scholarly journals A Novel Correction for the Adjusted Box-Pierce Test — New Risk Factors for Emergency Department Return Visits within 72 hours for Children with Respiratory Conditions — General Pediatric Model for Understanding and Predicting Prolonged Length of Stay

2020 ◽  
Author(s):  
◽  
Sidy Danioko
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Length Of Stay ◽  
Prolonged Length ◽  
Return Visits ◽  
Respiratory Conditions

scholarly journals Predictive factors for prolonged hospitalisation in acute pyelonephritis patients admitted to the emergency medicine ward

2021 ◽  
pp. 102490792110009
Author(s):  
Howard Tat Chun Chan ◽  
Ling Yan Leung ◽  
Alex Kwok Keung Law ◽  
Chi Hung Cheng ◽  
Colin A Graham
Keyword(s):  
Emergency Department ◽  
Emergency Medicine ◽  
Length Of Stay ◽  
Acute Pyelonephritis ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Prolonged Length ◽  
Reactive Protein ◽  
Prolonged Hospital ◽  
Emergency Medicine Ward

Background: Acute pyelonephritis is a bacterial infection of the upper urinary tract. Patients can be admitted to a variety of wards for treatment. However, at the Prince of Wales Hospital in Hong Kong, they are managed initially in the emergency medicine ward. The aim of the study is to identify the risk factors that are associated with a prolonged hospital length of stay. Methods: This was a retrospective cohort study conducted in Prince of Wales Hospital. The study recruited patients who were admitted to the emergency medicine ward between 1 January 2014 and 31 December 2017. These patients presented with clinical features of pyelonephritis, received antibiotic treatment and had a discharge diagnosis of pyelonephritis. The length of stay was measured and any length of stay over 72 h was considered to be prolonged. Results: There were 271 patients admitted to the emergency medicine ward, and 118 (44%) had a prolonged hospital length of stay. Univariate and multivariate analyses showed that the only statistically significant predictor of prolonged length of stay was a raised C-reactive protein (odds ratio 1.01; 95% confidence 1.01–1.02; p < 0.0001). Out of 271 patients, 261 received antibiotics in the emergency department. All 10 patients (8.5%) who did not receive antibiotics in emergency department had a prolonged length of stay (p = 0.0002). Conclusion: In this series of acute pyelonephritis treated in the emergency medicine ward, raised C-reactive protein levels were predictive for prolonged length of stay. Patients who did not receive antibiotics in the emergency department prior to emergency medicine ward admission had prolonged length of stay.

Risk Factors for Prolonged Length of Stay or Complications During Pediatric Respiratory Hospitalizations

2015 ◽  
Vol 5 (9) ◽  
pp. 461-473 ◽  
Author(s):  
S. V. Kaiser ◽  
L.-A. Bakel ◽  
M. J. Okumura ◽  
A. D. Auerbach ◽  
J. Rosenthal ◽  
...  
Keyword(s):  
Risk Factors ◽  
Length Of Stay ◽  
Prolonged Length

scholarly journals Prolonged Emergency Department Length of Stay as a Predictor of Adverse Outcomes in Patients with Intracranial Hemorrhage

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Erica M. Jones ◽  
Amelia K. Boehme ◽  
Aimee Aysenne ◽  
Tiffany Chang ◽  
Karen C. Albright ◽  
...  
Keyword(s):  
Emergency Department ◽  
Length Of Stay ◽  
Adverse Outcome ◽  
Independent Predictor ◽  
Adverse Outcomes ◽  
Stroke Patients ◽  
Significant Independent Predictor ◽  
Prolonged Length ◽  
Stroke Center ◽  
Shift Change

Objectives. Extended time in the emergency department (ED) has been related to adverse outcomes among stroke patients. We examined the associations of ED nursing shift change (SC) and length of stay in the ED with outcomes in patients with intracerebral hemorrhage (ICH). Methods. Data were collected on all spontaneous ICH patients admitted to our stroke center from 7/1/08–6/30/12. Outcomes (frequency of pneumonia, modified Rankin Scale (mRS) score at discharge, NIHSS score at discharge, and mortality rate) were compared based on shift change experience and length of stay (LOS) dichotomized at 5 hours after arrival. Results. Of the 162 patients included, 60 (37.0%) were present in the ED during a SC. The frequency of pneumonia was similar in the two groups. Exposure to an ED SC was not a significant independent predictor of any outcome. LOS in the ED ≥5 hours was a significant independent predictor of discharge mRS 4–6 (OR 3.638, 95% CI 1.531–8.645, and P = 0.0034) and discharge NIHSS (OR 3.049, 95% CI 1.491–6.236, and P = 0.0023) but not death. Conclusions. Our study found no association between nursing SC and adverse outcome in patients with ICH but confirms the prior finding of worsened outcome after prolonged length of stay in the ED.

