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Sample records for cardio-respiratory hospital admissions

  1. Vegetation fire smoke, indigenous status and cardio-respiratory hospital admissions in Darwin, Australia, 1996–2005: a time-series study

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    Hanigan Ivan C

    2008-08-01

    Full Text Available Abstract Background Air pollution in Darwin, Northern Australia, is dominated by smoke from seasonal fires in the surrounding savanna that burn during the dry season from April to November. Our aim was to study the association between particulate matter less than or equal to 10 microns diameter (PM10 and daily emergency hospital admissions for cardio-respiratory diseases for each fire season from 1996 to 2005. We also investigated whether the relationship differed in indigenous Australians; a disadvantaged population sub-group. Methods Daily PM10 exposure levels were estimated for the population of the city from visibility data using a previously validated model. We used over-dispersed Poisson generalized linear models with parametric smoothing functions for time and meteorology to examine the association between admissions and PM10 up to three days prior. An interaction between indigenous status and PM10 was included to examine differences in the impact on indigenous people. Results We found both positive and negative associations and our estimates had wide confidence intervals. There were generally positive associations between respiratory disease and PM10 but not with cardiovascular disease. An increase of 10 μg/m3 in same-day estimated ambient PM10 was associated with a 4.81% (95%CI: -1.04%, 11.01% increase in total respiratory admissions. When the interaction between indigenous status and PM10 was assessed a statistically different association was found between PM10 and admissions three days later for respiratory infections of indigenous people (15.02%; 95%CI: 3.73%, 27.54% than for non-indigenous people (0.67%; 95%CI: -7.55%, 9.61%. There were generally negative estimates for cardiovascular conditions. For non-indigenous admissions the estimated association with total cardiovascular admissions for same day ambient PM10 and admissions was -3.43% (95%CI: -9.00%, 2.49% and the estimate for indigenous admissions was -3.78% (95%CI: -13.4%, 6

  2. A 24-h assessment of physical activity and cardio-respiratory fitness among female hospital cleaners

    DEFF Research Database (Denmark)

    Larsen, Mette Korshøj; Krustrup, Peter; Jespersen, Tobias;

    2013-01-01

    The aim of this study was to evaluate the feasibility of methods for objective 24-h sampling of physical activity among cleaners. Twenty cleaners participated in three 24-h measurements. Amount of steps, heart rate (HR), cardio-respiratory fitness, body mass index (BMI) and blood pressure were...... measured. The methods were feasible for the objective 24-h sampling of physical activity and cardio-respiratory fitness among cleaners. Measurements showed that the cleaners walked 20,198 ± 4,627 steps per day. During working hours, the average cardio-respiratory load was 25 ± 6% of heart rate reserve (HRR......). The cleaners had a low estimated cardio-respiratory fitness (34 mlO2/kg/min), a high BMI (50%, >25 kg/m(2)) and blood pressure (50%, >120/>80 mmHg). The high amount of steps, the relatively high cardiovascular load at work and low cardio-respiratory fitness illustrate the need for further investigation...

  3. Cardio-Respiratory Coordination Increases during Sleep Apnea

    OpenAIRE

    Riedl, M.; Müller, A.; Kraemer, J. F.; Penzel, T; Kurths, J.; Wessel, N.

    2014-01-01

    Cardiovascular diseases are the main source of morbidity and mortality in the United States with costs of more than $170 billion. Repetitive respiratory disorders during sleep are assumed to be a major cause of these diseases. Therefore, the understanding of the cardio-respiratory regulation during these events is of high public interest. One of the governing mechanisms is the mutual influence of the cardiac and respiratory oscillations on their respective onsets, the cardio-respiratory coord...

  4. Cortico-cardio-respiratory network interactions during anesthesia.

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    Yuri Shiogai

    Full Text Available General anesthetics are used during medical and surgical procedures to reversibly induce a state of total unconsciousness in patients. Here, we investigate, from a dynamic network perspective, how the cortical and cardiovascular systems behave during anesthesia by applying nonparametric spectral techniques to cortical electroencephalography, electrocardiogram and respiratory signals recorded from anesthetized rats under two drugs, ketamine-xylazine (KX and pentobarbital (PB. We find that the patterns of low-frequency cortico-cardio-respiratory network interactions may undergo significant changes in network activity strengths and in number of network links at different depths of anesthesia dependent upon anesthetics used.

  5. Hospital Admissions from Nursing Homes: Rates and Reasons

    OpenAIRE

    Geir Egil Eide; Kristian Jansen; Anders Grimsmo; Kjell Krüger; Jonn Terje Geitung

    2011-01-01

    Hospital admissions from nursing homes have not previously been investigated in Norway. During 12 months all hospital admissions (acute and elective) from 32 nursing homes in Bergen were recorded via the Norwegian ambulance register. The principal diagnosis made during the stay, length of stay, and the ward were sourced from the hospital's data register and data were merged. Altogether 1,311 hospital admissions were recorded during the 12 months. Admissions from nursing homes made up 6.1% of ...

  6. Transitions in Physiologic Coupling: Sleep Stage and Age Dependence of Cardio-respiratory Phase Synchronization

    Science.gov (United States)

    Bartsch, Ronny P.; Ivanov, Plamen Ch.

    2012-02-01

    Recent studies have focused on various features of cardiac and respiratory dynamics with the aim to better understand key aspects of the underlying neural control of these systems. We investigate how sleep influences cardio-respiratory coupling, and how the degree of this coupling changes with transitions across sleep stages in healthy young and elderly subjects. We analyze full night polysomnographic recordings of 189 healthy subjects (age range: 20 to 90 years). To probe cardio-respiratory coupling, we apply a novel phase synchronization analysis method to quantify the adjustment of rhythms between heartbeat and breathing signals. We investigate how cardio-respiratory synchronization changes with sleep-stage transitions and under healthy aging. We find a statistically significant difference in the degree of cardio-respiratory synchronization during different sleep stages for both young and elderly subjects and a significant decline of synchronization with age. This is a first evidence of how sleep regulation and aging influence a key nonlinear mechanism of physiologic coupling as quantified by the degree of phase synchronization between the cardiac and respiratory systems, which is of importance to develop adequate modeling approaches.

  7. Perceived coercion in voluntary hospital admission.

    LENUS (Irish Health Repository)

    O'Donoghue, Brian

    2014-01-30

    The legal status of service users admitted to psychiatric wards is not synonymous with the level of coercion that they can perceive during the admission. This study aimed to identify and describe the proportion of individuals who were admitted voluntarily but experienced levels of perceived coercion comparable to those admitted involuntarily. Individuals admitted voluntarily and involuntarily to three psychiatric hospitals were interviewed using the MacArthur Admission Experience Interview and the Structured Clinical Interview for DSM-IV diagnoses. One hundered sixty-one individuals were interviewed and 22% of the voluntarily admitted service users had levels of perceived coercion similar to that of the majority of involuntarily admitted service users. Voluntarily admitted service users who experienced high levels of perceived coercion were more likely to have more severe psychotic symptoms, have experienced more negative pressures and less procedural justices on admission. Individuals brought to hospital under mental health legislation but who subsequently agreed to be admitted voluntarily and those treated on a secure ward also reported higher levels of perceived coercion. It needs to be ensured that if any service user, whether voluntary or involuntary, experiences treatment pressures or coercion that there is sufficient oversight of the practice, to ensure that individual\\'s rights are respected.

  8. IMPROVEMENT OF CARDIO-RESPIRATORY FUNCTION IN THE ELDERLY USING SOME MARTIAL ARTS EXERCISES

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    Cojocariu A.

    2012-12-01

    Full Text Available The aim of the present study is to identify the martial arts exercises which to improve the cardio-respiratory function to the elderly. It was started from the hypothesis that using the psycho-corporal gymnastics exercises (Tam The, it is possible to improve the heart rate, blood pressure and pulmonary elasticity values to the elderly, which would lead to the strengthening of health. In this experiment it was included 8 subjects with normal health status, aged between 55 and 60 years. The experiment was carried out over a period of six months, twice a week, one hour per course. Following the present study, we state the TAM-THE exercises have proven its efficiency in improving the cardio-respiratory function to elderly, especially regarding the improvement of heart rate and systolic blood pressure at rest and also of pulmonary elasticity.

  9. Cardio-respiratory symptoms in panic disorder: a contribution from cognitive-behaviour therapy

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    Anna Lucia Spear King

    2011-01-01

    Full Text Available Objective: To compare patients with panic disorder with agoraphobia treated with cognitive-behavioural therapy (CBT associated with the medication with patients treated only with medication and verify the behaviour of the cardio-respiratory symptoms of both groups. Methods: Randomized sample in the Psychiatry Institute of the Federal University of Rio de Janeiro, divided in two groups of 25 participants each. Group 1 undertook 10 weekly sessions of CBT with one hour of duration each together with medication. Group 2, Control, were administered medication that only consisted of tricyclic anti-depressants and selective inhibitors of the re-uptake of serotonin. Evaluation instruments were applied at the beginning and to the end of the interventions. Results: According to the applied scales, group 1 showed statistically more significant results than group 2, with: reduction of panic attacks, cardio-respiratory symptoms, anticipatory anxiety, agoraphobia avoidance and fear of bodily sensations. Conclusion: Exposures (in vivo and interoceptive, especially for induction symptom exercises and relaxation, were considered essential to prepare patients with panic disorder to handle future cardio-respiratory symptoms and panic attacks with agoraphobia.

  10. Temperature effects on hospital admissions for kidney morbidity in Taiwan

    International Nuclear Information System (INIS)

    Objective: This study aimed to associate hospital admissions of kidney diseases with extreme temperature and prolonged heat/cold events in 7 regions of Taiwan. Methods: Age-specific (10, O3, and NO2) and potential confounders. Results: We observed a V or J-shape association between daily average temperatures and the RR estimates for hospital admissions of kidney diseases in Taiwan. The lowest risk for hospital admissions of kidney diseases was found at around 25 °C, and risk increased as temperatures deviated from 25 °C. The pooled cumulative 8-day RR for all ages of population of the 7 study areas were 1.10 (95% confidence interval (CI): 1.01, 1.19) at 18 °C and 1.45 (95% CI: 1.27, 1.64) at 30 °C. High temperature has more profound influence on hospital admission of kidney diseases than low temperature. Temperature risks for hospital admissions were similar between younger (< 65 years) and elderly (65 + years) population. This study observed no significant effects of prolonged heat extremes on hospital admissions of kidney diseases. Conclusions: The heat effect for kidney morbidities leading to hospital admission was more significant than that of the cold temperature. This study did not find the age-dependent relative risks for temperature associating with hospital admissions of kidney diseases. - Highlights: ► V or J-shaped association was observed between daily temperatures and hospital admissions for renal diseases in Taiwan. ► The pooled relative risks accounting for 8 days of lag for the 7 study areas were 1.1 at 18 °C and 1.46 at 30 °C. ► There is no difference of the relative risk estimates for hospital admissions between younger and elderly population. ► We found significant protective effects of hospital admissions for prolonged cold extremes, but not for heat extremes

  11. Temperature effects on hospital admissions for kidney morbidity in Taiwan

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    Lin, Yu-Kai [Department of Environmental Health, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115 (United States); Wang, Yu-Chun [Department of Bioenvironmental Engineering, College of Engineering, Chung Yuan Christian University, 200 Chung-Pei Road, Chung Li 320, Taiwan (China); Research Center for Environmental Risk Management, Chung Yuan Christian University, 200 Chung-Pei Road, Chung Li 320, Taiwan (China); Ho, Tsung-Jung [The Division of Chinese Medicine, China Medical University Beigang Hospital, Taiwan (China); School Of Chinese Medicine, College of Chinese Medicine, China Medical University, 91 Xueshi Road, Taichung City 404, Taiwan (China); Lu, Chensheng, E-mail: cslu@hsph.harvard.edu [Department of Environmental Health, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115 (United States)

    2013-01-15

    Objective: This study aimed to associate hospital admissions of kidney diseases with extreme temperature and prolonged heat/cold events in 7 regions of Taiwan. Methods: Age-specific (< 65 years, 65 + years and all ages) hospital admission records of nephritis, nephrotic syndrome, or nephrosis, in the form of electronic insurance reimbursement claims, were retrieved from Taiwan's National Health Insurance Research Database during the period of 2000–2008. The area–age-specific relative risk (RR) accounting for 8 days of lag for temperature on hospital admissions of kidney diseases were estimated using distributed lag non-linear models with the Poisson distribution controlling for extreme temperature events, levels of air pollutants (PM{sub 10}, O{sub 3}, and NO{sub 2}) and potential confounders. Results: We observed a V or J-shape association between daily average temperatures and the RR estimates for hospital admissions of kidney diseases in Taiwan. The lowest risk for hospital admissions of kidney diseases was found at around 25 °C, and risk increased as temperatures deviated from 25 °C. The pooled cumulative 8-day RR for all ages of population of the 7 study areas were 1.10 (95% confidence interval (CI): 1.01, 1.19) at 18 °C and 1.45 (95% CI: 1.27, 1.64) at 30 °C. High temperature has more profound influence on hospital admission of kidney diseases than low temperature. Temperature risks for hospital admissions were similar between younger (< 65 years) and elderly (65 + years) population. This study observed no significant effects of prolonged heat extremes on hospital admissions of kidney diseases. Conclusions: The heat effect for kidney morbidities leading to hospital admission was more significant than that of the cold temperature. This study did not find the age-dependent relative risks for temperature associating with hospital admissions of kidney diseases. - Highlights: ► V or J-shaped association was observed between daily temperatures and

  12. Physical activity, Cardio-Respiratory Fitness, and Metabolic Traits in Rural Mexican Tarahumara

    DEFF Research Database (Denmark)

    Christensen, Dirk Lund; Alcala-Sanchez, Imelda; Leal-Berumen, Irene;

    2012-01-01

    Objectives: To study the association between physical activity energy expenditure (PAEE) and cardio-respiratory fitness (CRF) with key metabolic traits and anthropometric measures in the Tarahumara of Mexico. Methods: A cross-sectional study was carried out in five rural communities in Chihuahua......, Me´xico including 64 adult Tarahumara, mean (SD) age 40.7 (12.9) years. Using a combined accelerometer and heart rate sensor, PAEE was measured over three consecutive days and nights and a sub-maximal step test was carried out in order to (1) calibrate heart rate at the individual level and (2...

