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1.
Hematol., Transfus. Cell Ther. (Impr.) ; 44(1): 7-12, Jan.-Mar. 2022. tab
Article in English | LILACS | ID: biblio-1364882

ABSTRACT

Abstract Introduction Coronavirus Disease 2019 (COVID-19) is a novel viral disease with person-to-person transmission that has spread to many countries since the end of 2019. Although many unknowns were resolved within a year and the vaccine is available, it is still a major global health problem. Objective COVID-19 infection may present with a considerably wide spectrum of severity and host factors play a significant role in determining the course of the disease. One of these factors is blood groups. Based on previous experience, it is believed that the ABO blood group type affects prognosis, treatment response and length of stay in the hospital. In this study, our aim was to evaluate whether the blood group had an effect on the length of the hospital stay. To the best of our knowledge, no previous studies have assessed the effect of ABO blood groups, as well as age, on the length of the hospital stay in these settings. Methods In this retrospective cohort study, 969 patients admitted to our hospital between March 15, 2020 and May 15, 2020 were evaluated. The patients were divided into 4 groups according to ABO blood groups. The effect of the ABO blood group by age on the course of the disease, need for intensive care, duration of hospitalization and mortality in patients with COVID-19 infection, especially in geriatric patients, was evaluated. Results Of all the patients, 9.1% required admission to the intensive care unit (ICU), of whom 83% died. The average length of ICU stay was 11 days (0 - 59). The observed mortality rates in blood groups A, B, AB and 0 were 86.4%, 93.3%, 80.0% and 70.8%, respectively, indicating similar death rates in all ABO blood types. When the Rh phenotype was taken into consideration, no significant changes in results were seen. Conclusion As a result, we could not observe a significant relationship between blood groups and clinical outcomes in this study, which included a sample of Turkish patients with COVID-19.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , ABO Blood-Group System , COVID-19 , Coronavirus , Length of Stay
2.
Aletheia ; 54(1): 55-63, jan.-jun. 2021. tab
Article in Portuguese | LILACS-Express | LILACS, INDEXPSI | ID: biblio-1285019

ABSTRACT

RESUMO O presente estudo teve como objetivo descrever indicadores de saúde emocional de mães de bebês internados, considerando o tempo de internação em Unidade de Terapia Intensiva Neonatal (UTIN). Participaram 50 mães de bebês que estavam internados na UTIN da Maternidade Santa Isabel, em Bauru, SP. Para a caracterização da amostra utilizou-se de um questionário sociodemográfico com informações sobre as mães e os bebês. Para a avaliação da saúde emocional materna utilizou-se da Escala de Estresse Percebido (PSS - 14), o Inventário de Ansiedade Traço-Estado (IDATE) e o Inventário de Depressão de Beck (BDI-II). As mães responderam aos instrumentos em seus quartos ou nas dependências da UTI. Os resultados apontaram para índices mais altos de estresse (38%), ansiedade traço (54%) e ansiedade estado (64%). Das mães, 56% apresentaram dois ou mais indicadores clínicos de saúde emocional. Quanto maior o tempo de internação maior a depressão e a ansiedade estado. Os resultados sugerem atenção terapêutica às mães de bebês em UTIN.


ABSTRACT The present study aimed to describe the emotional health indicators of mothers of hospitalized infants, considering the length of hospital stay in Neonatal Intensive Care Unit (NICU). Fifty mothers of babies who were admitted to the NICU of the Maternidade Santa Isabel, in Bauru, SP, participated. To characterize the sample, a sociodemographic questionnaire was used with information about mothers and babies. For the evaluation of maternal emotional health, the Perceived Stress Scale (PSS-14), the Trait-State Anxiety Inventory (IDATE) and the Beck Depression Inventory (BDI-II) were used. Mothers responded to the instruments in their rooms or ICU facilities. The results pointed to higher rates of stress (38%), trait anxiety (54%) and state anxiety (64%). Of the mothers, 56% had two or more clinical indicators of emotional health. The longer the hospitalization time the greater the depression and the anxiety state. The results suggest therapeutic attention to the mothers of infants in NICUs.

3.
Braz. j. infect. dis ; 25(1): 101040, jan., 2021. tab, graf
Article in English | LILACS | ID: biblio-1249289

ABSTRACT

ABSTRACT Background: Clostridioides difficile infection (CDI) is the most common cause of healthcare-associated infections in Western countries. Risk factors, mortality, and healthcare utilization for CDI in Latin America are poorly understood. This study assessed risk factors and burden associated with nosocomial CDI in four Latin American countries. Methods: This retrospective, case-control study used databases and medical records from 8 hospitals in Argentina, Brazil, Chile, and Mexico to identify nosocomial CDI cases from 2014 − 2017. Cases were patients aged ≥18 years with diarrhea and a positive CDI test ≥72 h after hospital admission. Two controls (without diarrhea; length of hospital stay [LOS] ≥3 days; admitted ±14 days from case patient; shared same ward) were matched to each case. CDI-associated risk factors were assessed by univariate and multivariable analyses. CDI burden (LOS, in-hospital mortality) was compared between cases and controls. Results: The study included 481 cases and 962 controls. Mean age and sex were similar between cases and controls, but mean Charlson comorbidity index (4.3 vs 3.6; p< 0.001) and recent hospital admission (35.3% vs 18.8%; p< 0.001) were higher among cases. By multivariable analyses, CDI risk was associated with prior hospital admission within 3 months (odds ratio [OR], 2.08; 95% CI: 1.45, 2.97), recent antibiotic use (ie, carbapenem; OR, 2.85; 95% CI: 1.75, 4.64), acid suppressive therapy use (OR, 1.71; 95% CI: 1.14, 2.58), and medical conditions (ie, renal disease; OR, 1.48; 95% CI: 1.19, 1.85). In-hospital mortality rate (18.7% vs 6.9%; p< 0.001) and mean overall LOS (33.5 vs 18.8 days; p< 0.001) were higher and longer, respectively, in cases versus controls. Conclusion: Antibiotic exposure, preexisting medical conditions, and recent hospital admission were major risk factors for CDI in Argentina, Brazil, Chile, and Mexico. CDI was associated with increased in-hospital risk of death and longer LOS. These findings are consistent with published literature in Western countries.


