scholarly journals Preoperative Anaemia and Associated Postoperative Outcomes in Noncardiac Surgery Patients in Central Region of Ghana

2017 ◽  
Vol 2017 ◽  
pp. 1-10
Author(s):  
Gladys Amponsah ◽  
Alice Charwudzi
Keyword(s):  
Hospital Stay ◽  
Central Region ◽  
Length Of Hospital Stay ◽  
Study Data ◽  
Postoperative Outcomes ◽  
Allogeneic Blood ◽  
Surgical Patients ◽  
Prolonged Length ◽  
Prolonged Hospital ◽  
Preoperative Anaemia

Introduction. Several studies suggest that preoperative anaemia (PA) is associated with adverse postoperative outcomes, but little is known about these outcomes in the Central Region of Ghana. This study aims to determine the prevalence of PA among noncardiac surgical patients and its implications for their postoperative outcomes.Methods. This study was designed as an observational study; data including demographics and clinical and laboratory results were collected from the patients’ records and through interviews.Results. A total of 893 inpatient surgical cases undergoing elective and emergency operations, aged 15 years and above with mean age of 44.2 ± 17.0 yrs, were enrolled. The prevalence of PA was 54.3%, mostly microcytic with or without hypochromia (57.2%). The prevalence was higher in females than males (p≤0.001). Preoperative anaemia was significantly associated with prolonged length of hospital stay (OR: 2.12 (95% CI: 1.49–3.10)). Allogeneic blood transfusion significantly prolonged the length of hospital stay (OR 4.48 (95% CI: 2.67–7.51)). 15.5% of the anaemic patients received oral iron supplements compared to 2.2% of nonanaemic patients (p≤0.001).Conclusion. Preoperative anaemia is common among noncardiac surgical patients. It is independently and significantly associated with prolonged hospital stay leading to the use of increased healthcare resources. It is also the main predictor for perioperative allogeneic blood transfusions and the use of haematinics.

scholarly journals Pancreas preservation time as a predictor of prolonged hospital stay after pancreas transplantation

2021 ◽  
Vol 49 (2) ◽  
pp. 030006052098705
Author(s):  
Shengmin Mei ◽  
Zhichao Huang ◽  
Yinlei Dong ◽  
Zheng Chen ◽  
Jie Xiang ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Pancreas Transplantation ◽  
Patient Survival ◽  
Length Of Hospital Stay ◽  
Prolonged Length ◽  
Pancreas Preservation ◽  
Pancreas Kidney Transplantation ◽  
Simultaneous Pancreas Kidney ◽  
Prolonged Hospital ◽  
Relationship Of

Objective Length of hospital stay is a sensitive indicator of short-term prognosis. In this retrospective study, we investigated how pancreas preservation time affects length of hospital stay after pancreas transplantation. Methods Patients receiving pancreas transplantation (1998.7–2018.6) were identified from the Scientific Registry of Transplant Recipients database and grouped according to pancreas preservation time. We analyzed the relationship of pancreas preservation time with graft and patient survival and prolonged length of stay (PLOS; i.e., hospital stay ≥20 days). Results We included 18,099 pancreas transplants in the survival analysis. Pancreas preservation time >20 hours had a significantly higher risk of graft failure than 8 to 12 hours. Pancreas preservation time was not significantly associated with patient survival. We included 17,567 pancreas transplants in the analysis for PLOS. Compared with 8 to 12 hours, pancreas preservation time >12 hours had a significantly higher PLOS risk, which increased with increased pancreas preservation time. In simultaneous pancreas–kidney transplantation, we also found that pancreas preservation time was positively associated with PLOS risk with pancreas preservation time >12 hours. Conclusion Pancreas preservation time is a sensitive predictor of PLOS. Transplant centers should minimize pancreas preservation time to optimize patient outcomes.

scholarly journals The impact of complications on prolonged length of hospital stay after resection in colorectal cancer: A retrospective study of Taiwanese patients

2017 ◽  
Vol 45 (2) ◽  
pp. 691-705 ◽  
Author(s):  
Herng-Chia Chiu ◽  
Yi-Chieh Lin ◽  
Hui-Min Hsieh ◽  
Hsin-Pao Chen ◽  
Hui-Li Wang ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Length Of Stay ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Prolonged Hospital Stay ◽  
Prolonged Length ◽  
Regression Methods ◽  
Major Complications ◽  
Prolonged Hospital ◽  
The Impact

