Browsing by Subject "LENGTH-OF-STAY"

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  • Sartelli, Massimo; Di Bella, Stefano; McFarland, Lynne V.; Khanna, Sahil; Furuya-Kanamori, Luis; Abuzeid, Nadir; Abu-Zidan, Fikri M.; Ansaloni, Luca; Augustin, Goran; Bala, Miklosh; Ben-Ishay, Offir; Biffl, Walter L.; Brecher, Stephen M.; Camacho-Ortiz, Adrian; Cainzos, Miguel A.; Chan, Shirley; Cherry-Bukowiec, Jill R.; Clanton, Jesse; Coccolini, Federico; Cocuz, Maria E.; Coimbra, Raul; Cortese, Francesco; Cui, Yunfeng; Czepiel, Jacek; Demetrashvili, Zaza; Di Carlo, Isidoro; Di Saverio, Salomone; Dumitru, Irina M.; Eckmann, Christian; Eiland, Edward H.; Forrester, Joseph D.; Fraga, Gustavo P.; Frossard, Jean L.; Fry, Donald E.; Galeiras, Rita; Ghnnam, Wagih; Gomes, Carlos A.; Griffiths, Ewen A.; Guirao, Xavier; Ahmed, Mohamed H.; Herzog, Torsten; Kim, Jae Il; Iqbal, Tariq; Isik, Arda; Itani, Kamal M. F.; Labricciosa, Francesco M.; Lee, Yeong Y.; Juang, Paul; Karamarkovic, Aleksandar; Kim, Peter K.; Kluger, Yoram; Leppäniemi, Ari; Lohsiriwat, Varut; Machain, Gustavo M.; Marwah, Sanjay; Mazuski, John E.; Metan, Gokhan; Moore, Ernest E.; Moore, Frederick A.; Ordonez, Carlos A.; Pagani, Leonardo; Petrosillo, Nicola; Portela, Francisco; Rasa, Kemal; Rems, Miran; Sakakushev, Boris E.; Segovia-Lohse, Helmut; Sganga, Gabriele; Shelat, Vishal G.; Spigaglia, Patrizia; Tattevin, Pierre; Trana, Cristian; Urbanek, Libor; Ulrych, Jan; Viale, Pierluigi; Baiocchi, Gian L.; Catena, Fausto (2019)
    In the last three decades, Clostridium difficile infection (CDI) has increased in incidence and severity in many countries worldwide. The increase in CDI incidence has been particularly apparent among surgical patients. Therefore, prevention of CDI and optimization of management in the surgical patient are paramount. An international multidisciplinary panel of experts from the World Society of Emergency Surgery (WSES) updated its guidelines for management of CDI in surgical patients according to the most recent available literature. The update includes recent changes introduced in the management of this infection.
  • Tan, Xiao; van Egmond, Lieve; Partinen, Markku; Lange, Tanja; Benedict, Christian (2019)
    Sleep and circadian disruptions are frequently observed in patients across hospital wards. This is alarming, since impaired nocturnal sleep and disruption of a normal circadian rhythm can compromise health and disturb processes involved in recovery from illness (eg, immune functions). With this in mind, the present narrative review discusses how patient characteristics (sleep disorders, anxiety, stress, chronotype, and disease), hospital routines (pain management, timing of medication, nocturnal vital sign monitoring, and physical inactivity), and hospital environment (light and noise) may all contribute to sleep disturbances and circadian misalignment in patients. We also propose hospital-based strategies that may help reduce sleep and circadian disruptions in patients admitted to the hospital. (C) 2018 The Authors. Published by Elsevier B.V.
