scholarly journals Muscle strength and muscle mass as predictors of hospital length of stay in patients with moderate to severe COVID‐19: a prospective observational study

2021 ◽  
Author(s):  
Saulo Gil ◽  
Wilson Jacob Filho ◽  
Samuel Katsuyuki Shinjo ◽  
Eduardo Ferriolli ◽  
Alexandre Leopold Busse ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Length Of Stay ◽  
Observational Study ◽  
Muscle Mass ◽  
Prospective Observational Study ◽  
Hospital Length ◽  
Hospital Length Of Stay

Nursing Diagnoses as Predictors of Hospital Length of Stay: A Prospective Observational Study

2018 ◽  
Vol 51 (1) ◽  
pp. 96-105 ◽  
Author(s):  
Fabio D'Agostino ◽  
Ercole Vellone ◽  
Antonello Cocchieri ◽  
John Welton ◽  
Massimo Maurici ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Nursing Diagnoses

scholarly journals Intensive care discharge delay is associated with increased hospital length of stay: A multicentre prospective observational study

PLoS ONE ◽  
2017 ◽  
Vol 12 (7) ◽  
pp. e0181827 ◽  
Author(s):  
Ravindranath Tiruvoipati ◽  
John Botha ◽  
Jason Fletcher ◽  
Himangsu Gangopadhyay ◽  
Mainak Majumdar ◽  
...  
Keyword(s):  
Intensive Care ◽  
Length Of Stay ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Hospital Length ◽  
Hospital Length Of Stay

scholarly journals Muscle Strength and Muscle Mass as Predictors of Hospital Length of Stay in Patients with Moderate to Severe COVID-19: A Prospective Observational Study

2021 ◽  
Author(s):  
Saulo Gil ◽  
Wilson Jacob Filho ◽  
Samuel Katsuyuki Shinjo ◽  
Eduardo Ferriolli ◽  
Alexandre Leopold Busse ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Muscle Mass ◽  
Prospective Observational Study ◽  
Handgrip Strength ◽  
Vastus Lateralis ◽  
Hospital Length ◽  
Cross Sectional Area ◽  
Hospital Length Of Stay ◽  
Sectional Area ◽  
Cross Sectional

Importance: Strength and muscle mass are predictors of relevant clinical outcomes in critically ill patients, but in hospitalized patients with COVID-19 remains to be determined. Objective: To investigate whether muscle strength or muscle mass are predictive of hospital length of stay (LOS) in patients with moderate to severe COVID-19. Design: Prospective observational study. Setting: Clinical Hospital of the School of Medicine of the University of Sao Paulo. Participants: One hundred ninety-six patients were evaluated. Ten patients did not test positive for SARS-CoV-2 during hospitalization and were excluded from the analyses. The sample comprised patients of both sexes (50% male) with a mean age (SD) of 59 (SD = 15) years, body mass index of 29.5 (SD = 6.9) kg/m2. The prevalence of current smoking patients was 24.7%, and more prevalent coexisting conditions were hypertension (67.7%), obesity (40.9%), and type 2 diabetes (36.0%). Mean (SD) LOS was 8.6 days (7.7); 17.0% of the patients required intensive care; 3.8% used invasive mechanical ventilation; and 6.6% died during the hospitalization period. Main outcome: The outcome was LOS, defined as time from hospital admission to medical discharge. Results: The crude Hazard Ratio (HR) for LOS was greatest for handgrip strength comparing the strongest vs. other patients (1.54 [95%CI: 1.12 to 2.12; p = 0.008]). Evidence of an association between increased handgrip strength and shorter hospital stay was also identified when handgrip strength was standardized according to the sex-specific mean and standard deviation (1.23 [95%CI: 1.06 to 1.19; p = 0.008]). The magnitude of these associations remained consistent and statistically significant after adjusting for other covariates. Mean LOS was shorter for the strongest patients (7.5 , SD = 6.1 days) vs. others (9.2, SD = 8.4 days). Evidence of associations were also present for vastus lateralis cross-sectional area. The crude HR identified shorter hospital stay for patients with greater sex-specific standardized values (1.17 [95%CI: 1.01 to 1.36; p = 0.037]); however, we found increased uncertainty in the estimate with the addition of other covariates (1.18 [95%CI: 0.97 to 1.43; p = 0.092]). Evidence was also obtained associating longer hospital stays for patients with the lowest values for vastus lateralis cross-sectional area (0.69 [95%CI: 0.50 to 0.95; p = 0.025). Mean LOS for the patients with the lowest muscle cross-sectional area was longer (10.8, SD = 8.8 days) vs. others (7.7, SD = 7.2 days). Conclusions and Relevance: Muscle strength and mass assessed upon hospital admission are predictors of LOS in patients with moderate to severe COVID-19, which stresses the value of muscle health in prognosis of this disease.

