Multistate modelling to estimate excess length of stay and risk of death associated with organ/space infection after elective colorectal surgery

Shaw, Evelyn; Gomila-Grange, Aina; Piriz, M; Cuquet, Jordi; Vázquez, Ana María; Badia, Josep M.; Lérida, Ana; Fraccalvieri, Doménico; Marrón, Anna; Freixas, N.; Castro, Antoni; Cruz, A.; Cáceres, Enrique Limón; Gudiol, Francesc; Biondo, Sebastiano; Carratalà, Jordi; Pujol, Miquel; Camprubí, Daniel; Martín, L. Gajate; Sanz, C; Brugués, M; Serra‐Aracil, Xavier; Mora, Lorena de la; Diaz-Brito, Vicens; Moreno, Esther Kreisler; Obradors, F.; Espejo, Elena; Aguilar, Francesc; Pagespetit, L.; Nicolás, Carmen; Navarro, Annie; Vazquez, Rosa Maria; Arroyo, Noelle S.; López, Arturo Mejía; Iftimie, Simona

doi:10.1016/j.jhin.2018.08.010

Cited by 14 publications

(13 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The postoperative discharge time is an important indicator and the success of the intervention in geriatric patient anesthesia management (26). It has been found that the prolongation of the hospital stay of geriatric patients is an independent risk factor for mortality (27).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Factors Affecting the Length of Stay in Hospital of Transcatheter Aortic Valve Implantation (TAVI) Cases

Büyükçoban

İyilikçi

2021

Journal of Basic and Clinical Health Sciences

View full text Add to dashboard Cite

INTRODUCTIONAccording to the population projections made by the Ministry of Health in 1996, it is estimated that the population aged 65 and over will be 12.1% in our country in 2030 (1). In the geriatric age group, systems work in balance under physiological conditions, with reduced organ and reserve capacity. Atrophic and fibrotic changes in the aging process also affect the aortic valve. Aortic stenosis (AS) is the most common valvular heart disease in adults over 65 (2). Moderate ABSTRACT Purpose: In the treatment of inoperable patients with severe aortic stenosis or at high surgical risk, transcatheter aortic valve implantation (TAVI) is applied as an alternative to surgical aortic valve replacement. In our study, it was aimed to evaluate the factors affecting the length of stay in hospital of TAVI cases. Method: After obtaining the approval of the ethics committee, the patients who received TAVI between 09.06.2012-19.01.2018 in the Interventional Cardiology unit of Dokuz Eylül University were retrospectively screened. A total of 243 patients were included in the study. Demographic data, preoperative accompanying diseases and echocardiographic results of the cases, the type of anesthesia applied, the duration of postoperative coronary intensive care and hospital stay of them were recorded. The analysis of the data was carried out in the SPSS 22.0 statistical package program, and the independent variables and their relationship with discharge were tested with chi-square analysis. Results: 53.5% of the patients who underwent transcatheter aortic valve implantation received general anesthesia, 46.5% received local anesthesia and sedation. 93.8% of the patients were discharged upon recovery. There was no significant difference between patients' gender, age, mitral insufficiency level, aortic insufficiency level, tricuspid insufficiency level, aortic valve area, and preoperative comorbid diseases and postoperative discharge time (p> 0.05). There was a significant difference between the postoperative length of stay in hospital and the type of anesthesia (p=0.008). It was shown that patients underwent general anesthesia were discharged later than patients underwent sedation. Conclusion: Due to the high risks of surgery, it is of vital importance to shorten the length of stay in hospital in high-risk patients over 65 years of age who undergo TAVI.

show abstract

Section: Discussionmentioning

confidence: 99%

Evaluation of the Factors Affecting the Length of Stay in Hospital of Transcatheter Aortic Valve Implantation (TAVI) Cases

Büyükçoban

İyilikçi

2021

Journal of Basic and Clinical Health Sciences

View full text Add to dashboard Cite

show abstract

“…Increased LOS can lead to more healthcare costs but calculating these costs is complicated due to time-dependent bias [30, 31]. Meredith L. Kilgore et al [32] thought that it is possible that HAIs may lead to prolonged hospital stay which in turn increases the risk of infection (which was called mixing or endogeneity).…”

