scholarly journals Early versus Delayed Oral Feeding in Patients following Total Laryngectomy

2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
Ashley Hay ◽  
Lisa Pitkin ◽  
Kurinchi Gurusamy
Keyword(s):  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Hospital Length ◽  
Oral Feeding ◽  
Hospital Length Of Stay ◽  
Pharyngocutaneous Fistula ◽  
Early Oral Feeding ◽  
Significant Difference ◽  
Randomised Control Trials ◽  
Fistula Rate

Objectives. To assess the effects of early oral feeding in laryngectomy patients versus delayed oral feeding. The outcomes used are mortality, pharyngocutaneous fistula rate, quality of life, hospital length of stay, and complications. Method. We performed searches within five major databases until June 2013. We considered randomised control trials (RCTs) and included nonrandomised studies for the assessment of harms. Results. We included four RCTs for assessment of benefits and three nonrandomised studies for assessment of harms (393 participants). There was no statistically significant difference detected in mortality at six months, pharyngocutaneous fistulae, or complications. The length of hospital stay was shorter in the early feeding group, MD −2.72 days [95% CI −5.34 to −0.09]. Conclusion. Early oral feeding appears to have similar incidence of complications and has the potential to shorten the length of hospital stay. Further well-designed RCTs are necessary because of weakness in the available evidence.

scholarly journals The independent patient factors that affect length of stay following hip fractures

2018 ◽  
Vol 100 (7) ◽  
pp. 556-562 ◽  
Author(s):  
T Richards ◽  
A Glendenning ◽  
D Benson ◽  
S Alexander ◽  
S Thati
Keyword(s):  
Hip Fracture ◽  
Length Of Stay ◽  
Hospital Stay ◽  
Hip Fractures ◽  
Length Of Hospital Stay ◽  
Hospital Length ◽  
Acute Hospital ◽  
Hospital Length Of Stay ◽  
Patient Factors ◽  
Mobility Status

Introduction Management of hip fractures has evolved over recent years to drive better outcomes including length of hospital stay. We aimed to identify and quantify the effect that patient factors influence acute hospital and total health service length of stay. Methods A retrospective observational study based on National Hip Fracture Database data was conducted from 1 January 2014 to 31 December 2015. A multiple regression analysis of 330 patients was carried out to determine independent factors that affect acute hospital and total hospital length of stay. Results American Society of Anesthesiologists (ASA) grade 3 or above, Abbreviated Mental Test Score (AMTS) less than 8 and poor mobility status were independent factors, significantly increasing length of hospital stay in our population. Acute hospital length of stay can be predicted as 8.9 days longer when AMTS less than 8, 4.2 days longer when ASA grade was 3 or above and 20.4 days longer when unable to mobilise unaided (compared with independently mobile individuals). Other factors including total hip replacement compared with hemiarthroplasty did not independently affect length of stay. Conclusions Our analysis in a representative and generalisable population illustrates the importance of identifying these three patient characteristics in hip fracture patients. When recognised and targeted with orthogeriatric support, the length of hospital stay for these patients can be reduced and overall hip fracture care improved. Screening on admission for ASA grade, AMTS and mobility status allows prediction of length of stay and tailoring of care to match needs.

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 Importance of respiratory syncytial virus as a predictor of hospital length of stay in bronchiolitis

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 110
Author(s):  
Jefferson Antonio Buendia ◽  
Diana Guerrero Patino
Keyword(s):  
Hospital Stay ◽  
Negative Binomial ◽  
Length Of Hospital Stay ◽  
Negative Binomial Regression ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Negative Binomial Regression Model ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Syncytial Virus

IIntroduction : Bronchiolitis is the leading cause of hospitalization in children. Estimate potentially preventable variables that impact the length of hospital stay are a priority to reduce the costs associated with this disease. This study aims to identify clinical variables associated with length of hospital stay of bronchiolitis in children in a tropical middle-income country Methods: We conducted a retrospective cohort study in 417 infants with bronchiolitis in tertiary centers in Colombia. All medical records of all patients admitted throughto the emergency department were reviewed. To identify factors independently associated we use negative binomial regression model, to estimate incidence rate ratios (IRR) and adjust for potential confounding variables Results : The median of the length of hospital stay was 3.68 days, with a range of 0.774 days to 29 days, 138 (33.117%) of patients have a hospital stay of 5 or more days. After modeling and controlling for potential confounders age <6 months, comorbidities (CHD or neurological), BPD,  chest indrawing, Detection of RSV isolation, and C-reactive protein were independent predictors of LOS Conclusions : Our results show that in infants with bronchiolitis, Detection of RSV isolation, age <6 months, comorbidities (CHD or neurological), BPD,  chest indrawing, and C-reactive protein were independent predictors of LOS. As a potentially modifiable risk factor, efforts to reduce the probability of RSV infection can reduce the high medical cost associates with prolonged LOS in bronchiolitis.

