Abstract 23: Trends in Kawasaki Disease Incidence - 2004-2014

Circulation ◽  
2015 ◽  
Vol 131 (suppl_2) ◽  
Author(s):  
Sara K Sexson Tejtel ◽  
Andrea A Ramirez ◽  
Amy Liou ◽  
Thomas Seery ◽  
Debra Canter ◽  
...  
Keyword(s):  
Kawasaki Disease ◽  
Average Length ◽  
Disease Incidence ◽  
Steady Increase ◽  
Patients Âgés ◽  
The Past ◽  
Average Length Of Stay ◽  
Number Of Patients ◽  
The Us ◽  
Acquired Heart Disease

Background: Kawasaki disease is the leading cause of acquired heart disease in children in the US. While it remains a rare disease, the purpose of this study is to evaluate the incidence of KD Methods: To evaluate our hypothesis we used the Pediatric Health Information Systems (PHIS), 2004-2013, including all discharges at 44 of the largest freestanding children’s hospitals in the US. Results: Between 2004-2013, there were 16,417 hospitalizations for KD, 10,388 (61%) were male. The race of patients admitted with KD showed 5276 (31%) Caucasian, 2370 (14%) African American, 1586 (9.3%) Other, and 941 (5.5%) Asian. The average length of stay 3.9 days. The number of patients with KD increased annually for the past decade, Figure 1. The largest proportion of the increase was from those children between 1 and 5 years of age, Figure 2. Most children were only hospitalized once (14,231, 84%) however some children required subsequent hospitalization (1,291,8%). Conclusions: There has been a steady increase in the number of admissions per year for Kawasaki disease predominately for those patients ages 1-5 years.

scholarly journals P17 An audit of Trakcare discharge times for Laparoscopic Cholecystectomy

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Jacob Rapier ◽  
Steven Hornby ◽  
Jacob Rapier
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Length Of Stay ◽  
Initial Data ◽  
Best Practice ◽  
Average Length ◽  
Accurate Data ◽  
Day Case ◽  
Average Length Of Stay ◽  
Number Of Patients ◽  
Elective Laparoscopic Cholecystectomy

Abstract Introduction Nationally 61,220 Laparoscopic Cholecystectomies are carried out annually. Those carried out as day-cases reduce providers’ costs and increase income through the best practice tariff. The system in our trust to record discharges is ‘Trakcare’. The aim of this audit was to accurately measure the discharge times of patients undergoing elective Laparoscopic Cholecystectomies, to try and reduce the number of patients recorded as having an overnight stay by accurate data collection. Methods Initial data was collected for all elective Laparoscopic Cholecystectomy discharge times on Trakcare, over a 1 month period. This data was then re-audited prospectively both from Trakcare and discharges reported by nurses/patients. A comparison was then made of Trakcare against reported discharge times. Results Initially 54 operations were recorded, with 30 completed as day cases (55.6%). The re-audited data (on Trakcare) recorded 47 operations, with 15 completed as day cases (37.91%). Of these discharges we were able to capture 26 (55.32%) manually, and 11 were completed as day cases (42.31%). Measuring these 26 with the same operations on Trakcare we were unable to show a difference in the number of cases completed as a day case (11 vs 11), with only a 33 minute decrease in the average length of stay. Conclusion Trakcare is a reliable tool for measuring the date of discharge for patients. The recommendations in are: scheduling surgery for a time pre-13:00 shows a higher proportion of patients discharged the same day, and continue to use Trakcare to record discharge times.

