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Stay Decreased (stay + decreased)
Selected AbstractsDoes nutritional intervention for patients with hip fractures reduce postoperative complications and improve rehabilitation?JOURNAL OF CLINICAL NURSING, Issue 9 2009Anna-Karin Gunnarsson Aims and objectives., The aims were to investigate whether there were any differences between patients receiving nutritional intervention preoperatively and over five days postoperatively and patients who did not, in terms of postoperative complications, rehabilitation, length of stay and food and liquid intake. Background., Patients with hip fractures are often malnourished at admission to hospital and they typically do not receive the energy and calories needed postoperatively. Design., The design was a quasi-experimental, pre- and post-test comparison group design without random group assignment. Methods., One hundred patients with hip fractures were consecutively included. The control group (n = 50) received regular nutritional support. The intervention group (n = 50) received nutrition according to nutritional guidelines. The outcome measures used were risk of pressure ulcer, pressure ulcers, weight, nosocomial infections, cognitive ability, walking assistance and functional ability, collected preoperatively and five days postoperatively. Each patient's nutrient and liquid intake were assessed daily for five days postoperatively. Results., Significantly fewer (p = 0·043) patients in the intervention group (18%) had pressure ulcers five days postoperatively compared with the control group (36%). Nutrient and liquid intake was significantly higher (p < 0·001) in the intervention group. Median length of stay decreased from nine to seven days (p = 0·137), as did nosocomial infections, from 18,8·7% (p = 0·137). Conclusion., Patients with hip fractures receiving nutrition according to nutritional guidelines developed fewer pressure ulcers. This is invaluable to patients' quality of life and a major economic saving for society. Relevance to clinical practice., Great benefits can be gained for the patients through modest efforts by nurses and physicians such as nutritional intervention. [source] Safety, Efficacy, and Cost Advantages of Combined Coronary Angiography and AngioplastyJOURNAL OF INTERVENTIONAL CARDIOLOGY, Issue 3 2003CLAUDE LE FEUVRE M.D., F.E.S.C. Aim: The safety and efficacy of ad hoc PTCA has been previously reported and this approach is performed in many angioplasty centers as a routine procedure. The aim of this study is to examine whether this approach reduces the length, and cost of hospital stay. Methods and results: To determine the hospital costs we studied 2,440 PTCAs over 11 years in our institution (1990,2000). Urgent PTCA for acute coronary syndromes refractory to medical treatment were excluded. In 1809 patients (74%) angioplasty was performed immediately after coronary angiography, while separate procedures were performed in 631 patients. Indication for PTCA was unstable angina in 1342 patients (55%). In the ad hoc PTCA group, 92% of the culprit lesions were successfully treated; complications included myocardial infarction (2%), urgent bypass surgery (0.6%) and death (0.9%). The rate of combined procedure progressively increased from 54% in 1990 to 88% in 2000, with a significant decrease in the rate of complications. After adjusting for clinical and angiographic differences between combined and separate procedures, angiographic success and complication rates were not statistically different in the two groups. Mean length of hospital stay decreased all along the years, and was 45% less in the ad hoc PTCA group (11.4 ± 6.9vs18.2 ± 7.7in 1990,5.4 ± 4.3vs10.8 ± 5.7in 2000,P < 0.0001). The cost was 40% lower in the ad hoc PTCA group. For patients with stable angina, the savings were 49%, and for those with unstable angina, they were 29%. Conclusion: In the era of coronary stenting, ad hoc PTCA can be performed in most of the patients as safely and successfully as a separate procedure. It reduces the length, and the cost of hospital stay in patients with stable or unstable angina. (J Interven Cardiol 2003;16:195,199) [source] Measuring Prevalence: Increasing ,active prevalence' of cancer in Western Australia and its implications for health servicesAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 2 2002Kate J. Brameld Objective:To measure the active and total prevalence of cancer in Western Australia from 1990,98 and to examine trends in utilisation of hospital services by prevalent cancer patients. Method:Longitudinal analysis of linked cancer registrations, hospital separations and death registrations in Western Australia in 1990,98 using a population-based record linkage system. Results:There was an estimated total of 53,450 patients ever-diagnosed with cancer in Western Australia at 30 June 1998 (29.7 per 1,000 population), an increase of 51 % since mid-1990 (21.9/1,000). Patients with active disease accounted for 25% of the total prevalence, and the active prevalence of cancer increased from 5.1/1,000 in 1990 to 7.4/1,000 in 1998. In patients with active cancer, hospital admission rates for procedures other than chemotherapy and radiotherapy were stable or declining, but admission rates for chemotherapy and radiotherapy increased. The annual average cumulative length of stay decreased. Conclusions and implications:There has been a rapid increase in the number of prevalent patients requiring health care services for cancer during the 1990s. Most of the increase is due to improved survival, population growth and ageing. Further strain on Australian health care expenditure seems inevitable. [source] Early severe weight loss in newborns after discharge from regular nurseriesACTA PAEDIATRICA, Issue 5 2010E Tjora Abstract Aims:, To study incidence and risk factors of early neonatal dehydration in a Norwegian population based cohort. Methods:, Term neonates admitted to a paediatric department during 2002,2008 with a weight loss , 12% within three weeks of age were identified retrospectively through review of medical records. For each patient a sex-matched control group of two full-term infants was selected to assess risk factors for dehydration. Results:, A total of 38 of 37 321 infants (1.0,) were admitted at a median age of 6 (interquartile range 5,12) days, and the admission rate increased during the study period (p for trend = 0.008). Simultaneously, mean nursery stay decreased from 3.5 to 2.7 days (p = 0.022). Mean weight loss was 15.0% of birth weight and 17 of 29 (58.6%) had serum sodium above 145 mmol/L. The only significant difference between patients and controls was that mothers of patients were older (32.3 ± 5.0 vs. 29.4 ± 5.4 years, p = 0.005). Conclusion:, Short nursery stay may be a risk factor for dehydration in newborn infants. [source] | ||||||||||