Pectoralis major myofascial flap in salvage laryngectomy

2014 ◽  
Vol 128 (8) ◽  
pp. 714-719 ◽  
Author(s):  
E Cömert ◽  
Ü Tunçel ◽  
M Taner Torun ◽  
C Kiliç ◽  
A Buğra Cengiz ◽  
...  
Keyword(s):  
Length Of Hospital Stay ◽  
Pectoralis Major ◽  
Oral Feeding ◽  
Fistula Formation ◽  
Pharyngocutaneous Fistula ◽  
Similar Time ◽  
Significant Difference ◽  
Group 2 ◽  
Salvage Laryngectomy ◽  
Group 1

AbstractObjective:The main purpose of this study was to evaluate the effect of the pectoralis major myofascial flap on pharyngocutaneous fistula formation and time to oral feeding.Methods:This retrospective study reviewed 155 total laryngectomies. Patients were divided into two main groups. Group 1 included 110 patients who were treated primarily by total laryngectomy and group 2 comprised 45 patients who were treated by salvage laryngectomy with or without a pectoralis major myofascial flap.Results:The use of a pectoralis major myofascial flap did not have a significant effect on pharyngocutaneous fistula formation in the salvage group (p = 0.376). When comparing the oral feeding day of patients with pharyngocutaneous fistula, a significant difference was observed between the salvage group with pectoralis major myofascial flap reinforcement and the salvage group without pectoralis major myofascial flap reinforcement (p = 0.004).Discussion:Our study demonstrated that pectoralis major myofascial flap reinforcement did not decrease the rate of pharyngocutaneous fistula formation. Instead, it prevented the formation of large fistulas that would require surgical management, and showed a similar time to oral feeding and length of hospital stay to primary laryngectomy.

scholarly journals 904. Surgical Site Infection After Bariatric Surgery: a Small Risk that Defines Life and Death of Patients

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S486-S486
Author(s):  
Lucca G Giarola ◽  
Carlos Ernesto Ferreira Starling ◽  
Braulio Roberto Gonçalves Marinho Couto ◽  
Handerson Dias Duarte de Carvalho
Keyword(s):  
Bariatric Surgery ◽  
Logistic Regression ◽  
Surgical Site Infection ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Hospital Death ◽  
Site Infection ◽  
Belo Horizonte

Abstract Background Surgical site infection (SSI) in bariatric surgery can lead to devastating outcomes such as peritonitis, sepsis, septic shock and organ space infection. The objective of our study is to answer four questions: a) What is the SSI risk after bariatric surgery? b) What are the risk factors for SSI after bariatric surgery? c) What are the main outcomes to SSI in bariatric surgery? d) What are the main bacteria responsible for SSI in bariatric surgery? Methods A retrospective cohort study assessed 8,672 patients undergoing bariatric surgery between 2014/Jan and 2018/Dec from two hospitals at Belo Horizonte, Brazil. Data were gathered by standardized methods defined by the National Healthcare Safety Network (NHSN)/CDC procedure-associated protocols for routine SSI surveillance. Outcome: SSI, hospital death and total length of hospital stay. 20 preoperative and operative variables were evaluated by univariate and multivariate analysis (logistic regression). Results 77 SSI were diagnosed (risk = 0.9% [C.I.95% = 0.7%;1.1%]). Mortality rate in patients, without infection was only 0.03% (3/8,589) while hospital death of infected patients was 4% (3/77; RR = 112; p&lt; 0.001). Hospital length of stay in non-infected patients (days): mean = 2, std.dev.= 0.9; hospital stay in infected patients: mean = 7, std. dev. = 15.6 (p&lt; 0.001). Two main factors associated with SSI after bariatric surgery were identified by logistic regression: duration of procedure (hours), OR = 1.4;p=0.001, and laparoscopy procedure, OR = 0.3;p=0.020. From 77 SSIs, in 28 (36%) we identified 34 etiologic agents. The majority of SSI (59%) was caused by species of Streptococcus (32%), Klebsiella (15%), and Enterobacter (12%). Conclusion SSI is rare after bariatric surgery, however, when it happens, it’s a disaster for the patient. The incidence of SSI can be reduced significantly when laparoscopy procedure is used and the surgeon is able to perform a rapid surgery. Disclosures All Authors: No reported disclosures