Haitian Earthquake Relief: Disaster Response Aboard the USNS Comfort

2012 ◽  
Vol 6 (4) ◽  
pp. 370-377 ◽  
Author(s):  
Ryan M. Walk ◽  
Timothy F. Donahue ◽  
Zsolt Stockinger ◽  
M. Margaret Knudson ◽  
Miguel Cubano ◽  
...  
Keyword(s):  
Disaster Response ◽  
Average Length ◽  
Mass Casualty ◽  
Unique Identifier ◽  
Average Length Of Stay ◽  
Us Military ◽  
The Us ◽  
Patient Database ◽  
Medical Teams ◽  
Relief Efforts

ABSTRACTObjective: The Haitian earthquake of January 12, 2010, was a disaster essentially unprecedented in the Western Hemisphere's recorded history. The USNS Comfort departed from Baltimore, Maryland, within 72 hours of the earthquake and arrived in Port-au-Prince harbor on January 19. During the subsequent 40 days, the ship provided one of the largest relief efforts in the US Navy's history.Methods: The data analyzed included all patients evaluated and treated by the USNS Comfort between January 19 and February 27, 2010. A medical chart with a unique identifier was created for each patient on admission. A patient database was created from these records and used for this analysis.Results: A total of 872 patients and 185 patient escorts were processed aboard the ship. Ages ranged from younger than 1 day to 89 years: 635 were adults and 237 were children. Of those admitted, 817 of the patients were admitted for longer than 24 hours; the average length of stay was 8.0 days. The need for surgery was substantial: 454 patients went to the operating room (OR) 843 times for 927 cumulative procedures. A total of 58 patients underwent amputations.Conclusions: Haiti was almost completely reliant on foreign medical teams for trauma care. Analysis of the data illustrates the challenges of triage and treatment in a humanitarian mass-casualty response. The remarkable coordination and cooperation among the Haitian Ministry of Health, nongovernmental humanitarian aid organizations, and the US military highlighted the responders' respective capabilities and demonstrated the importance of collaboration in future disaster response efforts.(Disaster Med Public Health Preparedness. 2012;6:370–377)

Description of the Elderly Psychiatric Admissions in Recent Years

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
P. Rico-Villademoros ◽  
R. Touzon ◽  
E. Garnica
Keyword(s):  
Elderly Population ◽  
Average Length ◽  
The Elderly ◽  
Assistive Devices ◽  
Psychiatric Unit ◽  
Average Length Of Stay ◽  
Psychiatric Admissions ◽  
Number Of Patients ◽  
Stay Time ◽  
Acute Patients

Aims:To analyze the characteristics of the admissions of elderly patients in an acute psychiatric unit in recent years, to see if there have been any changes in the number, the average stay or in their referral from the hospital.Method:Details of all admissions in a psychiatric unit for acute patients aged over 65 since 1999 are collected by means of a computer system. the number of admissions, the average length of stay and where they go when discharged are taken into account.Results:In recent years the number of patients over 65 entering our unit has remained relatively stable. the average stay time remains high over all the studied years. It is proved that a large number of patients need to be moved to residences or other assistive devices when discharged.Conclusions:Despite the increase in elderly population, the number of patients over 65 who enter this unit has not significantly increased. their average stay remains always high over the years. It is striking the number of patients who can no longer go home when discharged, once they have been admitted.

Description of the Elderly Psychiatric Admissions in Recent Years

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
P. Rico-Villademoros ◽  
R. Touzon ◽  
E. Garnica
Keyword(s):  
Elderly Population ◽  
Average Length ◽  
The Elderly ◽  
Assistive Devices ◽  
Psychiatric Unit ◽  
Average Length Of Stay ◽  
Psychiatric Admissions ◽  
Number Of Patients ◽  
Stay Time ◽  
Acute Patients

Aims:To analyze the characteristics of the admissions of elderly patients in an acute psychiatric unit in recent years, to see if there have been any changes in the number, the average stay or in their referral from the hospital.Method:Details of all admissions in a psychiatric unit for acute patients aged over 65 since 1999 are collected by means of a computer system. The number of admissions, the average length of stay and where they go when discharged are taken into account.Results:In recent years the number of patients over 65 entering our unit has remained relatively stable. The average stay time remains high over all the studied years. It is proved that a large number of patients need to be moved to residences or other assistive devices when discharged.Conclusions:Despite the increase in elderly population, the number of patients over 65 who enter this unit has not significantly increased. Their average stay remains always high over the years. It is striking the number of patients who can no longer go home when discharged, once they have been admitted.