Subject(s)
Cross Infection/epidemiology , Clostridioides difficile , Clostridium Infections/epidemiology , Argentina , Brazil/epidemiology , Case-Control Studies , Retrospective Studies , Risk Factors , Clostridioides , Latin America/epidemiology , Mexico/epidemiology
4.
Ciênc. cuid. saúde ; 20: e55208, 2021. tab
Article in Portuguese | LILACS, BDENF | ID: biblio-1339617

ABSTRACT

RESUMO Objetivo: analisar os fatores associados às internações hospitalares de longa permanência de pacientes atendidos pelo Sistema Único de Saúde em instituição de alta complexidade. Método: estudo transversal quantitativo a partir de dados secundários de internações hospitalares de 2013 a 2015. Calculou-se a razão de prevalência por Regressão de Poisson bruta e ajustada. Resultados: das 12.689 internações nos anos de estudo, 645 foram de longa permanência (>30 dias), com uma prevalência de 5,1%. Predominaram entre o sexo masculino (62%), > 60 anos de idade (52,6%). As causas mais frequentes da hospitalização foram doenças do aparelho circulatório (33,5%) e causas externas (22,3%). O óbito ocorreu para 45,6%. Na análise bivariada, estiveram estatisticamente associadas às internações de longa permanência as variáveis: sexo, idade (60 anos e mais) o baixo ou a não escolaridade dos indivíduos, ser da 17ª regional de saúde, ter sido internado na especialidade neurocirurgia e ter necessitado de internação em UTI. No entanto, permaneceram no modelo final sexo masculino, residir na regional de saúde do município em análise e ter necessitado de internação em Unidade de Terapia Intensiva. (p<0,001). Conclusão: Estratégias de promoção da saúde voltadas à saúde do homem devem ser desenvolvidas pelo município, especialmente considerando que os mesmos são os que mais perdem a vida pela ausência de cuidados com a saúde e em decorrência dos agravos resultantes de causas externas.


RESUMEN Objetivo: analizar los factores asociados a las internaciones hospitalarias de larga estancia de pacientes atendidos por el Sistema Único de Salud en institución de alta complejidad. Método: estudio transversal cuantitativo a partir de datos secundarios de internaciones hospitalarias de 2013 a 2015. Se calculó la razón de prevalencia por Regresión de Poisson bruta y ajustada. Resultados: de las 12.689 internaciones en los años de estudio, 645 fueron de larga permanencia (>30 días), con una prevalencia de 5,1%. Predominaron entre el sexo masculino (62%), > 60 años de edad (52,6%). Las causas más frecuentes de la hospitalización fueron enfermedades del sistema circulatorio (33,5%) y causas externas (22,3%). El óbito ocurrió para 45,6%. En el análisis bivariado, estuvieron estadísticamente asociadas a las internaciones de larga estancia las variables: sexo, edad (60 años y más) la baja o la no escolaridad de los individuos, ser de la 17ª regional de salud, haber sido internado en la especialidad neurocirugía y haber necesitado de internación en UCI. Sin embargo, permanecieron en el modelo final sexo masculino, residir en la regional de salud del municipio en análisis y haber necesitado de internación en Unidad de Cuidados Intensivos. (p<0,001). Conclusión: Estrategias de promoción de la salud dirigidas a la salud del hombre deben ser desarrolladas por el municipio, especialmente considerando que los hombres son los que más pierden la vida por la ausencia de cuidados con la salud y en consecuencia de los agravios resultantes de causas externas.


ABSTRACT Objective: to analyze the factors associated with long-term hospitalizations of patients treated by the Unified Health System in a highly complex institution. Method: it is a quantitative cross-sectional study based on secondary data on hospital admissions from 2013 to 2015. The prevalence ratio was calculated using crude and adjusted Poisson regression. Results: about the 12,689 hospitalizations during the years of study, 645 were long hospital stay (>30 days), with a prevalence of 5.1%. There was a predominance of males (62%),> 60 years-old (52.6%). The most frequent causes of hospitalization were diseases of the circulatory system (33.5%) and external causes (22.3%). Death occurred to 45.6%. In the bivariate analysis, the following variables were statistically associated with long-term hospitalizations: gender, age (60 years-old and over), low or uneducated individuals, being from the 17th Regional Health Department, having been admitted to the neurosurgery specialty and having needing ICU admission. However, the male gender remained in the final model, staying in the regional health department of the municipality under analysis and requiring admission to the Intensive Care Unit (p <0.001). Conclusion: Health promotion strategies aimed at men's health should be developed by the municipality, especially considering that they are the ones who most lose their lives due to the lack of health care and due to injuries resulting from external causes.