Psychopathology in Medical Inpatients and its Relationship to Length of Hospital Stay: A Pilot Study

1987 ◽  
Vol 16 (3) ◽  
pp. 231-236 ◽  
Author(s):  
James L. Levenson ◽  
Robert Hamer ◽  
Joel J. Silverman ◽  
Louis F. Rossiter
Keyword(s):  
Pilot Study ◽  
Length Of Stay ◽  
Hospital Stay ◽  
Cognitive Dysfunction ◽  
Length Of Hospital Stay ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Medical Inpatients ◽  
Instrument Measuring ◽  
Psychiatric Intervention

A composite screening instrument measuring depression, anxiety, cognitive dysfunction, and pain identified 40 percent of a sample of general medical inpatients (30% of total patients before exclusions) as having significant psychopathology or pain, a reasonable number based on clinical incidence literature. These identified patients' hospital length of stay did not differ from the length of stay for other patients. The screen identified 21 percent as very depressed, 19 percent as very anxious, 15 percent as having cognitive dysfunction, and 11 percent with high pain levels. Depression, anxiety, and pain frequently occurred together. Further study is required to refine the instrument and assess its effectiveness at targeting patients for psychiatric intervention.

scholarly journals Risk Factors for Surgical Site Infection After Orthopedic Trauma Surgery: A Two-Year Prospective Multicenter Analysis

2020 ◽  
Vol 41 (S1) ◽  
pp. s377-s378
Author(s):  
Milena Reis Abreu ◽  
Larissa Paiva ◽  
Tamires Costa Mendes ◽  
Barbara Cristiny Maia ◽  
Ana Luiza Rodrigues ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hospital Stay ◽  
Risk Index ◽  
Trauma Surgery ◽  
Length Of Hospital Stay ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Orthopedic Trauma ◽  
Site Infection ◽  
Orthopedic Trauma Surgery

Background: Trauma is defined by the NHSN as “blunt or penetrating traumatic injury.” Therefore, if the surgery was performed because of a recent fall, for example, then it is a trauma surgery. Here, we investigated which preoperative and operative parameters are associated with surgical site infection (SSI) after orthopedic trauma surgery. Objective: We aimed to answer 3 main questions: What is the risk of wound infection for patients undergoing trauma surgery? What are the main etiologic agents of SSI after trauma surgery? And what are the risk factors associated with SSI after trauma surgery? Methods: This prospective multicenter cohort study included 2,035 patients undergoing trauma surgery between July 2016 and June 2018 in 4 hospitals in Belo Horizonte, Brazil. Outcome variables were SSI, hospital mortality, and length of hospital stay. The following preoperative and operative parameters were evaluated: age, length of hospital stay before surgery, duration of surgery, number of professionals at surgery, number of hospital admissions, surgical wound classification, American Society of Anesthesiologists (ASA) preoperative assessment score, type of surgery (elective, emergency), general anesthesia (yes, no), trauma surgery (yes, no), and the 3-point prediction Nosocomial Infections Surveillance (NNIS) risk index. Results: The overall estimated SSI risk was 2.8% (95% CI, 2.0%–3.6%). Hospital mortality risk after trauma surgery was 3.4% (95% CI, 2.8%–4.4%). Hospital length of stay parameters in noninfected patients were as follows: mean, 8 days; median, 3 days; SD, 12 days. Hospital length of stay parameters in infected patients were mean, 30 days; median, 23 days; with SD, 31 days. The parameters for hospital stay in infected patients were mean, 10 days; median, 3 days, and SD, 15.9 (P < .001). Trauma orthopedic surgery lasting >2 hours was associated with approximately twice the risk (RR, 2.2) of developing an SSI compared to ≤2 hours of surgery: 27 of 739 (3.7%) versus 21 of 1,290 (1.6%), respectively, (P = .005) (Fig. 1). The NNIS risk index predicts the risk of SSI after trauma surgery (P = .003): 13 of 737 SSIs (1.8%) had an NNIS risk index of 0; 20 of 736 SSIs (2.7%) had an NNIS risk index of 1; 8 of 211 SSIs (3.8%) had an NNIS risk index of 2; and 2 of 11 SSIs (18.2%) had an NNIS risk index of 3 (Fig. 2). Conclusions: We identified intrinsic risk factors for SSI after orthopedic trauma surgery. The identification of the actual SSI incidence after trauma surgery in developing country hospitals and associated risk factors may support actions to minimize the complications caused by SSI.Funding: NoneDisclosures: None

scholarly journals Early Nasojejunal Nutrition Versus Early Oral Feeding in Patients After Pancreaticoduodenectomy: A Randomized Controlled Trial