Objectives To assess the impact of minor, major and individual complications on prolonged length of hospital stay in patients with colorectal cancer (CRC) after surgery using multivariate models. Methods This was a retrospective review of data from patients who underwent surgery for stage I–III CRC at two medical centres in southern Taiwan between 2005–2010. Information was derived from four databases. Multivariate logistic regression methods were used to assess the impact of complications on prolonged length of stay (PLOS) and prolonged postoperative length of stay (PPOLOS). Results Of 1658 study patients, 251 (15.1%) experienced minor or major postsurgical complications during hospitalizations. Minor and major complications were significantly associated with PLOS (minor, odds ratio [OR] 3.59; major, OR 8.82) and with PPOLOS (minor, OR 5.55; major, OR 10.00). Intestinal obstruction, anastomosis leakage, abdominal abscess and bleeding produced the greatest impact. Conclusions Minor and major complications were stronger predictors of prolonged hospital stay than preoperative demographic and disease parameters. Compared with the PLOS model, the PPOLOS model better predicted risk of prolonged hospital stay. Optimal surgical and medical care have major roles in surgical CRC patients.

scholarly journals P72 Knowledge and application of the guidelines on intravenous fluid therapy in adult post op surgical patients amongst junior doctors in maidstone and tunrnbridge wells (mth) nhs trust

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Ekowo Onyekachi ◽  
Mark Cynk ◽  
Onyekachi Ekowo
Keyword(s):  
Hospital Stay ◽  
Retrospective Analysis ◽  
Fluid Therapy ◽  
Length Of Hospital Stay ◽  
Intravenous Fluid ◽  
Surgical Patients ◽  
Junior Doctors ◽  
Intravenous Fluid Therapy ◽  
Prolonged Length ◽  
Poor Outcome

Abstract Introduction Foundation Year doctors and Senior House officers are commonly made responsible for fluid prescriptions. Errors could lead to significant poor outcome for the patient. Methodology A total of 36 FY1s and SHOs were asked 8 questions to check their knowledge of the guideline for intravenous fluid therapy in adult surgical patients (GIFTASUP). Following this, a retrospective analysis of fluid prescriptions received by 37 patients who had elective colorectal surgeries was analysed over a 3-month period to see if the fluids received met the GIFTASUP guideline and see how this affected the outcome of the patients. Results 33(92%) of doctors studied are not aware of any guidelines for fluid prescription post operatively. 38(22%) of prescriptions made exceeded 2500mls in 24 hours. Ileus was significant amongst those patients who received fluid volumes more than 2500 mls in 24 hours (p = 0.045). Also, all 4 patients who had pneumonia received fluid volumes exceeding 2500mls in the days preceding the pneumonia. In addition, the length of hospital stay was 15 days and 9 days in those with fluids volumes greater than 2500mls and less than 2500mls in 24 hours, respectively. Conclusion Majority of the Foundation year doctors in MTH are not aware of post-operative fluid guidelines which resulted in errors in the prescriptions made. This is associated with pneumonia, ileus and prolonged length of hospital stay.

scholarly journals Association of metabolic equivalent of task (MET) score in length of stay in hospital following radical cystectomy with urinary diversion: a multi-institutional study

2021 ◽  
Author(s):  
Chun Shea ◽  
Abdul Rouf Khawaja ◽  
Khalid Sofi ◽  
Ghulam Nabi
Keyword(s):  
Hospital Stay ◽  
Radical Cystectomy ◽  
Urinary Diversion ◽  
Functional Capacity ◽  
Cox Regression ◽  
Length Of Hospital Stay ◽  
Postoperative Outcomes ◽  
Comorbid Conditions ◽  
Metabolic Equivalent ◽  
Metabolic Equivalent Of Task

Abstract Purpose The Metabolic equivalent of task (MET) score is used in patients’ preoperative functional capacity assessment. It is commonly thought that patients with a higher MET score will have better postoperative outcomes than patients with a lower MET score. However, such a link remains the subject of debate and is yet unvalidated in major urological surgery. This study aimed to explore the association of patients’ MET score with their postoperative outcomes following radical cystectomy. Methods We used records-linkage methodology with unique identifiers (Community Health Index/hospital number) and electronic databases to assess postoperative outcomes of patients who had underwent radical cystectomies between 2015 and 2020. The outcome measure was patients’ length of hospital stay. This was compared with multiple basic characteristics such as age, sex, MET score and comorbid conditions. A MET score of less than four (< 4) is taken as the threshold for a poor functional capacity. We conducted unadjusted and adjusted Cox regression analyses for time to discharge against MET score. Results A total of 126 patients were included in the analysis. Mean age on date of operation was 66.2 (SD 12.2) years and 49 (38.9%) were female. A lower MET score was associated with a statistically significant lower time-dependent risk of hospital discharge (i.e. longer hospital stay) when adjusted for covariates (HR 0.224; 95% CI 0.077–0.652; p = 0.006). Older age (adjusted HR 0.531; 95% CI 0.332–0.848; p = 0.008) and postoperative complications (adjusted HR 0.503; 95% CI 0.323–0.848; p = 0.002) were also found to be associated with longer hospital stay. Other comorbid conditions, BMI, disease staging and 30-day all-cause mortality were statistically insignificant. Conclusion A lower MET score in this cohort of patients was associated with a longer hospital stay length following radical cystectomy with urinary diversion.