Subject(s)
Humans , Male , Female , Long-Term Care , Hospitalization , Length of Stay , Patients , Bed Occupancy , Unified Health System , Mortality , Death , Delivery of Health Care , Empathy , Men's Health , Health Promotion , Hospitals , Intensive Care Units , Men , Neurosurgery
5.
Ciênc. cuid. saúde ; 20: e54726, 2021. tab
Article in Portuguese | LILACS, BDENF | ID: biblio-1339649

ABSTRACT

RESUMO Objetivo: Analisar o tempo de espera para correção de fratura de fêmur, seus fatores associados e o desfecho de hospitalização. Método: Transversal exploratório, com a população de idosos ≥60 anos internados por fratura de fêmur no período de 2015 a 2017. Os dados foram coletados através do prontuário físico, com análises estatísticas considerando o nível de significância estatística de p<0,05. Resultados: Dos idosos estudados, 61,4% correspondem ao sexo feminino. Aqueles que permaneceram por mais do que sete dias à espera de cirurgia se associaram ao tempo de hospitalização maior do que 10 dias, lesão por pressão (p<0,001) e ao desfecho óbito (p=0,003). A média de permanência hospitalar foi de 13,8 dias e do tempo esperado pela cirurgia de 6,6 dias. A espera da realização do risco cirúrgico e vaga em unidade de terapia intensiva foram fatores que provocaram atraso na realização da cirurgia em 23,2% dos idosos. Conclusão: Esperar pela cirurgia por mais de sete dias aumentou o tempo de permanência hospitalar e a taxa de mortalidade. Além disso, a ausência de vaga de terapia intensiva e a espera pelo risco cirúrgico contribuíram para o atraso da cirurgia e seu desfecho.


RESUMEN Objetivo: analizar el tiempo de espera para la corrección de fractura de fémur, sus factores asociados y el resultado de hospitalización. Método: transversal exploratorio, con la población de personas mayores ≥60 años internados por fractura de fémur en el período de 2015 a 2017. Los datos fueron recolectados a través del registro médico, con análisis estadísticos considerando el nivel de significancia estadística de p<0,05. Resultados: de los ancianos estudiados, 61,4% eran del sexo femenino. Aquellos que pasaron más de siete días a la espera de cirugía se asociaron al tiempo de hospitalización mayor que 10 días, lesión por presión (p<0,001) como desenlace el óbito (p=0,003). El promedio de permanencia hospitalaria fue de 13,8 días yel tiempo esperado por la cirugía de 6,6 días. La espera por la realización del riesgo quirúrgico y una cama en unidad de cuidados intensivos fueron factores que provocaron el retraso en la realización de la cirugía en 23,2% de los ancianos. Conclusión: esperar por la cirugía por más de siete días aumentó el tiempo de permanencia hospitalaria y la tasa de mortalidad. Además, la falta de camas en cuidados intensivos la espera por el riesgo quirúrgico contribuyeron para el retraso de la cirugía y su desenlace.


ABSTRACT Objective: To analyze the waiting time for femoral fracture repair, its associated factors, and the outcome of hospitalization. Method: This is a cross-sectional exploratory study involving an elderly population aged ≥60 years old and admitted to hospital for femoral fracture from 2015 to 2017. Data were collected from physical medical records, with statistical analyses considering p < 0.05 as the level of statistical significance. Results: Of the studied elderly patients, 61.4% are female. Those who stayed for more than seven days waiting for surgery showed association with a hospital stay longer than 10 days, pressure injuries (p<0.001), and death as outcome (p=0.003). The average hospital stay was 13.8 days, and the expected time until surgery was 6.6 days. Waiting for the surgical risk assessment and waiting for a vacancy in the intensive care unit were factors that caused delay in the surgery among 23.2% of the elderly. Conclusion: Waiting for surgery for more than seven days increased the length of hospital stay and the mortality rate. In addition, the absence of intensive care unit beds and waiting for the surgical risk assessment contributed to the delay in the surgery and its outcome.


Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , General Surgery , Aged , Femoral Fractures , Hospitalization , Unified Health System , Comorbidity , Health Personnel , Intensive Care Units , Length of Stay
6.
Article in Chinese | WPRIM | ID: wpr-908076

ABSTRACT

Objective:To explore the clinical application effect of early removal of drainage tube in rapid postoperative recovery of patients with thyroid cancer.Methods:A total of 90 thyroid cancer patients admitted to the First Affiliated Hospital of Henan University of Traditional Chinese Medicine from June 2018 to June 2019 were selected and divided into a control group and a study group according to the order of operation time. Patients in the control group were given routine extubation, and patients in the study group were removed early during rapid recovery after surgery. The complication rate, postoperative hospital stay, satisfaction, extubation time distribution, and drainage port healing rate 3 days after surgery were compared between the two groups of patients.Results:In the study group, the incidence of complications after drainage tube removal during rapid recovery after surgery was 6.7% (3/45), which was significantly lower than that of the control group, 26.7% (12/45), and the difference was statistically significant ( χ2 value was 6.48, P <0.05). The postoperative hospital stay in the study group was (3.25±0.89) days, and the satisfaction score was (97.83±7.25), which was significantly shorter than the control group's (5.68±0.96) days and (92.36±12.19). The difference was statistically significant ( t value was 12.45, 2.59, P <0.05). Conclusions:Early removal of the drainage tube during rapid postoperative recovery of patients with thyroid cancer can effectively reduce the trauma of the drainage tube orifice, shorten the hospital stay, and improve patient satisfaction.

