جستجوی مقالات مرتبط با کلیدواژه "hospital length of stay" در نشریات گروه "پزشکی"

Hospital length of stay (LOS) remains a vital metric for assessing patient outcomes and healthcare resource utilization. Given the substantial financial impact of diagnosing and treating colorectal anomalies, coupled with an increased susceptibility to postoperative complications, it is crucial to understand the factors affecting LOS following colorectal surgery. Our primary objective was to investigate the preoperative, intraoperative, and postoperative risk factors that have substantial influence over LOS following a colorectal procedure.

This study analyzed data from a retrospective study of adults who underwent various colorectal surgeries (colostomy, ileostomy, small bowel resection, etc.) at Cleveland Clinic Foundation (January 2005 - December 2014). Predictor variables were categorized into preoperative (patient demographics, medical history, comorbidities, lifestyle factors), intraoperative, and postoperative factors. LOS was grouped into short-term (SLOS) (≤ 7 days), medium-term (MLOS) (8-30 days), and long-term (LLOS) (> 30 days) stays. Multinomial logistic regression models assessed predictor effects on LOS.

Among the 7874 patients, 50.7% were females, with a minimum age of 20 years. SLOS were observed in 61.1%, MLOS in 37.6%, and LLOS in 1.3% of patients. Advanced age correlated with prolonged LOS, possibly due to age-related health challenges like weak immune systems. Coagulopathy, and fluid and electrolyte disorders raised MLOS and LLOS risk, likely due to complications like significant bleeding and electrolyte imbalances. Surgery duration predicted longer LOS, elevating LLOS and MLOS by 52% and 42%. Postoperative infections were associated to extended stays, possibly due to subsequent interventions, monitoring and recovery delays.

Our study revealed that key preoperative predictors of LOS included Age, coagulopathy, fluid and electrolyte disorders, severe weight loss, and drug abuse. Notably, intraoperative factors such as surgical approach (open vs laparoscopic) and surgery duration, alongside postoperative complications including superficial and serious infections, significantly influenced LOS. By incorporating these insights into the preoperative planning, clinicians could potentially develop tailored interventions to mitigate risk factors and enhance postoperative recovery, thus potentially reducing LOS and improving patient outcomes.

This study aims to characterize the demographic, clinical, and radiological features of gunshotwound (GSW) patients as well as identify predictors of prolonged hospitalization. In this retrospective study, a consecutive sampling method was used, including all patients withGSWs in any anatomical region. Data collection included demographic and clinical information, radiologicalfindings, treatment specifics, and outcome variables, such as hospitalization length of stay (LOS) as the primaryoutcome. To identify predictive factors associated with prolonged LOS, logistic regression analysis was used. We studied 212 GSW cases, including 95.8% were men and 4.2% were women. The mean age of thestudied group was 30.17±7.80 years. GSWs occurred in extremities (80.2%), abdomen (9.0%), thorax (4.7%),and head or neck (5.2%). Two patients (0.9%) had both abdominal and thoracic GSWs. The most prevalentradiological study was an X-ray (83.0%). Patients with head and neck GSWs had the longest emergencydepartment stay, while patients with abdominal GSW patients had the shortest (p=0.068). The highest ratesof blood product transfusion were observed in abdominal GSWs (63.2%), emergency surgery (63.2%), andICU admission (42.1%). Head and neck GSWs had the longest hospitalization LOS (7.5 days). Longer LOSwas significantly associated with abnormalities in radiological findings, receiving blood products, and ICUadmission (p≤0.001). Significant predictors of prolonged LOS were major abnormalities in radiological findings[odds ratio (OR)=5.3; 95% confidence interval (CI):2.8-10.2], head and neck GSWs (OR=6.1; 95% CI:1.2-31.9),and blood product transfusion (OR=4.1; 95% CI: 1.0-16.3). This study provides insights into factors influencing prolonged hospitalization in GSW patients,highlighting the importance of radiological findings, head and neck injuries, and blood product transfusion.

In the present study, the goal was to estimate the hospital length of stay among patients admitted with COVID-19 in a hospital in Tehran.

We used retrospective data on 446 hospitalized patients with COVID-19 who admitted from 7 March to 8 Oct 2020 in a referral hospital in Tehran, Iran. The prognostic effects of variables, including age, gender, comorbidity status, and symptoms were analyzed by using Kaplan-Meier methods and a competing risk analysis. Length of stay in hospital was calculated using time of last status minus time of admission. All analyses performed using SPSS version 22.0 and STATA version 15.

The mean age of cases was 57.09±16.85 years old. The median (IQR) of hospital length of stay among all patients was 7 (11-5) days. The length of Hospital stay, for >80 years’ patients (9days (15-5)) and females (7days (11-5)) was the longest. The most of cases (94 (21.1%)) were in 60–69 age group. In overall 267 (59.9%) of all cases were males and 179 (40.1%) were females. The most common symptom among patients was Respiratory distress 249 (55.8), Cough 233 (52.2) and fever 209 (46.9) respectively. Regarding having any comorbidities, 106 (23.8%) of COVID-19 cases had Cardiovascular disease, 114 (25.6%) had diabetes and 100 (22.4%) had hypertension. Most of deaths (21 (32.3%)) occurred in 70-79 years’ age group. The overall Case Fatality Rate (CFR) in under-studied cases was 14.6%.

Although the result of the present study showed that hospital length of stay in Iran is not higher than in other countries, but by applying some measures including the early detection of suspected cases and timely treatment and necessary funding on preparing required facilities, medicine and equipment, it could be shortened or at least prevented from increasing.

To assess the quality of applied pelvic binders using three dimensional computer tomography (3D CT). A local trauma registry was used to identify patients with pelvic fractures after high-energy trauma during 2011-2015. A 3D CT reconstruction was made from the initial trauma computer tomography images to assess the level of application, symmetricity of the binder and achieved fracture reduction. An acceptable application of the pelvic binder was deemed if it was at the trochanteric level, symmetric and minimized residual displacement. We found 73 patients with a pelvic fracture and a pelvic binder on the initial trauma CT-scan. The mean (±SD) age of the patients was 46±17 years and 40% (n=29) were females. The median ISS score was 38 (IQR;29-50), the mean systolic blood pressure on arrival was 106±46 mmHg and the median GCS on arrival was 14 (IQR;7-15). We found that 59% (n=43) of the binders were correctly applied (symmetric at the trochanteric level, symmetrical and with acceptable residual displacement of the fracture). The 30-day mortality was higher in patients with non-correct application 17% (n=5/30) compared to patients with correct application of the pelvic binder 9.3% (n=4/43) however this was not statistically significant (p=0.562). A substantial number of patients had non-correct application of pelvic binders. Future studies using 3D technique are encouraged to further investigate clinical impacts of non-appropriate application of pelvic binders.