Initiation of Sepsis Alert Protocol at a Community Teaching Hospital: Its Effect on Hospital Mortality of Septic Patients and Diurnal Differences in Adherence to the Protocol

CHEST Journal ◽  
2010 ◽  
Vol 138 (4) ◽  
pp. 389A
Author(s):  
Nutan Bhaskar ◽  
Rajesh Patel ◽  
Divya Ramaraju ◽  
Latha Achanta ◽  
Richard Eisenstaedt
Keyword(s):  
Hospital Mortality ◽  
Teaching Hospital ◽  
Community Teaching

scholarly journals Determinants of all-cause in-hospital mortality among patients who presented with COVID-19 to a community teaching hospital in Michigan

Heliyon ◽  
2021 ◽  
pp. e08566
Author(s):  
Ali Zakaria ◽  
Marc Piper ◽  
Lahib Douda ◽  
Nancy M. Jackson ◽  
Jeffrey C. Flynn ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Teaching Hospital ◽  
Community Teaching

scholarly journals 399. Risk Factors for Mortality in COVID-19 Patients in a Community Teaching Hospital

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S268-S268
Author(s):  
Justin A Andrade ◽  
Karina Muzykovsky ◽  
James Truong
Keyword(s):  
Risk Factors ◽  
Renal Failure ◽  
Logistic Regression ◽  
Hospital Mortality ◽  
Teaching Hospital ◽  
Case Series ◽  
Advanced Age ◽  
Retrospective Case ◽  
Multivariable Logistic Regression ◽  
Community Teaching

Abstract Background As of May 2020, there were over 190,000 confirmed COVID-19 cases in New York City (NYC) with approximately 13,000 deaths. Previously published literature identified risk factors (advanced age, higher severity of illness and elevated d-dimer) for mortality in a cohort of patients from Wuhan, China and mechanical ventilation in a case series from NYC. Another case series from NYC evaluated clinical outcomes only. There are limited published studies assessing clinical characteristics, outcomes and risk factors for mortality in COVID-19 patients in NYC. The objective of this study was to assess the risk factors for mortality in patients with confirmed COVID-19 infections. Methods This study was a single center retrospective case-control at The Brooklyn Hospital Center, a 464-bed community teaching hospital. Adult patients with confirmed COVID-19 infection, who received at least 24 hours of COVID-19 therapy were included. Endpoints assessed were risk factors for mortality in COVID-19 patients, increase in QTc, renal failure or renal replacement therapy, ventricular fibrillation or ventricular tachycardia. Baseline characteristics between survivor and non-survivors were analyzed utilizing Mann-Whitney U test/two-tailed t-tests for continuous data and Chi-square/Fisher’s exact test for categorical data. Univariable and multivariable logistic regression analyses were conducted to identify the risk factors for in-hospital mortality. Results Two-hundred and eighty six patients were included in this analysis, of whom 97 (33.9%) were non-survivors and 189 (66.1%) patients were survivors. Diabetes and coronary artery disease were more common in non-survivors compared to survivors (p = 0.003 and p < 0.001, respectively). Multivariable logistic regression showed higher in-hospital mortality in patients with advanced age (odds ratio 5.779, 95 % confidence interval 1.369–24.407), vasopressor initiation (OR 28.301, 95 % CI 3.307–242.176), and development of renal failure (OR 30.927, 95 % CI 1.871–511.201). Conclusion Risk factors associated with mortality for COVID-19 patients in a community teaching hospital include advanced age, vasopressor therapy, and development of renal failure. Disclosures All Authors: No reported disclosures

scholarly journals A Retrospective Review of 589 Percutaneous Tracheostomies in a Canadian Community Teaching Hospital

2021 ◽  
pp. 014556132110257
Author(s):  
Dongho Shin ◽  
Andrew Ma ◽  
Yvonne Chan
Keyword(s):  
Retrospective Study ◽  
Teaching Hospital ◽  
Intraoperative Complications ◽  
Percutaneous Tracheostomy ◽  
Hospital Setting ◽  
Complication Rates ◽  
Safe Alternative ◽  
Neck Extension ◽  
Intraoperative Complication ◽  
Community Teaching

Objective: The primary objective of this study was to review the complication rate of percutaneous tracheostomies performed by a single surgeon in a community teaching hospital. Methods: This retrospective study reviewed the patients who underwent percutaneous tracheostomy with bronchoscopic guidance in a community hospital setting between 2009 and 2017. Patients older than the age of 18 requiring percutaneous tracheostomy were chosen for this retrospective study. Patients who were medically unstable, had no palpable neck landmarks, and inadequate neck extension were excluded. Indications for percutaneous tracheostomy included patients who had failed to wean from mechanical ventilation, required pulmonary toileting, or in whom airway protection was required. Results: Of the 600 patients who received percutaneous tracheostomy, 589 patients were included in the study. Intraoperative complication (2.6%) and postoperative complication rates (11.4%) compared similarly to literature reported rates. The most common intraoperative complications were bleeding, technical difficulties, and accidental extubation. Bleeding, tube obstruction, and infection were the most common postoperative complications. Overall burden of comorbidity, defined by Charlson Comorbidity Index, and coagulopathy were also found to be associated with higher complication rates. The decannulation rate at discharge was 46.3%. Conclusion: Percutaneous tracheostomy is a safe alternative to open tracheostomies in the community setting for appropriately selected patients.

Cost-Effective Eradication of an Outbreak of Methicillin-Resistant Staphylococcus aureus in a Community Teaching Hospital

1988 ◽  
Vol 9 (6) ◽  
pp. 255-260 ◽  
Author(s):  
Nalini Rao ◽  
Sharon Jacobs ◽  
Linda Joyce
Keyword(s):  
Staphylococcus Aureus ◽  
Teaching Hospital ◽  
Cost Effective ◽  
Methicillin Resistant ◽  
Critical Care Units ◽  
Outbreak Period ◽  
Surgical Teaching ◽  
The Cost ◽  
Community Teaching ◽  
Microbiological Surveillance

AbstractDuring an eight-month period, 25 hospitalized patients became infected or colonized with methicillin-resistant Staphylococcus aureus (MRSA) in a 464-bed acute care, medical-surgical teaching hospital. There were only five cases during the eight months prior to the outbreak period (P < 0.0001). Initial measures, including category-specific isolation and education, did not limit the spread of the outbreak of a strain of MRSA. This prompted institution of additional measures including (1) strict isolation of all infected and colonized cases; (2) prospective microbiological surveillance to detect additional cases; (3) multiple site cultures of identified cases to determine the extent of colonization; (4) employee and environment surveillance; (5) antibiotic decolonization of patients and employees; and (6) educational efforts. The highest number of personnel carriers were noted in one of the critical care units where most of the cases occurred. The decolonization protocol was 100% effective for personnel carriers. The incidence of nosocomial cases of MRSA fell to zero in the five months following the implementation of the strategy. The cost of the entire eradication process was approximately half that of treating a single MRSA bacteremia.

Influence of house-staff experience on teaching-hospital mortality: The “July Phenomenon” revisited

2011 ◽  
Vol 6 (7) ◽  
pp. 389-394 ◽  
Author(s):  
Carl van Walraven ◽  
Alison Jennings ◽  
Jenna Wong ◽  
Alan J. Forster
Keyword(s):  
Hospital Mortality ◽  
Teaching Hospital ◽  
House Staff ◽  
July Phenomenon
Sign in / Sign up

Export Citation Format

Share Document