7.
Article | IMSEAR | ID: sea-204534

ABSTRACT

Background: Kangaroo mother care provides Low birth weight babies with warmth, protection from infection and increases the success of breast feeding. Babies who had received KMC care were found to have better neurologic outcome. The aim of the study is to compare the outcome of Kangaroo mother care and conventional method of care among Low birth weight babies in terms of growth and reduction of morbidities such as length of hospital stay, hypothermia and hypoglycemia.Methods: This cross-sectional study included 48 neonates with a birth weight of <2000 grams. Out of them 24 babies received KMC and the other 24 babies were given conventional care with a radiant warmer. The weight gain, length of hospital stay, occurrence of hypothermia and hypoglycaemia were monitored for all babies till discharge.Results: Babies who received KMC had a better weight gain (21.11'2.8 grams/day) versus (15.61'2.6 grams/day) those who received conventional care, and this was found to be statistically significant (p=0.001). Kangaroo mother care provided a statistically significant reduction in the risk of having hypothermia (p=0.03) and hypoglycemia (p=0.04). The babies who received Kangaroo mother care had a shorter length of hospital stay and this was found to be statistically significant (p=0.03).Conclusions: Kangaroo mother care improved the growth and reduced the problems of low birth weight babies such as hypothermia, hypoglycaemia and prolonged hospital stay. Hence, it should be recommended in the care of all these high-risk neonates.

8.
Rev. argent. cir ; 112(2): 141-156, 2020. tab
Article in English, Spanish | LILACS | ID: biblio-1125795

ABSTRACT

Antecedentes: la cirugía robótica es una alternativa a la cirugía abierta, microcirugía láser CO2, o quimiorradioterapia en vía aerodigestiva superior. El robot permite trasladar la técnica quirúrgica abierta a un abordaje mínimamente invasivo, con acceso por boca, para patología benigna y maligna. Actualmente se emplean diferentes terapéuticas con similares resultados oncológicos. Objetivo: introducir una herramienta quirúrgica para abordaje bucal. Comunicar la experiencia inicial con el uso del robot. Evaluar la preservación de respiración y deglución. Analizar variables que determinaron una disminución en la hospitalización. Material y métodos: 13 mujeres y 11 hombres. Edad entre 16 y 82 años, media de 55,08. Total 24 pacientes con enfermedad inflamatoria crónica (8), tumores benignos (4) y malignos (12). Variables consideradas en cirugía robótica: tiempo y lugar de internación, complicaciones, estado respiratorio y deglutorio, uso de técnicas reconstructivas. Se realizó videoendoscopia de deglución para objetivar la seguridad del método. Resultados: tiempo medio de internación: 1,92 días. El 83,3% internado 1 día. El 79,9% en internación general. Unidad cerrada: 20,1%. Ninguna traqueostomía. Cicatrización del lecho por segunda. Sin complicaciones. Edema de lengua: 2 pacientes. Conclusiones: la cirugía robótica favorece la exéresis con baja morbilidady máxima preservación de tejidos sanos. Disminuye: edema posoperatorio, uso colgajos para reparar el lecho, traqueotomía temporaria, tiempo de internación. La videoendoscopia de deglución demuestra utilidad para determinar la deglución segura. Limitante del presente trabajo es el tamaño de la muestra. Es importante incrementar el número de pacientes para valorizar supervivencia y calidad de vida.


Background: robotic surgery is an alternative to open surgery, CO2 laser microsurgery, or chemoradiation for the upper aero-digestive tract. This system allows surgeons to use the open surgical technique in a minimally invasive approach through the mouth to treat benign and malignant disorders. Different treatments are currently used with similar oncologic outcomes. Objective: the aim of this study was to introduce a surgical tool through transoral approach, report the initial experience with the use of the robotic system, evaluate respiratory and digestive functional preservation and analyze the variables associated with shorter hospital length of stay. Material and methods: A total of 24 patients (13 women and 11 men, mean age 55.08 years [16-82]) were included. Eight patients had chronic inflammatory disease, four had benign tumors and 12 had cancer. The variables considered in robotic surgery were hospital length of stay, place of postoperative care, complications, respiratory and swallowing function and use of reconstructive techniques. Flexible endoscopic evaluation of swallowing was performed to document safe function. Results: mean length of stay was 1.92 days; 83.3% stayed for one day; 79.9% were admitted to the general ward and 20.1% stayed in intensive or intermediate care units. None of the patients required tracheostomy. Healing of the surgical bed occurred by secondary intention. There were no complications. Tongue edema occurred in two patients. Conclusions: robotic surgery favors tumor removal with low morbidity and maximum preservation of healthy tissues while reducing postoperative edema, use of flaps for reconstruction, temporary tracheostomy and hospital length of stay. Flexible endoscopic evaluation of swallowing is useful to determine safe swallowing function. The main limitation of our study is the sample size. It is important to increase the number of patients to evaluate survival and quality of life.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Robotic Surgical Procedures/methods , Head and Neck Neoplasms/surgery , Argentina , Postoperative Period , General Surgery/methods , Deglutition , Capsule Endoscopy
9.
Organ Transplantation ; (6): 41-2020.
Article in Chinese | WPRIM | ID: wpr-781852