scholarly journals Influence of Weekday of Admission and Level of Distress on Length of Hospital Stay in Patients With Low Back Pain: A Retrospective Cohort Study

2020 ◽  
Author(s):  
Emanuel Brunner ◽  
André Meichtry ◽  
Davy Vancampfort ◽  
Reinhard Imoberdorf ◽  
David Gisi ◽  
...  
Keyword(s):  
Primary Care ◽  
Cohort Study ◽  
Back Pain ◽  
Hospital Stay ◽  
Linear Model ◽  
Length Of Hospital Stay ◽  
Complex Problem ◽  
Interdisciplinary Management ◽  
Prolonged Length ◽  
The Impact

Abstract BackgroundLow back pain (LBP) is often a complex problem requiring interdisciplinary management to address patients’ multidimensional needs. The inpatient care for patients with LBP in primary care hospitals is a challenge. In this setting, interdisciplinary LBP management is often unavailable during the weekend. Delays in therapeutic procedures may result in prolonged length of hospital stay (LoS). The impact of delays on LoS might be strongest in patients reporting high levels of psychological distress. Therefore, this study investigates which influence the weekday of admission and distress have on LoS of inpatients with LBP.MethodsRetrospective cohort study conducted between 1 February 2019 and 31 January 2020. ANOVA was used to test the hypothesized difference in mean effects of the weekday of admission on LoS. Further, a linear model was fitted for LoS with distress, categorical weekday of admission (Friday/Saturday vs. Sunday-Thursday), and their interactions.ResultsWe identified 173 patients with LBP. Mean LoS was 7.8 days (SD=5.59). Patients admitted on Friday (mean LoS=10.3) and Saturday (LoS=10.6) had longer stays but not those admitted on Sunday (LoS=7.1). Analysis of the weekday effect (Friday/Saturday vs. Sunday-Thursday) showed that admission on Friday or Saturday was associated with significant increase in LoS compared to admission on other weekdays (t=3.43, p=<0.001). 101 patients (58%) returned questionnaires, and complete data on distress was available from 86 patients (49%). According to a linear model for LoS, the effect of distress on LoS was significantly modified (t=2.51, p=0.014) by dichotomic weekdays of admission (Friday/Saturday vs. Sunday-Thursday).ConclusionsPatients with LBP are hospitalized significantly longer if they have to wait more than two days for interdisciplinary LBP management. This particularly affects patients reporting high distress. Our study provides a platform to further explore whether interdisciplinary LBP management addressing patients’ multidimensional needs reduces LoS in primary care hospitals.

scholarly journals EP.WE.782Retrospective analysis of acute surgical admissions during COVID-19 pandemic

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Shenbaga Rajamanikam ◽  
Suzzana Argyropoulos ◽  
Reza Arsalani Zadeh
Keyword(s):  
Length Of Stay ◽  
Hospital Stay ◽  
Surgical Procedures ◽  
Length Of Hospital Stay ◽  
Period Length ◽  
Surgical Patients ◽  
Surgical Team ◽  
Surgical Operations

Abstract Background COVID-19 pandemic has affected the number of surgical admissions and the number of emergency general surgical operations performed. COVID-19 pandemic has also led to changes in how some of the acute surgical patients were managed. Aim of the study was to compare acute surgical admissions and number of emergency general surgical procedures in this period. Material and Method We retrospectively analyzed acute surgical admissions during the pandemic from 20/3/20 to 19/4/20 and compared it with acute surgical admissions during pre-COVID-19 period from 1/11/2019 to 30/11/2019. Results During the COVID-19 pandemic 97 patients were assessed and admitted by the General surgical team, during the pre COVID-19 period 205 patients were assessed and admitted by the General surgical team. The number of acute surgical admissions during COVID-19 pandemic dropped by 53%. There were 46% less emergency surgeries performed during COVID 19 pandemic period. Length of stay during and before the COVID-19pandemic were 4.1 vs 4.4 days. Conclusion During the COVID-19 pandemic number of acute surgical admissions and the number of emergency surgeries were fewer than during pre COVID-19 pandemic. Length of hospital stay was less during COVID-19 pandemic.