2021 ◽  
Vol 11 ◽  
Author(s):  
Xinchun Liu ◽  
Qiuyang Chen ◽  
Yue Fu ◽  
Zipeng Lu ◽  
Jianmin Chen ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Surgical Complication ◽  
Controlled Trial ◽  
Length Of Hospital Stay ◽  
Reoperation Rate ◽  
Saline Group ◽  
Oral Feeding ◽  
Complication Rates ◽  
Clinical Trial Registration ◽  
Early Oral Feeding

ObjectiveThe aim of this study was to test the hypothesis that early oral feeding (EOF) is superior to early nasojejunal nutrition (ENN) after pylorus-preserving pancreaticoduodenectomy (PPPD) in terms of delayed gastric emptying (DGE).BackgroundDGE is a common complication after PPPD. Although EOF after PPPD is recommended by several international guidelines, there is no randomized trial to support this recommendation.MethodsFrom September 2016 to December 2017, a total of 120 patients undergoing PPPD were randomized into the ENN, EOF, or saline groups at a 1:1:1 ratio (40 patients in each group). The primary endpoint was the rate of clinically relevant DGE. Secondary endpoints included overall morbidity, postoperative pancreatic fistula, post-pancreatectomy hemorrhage, abdominal infection, length of hospital stay, reoperation rate, and in-hospital mortality.ResultsThe baseline characteristics and operative parameters were comparable between the groups. The incidence of clinically relevant DGE varied significantly among the three groups (ENN, 17.5%; EOF, 10.0%; saline, 32.5%; p =0.038). The saline group had a higher clinically relevant DGE rate than the EOF group (p = 0.014). The saline group also had greater overall morbidities than the ENN and EOF groups (p = 0.041 and p = 0.006, respectively). There were no significant differences in other surgical complication rates or postoperative hospital stay. No mortality was observed in any of the groups.ConclusionsNutritional support methods were not related to DGE after PPPD. EOF was feasible and safe after PPPD, and additional ENN should not be routinely administered to patients after PPPD.Clinical Trial RegistrationClinicalTrials.gov, identifier NCT03150615.

scholarly journals Importance of Respiratory Syncytial Virus as a Predictor of Hospital Length of Stay in Bronchiolitis

2020 ◽  
Author(s):  
jefferson buendia ◽  
Diana Guerrero ◽  
Carlos Rodriguez Martinez
Keyword(s):  
Hospital Stay ◽  
Negative Binomial ◽  
Length Of Hospital Stay ◽  
Negative Binomial Regression ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Negative Binomial Regression Model ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Syncytial Virus

Abstract BackgroundBronchiolitis is the leading cause of hospitalization in children. Estimate potentially preventable variables that impact the length of hospital stay are a priority to reduce the costs associated with this disease.ObjectiveThis study aims to identify clinical variables associated with length of hospital stay of bronchiolitis in children in a tropical middle-income countryMethodsWe conducted a retrospective cohort study in 417 infants with bronchiolitis in tertiary centers in Colombia. All medical records of all patients admitted to the emergency department were reviewed. To identify factors independently associated we use negative binomial regression model, to estimate incidence rate ratios (IRR) and adjust for potential confounding variablesResultsThe median of the length of hospital stay was 3.68 days, with a range of 0.74 days to 29 days, 138 (33.17%) of patients have a hospital stay of 5 or more days. After modeling and controlling for potential confounders age < 6 months, comorbidities (CHD or neurological), BPD, chest indrawing, RSV isolation, and C-reactive protein were independent predictors of LOSConclusionsOur results show that in infants with bronchiolitis, RSV isolation, age < 6 months, comorbidities (CHD or neurological), BPD, chest indrawing, and C-reactive protein were independent predictors of LOS. As a potentially modifiable risk factor, efforts to reduce the probability of RSV infection can reduce the hight medical cost associates with prolonged LOS in bronchiolitis.

Sign in / Sign up

Export Citation Format

Share Document