ICC results in good survival outcomes in selected patients. The aim of this study was to investigate factors affecting the chance of resectability of recurrent ICC. (2) Methods: LR for ICC performed between January 2001 and December 2020 were retrospectively reviewed. Patients who had undergone first LR were considered for the study. Data on recurrences were analyzed. A logistic regression model was used for multivariable analysis of factors related to RLR rate. (3) Results: In total, 140 patients underwent LR for ICC. Major/extended hepatectomies were required in 105 (75%) cases. The 90-day mortality was 5.7%, Clavien–Dindo grade 3, 4 complications were 9.3%, N+ disease was observed in 32.5%, and the median OS was 38.3 months. Recurrence occurred in 91 patients (65%). The site of relapse was the liver in 53 patients (58.2%). RLR was performed in 21 (39.6%) patients. Factors that negatively affected RLR were time to recurrence ≤12 months (OR 7.4, 95% CI 1.68–33.16, p = 0.008) and major hepatectomy (OR 16.7, 95% CI 3.8–73.78, p < 0.001) at first treatment. Survival after recurrence was better in patients who underwent RLR as compared with not resected patients (31 vs. 13.2 months, p = 0.02). (4) Conclusions: Patients with ICC treated at first resection with major hepatectomy and those who recurred in ≤12 months had significantly lower probability to receive a second resection for recurrence.

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Real Life Use of Bendamustine in Elderly Patients with Lymphoid Neoplasia

Journal of Personalized Medicine ◽

10.3390/jpm11040249 ◽

2021 ◽

Vol 11 (4) ◽

pp. 249

Author(s):

Irene Dogliotti ◽

Simone Ragaini ◽

Francesco Vassallo ◽

Elia Boccellato ◽

Gabriele De Luca ◽

...

Keyword(s):

Elderly Patients ◽

Rating Scale ◽

Single Agent ◽

Multivariable Analysis ◽

Real Life ◽

Lymphocytic Leukemia ◽

Factors Affecting ◽

Lymphoid Neoplasia ◽

Baseline Factors ◽

Grade 3

Background. Bendamustine is a cytotoxic alkylating drug with a broad range of indications as a single agent or in combination therapy in lymphoid neoplasia patients. However, its tolerability in elderly patients is still debated. Methods: An observational, retrospective study was carried out; patients with chronic lymphocytic leukemia (CLL) or lymphoma, aged ≥ 65 years old, treated with bendamustine-based regimens in first or subsequent lines between 2010 and 2020 were considered eligible. Results: Overall, 179 patients aged ≥ 65 years were enrolled, 53% between 71 and 79 years old. Cumulative Illness Rating Scale (CIRS) comorbidity score was ≥6 in 54% patients. Overall survival (OS) at 12 months was 95% (95% confidence interval [CI]: 90–97%); after a median follow up of 50 months, median OS was 84 months. The overall response rate was 87%, with 56% complete responses; the median time to progression (TTP) was 61 months. The baseline factors affecting OS by multivariable analysis were sex, histological diagnosis, renal function, and planned bendamustine dose, while only type of lymphoma and bendamustine dose impacted on TTP. Main adverse events were neutropenia (grade ≥ 3: 43%) and infections (any grade: 36%), with 17% of patients requiring hospital admission. Conclusions: The responses to bendamustine, as well as survival, are relevant even in advanced age patients, with a manageable incidence of acute toxicity.

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