scholarly journals Intervenção percutânea por via radial e tempo de permanência hospitalar

2018 ◽  
Vol 12 (6) ◽  
pp. 1665
Author(s):  
Denise Viana Rodrigues de Oliveira ◽  
João Pimenta ◽  
George Ximenes ◽  
Agueda Maria Ruiz Zimmer Cavalcante
Keyword(s):  
Health System ◽  
Hospital Stay ◽  
Pearson Correlation ◽  
Length Of Hospital Stay ◽  
Coronary Intervention ◽  
Study Data ◽  
Significance Level ◽  
Coronary Syndrome ◽  
Unified Health System ◽  
Factores De Riesgo

RESUMOObjetivo: analisar os fatores de risco relacionados ao procedimento percutâneo por via radial e o tempo de permanência hospitalar. Método: estudo quantitativo, longitudinal, prospectivo, descritivo e unicêntrico. A coleta de dados foi realizada por meio de questionário, com 100 pacientes, em três fases (pré-procedimento, transprocedimento e pós-procedimento), em 24h e após sete dias. Para as variáveis quantitativas, foram utilizados os testes Mann-Whitnney ou t de Student; para as qualitativas, o teste exato de Fisher. Para a associação entre duas variáveis quantitativas, foi utilizado o coeficiente de correlação de Pearson com nível de significância ≤5%. Resultados: 100 pacientes realizaram o procedimento com média de internação de 6,6 dias. Após a associação entre o tempo de permanência e as variáveis clínicas, o p não mostrou valor significante. Conclusão: os resultados aproximam-se mais da realidade dos hospitais do Sistema Único de Saúde; não houve linearidade no tempo de permanência hospitalar quando associado a diferentes fatores relacionados à intervenção percutânea. Descritores: Intervenção Coronária Percutânea; Tempo de Internação; Artéria Radial; Sistema Único de Saúde; Síndrome Coronária Aguda; Fatores de Risco.ABSTRACTObjective: to analyze the risk factors related to the percutaneous radial procedure and length of hospital stay. Method: quantitative, longitudinal, prospective, descriptive and unicentric study. Data was collected through a questionnaire, with 100 patients, in three phases (pre-procedure, transprocedure and post-procedure), in 24 hours and after seven days. For the quantitative variables, the Mann-Whitnney or Student's t tests were used; for the qualitative, Fisher's exact test. For the association between two quantitative variables, the Pearson correlation coefficient was used with significance level ≤5%. Results: 100 patients had the procedure with mean hospitalization of 6.6 days. After the association between the length of stay and clinical variables, p did not show significant value. Conclusion: the results are closer to the reality of the hospitals of the Unified Health System; there was no linearity in the length of hospital stay when associated with different factors related to the percutaneous intervention. Descriptors: Percutaneous Coronary Intervention; Length of hospitalization; Radial Artery; Unified Health System; Acute Coronary Syndrome; Risk Factors.RESUMEN Objetivo: analizar los factores de riesgo relacionados con el procedimiento percutáneo por vía radial y el tiempo de permanencia hospitalaria. Método: Estudio cuantitativo, longitudinal, prospectivo, descriptivo y unicéntrico. La recolección de datos fue realizada por medio de un cuestionario, con 100 pacientes, en tres fases: (pre-procedimiento, transprocedimiento y post-procedimiento), en 24h y después de siete días. Para las variables cuantitativas, se utilizaron las pruebas Mann-Whitnney o t de Student; para las cualitativas, la prueba exacta de Fisher. Para la asociación entre dos variables cuantitativas, se utilizó el coeficiente de correlación de Pearson con nivel de significancia ≤5 %%. Resultados: 100 pacientes realizaron el procedimiento, con promedio de internación de 6,6 días. Después de la asociación entre el tiempo de permanencia y las variables clínicas, el p no mostró valor significativo. Conclusión: los resultados se acercaron más a la realidad de los hospitales del Sistema Único de Salud; no hubo linealidad en el tiempo de permanencia hospitalaria, cuando asociado a diferentes factores relacionados a la intervención percutánea. Descriptores: Intervención Coronaria Percutánea; Tiempo de Internación; Arteria Radial; Sistema Único de Salud; Síndrome Coronária Aguda; Factores de Riesgo.