  • Cadilhac, Dominique A.; Dewey, Helen M.; Denisenko, Sonia; Bladin, Christopher F.; Meretoja, Atte (2019)
    BackgroundHospital costs for stroke are increasing and variability in care quality creates inefficiencies. In 2007, the Victorian Government (Australia) employed clinical facilitators for three years in eight public hospitals to improve stroke care. Literature on the cost implications of such roles is rare. We report changes in the costs of acute stroke care following implementation of this program.MethodsObservational controlled before-and-after cohort design. Standardised hospital costing data were compared pre-program (financial year 2006-07) and post-program (2010-11) for all admitted episodes of stroke or transient ischaemic attack (TIA) using ICD-10 discharge codes. Costs in Australian dollars (AUD) were adjusted to a common year 2010. Generalised linear regression models were used for adjusted comparisons.ResultsA 20% increase in stroke and TIA episodes was observed: 2624 pre-program (age>75years: 53%) and 3142 post-program (age>75years: 51%); largely explained by more TIA admissions (up from 785 to 1072). Average length of stay reduced by 22% (pre-program 7.3days to post-program 5.7days, p
  • Jäppinen, Anna-Maija; Munoz, Minna; Kettunen, Tarja; Piirainen, Arja (2020)
    Objective The aim of this study was to explore patients' narratives of patient education in physiotherapy after a total hip arthroplasty (THA). Method The data was collected via open thematic interviews from ten patients who had had a primary THA. The interviews were analysed using a qualitative, narrative method. Results Three story models of patient education in physiotherapy were identified: Supportive patient education in physiotherapy, Co-operative patient education in physiotherapy and Contradictory patient education in physiotherapy. The emphasis of narration in the first story model was on the trust in the guidance, functioning interaction in the second and insufficient patient education in physiotherapy in the third story model. Discussion According to the results of this study, patients with THA experience functioning interaction and trust in the patient education in physiotherapy as enhancing the rehabilitation process. Conversely insufficient patient education about exercising and follow-up physiotherapy made the patients feel insecure and according to them might have slowed down the rehabilitation process. These findings can be utilized in planning and improving patient education in physiotherapy after THA.
  • Saku, Sami A.; Makinen, Tatu J.; Madanat, Rami (2019)
    Background: In this study, we aimed to assess the length of hospital stay after total knee arthroplasty in a European healthcare setting. We also aimed to investigate risk factors and reasons for delayed discharge when using an opioid-sparing fast-track protocol. Methods: From our institutional database, we retrospectively identified all primary elective unilateral total knee arthroplasties performed during January to December 2015. Both patient-related and surgery-related variables were collected from our databases. Risk factors were analyzed using multivariable logistic regression analysis. Results: The median length of stay (LOS) was 3 days. Independent risk factors for delayed discharge were higher age, higher American Society of Anesthesiologists score, general anesthesia, surgery performed toward the end of the week, longer duration of surgery, longer stay in the post-anesthesia care unit, and shorter preoperative walking distance. The main reasons for delayed discharge were delayed functional recovery and pain. Conclusion: This study identified several independent risk factors for an LOS longer than 3 days. These risk factors add to the current knowledge on which patients have an increased risk of prolonged LOS, and which patients should be targeted when striving to further reduce the LOS. (C) 2019 Elsevier Inc. All rights reserved.
  • Salama, Essi; Niemelä, Solja; Suvisaari, Jaana; Laatikainen, Tiina; Koponen, Paivikki; Castaneda, Anu E. (2018)
    Background: Substance use is a well-known public health problem, but population-based research on migrants' substance use in Europe is limited. Factors related to the cultural background and current life situation might influence substance use among migrants. Here, the prevalence of substance use in Russian, Somali and Kurdish migrants in Finland is reported in comparison with the general population, and the associations between substance use and socio-economic and migration-related background factors among migrants are analysed. Methods: Cross-sectional data from the Finnish Migrant Health and Wellbeing Study (Maamu) and comparison group data of the general Finnish population (n = 1165) from the Health 2011 Survey were used. The survey participants were of Russian (n = 702), Somali (n = 512), and Kurdish (n = 632) origin. Substance use included self-reported alcohol use within previous 12 months (AUDIT-C questionnaire), current and lifetime daily smoking and lifetime use of cannabis and intravenous drugs. Results: Binge drinking was less prevalent among all migrant groups than in the general Finnish population (Russian men 65%, p <0.01; Russian women 30%, p <0.01, Somali men 2%, p <0.01, Kurdish men 27%, p <0.01, Kurdish women 6%, p <0.01, general population men 87% and women 72%). Current daily smoking was more prevalent among Russian (28%, p = 0.04) and Kurdish (29%, p <0.01) migrant men compared with the reference group (20%). Younger age and employment were associated with binge drinking among migrants. Socio-economic disadvantage increased the odds for daily smoking in Russian, Somali and Kurdish migrant men. Several migration-related factors, such as age at migration and language proficiency, were associated with substance use. Conclusions: Binge drinking is less common among migrants than in the Finnish general population. However, current daily smoking was more prevalent among Russian and Kurdish migrant men compared with the general population. Younger age, level of education, employment, duration of residence in Finland and language proficiency were associated with binge drinking and daily smoking with varying patterns of association depending on the migrant group and gender. These findings draw attention to the variation in substance use habits among migrant populations.