Patient-Specific Hemodynamic Simulations in Coronary Artery Aneurysms Caused by Kawasaki Disease

2010 ◽  
Author(s):  
Dibyendu Sengupta ◽  
Jane C. Burns ◽  
Andrew Kahn ◽  
Alison L. Marsden
Keyword(s):  
Kawasaki Disease ◽  
Coronary Arteries ◽  
Assessment Tool ◽  
San Diego County ◽  
Patient Specific ◽  
The Us ◽  
Acquired Heart Disease ◽  
Intravenous Gamma Globulin ◽  
Receive Treatment ◽  
To Receive

Kawasaki disease (KD) is an acute pediatric illness and the leading cause of acquired heart disease in children, with over 4,000 cases diagnosed annually in the US. The incidence of KD in San Diego County is 25/100,000 for children less than 5 years of age. In absence of a diagnostic test for KD, many patients are not diagnosed in time to receive treatment with intravenous gamma globulin. Approximately 25% of untreated patients develop large aneurysms in their coronary arteries, which puts them at risk for myocardial infarction. In this project we performed patient specific computational simulations of blood flow in aneurysmal left and right coronary arteries of a 10-year-old KD patient. Several relevant hemodynamic parameters such as wall shear stress (WSS) and recirculation time were obtained, as a first step toward developing a risk assessment tool for thrombosis in KD patients.

Synchronous primary ovarian and endometrial cancer in recent years: Changes in recent years.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e16554-e16554
Author(s):  
Maria Creselda deLeon ◽  
Giuseppe Del Priore ◽  
Deleep Gudipudi
Keyword(s):  
Endometrial Cancer ◽  
Disease Incidence ◽  
Tumor Grade ◽  
The United States ◽  
Disease Stage ◽  
Primary Ovarian Cancer ◽  
The Past ◽  
Included Patient ◽  
The Us ◽  
Age Of Diagnosis

e16554 Background: Patients with synchronous ovarian and endometrial cancer (SOEC) have been shown to have better prognosis when compared to patients with primary ovarian cancer alone; however with the increasing rate of obesity in the United States we hypothesize that this disease has significant characteristic changes compared to 20 years ago. Methods: This is retrospective study of patients with SOEC diagnosed between 1973-2009. We compared patients from 1973-1991 (n=962) to patients diagnosed between 1992-2009 (n=1800) when obesity became >10% of the US population starting in 1992. Using the Surveillance, Epidemiology, and End Results (SEER) registry, we obtained demographic information which included patient ID, primary site of tumor, year of diagnosis, sex, race, age group and survival months. SOEC was defined as diagnosis of ovarian and endometrial cancer within 0-12 months. Results: A query of SEOC yielded 2,762 women between the ages of 13-99 years. When we compared the stage of disease which was described as localized, regional, distant and unstaged, tumor grade and disease incidence, there was no difference found between the two groups. However when the age of diagnosis was compared, it was apparent that patients diagnosed between the years 1992-2009 were diagnosed at an earlier age 41-50 (28%) compared to patients diagnosed in 1973-1991 who were mostly diagnosed between ages 61-70 (31%) (p <0.001). Conclusions: We were able to demonstrate that women with SOEC in recent years are more likely to be diagnosed at an earlier age but that the disease stage, grade and incidence have stayed the same in the past 40 years. The hypothesis then that SOEC may have gone through some characteristic changes in the past 20 years seems plausible especially in the setting of increase incidence of obesity. [Table: see text]

scholarly journals Serum responses of children with Kawasaki Disease against SARS-CoV-2 proteins

2020 ◽  
Author(s):  
Arthur J Chang ◽  
Michael Croix ◽  
Patrick Kenney ◽  
Sarah Baron ◽  
Mark D Hicar
Keyword(s):  
Heart Disease ◽  
Kawasaki Disease ◽  
Pediatric Population ◽  
Infectious Agent ◽  
Inflammatory Disorder ◽  
Plasma Samples ◽  
The Past ◽  
Acquired Heart Disease