  13. Gill chemoreceptors and cardio-respiratory reflexes in the neotropical teleost pacu, Piaractus mesopotamicus.

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    Leite, C A C; Florindo, L H; Kalinin, A L; Milsom, W K; Rantin, F T

    2007-09-01

    This study examined the location and distribution of O(2) chemoreceptors involved in cardio-respiratory responses to hypoxia in the neotropical teleost, the pacu (Piaractus mesopotamicus). Intact fish and fish experiencing progressive gill denervation by selective transection of cranial nerves IX and X were exposed to gradual hypoxia and submitted to intrabuccal and intravenous injections of NaCN while their heart rate, ventilation rate and ventilation amplitude were measured. The chemoreceptors producing reflex bradycardia were confined to, but distributed along all gill arches, and were sensitive to O(2) levels in the water and the blood. Ventilatory responses to all stimuli, though modified, continued following gill denervation, however, indicating the presence of internally and externally oriented receptors along all gill arches and either in the pseudobranch or at extra-branchial sites. Chemoreceptors located on the first pair of gill arches and innervated by the glossopharyngeal nerve appeared to attenuate the cardiac and respiratory responses to hypoxia. The data indicate that the location and distribution of cardio-respiratory O(2) receptors are not identical to those in tambaqui (Colossoma macropomum) despite their similar habitats and close phylogenetic lineage, although the differences between the two species could reduce to nothing more than the presence or absence of the pseudobranch. PMID:17680247

  14. Prediction of mortality 1 year after hospital admission.

    LENUS (Irish Health Repository)

    Kellett, J

    2012-09-01

    Hospital admission, especially for the elderly, can be a seminal event as many patients die within a year. This study reports the prediction of death within a year of admission to hospital of the Simple Clinical Score (SCS) and ECG dispersion mapping (ECG-DM). ECG-DM is a novel technique that analyzes low-amplitude ECG oscillations and reports them as the myocardial micro-alternation index (MMI).

  15. [Compulsory admission to hospital in Tunisia: a necessary evolution].

    Science.gov (United States)

    Ellouze, Faten; Lahmar, Aymen; Beji, Rami; Dridi, Anis; Fadhel M'rad, Mohamed

    2015-01-01

    The evolution of the legislation governing compulsory admission to hospital in Tunisia is interesting for two reasons. The country's 2011 revolution notably brought about major changes to the legislative framework, from constitutional through to ordinary laws. At the same time, the current trend for globalisation is also affecting legislation: international laws, treaties and UN charters are imposed on the laws of individual countries. This article looks at how Tunisian law governing compulsory admission to hospital has had to evolve. PMID:26143219

  16. Possible adverse drug events leading to hospital admission in a Brazilian teaching hospital

    OpenAIRE

    Fabiana Rossi Varallo; Helaine Carneiro Capucho; Cleópatra da Silva Planeta; Patrícia de Carvalho Mastroianni

    2014-01-01

    OBJECTIVES: Drug safety problems can lead to hospital admission. In Brazil, the prevalence of hospitalization due to adverse drug events is unknown. This study aims to estimate the prevalence of hospitalization due to adverse drug events and to identify the drugs, the adverse drug events, and the risk factors associated with hospital admissions. METHOD: A cross-sectional study was performed in the internal medicine ward of a teaching hospital in São Paulo State, Brazil, from August to Decemb...

  17. Experimental evidence for phase synchronization transitions in human cardio-respiratory system

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    Bartsch, R; Kantelhardt, J W; Penzel, T; Bartsch, Ronny; Havlin, Shlomo; Kantelhardt, Jan W.; Penzel, Thomas

    2007-01-01

    Transitions in the dynamics of complex systems can be characterized by changes in the synchronization behavior of their components. Taking the human cardio-respiratory system as an example and using an automated procedure for screening the synchrograms of 112 healthy subjects we study the frequency and the distribution of synchronization episodes under different physiological conditions that occur during sleep. We find that phase synchronization between heartbeat and breathing is significantly enhanced during non-rapid-eye-movement (non-REM) sleep (deep sleep and light sleep) and reduced during REM sleep. Our results suggest that the synchronization is mainly due to a weak influence of the breathing oscillator upon the heartbeat oscillator, which is disturbed in the presence of long-term correlated noise, superimposed by the activity of higher brain regions during REM sleep.

  18. Cardio-respiratory Physiology of the European Eel (Agunilla anguilla) in Extreme Environments

    DEFF Research Database (Denmark)

    Methling, Caroline

    The main objective of this PhD thesis was to study the cardio-respiratory capabilities of the European eel (Anguilla anguilla) under extreme conditions. Three environmental conditions were studied i.e. temperature, dissolved oxygen and carbon dioxide, while a fourth condition was physiological...... and focused on the impressive spawning migration of A. anguilla. Ambient temperature influences the rate of most biological functions including metabolic processes, which in turn determines the overall metabolic capacity. In Paper I it is demonstrated that A. anguilla has a wide thermal optimum as absolute......-course of contraction, and thus maximum attainable heart rate in vivo, greatly depended on ambient temperature. The relative ventricular mass was increased after long term acclimation to 0°C and 10°C compared to individuals acclimated to 20°C, indicative of a compensatory mechanism for the limitation in heart rate...

  19. Hospital admissions: An examination of race and health insurance

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    Eric Gass

    2008-06-01

    Full Text Available This study examined the effects of racial differences and differences in insurance status on source of hospital admissions. The data source was the 2001 National Hospital Discharge Survey and included a sub-sample of 104,185 patients. 58.3% of patients were admitted through the emergency room, 75.0% of patients were White, 19.7% were Black, and 61.5% were on government insurance or uninsured. Black patients were found to have significantly higher levels of emergency room admissions (69.1%=p < .0001, regardless of insurance status (gov’t/self-pay, 73.7%=p < .0001, private insurance, 59.5%=p < .0001. Patients on government insurance or self-payment had significantly higher levels of emergency room admissions (65.8%=p < .0001. Regression analysis showed that both race and insurance type are significant predictors (p < .0001 of Source of Admission to the hospital. Percent probabilities confirmed this finding. Thus, it was concluded that racial differences witnessed in source of admission were not mediated by insurance type and that race and insurance type are significant, independent predictors of hospital admission source.

  20. Cardio-respiratory and electromyographic responses to ergometer and on-water rowing in elite rowers.

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    Bazzucchi, I; Sbriccoli, P; Nicolò, A; Passerini, A; Quinzi, F; Felici, F; Sacchetti, M

    2013-05-01

    The aim of this study was to compare muscle activation and cardio-respiratory response during ergometer and on-water rowing. Nine internationally competitive rowers (five Olympic Games medal winners, age 25.6 ± 4.8 years) were requested to perform a 1,000 m race simulation test in the two conditions. Surface electromyographic (sEMG) signals from trapezius superior (TRS), latissimus dorsi (LD), biceps brachii (BB), rectus femoris (RF), vastus medialis (VAM), vastus lateralis (VAL), biceps femoris (BF) and tibialis anterior (TA) muscles were recorded continuously during the tests together with other cardio-respiratory parameters: heart rate (HR), ventilation (VE), oxygen consumption (VO₂). On-water, subjects covered the same distance in a longer time (218.4 ± 3.8 s vs. 178.1 ± 5.6 s during ergometer test). TRS, LD, BB, RF, VAM and VAL muscle activation on-water was lower than off-water during the rowing race. VO₂ and VE responses were similar between the two conditions even if the time to complete the 1,000 m race simulation test was higher on-water. The results indicate that for most of the analyzed muscles EMG activation on the ergometer is higher than on-water with the maximal activity at the beginning of the on-water test due reasonably to overcome the forces opposing the forward motion, while the ergometer task elicited increasing muscle activation over time. The present data may be considered by coaches when choosing a rowing ergometer in substitution for the training on-water or when relying on the indoor tests to select the crew. PMID:23179206

  1. Adherence to inhaled therapy, mortality and hospital admission in COPD

    DEFF Research Database (Denmark)

    Vestbo, J; Anderson, J A; Calverley, P M A;

    2009-01-01

    between adherence and mortality remained unchanged and statistically significant after adjusting for other factors related to prognosis (hazard ratio 0.40 (95% CI 0.35 to 0.46), p... adherence and hospital admission remained unchanged and significant in a multivariate analysis (rate ratio 0.58 (95% CI 0.44 to 0.73, p... was more pronounced in patients with good adherence than in those with poor adherence. CONCLUSION: Adherence to inhaled medication is significantly associated with reduced risk of death and admission to hospital due to exacerbations in COPD. Further research is needed to understand these strong...

  2. Daily weather variables and affective disorder admissions to psychiatric hospitals

    Science.gov (United States)

    McWilliams, Stephen; Kinsella, Anthony; O'Callaghan, Eadbhard

    2014-12-01

    Numerous studies have reported that admission rates in patients with affective disorders are subject to seasonal variation. Notwithstanding, there has been limited evaluation of the degree to which changeable daily meteorological patterns influence affective disorder admission rates. A handful of small studies have alluded to a potential link between psychiatric admission rates and meteorological variables such as environmental temperature (heat waves in particular), wind direction and sunshine. We used the Kruskal-Wallis test, ARIMA and time-series regression analyses to examine whether daily meteorological variables—namely wind speed and direction, barometric pressure, rainfall, hours of sunshine, sunlight radiation and temperature—influence admission rates for mania and depression across 12 regions in Ireland over a 31-year period. Although we found some very weak but interesting trends for barometric pressure in relation to mania admissions, daily meteorological patterns did not appear to affect hospital admissions overall for mania or depression. Our results do not support the small number of papers to date that suggest a link between daily meteorological variables and affective disorder admissions. Further study is needed.

  3. Atmospheric pollutants and hospital admissions due to pneumonia in children

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    Juliana Negrisoli

    2013-12-01

    Full Text Available OBJECTIVE: To analyze the relationship between exposure to air pollutants and hospitalizations due to pneumonia in children of Sorocaba, São Paulo, Brazil. METHODS: Time series ecological study, from 2007 to 2008. Daily data were obtained from the State Environmental Agency for Pollution Control for particulate matter, nitric oxide, nitrogen dioxide, ozone, besides air temperature and relative humidity. The data concerning pneumonia admissions were collected in the public health system of Sorocaba. Correlations between the variables of interest using Pearson cofficient were calculated. Models with lags from zero to five days after exposure to pollutants were performed to analyze the association between the exposure to environmental pollutants and hospital admissions. The analysis used the generalized linear model of Poisson regression, being significant p<0.05. RESULTS: There were 1,825 admissions for pneumonia, with a daily mean of 2.5±2.1. There was a strong correlation between pollutants and hospital admissions, except for ozone. Regarding the Poisson regression analysis with the multi-pollutant model, only nitrogen dioxide was statistically significant in the same day (relative risk - RR=1.016, as well as particulate matter with a lag of four days (RR=1.009 after exposure to pollutants. CONCLUSIONS: There was an acute effect of exposure to nitrogen dioxide and a later effect of exposure to particulate matter on children hospitalizations for pneumonia in Sorocaba.

  4. Rising rates of hospital admissions for atrial fibrillation

    DEFF Research Database (Denmark)

    Friberg, Jens; Buch, Nina Pernille Gardshodn; Scharling, Henrik;

    2003-01-01

    Atrial fibrillation is a common arrhythmia associated with excess morbidity and mortality. We studied temporal changes in hospital admission rates for atrial fibrillation using data from a prospective population-based cohort study spanning 2 decades (the Copenhagen City Heart Study)....

  5. The effect of Sub-maximal exercise-rehabilitation program on cardio-respiratory endurance indexes and oxygen pulse in patients with spastic cerebral palsy

    OpenAIRE

    M Izadi; F. Nazem; M Hazavehei

    2006-01-01

    Background: Physical or cardio-respiratory fitness are of the best important physiological variables in children with cerebral palsy (CP), but the researches on exercise response of individuals with CP are limited. Our aim was to determine the effect of sub-maximal rehabilitation program (aerobic exercise) on maximal oxygen uptake, oxygen pulse and cardio- respiratory physiological variables of children with moderate to severe spastic cerebral palsy diplegia and compare with able-bodied child...

  6. Cardio-respiratory, haematological and biochemical parameter adjustments to exercise: effect of a probiotic in horses during training

    OpenAIRE

    Art, Tatiana; Votion, Dominique; Mc Entee, Kathleen; Amory, Hélène; Linden, Annick; Close, Roland; Lekeux, Pierre

    1994-01-01

    Two randomly distributed groups of thoroughbred horses were compared during a 12-week period for their cardio-respiratory and metabolic adjustment to strenuous exercise, training and detraining. The horses were trained following the same standardized schedule and were regularly investigated using standardized treadmill exercise tests (SET) of increasing speed. After the first SET and during the whole experimental period, a group of 6 horses received a probiotic (Bioracing) once a day while a ...

  7. Assessment of cardio-respiratory interactions in preterm infants by bivariate autoregressive modeling and surrogate data analysis

    OpenAIRE

    Indic, Premananda; Bloch-Salisbury, Elisabeth; Bednarek, Frank; Emery N Brown; Paydarfar, David; Barbieri, Riccardo

    2011-01-01

    Background: Cardio-respiratory interactions are weak at the earliest stages of human development, suggesting that assessment of their presence and integrity may be an important indicator of development in infants. Despite the valuable research devoted to infant development, there is still a need for specifically targeted standards and methods to assess cardiopulmonary functions in the early stages of life. We present a new methodological framework for the analysis of cardiovascular variables ...

  8. The resistance evaluation: Effects of a specific training program on professional fire-fighter cardio-respiratory fitness

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    P.J. Mourão

    2008-01-01

    Full Text Available The fire-fighters have an increased risk for developing cardiac pathologies and also a higher index of premature death than other individuals that perform high risk jobs. In this way, low physical fitness obviously limits fire-fighter performance, as well as degrades their health. However this fact not only damages the individual fire-fighter but also the institution that he represents hence severely questioning property and general public safety. The cardio-respiratory fitness had been identify as the most important physical fitness component. In this way, we developed a 12 weeks training program, to improve the cardio-respiratory fitness in a Professional fire-fighters corporation. According to reference values, before training these fire-fighters did not have enough cardio-respiratory fitness to adequately perform their job requirements with efficacy and safety (VO2máx=44,17ml/kg/min. However after training there was great improvement (VO2máx=52,69 ml/kg/min, providing a safe and more qualified service for the general population.