scholarly journals Associations of Skeletal Muscle With Symptom Burden and Clinical Outcomes in Hospitalized Patients With Advanced Cancer

2021 ◽  
Vol 19 (3) ◽  
pp. 319-327
Author(s):  
Emily van Seventer ◽  
J. Peter Marquardt ◽  
Amelie S. Troschel ◽  
Till D. Best ◽  
Nora Horick ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Muscle Mass ◽  
Advanced Cancer ◽  
Symptom Burden ◽  
Hospital Length ◽  
Hazard Ratio ◽  
Hospitalized Patients ◽  
Hospital Length Of Stay ◽  
Muscle Quality ◽  
Healthcare Use

Background: Low muscle mass (quantity) is common in patients with advanced cancer, but little is known about muscle radiodensity (quality). We sought to describe the associations of muscle mass and radiodensity with symptom burden, healthcare use, and survival in hospitalized patients with advanced cancer. Methods: We prospectively enrolled hospitalized patients with advanced cancer from September 2014 through May 2016. Upon admission, patients reported their physical (Edmonton Symptom Assessment System [ESAS]) and psychological (Patient Health Questionnaire-4 [PHQ-4]) symptoms. We used CT scans performed per routine care within 45 days before enrollment to evaluate muscle mass and radiodensity. We used regression models to examine associations of muscle mass and radiodensity with patients’ symptom burden, healthcare use (hospital length of stay and readmissions), and survival. Results: Of 1,121 patients enrolled, 677 had evaluable muscle data on CT (mean age, 62.86 ± 12.95 years; 51.1% female). Older age and female sex were associated with lower muscle mass (age: B, –0.16; P<.001; female: B, –6.89; P<.001) and radiodensity (age: B, –0.33; P<.001; female: B, –1.66; P=.014), and higher BMI was associated with higher muscle mass (B, 0.58; P<.001) and lower radiodensity (B, –0.61; P<.001). Higher muscle mass was significantly associated with improved survival (hazard ratio, 0.97; P<.001). Notably, higher muscle radiodensity was significantly associated with lower ESAS-Physical (B, –0.17; P=.016), ESAS-Total (B, –0.29; P=.002), PHQ-4-Depression (B, –0.03; P=.006), and PHQ-4-Anxiety (B, –0.03; P=.008) symptoms, as well as decreased hospital length of stay (B, –0.07; P=.005), risk of readmission or death in 90 days (odds ratio, 0.97; P<.001), and improved survival (hazard ratio, 0.97; P<.001). Conclusions: Although muscle mass (quantity) only correlated with survival, we found that muscle radiodensity (quality) was associated with patients’ symptoms, healthcare use, and survival. These findings underscore the added importance of assessing muscle quality when seeking to address adverse muscle changes in oncology.

scholarly journals CPAP Use in Covid-19 Patients: A Retrospective Observational Study in the Emergency Department.