Recently, numerous reports have suggested association of pediatric Coronavirus Disease 2019 (COVID-19) cases and Kawasaki Disease (KD). KD is a major cause of childhood acquired heart disease and vasculitis in the pediatric population. Epidemiological patterns suggest KD is related to an infectious agent; however, the etiology remains unknown1. As past reports have considered other coronaviruses to be related to KD2,3, these reports of pediatric COVID-19 related inflammatory disorder cases leads to the hypothesis of potential cross-coronavirus reactivity that would account for the past controversial proposals of other coronaviruses and these new cases. We sought to address this hypothesis by assessing the antigen targeting of biobanked plasma samples of febrile children, including those with KD, against SARS-CoV-2 proteins.

scholarly journals Frequency of hospitalization in patients diagnosed with congenital talipes equinovarus (CTEV)

2015 ◽  
Vol 125 (4) ◽  
pp. 219-222
Author(s):  
Piotr Okoński ◽  
Patrycja Misztal-Okońska ◽  
Marek Okoński ◽  
Piotr Książek ◽  
Mariusz Goniewicz
Keyword(s):  
Medical Records ◽  
Average Length ◽  
Medical Documentation ◽  
Congenital Talipes Equinovarus ◽  
Average Length Of Stay ◽  
Number Of Patients ◽  
Talipes Equinovarus ◽  
Congenital Limb ◽  
Congenital Talipes ◽  
Dysplasia Of The Hip

Abstract Introduction. Congenital talipes equinovarus (CTEV), also called clubfoot is the second after congenital dysplasia of the hip (CDH) most frequently occurring congenital limb defect. In Europe the deformity affects 1-2 newborns in 1000 live births. Aim. The aim of the study was to determine frequency of the deformity among other reasons for hospitalization, as well as depicting the profile of patients treated for clubfoot. Material and methods. Study method was the analysis of medical documentation from two Orthopaedic Wards of Prof. Antoni Gębala Children’s Hospital of Lublin. Medical records of patients treated for congenital talipes equinovarus (IDC 10-Q66.0) between 2008 and 2013 were the study material. Results. Results of the study show that in the analyzed period of time 310 children were hospitalized for clubfoot in hospotal. 39.35% (n=122) of the total number of patients were girls and 60.65% (n=188) were boys. The average age of patients was 3.69 years, (Me=1.09 years). Average age of girls was 4.17 (Me=1.35 years) and boys 3.89 (Me=0.83 years). The most numerous group consisted of infants up to 1 year (n=154; 49.68%). Conclusions. Clubfoot affects boys twice as often as girls. Moreover, in the examined hospital the average length of stay for patients with clubfoot has decreased. The research reveals that the average hospitalization length in children with congenital talipes equinovarus is systematically decreasing. The study shows that the number of patients being admitted to the Children’s Orthopedics Institute of the Hospital is increasing while the number of patients with clubfoot remains on the same level.

Emergency department presentation with colorectal cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15094-e15094
Author(s):  
Yasmin A. Zerhouni ◽  
Nelya Melnitchouk ◽  
Eric Schneider ◽  
Aparajita Singh
Keyword(s):  
Colorectal Cancer ◽  
Emergency Department ◽  
Average Length ◽  
Primary Diagnosis ◽  
Surgical Patients ◽  
Average Length Of Stay ◽  
The Us ◽  
Ed Visits ◽  
Index Hospital ◽  
Emergent Surgery