Preoperative Hyponatremia Is Associated with Reoperation and Prolonged Length of Hospital Stay following Total Knee Arthroplasty

2018 ◽  
Vol 32 (04) ◽  
pp. 344-351 ◽  
Author(s):  
Matthew Abola ◽  
Joseph Tanenbaum ◽  
Thomas Bomberger ◽  
Derrick Knapik ◽  
Steven Fitzgerald ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Risk Factor ◽  
Hospital Stay ◽  
Knee Arthroplasty ◽  
Length Of Hospital Stay ◽  
Adverse Outcomes ◽  
Limited Information ◽  
Improvement Program ◽  
Prolonged Length ◽  
Total Knee

AbstractHyponatremia is a risk factor for adverse surgical outcomes, but limited information is available on the prognosis of hyponatremic patients who undergo total knee arthroplasty (TKA). The purpose of this investigation was to compare the incidence of major morbidity (MM), 30-day readmission, 30-day reoperation, and length of hospital stay (LOS) between normonatremic and hypontremic TKA patients.The American College of Surgeons National Surgical Quality Improvement Program database was used to identify all primary TKA procedures. Hyponatremia was defined as <135 mEq/L and normonatremia as 135 to 145 mEq/L; hypernatremic patients (>145 mEq/L) were excluded. Multivariable logistic regression was used to determine the association between hyponatremia and outcomes after adjusting for demographics and comorbidities. An α level of 0.002 was used and calculated using the Bonferroni correction. Our final analysis included 88,103 patients of which 3,763 were hyponatremic and 84,340 were normonatremic preoperatively. In our multivariable models, hyponatremic patients did not have significantly higher odds of experiencing an MM (odds ratio [OR]: 1.05; 99% confidence interval [CI] 0.93–1.19) or readmission (OR: 1.12; 99% CI: 1–1.24). However, patients with hyponatremia did experience significantly greater odds for reoperation (OR: 1.24; 99% CI: 1.05–1.46) and longer hospital stay (OR: 1.15; 99% CI: 1.09–1.21). We found that hyponatremic patients undergoing TKA had increased odds of reoperation and prolonged hospital stay. Preoperative hyponatremia may be a modifiable risk factor for adverse outcomes in patients undergoing TKA, and additional prospective studies are warranted to determine whether preoperative correction of hyponatremia can prevent complications.

Does Alcohol Intoxication Protect Patients from Severe Injury and Reduce Hospital Mortality? The Association of Alcohol Consumption with the Severity of Injury and Survival in Trauma Patients

2013 ◽  
Vol 79 (12) ◽  
pp. 1289-1294 ◽  
Author(s):  
Chi-Hsun Hsieh ◽  
Li-Ting Su ◽  
Yu-Chun Wang ◽  
Chih-Yuan Fu ◽  
Hung-Chieh Lo ◽  
...  
Keyword(s):  
Alcohol Consumption ◽  
Hospital Stay ◽  
Brain Injuries ◽  
Injury Severity ◽  
Motor Vehicle ◽  
Length Of Hospital Stay ◽  
Trauma Patients ◽  
Prolonged Hospital Stay ◽  
Severe Injuries ◽  
Prolonged Hospital

Alcohol-related motor vehicle collisions are a major cause of mortality in trauma patients. This prospective observational study investigated the influence of antecedent alcohol use on outcomes in trauma patients who survived to reach the hospital. From 2005 to 2011, all patients who were older than 18 years and were admitted as a result of motor vehicle crashes were included. Blood alcohol concentration (BAC) was routinely measured for each patient on admission. Patients were divided into four groups based on their BAC level, which included nondrinking, BAC less than 100, BAC 100 to 200, and BAC 200 mg/dL or greater. Patient demographics, physical status and injury severity on admission, length of hospital stay, and outcome were compared between the groups. Odds ratios of having a severe injury, prolonged hospital stay, and mortality were estimated. Patients with a positive BAC had an increased risk of sustaining craniofacial and thoracoabdominal injuries. Odds ratios of having severe injuries (Injury Severity Score [ISS] 16 or greater) and a prolonged hospital stay were also increased. However, for those patients whose ISS was 16 or greater and who also had a brain injury, risk of fatality was significantly reduced if they were intoxicated (BAC 200 mg/dL or greater) before injury. Alcohol consumption does not protect patients from sustaining severe injuries nor does it shorten the length of hospital stay. However, there were potential survival benefits related to alcohol consumption for patients with brain injuries but not for those without brain injuries. Additional research is required to investigate the mechanism of this association further.

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