  9. Cardio-respiratory and daily activity monitor based on FMCW Doppler radar embedded in a wheelchair.

    Science.gov (United States)

    Postolache, Octavian; Girão, Pedro Silva; Postolache, Gabriela; Gabriel, Joaquim

    2011-01-01

    Unobtrusive monitoring of the cardio-respiratory and daily activity for wheelchair users became nowadays an important challenge, considering population aging phenomena and the increasing of the elderly with chronic diseases that affect their motion capabilities. This work reports the utilization of FMCW (frequency modulated continuous wave) Doppler radar sensors embedded in a manual wheelchair to measure the cardiac and respiratory activities and the physical activity of the wheelchair user. Another radar sensor is included in the system in order to quantify the motor activity through the wheelchair traveled distance, when the user performs the manual operation of the wheelchair. A conditioning circuit including active filters and a microcontroller based primary processing module was designed and implemented to deliver the information through Bluetooth communication protocol to an Android OS tablet computer. The main capabilities of the software developed using Android SDK and Java were the signal processing of Doppler radar measurement channel signals, graphical user interface, data storage and Wi-Fi data synchronization with remote physiological and physical activity database. PMID:22254706

  10. Socioeconomic status, lung function and admission to hospital for COPD

    DEFF Research Database (Denmark)

    Prescott, E; Lange, P; Vestbo, J

    1999-01-01

    This study analysed the effect of education and income on development of chronic obstructive pulmonary disease (COPD) assessing lung function and hospital admission. The study population consisted of 14,223 subjects, aged 20-90 yrs, randomly sampled from the population of Copenhagen in 1976...... duration of smoking and inhalation, the difference was 220+/-31 mL and 363+/-39 mL in females and males, respectively. Results for FVC were of the same magnitude. Using a socioeconomic index which combined information on education and household income the association with lung function did not differ by...... age. A total of 219 females and 265 males were admitted to hospital for COPD during follow-up. Education and income were significantly associated with admission to hospital. After detailed adjustment for smoking the relative risks (95% confidence intervals) for medium and high versus low socioeconomic...

  11. [The appropriateness of hospital admissions: reflections for a global approach].

    Science.gov (United States)

    Pasini, E; Scherillo, M; Ramponi, C

    2000-05-01

    In accordance with a recent definition, appropriateness of medical care is a diagnostic-therapeutic intervention with a correct use of resources and competency, and a procedure that satisfies the request of patients. This definition considers not only the risk/benefit relationship but also the interaction between costs and benefits. In this light, the concept of appropriateness needs a global approach. The identification of the Mission and Vision of the structure, the use of medical guidelines, the distribution of documents which inform patients on the procedures carried out in the hospital and the modalities of access to the structure, the implementation of procedures which define hospital admission and finally the random check of medical records could represent important steps to implement a quality system aimed at guaranteeing the appropriateness of hospital admissions in accordance with the international standards for total quality management ISO 9000. PMID:10834130

  12. Increasing malaria hospital admissions in Uganda between 1999 and 2009

    Directory of Open Access Journals (Sweden)

    Alegana Victor A

    2011-04-01

    Full Text Available Abstract Background Some areas of Africa are witnessing a malaria transition, in part due to escalated international donor support and intervention coverage. Areas where declining malaria rates have been observed are largely characterized by relatively low baseline transmission intensity and rapid scaling of interventions. Less well described are changing patterns of malaria burden in areas of high parasite transmission and slower increases in control and treatment access. Methods Uganda is a country predominantly characterized by intense, perennial malaria transmission. Monthly pediatric admission data from five Ugandan hospitals and their catchments have been assembled retrospectively across 11 years from January 1999 to December 2009. Malaria admission rates adjusted for changes in population density within defined catchment areas were computed across three time periods that correspond to periods where intervention coverage data exist and different treatment and prevention policies were operational. Time series models were developed adjusting for variations in rainfall and hospital use to examine changes in malaria hospitalization over 132 months. The temporal changes in factors that might explain changes in disease incidence were qualitatively examined sequentially for each hospital setting and compared between hospital settings Results In four out of five sites there was a significant increase in malaria admission rates. Results from time series models indicate a significant month-to-month increase in the mean malaria admission rates at four hospitals (trend P Conclusions The declining malaria disease burden in some parts of Africa is not a universal phenomena across the continent. Despite moderate increases in the coverage of measures to reduce infection and disease without significant coincidental increasing access to effective medicines to treat disease may not lead to severe disease burden reductions in high transmission areas of Africa

  13. [Big data, Roemer's law and avoidable hospital admissions].

    Science.gov (United States)

    van der Horst, H E

    2016-01-01

    From an analysis of data from 23 European countries to determine the impact of primary care on avoidable hospital admissions for uncontrolled diabetes it appeared that, contrary to expectation, countries with strong primary care did not have a lower rate of avoidable hospital admission. It is clear that Roemer's law, 'a bed built is a bed filled,' still applies. However, the validity of this sort of analysis can be questioned, as these data are highly aggregated, and registration quality differs between countries. It is also questionable if these datasets can be considered as 'big data' as there are relatively small numbers per country. Big data analyses are useful for discerning patterns and formulating hypotheses, but not for proving causality. An unwanted side effect of this kind of analysis might be that policymakers use these not so valid results to underpin their policy to their advantage. PMID:27484429

  14. A request for hospice admission from hospital to withdraw ventilation

    OpenAIRE

    Gannon, C.

    2005-01-01

    A request to admit a hospital inpatient with motor neurone disease to the hospice generated unusual unease. Significantly, withdrawal of ventilation had already been planned. The presumption that ventilation would be withdrawn after transfer presented a dilemma. Should the hospice accept the admission? If so, should the hospice staff stop the ventilation, and then when and how? Debate centred on the continuity of best interests and the logistics of withdrawing ventilation. The factors making ...

  15. Six months of dance intervention enhances postural, sensorimotor, and cognitive performance in elderly without affecting cardio-respiratory functions

    Directory of Open Access Journals (Sweden)

    Jan-ChristophKattenstroth

    2013-02-01

    Full Text Available During aging, sensorimotor, cognitive and physical performance decline, but can improve by training and exercise indicating that age-related changes are treatable. Dancing is increasingly used as an intervention because it combines many diverse features making it a promising neuroplasticity-inducing tool. We here investigated the effects of a 6-months dance class (1 h/week on a group of healthy elderly individuals compared to a matched control group. We performed a broad assessment covering cognition, intelligence, attention, reaction time, motor, tactile, and postural performance, as well as subjective well-being and cardio-respiratory performance. After 6 months, in the control group no changes, or further degradation of performance was found. In the dance group, beneficial effects were found for dance-related parameters such as posture and reaction times, but also for cognitive, tactile, motor performance, and subjective well-being. These effects developed without alterations in the cardio-respiratory performance. Correlation of baseline performance with the improvement following intervention revealed that those individuals, who benefitted most from the intervention, were those who showed the lowest performance prior to the intervention. Our findings corroborate previous observations that dancing evokes widespread positive effects. The pre-post design used in the present study implies that the efficacy of dance is most likely not based on a selection bias of particularly gifted individuals. The lack of changes of cardio-respiratory fitness indicates that even moderate levels of physical activity can in combination with rich sensorimotor, cognitive, social, and emotional challenges act to ameliorate a wide spectrum of age-related decline.

  16. Cardio-respiratory, haematological and biochemical parameter adjustments to exercise: effect of a probiotic in horses during training.

    Science.gov (United States)

    Art, T; Votion, D; McEntee, K; Amory, H; Linden, A; Close, R; Lekeux, P

    1994-01-01

    Two randomly distributed groups of thoroughbred horses were compared during a 12-week period for their cardio-respiratory and metabolic adjustment to strenuous exercise, training and detraining. The horses were trained following the same standardized schedule and were regularly investigated using standardized treadmill exercise tests (SET) of increasing speed. After the first SET and during the whole experimental period, a group of 6 horses received a probiotic (Bioracing) once a day while a group of 5 horses received a placebo. All other conditions were similar for both groups. During each SET, the oxygen uptake, carbon dioxide output, tidal volume (inspired volume), respiratory rate and expired minute volume were obtained using 2 ultrasonic pneumotachographs and a mass spectrometer. All the parameters were the mean of the values calculated during the last 20 s of the SET. Heart rate was continuously measured with a polar horse tester. Venous blood was sampled before and after the test and analyzed for various biochemical parameters. In both groups, training induced significant modification in most of the cardio-respiratory parameters, ie peak oxygen uptake, peak carbon dioxide output, respiratory exchange ratio, ventilation/min to oxygen-uptake ratio and oxygen-uptake to heart-rate ratio. After the 3-week detraining period, most of the values were again similar to the pre-training values in both groups. However, the training-induced modifications of most of the cardio-respiratory parameters occurred earlier and were proportionally greater in the probiotic-treated group than in the control. The respiratory coefficient decreased in the control but not in the treated group. All other parameters changed similarly in both groups. This suggests that Bioracing could modify the physiological effects of training by improving some aerobic metabolic capacities for carbohydrate utilization, but that this effect occurs only during training and not during periods of physical

  17. Possible adverse drug events leading to hospital admission in a Brazilian teaching hospital

    Directory of Open Access Journals (Sweden)

    Fabiana Rossi Varallo

    2014-03-01

    Full Text Available OBJECTIVES: Drug safety problems can lead to hospital admission. In Brazil, the prevalence of hospitalization due to adverse drug events is unknown. This study aims to estimate the prevalence of hospitalization due to adverse drug events and to identify the drugs, the adverse drug events, and the risk factors associated with hospital admissions. METHOD: A cross-sectional study was performed in the internal medicine ward of a teaching hospital in São Paulo State, Brazil, from August to December 2008. All patients aged ≥18 years with a length of stay ≥24 hours were interviewed about the drugs used prior to hospital admission and their symptoms/complaints/causes of hospitalization. RESULTS: In total, 248 patients were considered eligible. The prevalence of hospitalization due to potential adverse drug events in the ward was 46.4%. Overprescribed drugs and those indicated for prophylactic treatments were frequently associated with possible adverse drug events. Frequently reported symptoms were breathlessness (15.2%, fatigue (12.3%, and chest pain (9.0%. Polypharmacy was a risk factor for the occurrence of possible adverse drug events. CONCLUSION: Possible adverse drug events led to hospitalization in a high-complexity hospital, mainly in polymedicated patients. The clinical outcomes of adverse drug events are nonspecific, which delays treatment, hinders causality analysis, and contributes to the underreporting of cases.

  18. Admission hyperuricemia increases the risk of acute kidney injury in hospitalized patients *

    OpenAIRE

    Cheungpasitporn, Wisit; Thongprayoon, Charat; Harrison, Andrew M.; Erickson, Stephen B.

    2015-01-01

    Background The association between elevated admission serum uric acid (SUA) and risk of in-hospital acute kidney injury (AKI) is limited. The aim of this study was to assess the risk of developing AKI in all hospitalized patients with various admission SUA levels. Methods This is a single-center retrospective study conducted at a tertiary referral hospital. All hospitalized adult patients who had admission SUA available from January 2011 through December 2013 were analyzed in this study. Admi...

  19. Description of total population hospital admissions for cleft lip and/or palate in Australia

    OpenAIRE

    Lo, Jonathan Y. J.; Kilpatrick, Nicky; Jacoby, Peter; Slack-Smith, Linda M.

    2015-01-01

    Background Orofacial clefts are a group of frequently observed congenital malformations often requiring multiple hospital admissions over the lifespan of affected individuals. The aim of this study was to describe the total-population hospital admissions with principal diagnosis of cleft lip and/or palate in Australia over a 10 year period. Methods Data for admissions to hospitals were obtained from the Australian Institute of Health and Welfare National Hospital Morbidity Database (July 2000...

  20. Hospital admission of high risk infants for respiratory syncytial virus infection: implications for palivizumab prophylaxis

    OpenAIRE

    Heikkinen, T.; Valkonen, H; Lehtonen, L; Vainionpaa, R; Ruuskanen, O.

    2005-01-01

    Objectives: To determine the rates of hospital admission for respiratory syncytial virus (RSV) infection among children born at different gestational ages. To assess the theoretical impact of palivizumab prophylaxis on admissions for RSV infection.

  1. Admission to psychiatric hospital in the early and late postpartum periods: Scottish national linkage study

    OpenAIRE

    Langan-Martin, Julie; McLean, Gary; Cantwell, Roch; Smith, Daniel J.

    2016-01-01

    Objective: To describe weekly admission rates for affective and non-affective psychosis, major depression and other psychiatric disorders in the early and late postpartum periods. To assess the impact of socioeconomic status, age and parity on admission rates. Methods: Scottish maternity records were linked to psychiatric hospital admissions. 3290 pregnancy-related psychiatric admissions were assessed. Weekly admission rates were calculated for the pregnancy period, early postpartum perio...