ABSTRACT

Enhanced recovery after surgery (ERAS) refers to adopting a series of perioperative optimization measures to prevent or reduce the inflammatory stress response, promote rapid postoperative recovery of patients, shorten the length of hospital stay, reduce the incidence of postoperative complications, readmission rate and mortality rate. As the only effective treatment for end-stage liver disease, liver transplantation is characterized with difficult operation, long operation time, large amount of blood transfusion during operation and complicated postoperative management, etc. Postoperative recovery of liver transplantation is facing great challenges. In this article, research progresses on the application of ERAS in the perioperative period of liver transplantation and the suggestions for the implementation of ERAS during this period were introduced.

10.
Article in Chinese | WPRIM | ID: wpr-811601

ABSTRACT

Objective@#To explore the efficacy of a combination regimen by Lopinave/Litonawe (LPV/r), emtricitabine and tenofovir alafenamide fumarate (FTC/TAF) for the treatment of novel coronavirus pneumonia (NCP).@*Methods@#We design the protocol as a real world study, which includes two groups: prospective intervention cohort (T1) and historical control group (T2). For T1 group, ninety patients will be enrolled who are diagnosed as NCP. All patients in T1 group will receive standard therapies following the recommendation in the guidelines of National Commission of Health, and they will be administered an anti-virus regimen includes LPV/r and FTC/TAF. The T2 group will enroll patients who have received single regimen includes LPV/r. The major outcome is the survival rate of patients. Secondary outcomes are the time of seroconversion of RNA, ARDS progression rate and length of hospital stay.@*Conclusions@#The results of this real world study might provide clinical practitioners a high efficiency and fast antivirus regimen for NCP. In addition, the conduction of this study will accelerate screening for other new effective therapeutic method.

11.
Chinese Journal of Traumatology ; (6): 163-167, 2020.
Article in English | WPRIM | ID: wpr-827835

ABSTRACT

PURPOSE@#To investigate the effect of early enteral nutrition on outcomes of trauma patients in the intensive care unit (ICU).@*METHODS@#Clinical data of trauma patients in the ICU of Daping Hospital, China from January 2012 to December 2017 was retrospectively analyzed, including patient age, gender, injury mechanism, injury severity score (ISS), nutritional treatment, postoperative complications (wound infection, abdominal abscess, anastomotic rupture, pneumonia), mortality, and adverse events (nausea, vomiting, abdominal distention). Only adult trauma patients who developed bloodstream infection after surgery for damage control were included. Patients were divided into early enteral nutrition group (48 h). Data of all trauma patients were collected by the same investigator. Data were expressed as frequency (percentage), mean ± standard deviation (normal distribution), or median (Q, Q) (non-normal distribution) and analyzed by Chi-square test, Student's t-test, or rank-sum test accordingly. Multiple logistic regression analysis was further adopted to investigate the significant variables with enteral nutrition.@*RESULTS@#Altogether 876 patients were assessed and 110 were eligible for this study, including 93 males and 17 females, with the mean age of (50.0 ± 15.4) years. Traffic accidents (46 cases, 41.8%) and fall from height (31 cases, 28.2%) were the dominant injury mechanism. There were 68 cases in the early enteral nutrition group and 42 cases in the control group. Comparison of general variables between early enteral nutrition group and control group revealed significant difference regarding surgeries of enterectomy (1.5% vs. 19.0%, p = 0.01), ileum/transverse colon/sigmoid colostomy (4.4% vs. 16.3%, p = 0.01) and operation time (h) (3.2 (1.9, 6.1) vs. 4.2 (1.8, 8.8), p = 0.02). Other variables like ISS (p = 0.31), acute physiology and chronic health evaluation≥20 (p = 0.79), etc. had no obvious difference. Chi-square test showed a much better result in early enteral nutrition group than in control group regarding morality (0 vs. 11.9%, p = 0.03), length of hospital stay (days) (76.8 ± 41.4 vs. 81.4 ± 44.7, p = 0.01) and wound infection (10.3% vs. 26.2%, p = 0.03). Logistic regression analysis showed that the incidence of wound infection was related to the duration required to achieve the enteral nutrition standard (OR = 1.095, p = 0.002). Seventy-six patients (69.1%) achieved the nutritional goal within a week and 105 patients (95.5%) in the end. Trauma patients unable to reach the enteral nutrition target within one week were often combined with abdominal infection, peritonitis, bowel resection, intestinal necrosis, intestinal fistula, or septic shock.@*CONCLUSION@#Early enteral nutrition for trauma patients in the ICU is correlated with less wound infection, lower mortality, and shorter hospital stay.