e15094 Background: Despite screening protocols shown to reduce mortality, colorectal cancer (CRC) remains the 2nd leading cause of cancer death in the US. CRC patients who have emergent surgery have worse outcomes than those treated electively. We examined presentation and index hospital outcomes for emergency department (ED) patients with a primary diagnosis of CRC. Methods: The 2013 Healthcare Cost and Utilization Project Nationwide Emergency Department Sample was queried and all patients with a primary ICD-9-CM diagnosis of CRC were identified. Descriptive analyses were weighted to the level of the US population. Results: Among 134,869,015 ED visits, approximately 44,717 patients received a primary diagnosis of CRC. Patients with CRC were older (68 vs. 40 years, p < 0.001) and more likely to be male (50.4% vs. 44.3%, p < 0.001) than those presenting for other reasons. Among CRC patients, 88.6% were older than 50 years with males younger than females (66 vs. 70y, p < 0.001) and 90.4% were insured. 88.6% were admitted of whom 44% underwent oncologic resection. Females were more likely to undergo resection (47% vs.42%, p = < 0.001) and to be older at time of surgery (71 vs. 68, p = < 0.001). Average length of stay was 12.5 days for surgical vs. 6.6 days for non-surgical patients (p < 0.001). After admission, 68.0% of those admitted vs. 64.7% of patients who had surgery were discharged home. 6.9% of admitted CRC patients and 4.7% of surgical patients died in-hospital. Average total charges were $124,846 for patients undergoing resection vs. $53,542 for inpatients who did not undergo surgery (p < 0.001). Conclusions: Most patients presenting to the ED for CRC are admitted and many require surgical intervention. Because nearly 90% were 50 or older and insured, further research is warranted to determine if increased screening among eligible patients might reduce the numbers of ED presentations and emergent surgical procedures for CRC.

scholarly journals 1403. The Pediatric Emergency Room as a Promising Setting for Receiving the Flu Shot

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S709-S709
Author(s):  
Christine M Miller ◽  
Erin McMahon ◽  
Marissa Parrillo ◽  
Celia Sobelman ◽  
Peter Golenia ◽  
...  
Keyword(s):  
Influenza Vaccine ◽  
Outcome Measures ◽  
Average Length ◽  
Pediatric Emergency ◽  
Secondary Outcome ◽  
P Value ◽  
Eligibility Criteria ◽  
Average Length Of Stay ◽  
Number Of Patients ◽  
Flu Shot

Abstract Background Children are the most likely population to get influenza, and are two times more likely compared to adults aged 65 and greater (attack rate by age group: 0-17 yo 9.3%, 18-74 yo 8.8%, 65 + 3.9%). Additionally, children are at high risk of suffering complications from influenza. According to the CDC, the overall effectiveness of the 2018-2019 flu vaccine for both strains A and B was 48% in children aged 6m-8 years and 7% in children aged 9- 17 years. Currently our Pediatric Emergency Department (PED) does not routinely offer influenza vaccine to unvaccinated patients. Our project goals are to identify barriers to the administration of influenza vaccine in the PED and to offer and administer influenza vaccine to eligible patients. Methods After performing root cause analysis with key stakeholders, the first countermeasure implemented in a Plan-Do-Study Act (PDSA) cycle was the development of a screening form including eligibility criteria, history of influenza vaccine, consent for vaccine or reason for declining vaccine. The screening form was administered by resident physicians in our PED from October to November who then went on to order the vaccine for eligible patients who consented. Primary outcome measures included number of patients screened per month, percent of patients who desired the vaccine, and the percent of patients who received the vaccine in the ED during their visit. Secondary outcome measures included length of PED stay. Results Preliminary results show that 75% (42/56,CI: 62%-86%) of children screened in the PED between October and November were eligible for the influenza vaccine. Of those eligible, 59% (29/42, CI: 43%-74%) received the vaccine. The average length of stay was comparable between those that received influenza vaccine and those that did not (p value 0.4756). Conclusion A subset of eligible patients are now being offered and receiving the flu shot in our PED. Over half of eligible patients received the influenza vaccine, demonstrating that a resident administered screening form has been a successful countermeasure for increasing vaccine rates. Future PDSA cycles will focus on further increasing the number of patients screened and capturing patients who consented but did not receive vaccine. Disclosures All Authors: No reported disclosures

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