  2. Research into the Effect of Heavy Metals and Their Binary Mixture on the Cardio-Respiratory System of Fish Larvae

    Directory of Open Access Journals (Sweden)

    Aistė Liekytė

    2011-12-01

    Full Text Available This article investigates toxic effects of heavy metals (Ni, Cu and their binary mixture (Ni+Cu on the cardio-respiratory system of rainbow trout (Oncorhynchus mykiss larvae depending on the type of metal, metal concentration and the duration of their exposure. The one-day larvae of rainbow trout were exposed to Ni (0,1; 0,2 mg/l, respectively, Cu (0,25; 0;5 mg/l, respectively and their binary mixture. During long-term exposure (30 days, the physiological parameters of larvae, e.g. heart rate (counts/min, gill ventilation frequency (counts/min after 5, 10 and 20 days of exposure were recorded. During experimental studies, the effects of heavy metals and their binary mixture on the heart rate and gill ventilation frequency of rainbow trout larvae depending on the type of metal, their concentrations and exposure duration were determined. Consequently, comparative studies on toxic effects of heavy metals and their binary mixture on the cardio-respiratory system of rainbow trout larvae showed that the binary mixture was more toxic to larvae than to single metals.Article in Lithuanian

  3. Correlation study of air pollution and cardio-respiratory diseases through NAA of an atmospheric pollutant biomonitor

    International Nuclear Information System (INIS)

    In this study neutron activation analysis was applied to analyze lichen samples used as atmospheric pollutant biomonitors in order to verify if there is correlation between air pollution and its effects on the cardio respiratory system. Canoparmelia texana lichenized fungii species was chosen for passive biomonitoring of atmospheric pollutants. The population group selected for this study was adults over 45 years. Lichen samples collected in Sao Paulo city were cleaned, freeze-dried and ground for the analyses. Aliquots of samples were irradiated at the IEA-R1 nuclear research reactor for short and long periods along with synthetic element standards. The induced gamma activities of the samples and standards were measured using a gamma ray spectrometer with an HPGe detector and the concentrations of As, Ba, Br, Ca, Cd, Cl, Co, Cr, Cs, Fe, Hf, K, Mg, Mn, Na, Rb, Sb, Sc, Se,Th, V, Zn and lanthanides were determined. For quality control of the results, certified reference materials were analyzed together. Mortality data for the population due to cardio-respiratory diseases were obtained from the database of the Secretariat of Health of the Sao Paulo Municipality for the years 2005-2009. Results obtained point to vehicular and industrial emissions as the origins of pollutants in Sao Paulo city. The statistical treatment of Pearson's correlation applied to the results of lichen element concentrations and mortality rates indicated significant positive correlation for the elements Co, Mn and Zn for adults. (author)

  4. Air pollutants and hospital admissions due to stroke

    Directory of Open Access Journals (Sweden)

    Samara Gavinier

    2014-07-01

    Full Text Available International studies have demonstrated associations between exposure to air pollutants and deaths and hospitalizations due to stroke. However, the profile of these associations is not known in Brazil. This study aims to estimate the association between exposure to air pollutants and hospital admissions due to stroke in individuals who live in a medium-sized city, Sorocaba, Sao Paulo, Brazil. This was ecological time-series study using hospitalization data relating to the diagnosis of stroke (ICD-10 I.60-I.64 in persons 50 years of age or older who resided in the city of Sorocaba between January 1, 2007 to December 31, 2011. The pollutants studied were particulate matter, ozone, nitrogen dioxide and nitrogen oxide, controlled by apparent temperature. The generalized additive model using Poisson regression for the day of hospitalization and for up to five days of lag was used for the analysis. It was not possible to estimate the association between exposure to daily levels of particulate matter, ozone and nitrogen oxide and hospitalizations for strokes, but it was possible to identify an association between exposure to nitrogen dioxide and hospitalization for stroke (RR = 1.004, 95% CI 1.000-1.008 for the third one-day lag. An increase of 10 g m - ³ in concentrations of this pollutant represented an increase of 4 percentage points in the risk of hospitalization. Thus, it was established that the nitrogen dioxide is associated with hospitalization for stroke in a medium-sized city, i.e., Sorocaba.

  5. Qualitative critical incident study of patients’ experiences leading to emergency hospital admission with advanced respiratory illness

    OpenAIRE

    Karasouli, Eleni; Munday, Daniel; Bailey, Cara; Staniszewska, Sophie; Hewison, Alistair; Griffiths, Frances

    2016-01-01

    Objectives The high volume of emergency admissions to hospital is a challenge for health systems internationally. Patients with lung cancer and chronic obstructive pulmonary disease (COPD) are frequently admitted to hospital as emergency cases. While the frequency of emergency admission has been investigated, few studies report patient experiences, particularly in relation to the decision-making process prior to emergency admission. We sought to explore patient and carer experiences and those...

  6. A medical admission unit reduces duration of hospital stay and number of readmissions

    DEFF Research Database (Denmark)

    Vork, Jan C; Brabrand, Mikkel; Folkestad, Lars;

    2011-01-01

    Political initiatives promoting a more efficient emergency admission process have triggered a reorganisation of the Danish health system with a view to creating fewer and larger admission units counting more experienced physicians. At our hospital, a medical admission unit (MAU) was established. ...... present the effect of this on the length of hospital stay, mortality rates and the number of readmissions for the last year with the previous structure and the first year of the new MAU structure....

  7. Delay in hospital admission of patients with cerebral vein and dural sinus thrombosis.

    Science.gov (United States)

    Ferro, José M; Lopes, M G; Rosas, M J; Fontes, J

    2005-01-01

    Factors influencing early hospital admission have been described for several stroke types but not for cerebral vein and dural sinus thrombosis (CVT). CVT is more difficult to diagnose than arterial stroke; delay in hospital admission may postpone CVT treatment. The purposes of this study were: (1) to describe the delay between the onset of symptoms and hospital admission of patients with CVT, and (2) to identify the variables that influence that delay. We registered the interval (days) between the onset of symptoms and hospital admission in 91 consecutive patients admitted to 20 Portuguese hospitals between June 1995 and June 1998. We also studied the impact of admission delay on treatments (prescription of anticoagulants and the number of days elapsed between the onset of symptoms and start of anticoagulation and admission). Median admission delay was 4 days. Twenty-two (25%) patients were admitted within 24 h. Two thirds of the patients were admitted within 7 days and 75% within 13 days. In multiple logistic regression analysis, admission within 24 h was positively associated with mental status disorder (delirium or abulia; OR = 4.59; 95% CI = 1.41-14.89) and negatively associated with headache (OR = 0.03; 95% CI = 0.00-0.32). Presentation as isolated intracranial hypertension was associated with admission delay of more than 4 days (OR = 2.63; 95% CI = 0.97-7.14). Papilloedema was associated with an admission delay of more than 13 days (OR = 4.69; 95% CI = 1.61-13.61). There was no association between admission delay and the proportion of anticoagulated patients. The interval between onset of symptoms and start of anticoagulation was shorter in patients admitted earlier (p = 0.0001, for either admission within 24 h, 4 or 13 days). There is a considerable delay until the clinical picture associated with CVT is recognised as justifying hospital admission, especially when patients present with symptoms identical to isolated intracranial hypertension syndrome. PMID

  8. Influence of smoking and alcohol consumption on admissions and duration of hospitalization

    DEFF Research Database (Denmark)

    Hvidtfeldt, Ulla A; Rasmussen, Søren; Grønbaek, Morten;

    2010-01-01

    BACKGROUND: Previous studies have linked smoking and alcohol consumption to a considerable disease burden and large healthcare expenditures. However, findings from studies based on individual level data are sparse and inconclusive. Our objective was to assess the association between alcohol.......80-8.26) in women were observed among smokers of >20 g/day compared to never-smokers. For any admission (excl. smoking-related causes), corresponding ORs were 1.32 (95% CI 1.15-1.51) and 1.80 (95% CI 1.58-2.06), respectively. In men, a U-shaped association between alcohol consumption and risk of admission was...... found, both regarding any admission and admissions due to alcohol-related diseases. Alcohol was associated with alcohol-related admissions in women but not with duration of hospitalization. CONCLUSIONS: Smoking was associated with increased risk of hospital admission and duration of hospitalization. A U...

  9. Surgical management of colonic volvulus during same hospital admission

    International Nuclear Information System (INIS)

    Objective was to study the local patient profile, diagnostic methods and treatment outcome in patients with large bowel volvulus to recommend a management plan. A retrospective study of patient's record with a final diagnosis of large bowel volvulus treated at King Saud Medical Complex, Riyadh, Saudi Arabia between January 2000 and December 2007 were performed for patient demography, clinical presentations, co-morbidity, diagnostic methods, anatomical types, management and outcome. Forty-two patients with large bowel volvulus were reviewed. They presented 8.5% of all intestinal obstructions treated. Most had sigmoid volvulus (83%), were less than 60 years of age and were male. Recognized risk factors were present in 12 (29%) patients. Diagnosis was suspected on plain abdominal x-ray in 28 patients (69%), although the characteristic signs of omega and coffee bean were seen only in 16 patients. Eight patients required emergency surgery. Endoscopic decompression was successful in 34 patients, followed by a definitive surgery in 24 patients. Seven patients refused surgery; 3 of them were readmitted with recurrence and were operated. Three patients were unfit for surgery. There were 3 deaths. Large bowel volvulus is uncommon in this area. Abdominal distension with pain, constipation and characteristic gas pattern in plain x-ray can help diagnose most cases. Decompression can be achieved in most patients with sigmoid volvulus, followed by surgery during the same hospital admission. Transverse colon and cecal volvulus usually need emergency surgery. (author)

  10. Prescribing Omissions according to START and related hospital admission in geriatric patients

    OpenAIRE

    Dalleur, Olivia; Spinewine, Anne; Henrard, Séverine; Losseau, Claire; Speybroeck, Niko; Boland, Benoît; 4ème Symposium interdisciplinaire de recherche sur le vieillissement

    2011-01-01

    Objective: To study the performance of START (Screening Tool to Alert doctors to Right Treatment) in detecting prescribing omissions (PO) at home and related acute hospital admission in frail older people. Design: Patients aged ≥75 years with frailty features (ISAR≥2/6) were prospectively assessed by the geriatric liaison team after acute hospital admission. Setting: This study was performed in a 900-bed teaching hospital in Brussels. Main Outcome Measures were PO and PO related-h...

  11. Air pollution and hospital admissions for respiratory and cardiovascular diseases in Hong Kong

    OpenAIRE

    Wong, T. W.; Lau, T. S.; Yu, T. S.; Neller, A.; Wong, S L; Tam, W; Pang, S. W.

    1999-01-01

    OBJECTIVE: To investigate short term effects of concentrations of pollutants in ambient air on hospital admissions for cardiovascular and respiratory diseases in Hong Kong. METHODS: Retrospective ecological study. A Poisson regression was performed of concentrations of daily air pollutant on daily counts of emergency hospital admissions in 12 major hospitals. The effects of time trend, season, and other cyclical factors, temperature, and humidity were accounted for. Autocorrelation and ...

  12. Hospital admission interviews are time-consuming with several interruptions

    DEFF Research Database (Denmark)

    Ghazanfar, Misbah N; Honoré, Per Gustaf Hartvig; Nielsen, Trine R H;

    2012-01-01

    The admission interview is an important procedure to reduce medication errors. Studies indicate that physicians do not spend much time on the interview and that the major obstacles are lack of time and heavy workload. The aim of this study was to measure the time physicians spend on admission...... interviews and to describe factors that affect time consumption....

  13. Acute Toxicity and Cardio-Respiratory Effects of 2-Deoxy-D-Glucose: A Promising Radio Sensitiser

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    To evaluate the acute toxicity of 2-deoxy-D-glucose (2DG) by oral (p.o.) and intravenous (i.v.) routes, and also the cardio-respiratory effects following high doses of 2DG in animal models. Methods The LD50 of 2DG (in water)was determined in rats and mice by p.o. route and in mice by i.v. route. The effect of 2-DG (250 mg/kg, 500 mg/kg, and 1000mg/kg, i.v.) was studied on various cardio-respiratory parameters viz., mean arterial blood pressure, heart rate and respiratory rate in anaesthetised rats. The effect of 2DG (500 mg/kg, 1000 mg/kg, and 2000 mg/kg, p.o.) was also studied on various respiratory parameters viz., respiratory rate and tidal volume in conscious rats and mice using a computer program. Results The p.o. LD50 of 2DG was found to be >8000 mg/kg in mice and rats, and at this dose no death was observed. The LD50 in mice by i.v. route was found to be 8000 mg/kg. At this dose 2 out of 4 mice died and the death occurred within 6 h. A significant increase in the body weight was observed after p.o. administration of 2DG in rats at 500 mg/kg, 1000 mg/kg, and 2000 mg/kg doses. There was no significant change in the body weight at 4000 mg/kg and 8000 mg/kg by the p.o. route in rats and up to 8000 mg/kg by p.o. as well as i.v. routes in mice. Intravenous administration of 2DG (250 mg/kg, 500 mg/kg, and 1000 mg/kg)in anaesthetised rats showed a time-dependent decrease in the mean arterial blood pressure. There was no change in the heart rate in any of the treatment groups. The tidal volume was not changed significantly by p.o administration in conscious rats, but a significant decrease in the respiratory frequency at 500 mg/kg and 1000 mg/kg doses was observed. In the mice also there was no change in the tidal volume after p.o, administration, but the respiratory frequency decreased significantly at 2000 mg/kg dose.Conclusion 2DG is a safe compound but can cause a fall in the blood pressure and a decrease in respiratory frequency at high doses.

  14. Asma e Gravidez: Tratamento Hospitalar Asthma and Pregnancy: Hospital Admission

    Directory of Open Access Journals (Sweden)

    Francisco Mauad Filho

    2001-09-01

    pregnant patients who required hospital admission to control acute exacerbations. Patients and Method: retrospective study of 12 pregnant asthmatic patients admitted at the Hospital das Clínicas, Department of Obstetrics and Gynecology, FMRP-USP, during the period between 1992 and 1996. The analyzed data included: maternal age, prenatal care, length of hospitalization, gestational age at delivery, type of delivery, neonatal weight and Apgar score. Results: among the 12 asthmatic pregnant patients 7 did not have prenatal care for acute exacerbation treatment before hospitalization. Three of 12 developed preeclampsia (one with premature rupture of membranes and infection of the amniotic cavity and one with premature separation of the placenta; 2 of 12 were diagnosed with premature placental aging (one with premature labor and twin-to-twin transfusion syndrome and one with oligohydramnios; 1 of 12 was diagnosed with oligohydramnios and fetal death and had pneumonia, and 1 of 12 was diagnosed with polyhydramnios. Among the infants, 3 were small for gestational age. Conclusions: perinatal complications were more frequent in asthmatic pregnant patients who required hospital care for the acute exacerbations. Chronic asthmatic patients in reproductive age should be advised before pregnancy about the prophylactic measures to reduce the incidence of acute crises and exacerbations during pregnancy should be treated promptly.