Subject(s)
Adult , Aged , Critical Care , Enteral Nutrition , Humans , Length of Stay , Middle Aged , Time Factors , Treatment Outcome , Wound Infection , Epidemiology , Wounds and Injuries , Mortality , Therapeutics
12.
Article | IMSEAR | ID: sea-205069

ABSTRACT

Background: Procalcitonin testing (PCT) demonstrates its effectiveness for specifically diagnosing bacterial infections, as it is elevated in bacterial infections but not viral infections. Its clinical usefulness has been shown with antibiotic selection for different infections. Methods: This retrospective observational study aims to evaluate PCT test clinical utility in reducing the use of antibiotics, and the length of hospital stays. The study conducted at a tertiary hospital in Riyadh, Saudi Arabia included a total of 660 patients who were ordered procalcitonin test. Results: Subjects were grouped according to PCT level. All patients with PCT level ≥ 0.1 ng/ml (n=457) are qualified to receive antibiotic treatments. A total of 75.7% were prescribed antibiotics. The length of hospital stay (LOS) in patients who received antibiotics was statistically significantly higher than patients who did not receive any antibiotics (LOS 32.7 vs. 65.1 days, p-value=0.01). However all patients with PCT level <0.1ng/mL (n=203) show no statistically significant difference in the length of stay at hospital among patients who were prescribed an antibiotic or not (p-value=0.64). Only 31% of this group has inappropriately prescribed an antibiotic. Another infection precursor-like WBC count was also evaluated with no significant differences among groups. Conclusion: This study showed that the utilization of PCT guided antibiotic prescribing reduces the length of stay and reduces antibiotic use. PCT guided antibiotic prescribing can be utilized efficiently in hospital settings.

13.
Article in Chinese | WPRIM | ID: wpr-753869

ABSTRACT

Objective To investigate the change of the nutritional status of elderly patients in Chinese major hospitals dynamically with nutritional risk screening 2002 (NRS 2002) and subjective global assessment (SGA) during hospitalization.Methods A prospective,multi-center survey was conducted on over 65 years old patients who were admitted in departments of gastroenterology,respiratory medicine,general surgery,geriatrics,thoracic surgery,neurology,orthopedics and medical oncology of 9 large hospitals in China for 7-30 days between June 2014 and September 2014.On admission and within 24 hours after discharge,the clinical data were recorded,physical indices were measured,and laboratory examination were conducted.NRS 2002 and SGA were used to make an evaluation.The nutritional supports and clinical outcomes were also recorded and then the correlation between nutritional status and clinical outcomes were analyzed.Results A total of 2558 patients above 65 years old were included into the study.Compared with their status on admission,their grip strength,upper arm circumference and crural circumference were reduced significantly at discharge (P<0.05).The total protein,albumin and hemoglobin levels were significantly lower than those on admission (P<0.05).The incidence of nutritional risk (NRS 2002 score ≥ 3) and malnutrition (SGA B + C) on admission were lower than those at discharge (51.1% vs 53.0%,32.6% vs 35.6%).The hospitalization time and medical expenses were higher in patients with malnutrition on admission than in those with normal nutrition intakes.The nutritional status at discharge was negatively correlated with hospitalization time and medical expenses.61.3% patients having nutritional risk did not take nutritional support during the hospital stay,while utilization rate of parenteral nutrition was higher than that of enteral nutrition in patients receiving nutritional support (19.6% vs 11.9%).Conclusion Elderly patients have higher possibilities of facing nutritional risk or malnutrition on admission,these are associated with poor clinical outcomes and their nutritional status will not improve significantly at discharge.Therefore,the screening and evaluation of nutritional status in elderly patients during hospitalization should be conducted and their nutritional intervention should be standardized so as to improve the clinical outcomes.

14.
Article in Chinese | WPRIM | ID: wpr-735308

ABSTRACT

@#Objective     To analyze the risk factors associated with prolonged length of hospital stay (PLOS) after lobectomy for lung cancer patients. Methods     The clinical records of 771 lung cancer patients undergoing lobectomy between May 2012 and June 2016 in the Second Affiliated Hospital of Harbin Medical University were retrospectively analyzed. According to different length of hospital stay (LOS), 771 patients were divided into two groups, a normal LOS group and a PLOS group. In the normal LOS group, there were 551 patients including 234 females and 317 males with a median age of 59 years, whose LOS was shorter than 8.0 days. In the PLOS group, there were 220 patients including 72 females and 148 males with a median age of 60 years, whose LOS was no less than 8.0 days. Then, we analyzed the independent risk factors of PLOS by multivariate logistic regression analysis. Results     Univariate analysis showed that risk factors for PLOS included male, arrhythmias and atrioventricular block, smaller FVC%, unilateral pneumonectomy, operation and anesthesia duration, intraoperative blood loss and number of lymph node dissection in the operation (P<0.05). Multivariate logistic regression analysis showed that the age ≥75 years (OR=4.100, 95%CI 1.677 to 10.026), unilateral pneumonectomy (OR=2.563, 95%CI 1.473 to 4.460), FVC% < 89.05% (OR=1.500, 95%CI 1.020 to 2.206), numbers of lymph node dissection≥ 13.5 (OR=1.826, 95%CI 1.262 to 2.642), operation duration≥126.5 min (OR=1.858, 95%CI 1.200 to 2.876) and arrhythmia (OR=2.944, 95%CI 1.380 to 6.284) were independent risk factors of PLOS (all P<0.05). Conclusion     LOS is influenced by age, surgical type, FVC%, numbers of lymph node dissection, arrhythmia and operation duration. Careful assessment and appropriate management of risk factors are helpful to improve postoperative recovery after lobectomy for lung cancer patients.