Section: Discussionmentioning

confidence: 99%

Impact of Healthcare-Associated Infections on Length of Stay: A Study in 68 Hospitals in China

Huixue

et al. 2019

BioMed Research International

View full text Add to dashboard Cite

Healthcare-associated infections (HAIs) not only bring additional medical cost to the patients but also prolong the length of stay (LOS). 2119 HAI case-patients and 2119 matched control-patients were identified in 68 hospitals in 14 primary sampling provinces of 7 major regions of China. The HAI caused an increase in stay of 10.4 days. The LOS due to HAI increased from 9.7 to 10.9 days in different levels of hospitals. There was no statistically significant difference in the increased LOS between different hospital levels. The increased LOS due to HAI in different regions was 8.2 to 12.6 days. Comparing between regions, we found that the increased LOS due to HAI in South China is longer than other regions except the Northeast. The gastrointestinal infection (GI) caused the shortest extra LOS of 6.7 days while the BSI caused the longest extra LOS of 12.8 days. The increased LOS for GI was significantly shorter than that of other sites. Among 2119 case-patients, the non-multidrug-resistant pathogens were detected in 365 cases. The average increased LOS due to these bacterial infections was 12.2 days. E. coli infection caused significantly shorter LOS. The studied MDROs, namely, MRSA, VRE, ESBLs-E. coli, ESBLs-KP, CR-E. coli, CR-KP, CR-AB, and CR-PA were detected in 381 cases (18.0%). The average increased LOS due to these MDRO infections was 14 days. Comparing between different MDRO infections, we found that the increased LOS due to HAI caused by CR-PA (26.5 days) is longer than other MDRO infections (shorter than 19.8 days).

show abstract

“…As LOS attributable to HCAI is mainly caused by the days after HCAI acquired actually, it is necessary to account for the time of HCAI during estimation [11, 15]. Based on the pathway of patients’ states during hospitalization, MSM provides a weighted average of the LOS [16]. In the 4-state model, we treated admission without infection as state 0, HCAI acquisition as state 1, discharge as state 2, and in-hospital death as state 3 (Fig.…”

Section: Methodsmentioning

confidence: 99%

Estimating extra length of stay and risk factors of mortality attributable to healthcare-associated infection at a Chinese university hospital: a multi-state model

et al. 2019

View full text Add to dashboard Cite

BackgroundThe current evidence of extra length of stay (LOS) attributable to healthcare-associated infection (HCAI) scarcely takes time-dependent bias into consideration. Plus, limited evidences were from developing countries. We aim to estimate the extra LOS and risk factors of mortality attributable to HCAI for inpatients.MethodsMulti-state model (MSM) was adopted to estimate the extra LOS attributable to HCAI of each type and subgroup. COX regression model was used to examine the risk of mortality.ResultsA total of 51,691 inpatients were included and 1709 (3.31%) among them developed HCAI. Lower respiratory tract infection and Acinetobacter baumannii were the most prevalent HCAI and causative pathogen in surveyed institute. Generally, the expected extra LOS attributable to HCAI was 2.56 days (95% confidence interval: 2.54–2.61). Patients below 65 had extra LOS attributable to HCAI longer about 2 days than those above. The extra LOS attributable to HCAI of male patients was 1.33 days longer than female. Meanwhile, age above 65 years old and HCAI were the risk factors of mortality for inpatients.ConclusionsHCAI contributes to an increase in extra LOS of inpatients in China. The effect of HCAI on extra LOS is different among subgroups, with the age below 65, male and medicine department more sensitive.

show abstract

Multistate modelling to estimate excess length of stay and risk of death associated with organ/space infection after elective colorectal surgery

Cited by 14 publications

References 34 publications

Evaluation of the Factors Affecting the Length of Stay in Hospital of Transcatheter Aortic Valve Implantation (TAVI) Cases

Evaluation of the Factors Affecting the Length of Stay in Hospital of Transcatheter Aortic Valve Implantation (TAVI) Cases

Impact of Healthcare-Associated Infections on Length of Stay: A Study in 68 Hospitals in China

Estimating extra length of stay and risk factors of mortality attributable to healthcare-associated infection at a Chinese university hospital: a multi-state model

Contact Info

Product

Resources

About