  15. The effect of Sub-maximal exercise-rehabilitation program on cardio-respiratory endurance indexes and oxygen pulse in patients with spastic cerebral palsy

    Directory of Open Access Journals (Sweden)

    M Izadi

    2006-05-01

    Full Text Available Background: Physical or cardio-respiratory fitness are of the best important physiological variables in children with cerebral palsy (CP, but the researches on exercise response of individuals with CP are limited. Our aim was to determine the effect of sub-maximal rehabilitation program (aerobic exercise on maximal oxygen uptake, oxygen pulse and cardio- respiratory physiological variables of children with moderate to severe spastic cerebral palsy diplegia and compare with able-bodied children. Methods: In a controlled clinical trial study, 15 children with diplegia spastic cerebral palsy, were recruited on a voluntarily basis (experimental group and 18 subjects without neurological impairments selected as control group. In CP group, aerobic exercise program performed on the average of exercise intensity (144 beat per minute of heart rate, 3 times a week for 3 months. The time of each exercise session was 20-25 minutes. Dependent variables were measured in before (pretest and after (post test of rehabilitation program through Mac Master Protocol on Tantories cycle ergometer in CP group and compared with the control group. Results: The oxygen pulse (VO2/HR during ergometery protocol was significantly lower in CP group than normal group (P<0.05. No significant statistical difference in maximal oxygen uptake (VO2 max was found between groups. The rehabilitation program leads to little increase of this variable in CP group. After sub-maximal exercise in pretest and post test, the heart rate of patient group was greater than control group, and aerobic exercise leads to significant decrease in heart rate in CP patients(P<0.05. Conclusion: The patients with spastic cerebral palsy, because of high muscle tone, severe spasticity and involuntarily movements have higher energy cost and lower aerobic fitness than normal people. The rehabilitation exercise program can improve physiological function of muscle and cardio-respiratory endurance in these

  16. The effects of the 2009 dust storm on emergency admissions to a hospital in Brisbane, Australia

    Science.gov (United States)

    Barnett, Adrian G.; Fraser, John F.; Munck, Lynette

    2012-07-01

    In September 2009 an enormous dust storm swept across eastern Australia. Dust is potentially hazardous to health as it interferes with breathing, and previous dust storms have been linked to increased risks of asthma and even death. We examined whether the 2009 Australian dust storm changed the volume or characteristics of emergency admissions to hospital. We used an observational study design, using time series analyses to examine changes in the number of admissions, and case-only analyses to examine changes in the characteristics of admissions. The admission data were from the Prince Charles Hospital, Brisbane, between 1 January 2009 and 31 October 2009. There was a 39% increase in emergency admissions associated with the storm (95% confidence interval: 5, 81%), which lasted for just 1 day. The health effects of the storm could not be detected using particulate matter levels. We found no significant change in the characteristics of admissions during the storm; specifically, there was no increase in respiratory admissions. The dust storm had a short-lived impact on emergency hospital admissions. This may be because the public took effective avoidance measures, or because the dust was simply not toxic, being composed mainly of soil. Emergency departments should be prepared for a short-term increase in admissions during dust storms.

  17. Sprint interval and sprint continuous training increases circulating CD34+ cells and cardio-respiratory fitness in young healthy women.

    Directory of Open Access Journals (Sweden)

    Emma Harris

    Full Text Available INTRODUCTION: The improvement of vascular health in the exercising limb can be attained by sprint interval training (SIT. However, the effects on systemic vascular function and on circulating angiogenic cells (CACs which may contribute to endothelial repair have not been investigated. Additionally, a comparison between SIT and sprint continuous training (SCT which is less time committing has not been made. METHODS: 12 women (22±2 yrs completed 12 sessions of either SIT (n = 6 or work-matched SCT (n = 6 on 3 days/week. Pre and post-training assessments included brachial artery endothelial function and peripheral blood analysis for CAC number (CD34+/CD34+CD45dim. CAC function was measured by migration and adhesion assays. Cardio-respiratory fitness, carotid arterial stiffness and carotid-radial and brachial-foot pulse wave velocity (PWV were also evaluated. RESULTS: CD34+ CACs increased following training in both groups but CD34+CD45dim did not (Pre CD34+: 40±21/105 leukocytes, Post CD34+: 56±24/105 leukocytes, main time effect p0.05. DISCUSSION: SCT involving little time commitment is comparable to SIT in increasing CD34+ cell number and [Formula: see text]. An increased mobilisation of CD34+ CACs suggests that sprint training may be an effective method to enhance vascular repair.

  18. Cardio-respiratory interactions and relocation of heartbeats within the respiratory cycle during spontaneous and paced breathing

    International Nuclear Information System (INIS)

    The capability of respiratory sinus arrhythmia (RSA) to generate privileged locations for the occurrence of R-peaks within the respiratory cycle has been questioned in recent works, challenging the hypothesis that RSA might play a role in improving pulmonary gas exchange. We assessed such a capability submitting healthy humans to spontaneous and paced breathing (SB and PB) protocols, estimating the fraction of beats occurring during inspiration, at low, medium, and high respiratory volumes, and during the first and second half of inspiration and expiration. Then, the same fractions were computed assuming a random uniform distribution of heartbeats, and the differences were compared. The results found are as follows: (1) during PB at 6 rpm, heartbeats redistribute toward inspiration; (2) during SB and PB at 12 rpm, heartbeats tend to cluster when respiratory volume is high; (3) since such redistributions are limited in magnitude, it is possible that its physiological relevance is marginal, for instance, in terms of within-cycle variations in lung perfusion; (4) two groups of subjects with considerably different levels of RSA showed similar redistribution of heartbeats, suggesting that this phenomenon might be an underlying effect of the overall cardio-respiratory interactions, and not directly of RSA

  19. Service users' perceptions about their hospital admission elicited by service user-researchers or by clinicians.

    LENUS (Irish Health Repository)

    O'Donoghue, Brian

    2013-05-01

    OBJECTIVE Service users may express positive, ambivalent, or negative views of their hospital admission. The objective of this study was to determine whether the background of the interviewer-service user-researcher or clinician-influences the information elicited. The primary outcome was the level of perceived coercion on admission, and secondary outcomes were perceived pressures on admission, procedural justice, perceived necessity for admission, satisfaction with services, and willingness to consent to participate in the study. METHODS Participants voluntarily and involuntarily admitted to three hospitals in Ireland were randomly allocated to be interviewed at hospital discharge by either a service user-researcher or a clinician. Interviewers used the MacArthur Admission Experience Survey and the Client Satisfaction Questionnaire. RESULTS A total of 161 participants were interviewed. No differences by interviewer status or by admission status (involuntary or voluntary) were found in levels of perceived coercion, perceived pressures, procedural justice, perceived necessity, or satisfaction with services. Service users were more likely to decline to participate if their consent was sought by a service user-researcher (24% versus 8%, p=.003). CONCLUSIONS Most interviewees gave positive accounts of their admission regardless of interviewer status. The findings indicate that clinicians and researchers can be more confident that service users\\' positive accounts of admissions are not attributable to a response bias. Researchers can also feel more confident in directly comparing the results of studies undertaken by clinicians and by service user-researchers.

  20. Impact of childhood trauma on risk of relapse requiring psychiatric hospital admission for psychosis.

    Science.gov (United States)

    Petros, N; Foglia, E; Klamerus, E; Beards, S; Murray, R M; Bhattacharyya, S

    2016-08-01

    Relapse in psychosis typically necessitates admission to hospital placing a significant financial burden on the health service. Exposure to childhood trauma is associated with an increased risk of psychosis, however, the extent to which this influences relapse is unclear. This report summarises current research investigating the influence of childhood trauma on relapse requiring psychiatric hospital admission for psychosis. Seven studies were included; two revealed a positive association between childhood trauma and relapse admission, two studies found a negative relationship and three found no significant difference. Inconsistent current evidence suggests a need for further research in this area. PMID:27151070

  1. Length of stay of COPD hospital admissions between 2006 and 2010: a retrospective longitudinal study

    Directory of Open Access Journals (Sweden)

    Harries TH

    2015-03-01

    Full Text Available Timothy H Harries,1 Hannah V Thornton,2 Siobhan Crichton,1 Peter Schofield,1 Alexander Gilkes,1 Patrick T White1 1King’s College London, King’s Health Partners, Division of Health and Social Care Research, London, UK; 2University of Bristol, Centre for Academic Primary Care, NIHR School for Primary Care Research, School of Social and Community Medicine, Canynge Hall, Bristol, UK Background: Hospitalizations for COPD are associated with poor patient prognosis. Length of stay (LOS of COPD admissions in a large urban area and patient and hospital factors associated with it are described. Methods: Retrospective longitudinal study. All COPD patients registered with London general practitioners and admitted as an emergency with COPD (2006–2010, not having been admitted with COPD in the preceding 12 months were included. Association of patient and hospital characteristics with mean LOS of COPD admissions was assessed. Association between hospital and LOS was determined by negative binomial regression. Results: The total number of admissions was 38,504, from 22,462 patients. The mean LOS for first admissions fell by 0.8 days (95% confidence interval [CI]: 0.7–1.5 from 8.2 to 7.0 days between 2006 and 2010. Seventy-nine percent of first admissions were ≤10 days, with a mean LOS of 3.7 days (2009–2010. The mean LOS of successive COPD admissions of the same patients was the same or less throughout the study period. The interval between successive admissions fell from a mean of 357 days between the first and second admission to a mean of 19 days after eight admissions. Age accounted for 2.3% of the variance in LOS. Socioeconomic deprivation did not predict LOS. Fewer discharges happened at the weekend (1,893/day than on weekdays (5,218/day. The mean LOS varied between hospitals, from 4.9 days (95% CI: 3.8–5.9 to 9.5 days (95% CI: 8.6–10.3 when adjusting for clustering, age, sex, and socioeconomic deprivation.Conclusion: The fall in LOS of

  2. Rising costs and hospital admissions for hepatocellular carcinoma in Portugal (1993-2005)

    Institute of Scientific and Technical Information of China (English)

    Rui Tato Marinho; José Giria; Miguel Carneiro Moura

    2007-01-01

    AIM: To determine, for hepatocellular carcinoma (HCC), the patient demographic profile and costs of their admissions to the hospitals of the Portuguese National Health System from 1993 to 2005.METHODS: The National Registry (ICD-9CM, International Classification of Diseases, 155.0) provided data from the 97 Hospitals in Portugal.RESULTS: We studied 7932 admissions that progressively rose from 292 in 1993 to 834 in 2005, having a male predominance of 78% (6130/7932). The global rate of hospital admissions for HCC rose from 3.1/105 in 1993 to 8.3/105 in 2005. The average length of stay decreased from 17.5 ± 17.9 d in 1993 to 9.3 ± 10.4 d in 2005, P < 0.001. The average hospital mortality for HCC remained high over these years, 22.3% in 1993 and 26.7% in 2005. Nationally, hospital costs (in Euros - ∈) rose in all variables studied: overall costs from ∈533000 in 1993, to ∈4629000 in 2005, cost per day of stay from ∈105 in 1993, to ∈597 in 2005, average cost of each admission from ∈1828 in 1993, to ∈5550 in 2005. In 2005, 1.8% (15/834) of hospital admissions for HCC were related to liver transplant, and responsible for a cost of about ∈1.5 million, corresponding to one third of the overall costs for HCC admissions in that same year.CONCLUSION: From 1993 to 2005 hospital admissions in Portugal for HCC tripled. Overall costs for these admissions increased 9 times, with all variables related to cost analysis rising accordingly. Liver transplant, indicated in a small group of patients, showed a disproportionate increase in costs.

  3. Caregivers' perceptions of coercion in psychiatric hospital admission.

    Science.gov (United States)

    Ranieri, Veronica; Madigan, Kevin; Roche, Eric; Bainbridge, Emma; McGuinness, David; Tierney, Kevin; Feeney, Larkin; Hallahan, Brian; McDonald, Colm; O'Donoghue, Brian

    2015-08-30

    While knowledge on service users' perspective on their admissions to psychiatric wards has improved substantially in the last decade, there is a paucity of knowledge of the perspectives of caregivers. This study aimed to determine caregiver's perception of the levels of perceived coercion, perceived pressures and procedural justice experienced by service users during their admission to acute psychiatric in-patient units. The perspective of caregivers were then compared to the perspectives of their related service users, who had been admitted to five psychiatric units in Ireland. Caregivers were interviewed using an adapted version of the MacArthur admission experience interview. Sixty-six caregivers participated in this study and the majority were parents. Seventy one percent of service users were admitted involuntarily and nearly half had a diagnosis of schizophrenia or schizoaffective disorder. Caregivers of involuntarily admitted individuals perceived the service users' admission as less coercive than reported by the service users. Caregivers also perceived a higher level of procedural justice in comparison to the level reported by service users. Reducing the disparity of perceptions between caregivers and service users could result in caregivers having a greater understanding of the admission process and why some service users may be reluctant to be admitted. PMID:26163727

  4. After-hours equine emergency admissions at a university referral hospital (1998 - 2007 : causes and interventions

    Directory of Open Access Journals (Sweden)

    A. Viljoen

    2009-05-01

    Full Text Available Medical records of equine after-hours admissions from 1998 to 2007 are reviewed. Data extracted from the medical records included signalment, reason for admission, pre-admission treatment, clinical presentation, procedures performed, final diagnoses, complications occurring in hospital, length of stay and outcome. Eight hundred and twenty after-hours admissions were available of which 75 % were classified as emergencies. Most horses originated from Gauteng province (82 %, with Thoroughbred, Arabian, and Warmbloods representing 46 %, 10 % and 7 % of horses. Horses had a median age of 7 years and were predominantly male (60 %. Gastrointestinal (64 % and musculoskeletal (19 % disorders were the primary reasons for admission. Anti-inflammatories, sedation and antibiotics were given in 51 %, 20 % and 15 % of cases respectively prior to referral. On admission, 23 % of horses had surgical intervention. Intravenous catheterisation (64 %, rectal examination (61 %, nasogastric intubation (56 %, abdominocentesis (33 % and ultrasonography (19 % were the procedures performed most frequently. Surgical and medical colics constituted 28 % and 27 % respectively of the overall diagnoses, while piroplasmosis was diagnosed in 5 % of horses. Post-admission complications occurred in <2 % of horses. The median length of stay was 4 days (95 % CI: 1 to 21 days. Overall survival to discharge was 74 %. This study demonstrates that the majority of after-hours equine admissions to a university referral hospital required medical intervention and were mostly due to gastrointestinal disorders. Information obtained from this study can be used in emergency referral planning.