15.
Rev. Pesqui. Fisioter ; 8(2): 167-174, maio, 2018. tab, ilus
Article in English, Portuguese | LILACS | ID: biblio-912922

ABSTRACT

Introdução: Os pacientes neurocirúrgicos são predispostos a disfunções neurológicas inerentes à doença de base, às alterações sensório-motoras, cognitivas e tem sua mobilidade reduzida na fase aguda pós-operatória. Objetivo: Investigar a correlação entre desempenho funcional e o tempo de permanência de pacientes neurocirúrgicos na unidade de terapia intensiva (UTI) e descrever a frequência de retirada do leito nesse período. Métodos: Trata-se de um estudo observacional, de corte transversal, realizado em uma UTI cirúrgica de um hospital de alta complexidade da rede pública estadual em Salvador, Bahia. Foram incluídos indivíduos adultos submetidos a algum tipo de neurocirurgia, sendo excluídos aqueles transferidos para outra unidade ou hospital antes da alta. Retirou-se dos prontuários dados sociodemográficos, clínicos e sobre a retirada do leito. A medida de independência funcional (MIF) foi avaliada no momento da alta e a correlação com o tempo de internação na UTI foi verificada através do coeficiente de Spearman. Resultados: Foram incluídos no estudo 26 pacientes, sendo 57,7% (15) do sexo feminino, com idade média de 37,2±12,9 anos. Foi observado que 56% (14) dos pacientes foram mobilizados em menos de 24 horas de internação da UTI e aqueles que não foram mobilizados durante o internamento tiveram como justificativa a restrição médica. Não houve correlação entre o escore funcional da MIF na alta com o tempo de internação na UTI (r= 0,3 p=0,11). Conclusão: A prática de retirada do leito foi iniciada dentro das 24 horas de internação na UTI, evidenciando um perfil de pacientes com independência funcional modificada ou completa na alta, entretanto sem correlação com o tempo de internação na UTI. [AU]


Introduction: Neurosurgical patients are predisposed to neurological dysfunctions inherent to baseline disease, sensory-motor and cognitive alterations, and their mobility is reduced in the acute postoperative phase. Objective: To investigate the correlation between functional performance and length of stay of neurosurgical patients in the intensive care unit (ICU) and to describe the frequency of bed removal in this period. Methods: This is a cross-sectional, observational study performed at a surgical ICU of a highly complex hospital of the state public network in Salvador, Bahia. Adult subjects submitted to some type of neurosurgery were included, excluding those transferred to another unit or hospital before discharge. Sociodemographic, clinical data and bedside removal were removed from the medical records. The functional independence measure (FIM) was assessed at the time of discharge and the correlation with ICU length of stay was verified using the Spearman coefficient. Results: A total of 26 patients were included in the study, of which 57.7% (15) were females, with a mean age of 37.2 ± 12.9 years. It was observed that 56% (14) of the patients were mobilized in less than 24 hours of ICU admission and those who were not mobilized during hospitalization had medical justification. There was no correlation between the MIF functional score at discharge and the length of ICU stay (r = 0.3; p = 0.11). Conclusion: The practice of bed withdrawal was started within 24 hours of ICU stay, evidencing a profile of patients with modified or complete functional independence at discharge, but without correlation with the length of ICU stay. [AU]


Subject(s)
Early Ambulation , Intensive Care Units , Neurosurgery
16.
Chinese Critical Care Medicine ; (12): 804-806, 2018.
Article in Chinese | WPRIM | ID: wpr-703719

ABSTRACT

Objective To evaluate the effect of iron metabolism of preoperation on the length of intensive care unit (ICU) stay in liver transplant recipients.Methods A retrospective study was conducted. 120 adult liver transplant recipients admitted to Tianjin First Central Hospital from September 2015 to September 2017 were enrolled. The basic data, model of end-stage liver disease (MELD) evaluation system score at admission; iron metabolism index, routine blood test, blood biochemistry, coagulation time and C-reactive protein (CRP) level within 24 hours after admission; intraoperative clinical indicators such as operation time, operation bleeding volume, red blood cells and fresh frozen plasma input volume, hot ischemia time, cold ischemia time, urine volume; and the length of ICU stay were collected. All patients were divided into iron deficiency group (ID group; serum ferritin < 100μg/L, or serum ferritin 100-300μg/L and transferrin saturation < 0.20) and non-iron deficiency group (non-ID group; serum ferritin > 300μg/L, or serum ferritin 100-300μg/L and transferrin saturation > 0.20) according iron deficiency standard. The indexes of iron metabolism, basic data and clinical indicators of two groups were compared. The correlation between serum ferritin level and the length of ICU stay was analyzed by Pearson correlation.Results Compared with non-ID group, the levels of serum iron concentration and serum ferritin were significantly decreased in ID group [serum iron concentration (μmol/L): 3.50±1.62 vs. 14.50±2.31, serum ferritin (μg/L): 67.00±31.54 vs. 315.00±36.73, bothP < 0.01], infusion volume of intraoperative red blood cells and fresh frozen plasma were significantly increased, and the length of ICU stay was significantly prolonged (days: 6.5±2.4 vs. 3.3±0.5,P < 0.01). There was no significant difference in transferrin saturation, CRP and other clinical indicators between the two groups. Correlation analysis showed that serum ferritin level was negative correlated with the length of ICU stay (r = -0.768,P < 0.001).Conclusion Preoperative iron deficiency in liver transplant recipients will lead to increased blood transfusion and prolonged length of ICU stays.