scholarly journals Risk factors for prolonged length of stay after colorectal surgery

2013 ◽  
Vol 33 (1) ◽  
pp. 22-27 ◽  
Author(s):  
Luiz Felipe de Campos Lobato ◽  
Patrícia Cristina Alves Ferreira ◽  
Elizabeth C. Wick ◽  
Ravi P. Kiran ◽  
Feza H. Remzi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Colorectal Surgery ◽  
Length Of Stay ◽  
Prolonged Length

Impact of Antibiotic-Resistant Pathogens Colonizing the Respiratory Secretions of Patients in an Extended-Care Area of the Emergency Department

2003 ◽  
Vol 24 (5) ◽  
pp. 351-355 ◽  
Author(s):  
Sônia R. P. E. Dantas ◽  
M. Luiza Moretti-Branchini
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Mechanical Ventilation ◽  
Length Of Stay ◽  
Univariate Analysis ◽  
Antibiotic Resistant ◽  
Prolonged Stay ◽  
Nasogastric Intubation ◽  
Extended Care ◽  
The Mean

AbstractObjective:To determine the incidence of acquired infection, and the incidence, risk factors, and molecular typing of multidrug-resistant bacterial organisms (MROs) colonizing respiratory secretions or the oropharynx of patients in an extended-care area of the emergency department (ED) in a tertiary-care university hospital.Methods:A case-control study was conducted regarding risk factors for colonization with MROs in ED patients from July 1996 to August 1998. The most prevalent MRO strains were determined using plasmid and genomic analysis with PFGE.Results:MROs colonized 59 (25.4%) of 232 ED patients and 173 controls. The mean ED length of stay for the 59 cases was 13.9 days versus 9.8 days for the 173 controls. The mean length of stay prior to the first isolation of MROs was 9.9 days. MRO species included Acinetobacter baumannii, Staphylococcus aureus, and Pseudomonas aeruginosa. The rate of hospital-acquired infection was 32.7 per 1,000 ED patient-days. The case fatality rate was significantly higher for cases. Univariate analysis identified mechanical ventilation, nebulization, nasogastric intubation, urinary catheterization, antibiotic therapy, and number of antibiotics as risk factors for MRO colonization. Multivariate regression analysis found that mechanical ventilation and nasogastric intubation independently predicted MRO colonization. Endemic clones were identified by PFGE in ED patients and were also found in patients in other parts of the hospital.Conclusions:Prolonged stay in the ED posed a risk for colonization with MROs and for contracting nosocomial infections, both of which were associated with increased mortality. Patients colonized with antibiotic-resistant A. baumannii may serve as a reservoir for spread in this hospital.

scholarly journals Predicting Unscheduled Emergency Department Return Visits Among Older Adults: Population-Based Retrospective Study (Preprint)

2020 ◽  
Author(s):  
Rai-Fu Chen ◽  
Kuei-Chen Cheng ◽  
Yu-Yin Lin ◽  
I-Chiu Chang ◽  
Cheng-Han Tsai
Keyword(s):  
Older Adults ◽  
Emergency Department ◽  
Health Insurance ◽  
Chronic Illness ◽  
Length Of Stay ◽  
Prediction Model ◽  
Older Adult ◽  
National Health Insurance ◽  
Research Database ◽  
Return Visits