  5. Effect of gender on hospital admissions for asthma and prevalence of self-reported asthma

    DEFF Research Database (Denmark)

    Prescott, E; Lange, P; Vestbo, J

    1997-01-01

    BACKGROUND: Women are more often admitted to hospital for asthma than men. A study was undertaken to determine whether this is caused by gender differences in the prevalence or severity of the disease. METHODS: Admissions to hospital for asthma in 13,540 subjects were followed from 1977 to 1993. ...

  6. Cause-specific hospital admissions on hot days in Sydney, Australia.

    Directory of Open Access Journals (Sweden)

    Pavla Vaneckova

    Full Text Available BACKGROUND: While morbidity outcomes for major disease categories during extreme heat have received increasing research attention, there has been very limited investigation at the level of specific disease subcategories. METHODOLOGY/PRINCIPAL FINDINGS: We analyzed daily hospital admissions for cardiovascular (CVD, respiratory (RD, genitourinary (GU and mental diseases (MD, diabetes (DIA, dehydration (DEH and 'the effects of heat and light' (HEAT in Sydney between 1991 and 2009. We further investigated the sensitivity to heat of subcategories within the major disease groups. We defined hot days as those with temperatures in the 95(th and 99(th percentiles within the study period. We applied time-stratified case-crossover analysis to compare the hospital admissions on hot days with those on non-hot days matched by day of the week. We calculated the odds ratios (OR of admissions between the two types of days, accounting for other environmental variables (relative humidity, ozone and particulate matter and non-environmental trends (public and school holidays. On hot days, hospital admissions increased for all major categories except GU. This increase was not shared homogeneously across all diseases within a major category: within RD, only 'other diseases of the respiratory system' (includes pleurisy or empyema increased significantly, while admissions for asthma decreased. Within MD, hospital admissions increased only for psychoses. Admissions due to some major categories increased one to three days after a hot day (e.g., DIA, RD and CVD and on two and three consecutive days (e.g., HEAT and RD. CONCLUSIONS/SIGNIFICANCE: High ambient temperatures were associated with increased hospital admissions for several disease categories, with some within-category variation. Future analyses should focus on subgroups within broad disease categories to pinpoint medical conditions most affected by ambient heat.

  7. Temporal dynamics of emergency department and hospital admissions of pediatric asthmatics

    Science.gov (United States)

    Kimes, Daniel; Levine, Elissa; Timmins, Sidey; Weiss, Sheila R.; Bollinger, Mary E.; Blaisdell, Carol

    2004-01-01

    Asthma is a chronic disease that can result in exacerbations leading to urgent care in emergency departments (EDs) and hospitals. We examined seasonal and temporal trends in pediatric asthma ED (1997-1999) and hospital (1986-1999) admission data so as to identify periods of increased risk of urgent care by age group, gender, and race. All pediatric ED and hospital admission data for Maryland residents occurring within the state of Maryland were evaluated. Distinct peaks in pediatric ED and hospital asthma admissions occurred each year during the winter-spring and autumn seasons. Although the number and timing of these peaks were consistent across age and racial groups, the magnitude of the peaks differed by age and race. The same number, timing, and relative magnitude of the major peaks in asthma admissions occurred statewide, implying that the variables affecting these seasonal patterns of acute asthma exacerbations occur statewide. Similar gross seasonal trends are observed worldwide. Although several environmental, infectious, and psychosocial factors have been linked with increases in asthma exacerbations among children, thus far they have not explained these seasonal patterns of admissions. The striking temporal patterns of pediatric asthma admissions within Maryland, as described here, provide valuable information in the search for causes.

  8. Assessment and prediction of short term hospital admissions: the case of Athens, Greece

    Science.gov (United States)

    Kassomenos, P.; Papaloukas, C.; Petrakis, M.; Karakitsios, S.

    The contribution of air pollution on hospital admissions due to respiratory and heart diseases is a major issue in the health-environmental perspective. In the present study, an attempt was made to run down the relationships between air pollution levels and meteorological indexes, and corresponding hospital admissions in Athens, Greece. The available data referred to a period of eight years (1992-2000) including the daily number of hospital admissions due to respiratory and heart diseases, hourly mean concentrations of CO, NO 2, SO 2, O 3 and particulates in several monitoring stations, as well as, meteorological data (temperature, relative humidity, wind speed/direction). The relations among the above data were studied through widely used statistical techniques (multivariate stepwise analyses) and Artificial Neural Networks (ANNs). Both techniques revealed that elevated particulate concentrations are the dominant parameter related to hospital admissions (an increase of 10 μg m -3 leads to an increase of 10.2% in the number of admissions), followed by O 3 and the rest of the pollutants (CO, NO 2 and SO 2). Meteorological parameters also play a decisive role in the formation of air pollutant levels affecting public health. Consequently, increased/decreased daily hospital admissions are related to specific types of meteorological conditions that favor/do not favor the accumulation of pollutants in an urban complex. In general, the role of meteorological factors seems to be underestimated by stepwise analyses, while ANNs attribute to them a more important role. Comparison of the two models revealed that ANN adaptation in complicate environmental issues presents improved modeling results compared to a regression technique. Furthermore, the ANN technique provides a reliable model for the prediction of the daily hospital admissions based on air quality data and meteorological indices, undoubtedly useful for regulatory purposes.

  9. Objective standards for the emergency services: emergency admission to hospital.

    OpenAIRE

    West, R.

    2001-01-01

    The primary objectives of the emergency services are to minimize early mortality and complications, although longer-term morbidity, quality of life and late mortality may also be influenced by early actions. Evaluation of the emergency services and demonstration of quality need to reflect these objectives by appropriate choice of outcome measures. This brief review of leading measures of quality in emergency admissions discusses population-based 30-day mortality, after examining some limitati...

  10. Pharmacy services at admission and discharge in adult, acute, public hospitals in Ireland.

    LENUS (Irish Health Repository)

    Grimes, Tamasine

    2012-02-01

    OBJECTIVES: to describe hospital pharmacy involvement in medication management in Ireland, both generally and at points of transfer of care, and to gain a broad perspective of the hospital pharmacy workforce. METHODS: a survey of all adult, acute, public hospitals with an accident and emergency (A&E) department (n = 36), using a semi-structured telephone interview. KEY FINDINGS: there was a 97% (n = 35) response rate. The majority (n = 25, 71.4%) of hospitals reported delivery of a clinical pharmacy service. On admission, pharmacists were involved in taking or verifying medication histories in a minority (n = 15, 42.9%) of hospitals, while few (n = 6,17.1%) deployed staff to the A&E\\/acute medical admissions unit. On discharge, the majority (n = 30,85.7%) did not supply any take-out medication, a minority (n =5,14.3%) checked the discharge prescription, 51.4% (n = 18) counselled patients, 42.9% (n = 15) provided medication compliance charts and one hospital (2.9%) communicated with the patient\\'s community pharmacy. The number of staff employed in the pharmacy department in each hospital was not proportionate to the number of inpatient beds, nor the volume of admissions from A&E. There were differences identified in service delivery between hospitals of different type: urban hospitals with a high volume of admissions from A&E were more likely to deliver clinical pharmacy. CONCLUSIONS: the frequency and consistency of delivering pharmacy services to facilitate medication reconciliation at admission and discharge could be improved. Workforce constraints may inhibit service expansion. Development of national standards of practice may help to eliminate variation between hospitals and support service development.

  11. Effect of air pollution on pediatric respiratory emergency room visits and hospital admissions

    Directory of Open Access Journals (Sweden)

    S.C.L. Farhat

    2005-02-01

    Full Text Available In order to assess the effect of air pollution on pediatric respiratory morbidity, we carried out a time series study using daily levels of PM10, SO2, NO2, ozone, and CO and daily numbers of pediatric respiratory emergency room visits and hospital admissions at the Children's Institute of the University of São Paulo Medical School, from August 1996 to August 1997. In this period there were 43,635 hospital emergency room visits, 4534 of which were due to lower respiratory tract disease. The total number of hospital admissions was 6785, 1021 of which were due to lower respiratory tract infectious and/or obstructive diseases. The three health end-points under investigation were the daily number of emergency room visits due to lower respiratory tract diseases, hospital admissions due to pneumonia, and hospital admissions due to asthma or bronchiolitis. Generalized additive Poisson regression models were fitted, controlling for smooth functions of time, temperature and humidity, and an indicator of weekdays. NO2 was positively associated with all outcomes. Interquartile range increases (65.04 µg/m³ in NO2 moving averages were associated with an 18.4% increase (95% confidence interval, 95% CI = 12.5-24.3 in emergency room visits due to lower respiratory tract diseases (4-day moving average, a 17.6% increase (95% CI = 3.3-32.7 in hospital admissions due to pneumonia or bronchopneumonia (3-day moving average, and a 31.4% increase (95% CI = 7.2-55.7 in hospital admissions due to asthma or bronchiolitis (2-day moving average. The study showed that air pollution considerably affects children's respiratory morbidity, deserving attention from the health authorities.

  12. Mold sensitization is common amongst patients with severe asthma requiring multiple hospital admissions

    Directory of Open Access Journals (Sweden)

    Hopkinson Linda C

    2005-02-01

    Full Text Available Abstract Background Multiple studies have linked fungal exposure to asthma, but the link to severe asthma is controversial. We studied the relationship between asthma severity and immediate type hypersensitivity to mold (fungal and non-mold allergens in 181 asthmatic subjects. Methods We recruited asthma patients aged 16 to 60 years at a University hospital and a nearby General Practice. Patients were categorized according to the lifetime number of hospital admissions for asthma (82 never admitted, 53 one admission, 46 multiple admissions. All subjects had allergy skin prick tests performed for 5 mold allergens (Aspergillus, Alternaria, Cladosporium, Penicillium and Candida and 4 other common inhalant allergens (D. pteronyssinus, Grass Pollen, Cat and Dog. Results Skin reactivity to all allergens was commonest in the group with multiple admissions. This trend was strongest for mold allergens and dog allergen and weakest for D. pteronyssinus. 76% of patients with multiple admissions had at least one positive mold skin test compared with 16%-19% of other asthma patients; (Chi squared p Conclusion These findings support previous suggestions that mold sensitization may be associated with severe asthma attacks requiring hospital admission.

  13. From hospital admission to independent living: is prediction possible?

    Science.gov (United States)

    Lipskaya-Velikovsky, Lena; Kotler, Moshe; Easterbrook, Adam; Jarus, Tal

    2015-04-30

    An integral component of recovery from mental illness is being able to engage in everyday activities. This ability is often restricted among people with schizophrenia. Although functional deficits are addressed during hospitalization, the ability to predict daily functioning based on information gathered during hospitalization has not been well established. This study examines whether measurements completed during hospitalization can be useful for predicting independent living within the community. Inpatients with schizophrenia (N=104) were enrolled in the study and assessed for cognitive functioning, functional capacity and symptoms. They were approached again 6 months after discharge to evaluate their functioning with respect to everyday life Instrumental Activities of Daily Living (IADL) and Activities of Daily Living (ADL). Functional capacity during hospitalization predicted 26.8% of ADL functioning and 38.8% of IADL functioning. ADL was best predicted by the severity of negative symptoms, cognitive functioning, and the number of hospitalizations (51.2%), while IADL was best predicted by functional capacity, cognition, and number of hospitalizations (60.1%). This study provides evidence that evaluations during hospitalization can be effective, and demonstrates the advantage of a holistic approach in predicting daily functioning. When a holistic approach is not practical, a functional capacity measurement may serve as an effective predictor. PMID:25747682

  14. Can advanced paramedics in the field diagnose patients and predict hospital admission?

    LENUS (Irish Health Repository)

    Cummins, Niamh Maria

    2013-02-13

    BACKGROUND: Accurate patient diagnosis in the prehospital environment is essential to initiate suitable care pathways. The advanced paramedic (AP) is a relatively recent role in Ireland, and refers to a prehospital practitioner with advanced life-support skills and training. OBJECTIVES: The objectives of this study were to compare the diagnostic decisions of APs with emergency medicine (EM) physicians, and to investigate if APs, as currently trained, can predict the requirement for hospital admission. METHODS: A prospective study was initiated, whereby each emergency ambulance call received via the statutory 999 system was recorded by the attending AP. The AP was asked to provide a clinical diagnosis for each patient, and to predict if hospital admission was required. The data was then cross-referenced with the working diagnosis of the receiving emergency physician and the hospital admission records. RESULTS: A total of 17 APs participated in the study, and 1369 emergency calls were recorded over a 6-month period. Cases where a general practitioner attended the scene were excluded from the concordance analysis. Concordance with the receiving emergency physician represents 70% (525\\/748) for all cases of AP diagnosis, and is mirrored with 70% (604\\/859) correct hospital admission predictions. CONCLUSIONS: AP diagnosis and admission prediction for emergency calls is similar to other emergency medical services systems despite the relative recency of the AP programme in Ireland. Recognition of non-concordance case types may identify priorities for AP education, and drive future AP practice in areas such as \\'treat and refer\\'.

  15. Effects of diurnal temperature range on cardiovascular and respiratory hospital admissions in Korea.

    Science.gov (United States)

    Lim, Youn-Hee; Hong, Yun-Chul; Kim, Ho

    2012-02-15

    The effects of heat and cold waves have been studied as risk factors for cardiovascular and respiratory diseases. However, few studies have examined the effect of diurnal temperature changes on health. We hypothesized that the diurnal temperature range (DTR) may affect the rate of hospital admissions for cardiovascular- and respiratory-related diseases, and therefore investigated the risk of hospital admissions of cardiovascular (stroke, myocardial infarction, ischemic heart disease, cardiac failure, cardiac disease, and arrhythmia) and respiratory (asthma, chronic obstructive pulmonary disease, and pneumonia) diseases attributable to DTR in four metropolitan areas in Korea during 2003-2006. The area-combined effects of DTR on some cardiovascular and respiratory diseases were significantly increased by an increment of DTR. In particular, the effects on cardiac failure and asthma were significant with the percentage change of hospital admissions per 1 °C increment of DTR at 3.0% (95% CI, 1.4-4.6) and 1.1% (95% CI, 0.1-2.0), respectively, among 9 diseases. For those 75 years and older, the DTR effect on asthma admissions was greater than in those aged under 75 years. These results support the hypothesis of a positive association between DTR and cardiovascular and respiratory hospital admission. PMID:22281041

  16. Risk of hospital admission for COPD following smoking cessation and reduction

    DEFF Research Database (Denmark)

    Godtfredsen, N S; Vestbo, J; Osler, M;

    2002-01-01

    BACKGROUND: Little is known about the effects of changes in smoking habits on the subsequent risk of chronic obstructive pulmonary disease (COPD). The aim of this study was to investigate the relationship between smoking cessation and reduction and admission to hospital for COPD in a general...... population sample. METHODS: A total of 19,709 participants from three prospective population studies in Copenhagen were followed with record linkage for date of first hospital admission for COPD until 1998 (mean follow up 14 years). Heavy smokers (>/=15 cigarettes/day) who reduced their tobacco consumption...