2020 ◽  
Author(s):  
Nicolo Capsoni ◽  
Daniele Privitera ◽  
Annamaria Mazzone ◽  
Chiara Airoldi ◽  
Laura Angaroni ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Observational Study ◽  
Invasive Mechanical Ventilation ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Retrospective Observational Study ◽  
Positive Pressure ◽  
Number Of Patients ◽  
Mechanical Ventilation Time ◽  
Medical Wards

Abstract BackgroundDuring COVID-19 outbreak, with the increasing number of patients presenting with acute respiratory failure (ARF), a large use of non-invasive positive pressure ventilation (NIPPV) was done in the Emergency Departments (EDs) and medical wards despite the lack of recommendations. We aimed to assess the use of continuous positive airway pressure (CPAP) in the ED. The primary endpoint was the rate of CPAP failure and the need of endotracheal intubation (ETI). Secondary endpoints were in-hospital mortality and intensive care unit (ICU) and in-hospital length of stay. Study design and MethodsA retrospective observational study enrolling adult patients admitted to the ED of Niguarda Hospital, Milan, Italy, with ARF due to COVID-19 pneumonia from March 18th to April 18th 2020, was conducted. Only patients who strictly followed a local CPAP protocol were enrolled. ResultsA total of 52 patients were included in this study. 38 patients (73%) were judged eligible for ETI. 18 (34.6%) were intubated. 16 (30.8%) patients died: 7 (38.9%) and 9 (26.5%) in the ETI and non-ETI group respectively. The median hospital length of stay was different in ETI and non-ETI patients: 26 days [IQR 16-37] vs 15 days [IQR 9-17] (p=0.005). The median invasive mechanical ventilation time was 11 days [IQR 7-21] with an ICU length of stay of 14.5 days [IQR 10-28]. During the CPAP trial, variations between ETI and non-ETI patients over time were found for positive end-expiratory pressure (PEEP) (p=0.003) and respiratory rate (RR) (p=0.059).ConclusionsA short closed monitored CPAP trial could be considered for ARF due to COVID-19 pneumonia before considering ETI. A progressive PEEP titration should target patient’s SpO2 improvement and RR reduction. More studies are needed to evaluate the efficacy and predictors of failure of CPAP and NIPPV in patients with ARF due to COVID-19 pneumonia.

scholarly journals Factors Associated with Prolonged Hospital Length of Stay in Adults with Imported Falciparum Malaria—An Observational Study from a Tertiary Care University Hospital in Berlin, Germany

2021 ◽  
Vol 9 (9) ◽  
pp. 1941
Author(s):  
Bodo Hoffmeister
Keyword(s):  
Length Of Stay ◽  
Observational Study ◽  
Falciparum Malaria ◽  
Early Recognition ◽  
Tertiary Care ◽  
Hospital Length ◽  
University Hospital ◽  
Hospital Length Of Stay ◽  
Acute Pulmonary Oedema ◽  
Factors Associated

Outcome of falciparum malaria is largely influenced by the standard of care provided, which in turn depends on the available medical resources. Worldwide, the COVID-19 pandemic has had a major impact on the availability of these resources, even in resource-rich healthcare systems such as Germany’s. The present study aimed to determine the under-explored factors associated with hospital length of stay (LOS) in imported falciparum malaria to identify potential targets for improving management. This retrospective observational study used multivariate Cox proportional hazard regression with time to discharge as an endpoint for adults hospitalized between 2001 and 2015 with imported falciparum malaria in the Charité University Hospital, Berlin. The median LOS of the 535 cases enrolled was 3 days (inter-quartile range, IQR, 3–4 days). The likelihood of being discharged by day 3 strongly decreased with severe malaria (hazard ratio, HR, 0.274; 95% Confidence interval, 95%CI: 0.190–0.396) and by 40% with each additional presenting complication (HR, 0.595; 95%CI: 0.510–0.694). The 55 (10.3%) severe cases required a median LOS of 7 days (IQR, 5–12 days). In multivariate analysis, occurrence of shock (adjusted HR, aHR, 0.438; 95%CI 0.220–0.873), acute pulmonary oedema or acute respiratory distress syndrome (aHR, 0.450; 95%CI: 0.223–0.874), and the need for renal replacement therapy (aHR, 0.170; 95%CI: 0.063–0.461) were independently associated with LOS. All patients survived to discharge. This study illustrates that favourable outcomes can be achieved with high-standard care in imported falciparum malaria. Early recognition of disease severity together with targeted supportive care can lead to avoidance of manifest organ failure, thereby potentially decreasing LOS and alleviating pressure on bed capacities.

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