BACKGROUND Unscheduled emergency department return visits (EDRVs) are key indicators for monitoring the quality of emergency medical care. A high return rate implies that the medical services provided by the emergency department (ED) failed to achieve the expected results of accurate diagnosis and effective treatment. Older adults are more susceptible to diseases and comorbidities than younger adults, and they exhibit unique and complex clinical characteristics that increase the difficulty of clinical diagnosis and treatment. Older adults also use more emergency medical resources than people in other age groups. Many studies have reviewed the causes of EDRVs among general ED patients; however, few have focused on older adults, although this is the age group with the highest rate of EDRVs. OBJECTIVE This aim of this study is to establish a model for predicting unscheduled EDRVs within a 72-hour period among patients aged 65 years and older. In addition, we aim to investigate the effects of the influencing factors on their unscheduled EDRVs. METHODS We used stratified and randomized data from Taiwan’s National Health Insurance Research Database and applied data mining techniques to construct a prediction model consisting of patient, disease, hospital, and physician characteristics. Records of ED visits by patients aged 65 years and older from 1996 to 2010 in the National Health Insurance Research Database were selected, and the final sample size was 49,252 records. RESULTS The decision tree of the prediction model achieved an acceptable overall accuracy of 76.80%. Economic status, chronic illness, and length of stay in the ED were the top three variables influencing unscheduled EDRVs. Those who stayed in the ED overnight or longer on their first visit were less likely to return. This study confirms the results of prior studies, which found that economically underprivileged older adults with chronic illness and comorbidities were more likely to return to the ED. CONCLUSIONS Medical institutions can use our prediction model as a reference to improve medical management and clinical services by understanding the reasons for 72-hour unscheduled EDRVs in older adult patients. A possible solution is to create mechanisms that incorporate our prediction model and develop a support system with customized medical education for older patients and their family members before discharge. Meanwhile, a reasonably longer length of stay in the ED may help evaluate treatments and guide prognosis for older adult patients, and it may further reduce the rate of their unscheduled EDRVs.

Risk factors for prolonged length of stay in patients undergoing surgery for intramedullary spinal cord tumors

2021 ◽  
Vol 91 ◽  
pp. 396-401
Author(s):  
Romaric Waguia ◽  
Timothy Y. Wang ◽  
Vikram A. Mehta ◽  
Luis Ramirez ◽  
Edwin McCray ◽  
...  
Keyword(s):  
Risk Factors ◽  
Spinal Cord ◽  
Length Of Stay ◽  
Spinal Cord Tumors ◽  
Intramedullary Spinal Cord ◽  
Prolonged Length

Risk factors for early return visits to the emergency department in patients with urinary tract infection

2018 ◽  
Vol 36 (1) ◽  
pp. 12-17 ◽  
Author(s):  
Sarah Jorgensen ◽  
Mira Zurayk ◽  
Samantha Yeung ◽  
Jill Terry ◽  
Maureen Dunn ◽  
...  
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Early Return ◽  
Return Visits

Risk factors and outcomes for hyperbilirubinaemia after heart surgery in children

2020 ◽  
Vol 30 (6) ◽  
pp. 761-768
Author(s):  
Daniel M. Pasternack ◽  
Manal AlQahtani ◽  
Rafael Zonana Amkie ◽  
Lisa J. Sosa ◽  
Marcelle Reyes ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiac Surgery ◽  
Length Of Stay ◽  
Parenteral Nutrition ◽  
Extracorporeal Membrane Oxygenation ◽  
Total Parenteral Nutrition ◽  
Morbidity And Mortality ◽  
Prolonged Length ◽  
Conjugated Hyperbilirubinaemia ◽  
Neonates And Infants

AbstractIntroduction:Liver dysfunction, associated with morbidity and mortality, is common in patients with CHD. We investigate risk factors for and outcomes of hyperbilirubinaemia in neonates and infants after cardiac surgery.Materials and methods:In a retrospective analysis of neonates and infants undergoing cardiac surgery at our institution between January 2013 and December 2017, we identified those with post-operative conjugated hyperbilirubinaemia. We tested various demographic and surgical risk factors, and use of post-operative interventions, for an association with conjugated hyperbilirubinaemia. We also tested hyperbilirubinaemia for association with post-operative mortality and prolonged length of stay.Results:We identified 242 post-operative admissions, of which 45 (19%) had conjugated hyperbilirubinaemia. The average conjugated bilirubin level in this group was 2.0 mg/dl versus 0.3 mg/dl for peers without hyperbilirubinaemia. The post-operative use of both extracorporeal membrane oxygenation (OR 4.97, 95% CI 1.89–13.5, p = 0.001) and total parenteral nutrition (OR 2.98, 95% CI 1.34–7.17, p = 0.010) was associated with conjugated hyperbilirubinaemia. No demographic variable analysed was found to be a risk factor. Hyperbilirubinaemia was associated with higher odds of mortality (OR 3.74, 95% CI 2.69–13.8, p = 0.005) and prolonged length of stay (OR 2.87, 95% CI 2.02–7.97, p = 0.005), which were independent of other risk factors.Discussion:We identified the post-operative use of total parenteral nutrition and extracorporeal membrane oxygenation as risk factors for hyperbilirubinaemia. These patients were more likely to experience morbidity and mortality than control peers. As such, bilirubin may be marker for elevated risk of poor post-operative outcomes and should be more frequently measured after cardiac surgery.

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