  17. Seasonal variation in objectively measured physical activity, sedentary time, cardio-respiratory fitness and sleep duration among 8–11 year-old Danish children: a repeated-measures study

    DEFF Research Database (Denmark)

    Hjorth, Mads F.; Chaput, Jean-Philippe; Michaelsen, Kim;

    2013-01-01

    running test. RESULTS: The children had 5% more sedentary time, 23% less time in moderate-to-vigorous physical activity and 2% longer sleep duration during winter compared to spring and cardio-respiratory fitness was 4% higher during spring compared to autumn (P <0.001). Sedentary time was higher and...... was, therefore, to examine between-season and within-week variation in physical activity, sedentary behaviour, cardio-respiratory fitness and sleep duration among 8–11 year-old children. METHODS: A total of 1021 children from nine Danish schools were invited to participate and 834 accepted. Due to...... missing data, 730 children were included in the current analytical sample. An accelerometer was worn for 7 days and 8 nights during autumn, winter and spring, from which physical activity, sedentary time and sleep duration were measured. Cardio-respiratory fitness was assessed using a 10-min intermittent...

  18. Postpartum maternal morbidity requiring hospital admission in Lusaka, Zambia – a descriptive study

    Directory of Open Access Journals (Sweden)

    Murray Susan F

    2005-02-01

    Full Text Available Abstract Background Information on the extent of postpartum maternal morbidity in developing countries is extremely limited. In many settings, data from hospital-based studies is hard to interpret because of the small proportion of women that have access to medical care. However, in those areas with good uptake of health care, the measurement of the type and incidence of complications severe enough to require hospitalisation may provide useful baseline information on the acute and severe morbidity that women experience in the early weeks following childbirth. An analysis of health services data from Lusaka, Zambia, is presented. Methods Six-month retrospective review of hospital registers and 4-week cross-sectional study with prospective identification of postpartum admissions. Results Both parts of the study identified puerperal sepsis and malaria as, respectively, the leading direct and indirect causes of postpartum morbidity requiring hospital admission. Puerperal sepsis accounted for 34.8% of 365 postpartum admissions in the 6-month period. Malaria and pneumonia together accounted for one-fifth of all postpartum admissions (14.5% & 6% respectively. At least 1.7% of the postpartum population in Lusaka will require hospital-level care for a maternal morbidity. Conclusions In developing country urban settings with high public health care usage, meticulous review of hospital registers can provide baseline information on the burden of moderate-to-severe postpartum morbidity.

  19. Coerced hospital admission and symptom change--a prospective observational multi-centre study.

    Directory of Open Access Journals (Sweden)

    Thomas W Kallert

    Full Text Available INTRODUCTION: Coerced admission to psychiatric hospitals, defined by legal status or patient's subjective experience, is common. Evidence on clinical outcomes however is limited. This study aimed to assess symptom change over a three month period following coerced admission and identify patient characteristics associated with outcomes. METHOD: At study sites in 11 European countries consecutive legally involuntary patients and patients with a legally voluntary admission who however felt coerced, were recruited and assessed by independent researchers within the first week after admission. Symptoms were assessed on the Brief Psychiatric Rating Scale. Patients were re-assessed after one and three months. RESULTS: The total sample consisted of 2326 legally coerced patients and 764 patients with a legally voluntary admission who felt coerced. Symptom levels significantly improved over time. In a multivariable analysis, higher baseline symptoms, being unemployed, living alone, repeated hospitalisation, being legally a voluntary patient but feeling coerced, and being initially less satisfied with treatment were all associated with less symptom improvement after one month and, other than initial treatment satisfaction, also after three months. The diagnostic group was not linked with outcomes. DISCUSSION: On average patients show significant but limited symptom improvements after coerced hospital admission, possibly reflecting the severity of the underlying illnesses. Social factors, but not the psychiatric diagnosis, appear important predictors of outcomes. Legally voluntary patients who feel coerced may have a poorer prognosis than legally involuntary patients and deserve attention in research and clinical practice.

  20. Clinical audit of COPD patients requiring hospital admissions in Spain: AUDIPOC study.

    Directory of Open Access Journals (Sweden)

    Francisco Pozo-Rodríguez

    Full Text Available BACKGROUNDS: AUDIPOC is a nationwide clinical audit that describes the characteristics, interventions and outcomes of patients admitted to Spanish hospitals because of an exacerbation of chronic obstructive pulmonary disease (ECOPD, assessing the compliance of these parameters with current international guidelines. The present study describes hospital resources, hospital factors related to case recruitment variability, patients' characteristics, and adherence to guidelines. METHODOLOGY/PRINCIPAL FINDINGS: An organisational database was completed by all participant hospitals recording resources and organisation. Over an 8-week period 11,564 consecutive ECOPD admissions to 129 Spanish hospitals covering 70% of the Spanish population were prospectively identified. At hospital discharge, 5,178 patients (45% of eligible were finally included, and thus constituted the audited population. Audited patients were reassessed 90 days after admission for survival and readmission rates. A wide variability was observed in relation to most variables, hospital adherence to guidelines, and readmissions and death. Median inpatient mortality was 5% (across-hospital range 0-35%. Among discharged patients, 37% required readmission (0-62% and 6.5% died (0-35%. The overall mortality rate was 11.6% (0-50%. Hospital size and complexity and aspects related to hospital COPD awareness were significantly associated with case recruitment. Clinical management most often complied with diagnosis and treatment recommendations but rarely (<50% addressed guidance on healthy life-styles. CONCLUSIONS/SIGNIFICANCE: The AUDIPOC study highlights the large across-hospital variability in resources and organization of hospitals, patient characteristics, process of care, and outcomes. The study also identifies resources and organizational characteristics associated with the admission of COPD cases, as well as aspects of daily clinical care amenable to improvement.

  1. Hyponatraemia at hospital admission is a predictor of overall mortality

    DEFF Research Database (Denmark)

    Balling, L; Gustafsson, F; Goetze, J P; Dalsgaard, M; Nielsen, H; Boesgaard, S; Bay, M; Kirk, V; Nielsen, O W; Køber, L; Iversen, K

    2015-01-01

    spectrum of medical and surgical diagnoses. METHODS: Consecutive patients >40 years of age admitted to a general district hospital in Greater Copenhagen between 1 April 1998 and 31 March 1999. Median follow-up time was 5.16 years (range 0-4372 days). Plasma sodium measurements were available in 2960...

  2. Mold sensitization is common amongst patients with severe asthma requiring multiple hospital admissions

    OpenAIRE

    Hopkinson Linda C; O'Driscoll B Ronan; Denning David W

    2005-01-01

    Abstract Background Multiple studies have linked fungal exposure to asthma, but the link to severe asthma is controversial. We studied the relationship between asthma severity and immediate type hypersensitivity to mold (fungal) and non-mold allergens in 181 asthmatic subjects. Methods We recruited asthma patients aged 16 to 60 years at a University hospital and a nearby General Practice. Patients were categorized according to the lifetime number of hospital admissions for asthma (82 never ad...

  3. Causes and incidence of 30 day hospital re-admissions after primary TKJR

    Science.gov (United States)

    Mortimer, John; van Dalen, John

    2016-01-01

    Objective: 30 day re-admission of patients following TKJR is estimated between 0.9-9.9%. It’s a cause of significant cost to the healthcare system and marks significant patient morbidity. Aim: The aim of this study is to describe the causes and incidence of patient re-admission to hospital within 30 days of a primary total knee joint replacement between 2009-2015 in a single centre. Methods: In a retrospective cohort study, computerized records were used to evaluated the causes and incidence of patient re-admission within 30 days of discharge following primary TKJR. Results: The total 30 day Re-admission rate was 5.0%. Medical causes for re-admission accounted for 29% of re-admissions. 34% were attributed to non-specific pain/swelling. Infection was attributed to 26%. 29% of patients presented with wound problems, either infective or non-infective. The total incidence of re-operation at 30 days was 0.77%. Conclusions: Our rate of re-admission is consistent with previous studies in the literature. Many patients were found to have no specific cause for re-admission. This suggests it may be possible to further reduce re-admission rates with improved patient education and management of common post-operative symptoms such as pain and swelling. Infection remains a common complication; fortunately the majority superficial infections are successfully treated with antibiotics and few requiring a washout operation. Medical complications account for almost a third showing the importance of good management of patient medical co-morbidities and risk factors.

  4. Sex-related differences in hospital admissions attributed to adverse drug reactions in the Netherlands

    NARCIS (Netherlands)

    E.M. Rodenburg (Eline); B.H.Ch. Stricker (Bruno); L.E. Visser (Loes)

    2011-01-01

    textabstractAIM Adverse drug reactions (ADRs) are a major burden in health care, regularly leading to hospital admission, morbidity or death. Women tend to have a higher risk of adverse drug reactions with a 1.5 to 1.7-fold greater risk than men. Our primary aim was to study differences in ADR-relat

  5. Impact of urban atmospheric environment on hospital admissions in the elderly

    Directory of Open Access Journals (Sweden)

    Edelci Nunes da Silva

    2012-08-01

    Full Text Available OBJECTIVE: To analyze the impact of intra-urban atmospheric conditions on circulatory and respiratory diseases in elder adults. METHODS: Cross-sectional study based on data from 33,212 hospital admissions in adults over 60 years in the city of São Paulo, southeastern Brazil, from 2003 to 2007. The association between atmospheric variables from Congonhas airport and bioclimatic index, Physiological Equivalent Temperature, was analyzed according to the district's socioenvironmental profile. Descriptive statistical analysis and regression models were used. RESULTS: There was an increase in hospital admissions due to circulatory diseases as average and lowest temperatures decreased. The likelihood of being admitted to the hospital increased by 12% with 1ºC decrease in the bioclimatic index and with 1ºC increase in the highest temperatures in the group with lower socioenvironmental conditions. The risk of admission due to respiratory diseases increased with inadequate air quality in districts with higher socioenvironmental conditions. CONCLUSIONS: The associations between morbidity and climate variables and the comfort index varied in different groups and diseases. Lower and higher temperatures increased the risk of hospital admission in the elderly. Districts with lower socioenvironmental conditions showed greater adverse health impacts.

  6. Live vaccine against measles, mumps, and rubella and the risk of hospital admissions for nontargeted infections

    DEFF Research Database (Denmark)

    Sørup, Signe; Benn, Christine Stabell; Poulsen, Anja;

    2014-01-01

    , mumps, and rubella (MMR) is associated with lower rates of hospital admissions for infections among children in Denmark. DESIGN, SETTING, AND PARTICIPANTS: Population-based cohort study of Danish children born 1997-2006 and followed up from ages 11 months to 2 years (last follow-up, August 31, 2008...

  7. Depression After First Hospital Admission for Acute Coronary Syndrome

    DEFF Research Database (Denmark)

    Osler, Merete; Mårtensson, Solvej; Wium-Andersen, Ida Kim; Prescott, Eva; Andersen, Per Kragh; Jørgensen, Terese Sara Høj; Carlsen, Kathrine; Wium-Andersen, Marie Kim; Jørgensen, Martin Balslev

    2016-01-01

    depression and mortality via linkage to patient, prescription, and cause-of-death registries until the end of 2012. Incidence of depression (as defined by hospital discharge or antidepressant medication use) and the relationship between depression and mortality were examined using time-to-event models. In......We examined incidence of depression after acute coronary syndrome (ACS) and whether the timing of depression onset influenced survival. All first-time hospitalizations for ACS (n = 97,793) identified in the Danish Patient Registry during 2001-2009 and a reference population were followed for...... total, 19,520 (20.0%) ACS patients experienced depression within 2 years after the event. The adjusted rate ratio for depression in ACS patients compared with the reference population was 1.28 (95% confidence interval (CI): 1.25, 1.30). During 12 years of follow-up, 39,523 (40.4%) ACS patients and 27...

  8. Characteristics and outcomes of injured older adults after hospital admission

    OpenAIRE

    Aitken, L. M.; Burmeister, E.; Lang, J; Chaboyer, W.; Richmond, T. S.

    2010-01-01

    OBJECTIVES: To describe the seriously injured adult population aged 65 and older; compare the differences in injury characteristics and outcomes in three subgroups aged 65 to 74, 75 to 84, and 85 and older; and identify predictors of death, complications, and hospital discharge destination. DESIGN: Retrospective secondary analysis of data from the Queensland Trauma Registry (QTR) using all patients aged 65 and older admitted from 2003 through 2006. SETTING: Data from 15 regional and t...

  9. Prevalence of Current DSM-IV Alcohol Use Disorders in Short-Stay, General Hospital Admissions, United States, 1994.

    OpenAIRE

    Barbara A. Smothers; Harold T. Yahr; Michael D. Sinclair

    2003-01-01

    Provides the first national prevalence estimates of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) alcohol use disorders, based on a structured, diagnostic instrument for inpatient admissions to U.S. general hospitals. Existing prevalence estimates for inpatient admissions come from studies conducted in one or two hospitals and do not support national inference. Notes that the prevalence of alcohol abuse or dependence in current-drinking admissions was substant...

  10. The Impact of a Proactive Chronic Care Management Program on Hospital Admission Rates in a German Health Insurance Society

    OpenAIRE

    Hamar, Brent; Wells, Aaron; Gandy, William; Haaf, Andreas; Coberley, Carter; Pope, James E.; Rula, Elizabeth Y.

    2010-01-01

    Hospital admissions are the source of significant health care expenses, although a large proportion of these admissions can be avoided through proper management of chronic disease. In the present study, we evaluate the impact of a proactive chronic care management program for members of a German insurance society who suffer from chronic disease. Specifically, we tested the impact of nurse-delivered care calls on hospital admission rates. Study participants were insured individuals with corona...