17.
Article in English | WPRIM | ID: wpr-732399

ABSTRACT

ntroduction: Enhanced recovery after surgery (ERAS) protocols are multidisciplinary perioperative care aimed to achieve early recovery after surgery by maintaining preoperative organ function and reducing the surgical induced stress response. Case presentation: A 79-year-old female patient with Transverse Colon Adenocarcinoma, elective admitted for colon resection. Patient was cachexia with weight 33 kg; loss of 7 kg within 1 month; PGSGA score 14 (severe malnourished); Albumin 30 g/L. She experienced very poor oral intake for past 1 month with intake of 450 kcal/day and 15 g/day protein. Carbohydrate loading with 100 g carbohydrate as evening drink and 50 g carbohydrate 3 hours pre-operation. Clear fluid (carbohydrate plus whey protein drink) was allowed on the first day of operation (POD). Regular diet was started on the POD3 since patient tolerated 500 ml of clear fluid. Patient tolerated well with solid food on POD4 and allowed discharged on POD5. As summary, length of hospital stay 5 days 2 hours, ambulation length 20 hours, length of clear fluid toleration 18 hours, length of solid food toleration 4 days and length of gastrointestinal function (flatus & bowel open) 4.5 days. Discussion: Advanced age is a proven risk factor of post-operative complications. Shorter hospital stay was found associated with a lower risk of post-operative complications. Length of hospitalization after colorectal surgery does not significantly differ between younger and older age groups of the patients. Conclusion: ERAS showed good overall outcome even elderly. Good quality of care at home is required and crucial as well after quicker discharged.

18.
Journal of Clinical Surgery ; (12): 544-546, 2017.
Article in Chinese | WPRIM | ID: wpr-616990

ABSTRACT

Objective To explore the relationship of preoperative hemoglobin concentration and use of hospital resources.Methods 108 patients receiving cardiac surgery in the central hospital of wuhan were included.The relationship of preoperative hemoglobin concentration was explored on blood transfusion rates,return to the operating room for bleeding and/or cardiac tamponade,postoperative intensive care unit(ICU)and in-hospital length of stay,and mortality.Results For every 10-unit increase in hemoglobin(g/L),blood transfusion requirements were reduced by 8.0%,6.0%,and 3.0% for red blood cell units,platelet pools,and fresh frozen plasma units,respectively.For each 10-unit decrease in hemoglobin(g/L),the probability(over time)of discharge from the ICU and hospital increased 7.0%,16.0% respectively.Conclusion A lower preoperative hemoglobin concentration resulted in increased use of hospital resources after cardiac surgery.Therefore,the correction of decreasing preoperative hemoglobin concentration could improve the use of hospital resources after cardiac surgery.

19.
China Pharmacy ; (12): 2750-2753, 2017.
Article in Chinese | WPRIM | ID: wpr-616332

ABSTRACT

OBJECTIVE:To investigate the influence of cephalosporins antibiotics on cost and length of hospital stay in pa-tients underwent gallbladder calculus resection,and to provide reference for drug use in clinic. METHODS:A total of 1866 patients underwent gallbladder calculus resection were collected from 9 third grade class A hospitals in Guangxi during 2013-2014. SPSS 22.0 software was adopted to analyze cost and length of hospital stay in patients underwent gallbladder calculus resection. RESULTS:Multi-factor analysis showed that the factors which significantly affected the cost and length of hospital stay were antibiotics,hospi-tals,age,surgery types and disease species (all P0.05). CONCLUSIONS:Cephalospo-rins antibiotics can significantly influence the cost and length of hospital stay in patients underwent gallbladder calculus resec-tion. Antibiotics selection canbe considered comprehensively ac-cording to local medical resources and the patients'demands.

20.
Organ Transplantation ; (6): 225-228, 2017.
Article in Chinese | WPRIM | ID: wpr-731684

ABSTRACT

Objective To investigate the effect of preoperative hyperbaric oxygen therapy upon the incidence of hypoxemia in patients after renal transplantation. Methods In the experimental group, 55 patients received hyperbaric oxygen therapy prior to renal transplantation, and 66 counterparts in the control group underwent conventional renal transplantation. Postoperatively, the incidence of hypoxemia, pulmonary infection, time of in-bed oxygen inhalation and length of hospital stay were statistically compared between two groups. Results In the experimental group, 12 among 55 patients (22%) presented with hypoxemia after renal transplantation, and 20 of 66 (30%) in the control group. In the experimental group, 4 cases suffered from pulmonary infection with an incidence of b7%, and 14 (21%) in the control group. In the experimental group, the incidences of hypoxemia and pulmonary infection were lower than those in the control group (both P<0.05). Inthe experimental group, the time of in-bed oxygen inhalation and length of hospital stay were (5.9±2.0) d and (17.7±3.7) d, significantly shorter compared with (6.8±2.6) d and (20.5±4.2) d in the control group (both P<0.05). Conclusions Prior to renal transplantation, hyperbaric oxygen therapy can significantly reduce the risk of hypoxemia and pulmonary infection after renal transplantation, which can be served as a conventional preventive measure against the incidence of hypoxemia following renal transplantation.

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