  • Sartelli, Massimo; Malangoni, Mark A.; Abu-Zidan, Fikri M.; Griffiths, Ewen A.; Di Bella, Stefano; McFarland, Lynne V.; Eltringham, Ian; Shelat, Vishal G.; Velmahos, George C.; Kelly, Ciaran P.; Khanna, Sahil; Abdelsattar, Zaid M.; Alrahmani, Layan; Ansaloni, Luca; Augustin, Goran; Bala, Miklosh; Barbut, Frederic; Ben-Ishay, Offir; Bhangu, Aneel; Biffl, Walter L.; Brecher, Stephen M.; Camacho-Ortiz, Adrian; Cainzos, Miguel A.; Canterbury, Laura A.; Catena, Fausto; Chan, Shirley; Cherry-Bukowiec, Jill R.; Clanton, Jesse; Coccolini, Federico; Cocuz, Maria Elena; Coimbra, Raul; Cook, Charles H.; Cui, Yunfeng; Czepiel, Jacek; Das, Koray; Demetrashvili, Zaza; Di Carlo, Isidoro; Di Saverio, Salomone; Dumitru, Irina Magdalena; Eckert, Catherine; Eckmann, Christian; Eiland, Edward H.; Enani, Mushira Abdulaziz; Faro, Mario; Ferrada, Paula; Forrester, Joseph Derek; Fraga, Gustavo P.; Frossard, Jean Louis; Galeiras, Rita; Ghnnam, Wagih; Gomes, Carlos Augusto; Gorrepati, Venkata; Ahmed, Mohamed Hassan; Herzog, Torsten; Humphrey, Felicia; Kim, Jae Il; Isik, Arda; Ivatury, Rao; Lee, Yeong Yeh; Juang, Paul; Furuya-Kanamori, Luis; Karamarkovic, Aleksandar; Kim, Peter K.; Kluger, Yoram; Ko, Wen Chien; LaBarbera, Francis D.; Lee, Jae Gil; Leppaniemi, Ari; Lohsiriwat, Varut; Marwah, Sanjay; Mazuski, John E.; Metan, Gokhan; Moore, Ernest E.; Moore, Frederick Alan; Nord, Carl Erik; Ordonez, Carlos A.; Pereira Junior, Gerson Alves; Petrosillo, Nicola; Portela, Francisco; Puri, Basant K.; Ray, Arnab; Raza, Mansoor; Rems, Miran; Sakakushev, Boris E.; Sganga, Gabriele; Spigaglia, Patrizia; Stewart, David B.; Tattevin, Pierre; Timsit, Jean Francois; To, Kathleen B.; Trana, Cristian; Uhl, Waldemar; Urbanek, Libor; van Goor, Harry; Vassallo, Angela; Zahar, Jean Ralph; Caproli, Emanuele; Viale, Pierluigi (2015)
    In the last two decades there have been dramatic changes in the epidemiology of Clostridium difficile infection (CDI), with increases in incidence and severity of disease in many countries worldwide. The incidence of CDI has also increased in surgical patients. Optimization of management of C difficile, has therefore become increasingly urgent. An international multidisciplinary panel of experts prepared evidenced-based World Society of Emergency Surgery (WSES) guidelines for management of CDI in surgical patients.