  11. Regular physical activity reduces hospital admission and mortality in chronic obstructive pulmonary disease: a population based cohort study

    DEFF Research Database (Denmark)

    Garcia-Aymerich, J; Lange, Peter; Benet, M; Schnohr, P; Antó, J M

    2006-01-01

    (very low, low, moderate, and high). Dates and causes of hospital admissions and mortality were obtained from Danish registers. Adjusted associations between physical activity and hospital admissions for COPD and mortality were obtained using negative binomial and Cox regression models, respectively...

  12. The impact of heat, cold, and heat waves on hospital admissions in eight cities in Korea

    Science.gov (United States)

    Son, Ji-Young; Bell, Michelle L.; Lee, Jong-Tae

    2014-01-01

    Although the impact of temperature on mortality is well documented, relatively fewer studies have evaluated the associations of temperature with morbidity outcomes such as hospital admissions, and most studies were conducted in North America or Europe. We evaluated weather and hospital admissions including specific causes (allergic disease, asthma, selected respiratory disease, and cardiovascular disease) in eight major cities in Korea from 2003 to 2008. We also explored potential effect modification by individual characteristics such as sex and age. We used hierarchical modeling to first estimate city-specific associations between heat, cold, or heat waves and hospitalizations, and then estimated overall effects. Stratified analyses were performed by cause of hospitalization, sex, and age (0-14, 15-64, 65-74, and ≥75 years). Cardiovascular hospitalizations were significantly associated with high temperature, whereas hospitalizations for allergic disease, asthma, and selected respiratory disease were significantly associated with low temperature. The overall heat effect for cardiovascular hospitalization was a 4.5 % (95 % confidence interval 0.7, 8.5 %) increase in risk comparing hospitalizations at 25 to 15 °C. For cold effect, the overall increase in risk of hospitalizations comparing 2 with 15 °C was 50.5 (13.7, 99.2 %), 43.6 (8.9, 89.5 %), and 53.6 % (9.8, 114.9 %) for allergic disease, asthma, and selected respiratory disease, respectively. We did not find statistically significant effects of heat waves compared with nonheat wave days. Our results suggest susceptible populations such as women and younger persons. Our findings provide suggestive evidence that both high and low ambient temperatures are associated with the risk of hospital admissions, particularly in women or younger person, in Korea.

  13. Overweight and obesity among older adults on admission to hospital.

    LENUS (Irish Health Repository)

    Lithander, F E

    2011-03-01

    Poor nutritional status, which includesboth under- a nd over-nutrition, i s associated w it h poor health outcomes. T his cross-sectional study assessed the nutritional status of older patients admitted to an acute geriatric ward of a Dublin hospital. Anthropometric and clinical measurements were made. Thirty patients, mean (sd) age 79 (7) y and body mass index 26.6 (4.7) kg\\/m2, participated. More patients were overweight (n = 12) or obese (n = 9) than underweight (n= 1) or healthy weight (n = 8) which indicates that this age-group may be part of the Irish obesity epidemic.

  14. Air pollution and hospital admissions for respiratory conditions in Rome, Italy.

    Science.gov (United States)

    Fusco, D; Forastiere, F; Michelozzi, P; Spadea, T; Ostro, B; Arcà, M; Perucci, C A

    2001-06-01

    Most of the evidence regarding the association between particulate air pollution and emergency room visits or hospital admissions for respiratory conditions and asthma comes from the USA. European time-series analyses have suggested that gaseous air pollutants are important determinants of acute hospitalization for respiratory conditions, at least as important as particulate mass. The association between daily mean levels of suspended particles and gaseous pollutants (sulphur dioxide, nitrogen dioxide, carbon monoxide, ozone) was examined. The daily emergency hospital admissions for respiratory conditions in the metropolitan area of Rome during 1995-1997 were also recorded. Daily counts of hospital admissions for total respiratory conditions (43 admissions day(-1)), acute respiratory infections including pneumonia (18 day(-1)), chronic obstructive pulmonary disease (COPD) (13 day(-1)), and asthma (4.5 day(-1)) among residents of all ages and among children (0-14 yrs) were analysed. The generalized additive models included spline smooth functions of the day of study, mean temperature, mean humidity, influenza epidemics, and indicator variables for day of the week and holidays. Total respiratory admissions were significantly associated with same-day level of NO2 (2.5% increase per interquartile range (IQR) change, 22.3 microg x m(-3)) and CO (2.8% increase per IQR, 1.5 mg x m(-3)). No effect was found for particulate matter and SO2, whereas O3 was associated with admissions only among children (lag 1, 5.5% increase per IQR, 23.9 microg x m3). The effect of NO2 was stronger on acute respiratory infections (lag 0, 4.0% increase) and on asthma among children (lag 1, 10.7% increase). The admissions for all ages for asthma and COPD were associated only with same-day level of CO (5.5% and 4.3% increase, respectively). Multipollutant models confirmed the role of CO on all respiratory admissions, including asthma and COPD, and that of NO2 on acute respiratory infections

  15. Pattern and outcome of medical admissions in a Nigerian rural teaching hospital (2009-2012

    Directory of Open Access Journals (Sweden)

    John Osarenkhoe

    2014-01-01

    Full Text Available Background: Medical diseases vary depending on the locality and it reflects the pattern of medical admissions into a medical centre. We set out to collect, analyse, present the report of results from Igbinedion University Teaching Hospital to the wider scientific community on pattern and outcome of patients in medical wards in the hospital between January 2009 to December 2012. This we believe would reflect the relative pattern, trend of diseases burden and relative importance of diseases in the hospital locality. Methods: The study was a retrospective descriptive study where data of admission cases in both male and female medical wards were collected (from the admission register with occasional reference to some patients′ case notes and analysed. Results: A total of 1066 patients were admitted during the study period, Male patients constituted 52.5% while female were 47.5% (Male: Female ratio 1.11:1 , age range 14-99 years while under 20 years, Under 30 years and Elderly constituted 30.1%, 59.3% and 12.5% respectively. Malaria, hypertension, Vaso-occlussive Crisis in Sickle Cell Diseases, Peptic Ulcer Disease, Gastroenteritis and Enteric Fever were the most common diseases admitted during the study period. Infectious and parasitic diseases was found to constitute the majority of diseases admitted. 81.2%, 4.6% and 1.6% of admitted patients were discharged, referred and died respectively. Discussions and Conclusion: The large proportion of patients in younger age groups was likely due to the university community that is located in the same town with the teaching hospital. Elderly patients accounted for 11.1% of total hospitalization similar to value gotten in another Teaching Hospital. The study showed essentially that Infectious diseases constituted the bulk of admission with malaria being the largest single disease. Non-Communicable Diseases (NCDs were also prominent. Majority of the patients were discharged home with lesser outcome of

  16. Coarse Particulate Air Pollution Associated with Increased Risk of Hospital Admissions for Respiratory Diseases in a Tropical City, Kaohsiung, Taiwan.

    Science.gov (United States)

    Cheng, Meng-Hsuan; Chiu, Hui-Fen; Yang, Chun-Yuh

    2015-10-01

    This study was undertaken to determine whether there was an association between coarse particles (PM₂.₅-₁₀) levels and frequency of hospital admissions for respiratory diseases (RD) in Kaohsiung, Taiwan. Hospital admissions for RD including chronic obstructive pulmonary disease (COPD), asthma, and pneumonia, and ambient air pollution data levels for Kaohsiung were obtained for the period from 2006 to 2010. The relative risk of hospital admissions for RD was estimated using a case-crossover approach, controlling for weather variables, day of the week, seasonality, and long-term time trends. For the single pollutant model (without adjustment for other pollutants), increased rate of admissions for RD were significantly associated with higher coarse PM levels only on cool days (carbon monoxide, or ozone on cool days. This study provides evidence that higher levels of PM₂.₅-₁₀ enhance the risk of hospital admissions for RD on cool days. PMID:26501308

  17. Particulate matter and hospital admissions due to ischemic heart disease in Sorocaba, SP

    Directory of Open Access Journals (Sweden)

    Samara da Silva Gavinier

    2013-12-01

    Full Text Available There is evidence that air pollution is a risk factor for ischemic heart diseases (IHD. The objective of this study was to estimate the association between exposure to particulate matter (PM10 and hospital admissions due to ischemic heart diseases. It was a time-series ecological study with individuals of both genders, 50 or more years old, and residents of Sorocaba, São Paulo. The admission data was obtained from the DATASUS site according to ICD-10 (I20 to I22 and I24 to I25.0, for the period from January 1st 2007 to December 31st 2010. The concentrations of air pollutants (particulate matter, ozone, nitrogen dioxide, nitrogen oxide and oxides of nitrogen, temperature and mean relative humidity were provided by the São Paulo State Environmental Agency. The generalized additive model Poisson regression with lags of up to four days was used. There were 1804 admissions during the period. Exposure to PM10 was significantly associated with hospitalization for IHD two and four days after exposure with RR = 1.006, 95% CI 1.001-1.012 and an increment of 21 μg m-³ was associated with an increase of 13% in risk of hospitalization two days after exposure and 14% after four days. It was therefore possible to identify an association with exposure to PM10 in hospitalizations due to ischemic heart diseases in individuals from a medium-sized city of Sao Paulo.

  18. Admission Serum Uric Acid Levels and In-Hospital Outcomes in Patients with Acute Coronary Syndrome

    Directory of Open Access Journals (Sweden)

    Abu Sadique Abdullah

    2015-05-01

    Full Text Available Background: Uric acid is an independent risk factor for cardiovascular disease. Hospital admission for ischemic heart disease (IHD is increasing rapidly in our country. Although studies were conducted abroad regarding association of serum uric acid with in-hospital outcomes in patients with acute coronary syndrome (ACS, no data is yet available to show the association in our country. Objective: The objective of this study was to assess the association of serum uric acid level on admission with in-hospital outcomes of the patients with ACS. Materials and Methods: This cross sectional comparative study was done in the Department of Cardiology, Dhaka Medical College Hospital (DMCH from January to December 2012. After proper ethical consideration total 93 ACS patients were enrolled in the study by nonrandom sampling. Serum uric acid of all subjects was measured within 24 hours of admission. Then in-hospital outcomes were observed in all subjects. Results: The frequency of hyperuricemia among ACS patients was 24.7% (22.54% in male and 31.82% in female. Hyperuricemic patients significantly developed heart failure (30.4% vs 11.4%, p=0.032 and conduction defect (13.0% vs 1.4%, p=0.017 than normouricemic subjects. The mean ejection fraction was significantly lower in hyperuricemic patients than patients with normal uric acid level (50.87 ± 10.27% vs 55.94 ± 6.66%. The mean ± SD duration of hospital stay of hyperuricemic group was significantly longer in patients with ACS (8.26 ± 1.18 vs 7.51±1.18 days, p=0.010. Conclusion: The measurement of serum uric acid level, an easily available and inexpensive biochemical tool, might turn out as a valuable risk marker for prediction of in-hospital outcomes in patients with ACS.

  19. Admission time to hospital: a varying standard for a critical definition for admissions to an intensive care unit from the emergency department.

    Science.gov (United States)

    Nanayakkara, Shane; Weiss, Heike; Bailey, Michael; van Lint, Allison; Cameron, Peter; Pilcher, David

    2014-11-01

    Objective Time spent in the emergency department (ED) before admission to hospital is often considered an important key performance indicator (KPI). Throughout Australia and New Zealand, there is no standard definition of 'time of admission' for patients admitted through the ED. By using data submitted to the Australian and New Zealand Intensive Care Society Adult Patient Database, the aim was to determine the differing methods used to define hospital admission time and assess how these impact on the calculation of time spent in the ED before admission to an intensive care unit (ICU). Methods Between March and December of 2010, 61 hospitals were contacted directly. Decision methods for determining time of admission to the ED were matched to 67787 patient records. Univariate and multivariate analyses were conducted to assess the relationship between decision method and the reported time spent in the ED. Results Four mechanisms of recording time of admission were identified, with time of triage being the most common (28/61 hospitals). Reported median time spent in the ED varied from 2.5 (IQR 0.83-5.35) to 5.1h (2.82-8.68), depending on the decision method. After adjusting for illness severity, hospital type and location, decision method remained a significant factor in determining measurement of ED length of stay. Conclusions Different methods are used in Australia and New Zealand to define admission time to hospital. Professional bodies, hospitals and jurisdictions should ensure standardisation of definitions for appropriate interpretation of KPIs as well as for the interpretation of studies assessing the impact of admission time to ICU from the ED. What is known about the topic? There are standards for the maximum time spent in the ED internationally, but these standards vary greatly across Australia. The definition of such a standard is critically important not only to patient care, but also in the assessment of hospital outcomes. Key performance indicators rely

  20. Extreme weather and air pollution effects on cardiovascular and respiratory hospital admissions in Cyprus.

    Science.gov (United States)

    Tsangari, H; Paschalidou, A K; Kassomenos, A P; Vardoulakis, S; Heaviside, C; Georgiou, K E; Yamasaki, E N

    2016-01-15

    In many regions of the world, climatic change is associated with increased extreme temperatures, which can have severe effects on mortality and morbidity. In this study, we examine the effect of extreme weather on hospital admissions in Cyprus, for inland and coastal areas, through the use of synoptic weather classifications (air mass types). In addition, the effect of particulate air pollution (PM10) on morbidity is examined. Our results show that two air mass types, namely (a) warm, rainy days with increased levels of water vapour in the atmosphere and (b) cold, cloudy days with increased levels of precipitation, were associated with increased morbidity in the form of hospital admissions. This was true both for cardiovascular and respiratory conditions, for all age groups, but particularly for the elderly, aged over 65. Particulate air pollution was also associated with increased morbidity in Cyprus, where the effect was more pronounced for cardiovascular diseases. PMID:26519584

  1. Point-of-care testing of HbA1c in diabetes care and preventable hospital admissions

    DEFF Research Database (Denmark)

    Kristensen, Troels; Rose Olsen, Kim

    Background: Point-of-care testing (POCT) of HbA1c may result in improved diabetic control, better patient outcomes and enhanced clinical efficiency with fewer patient visits and subsequent reductions in hospitalizations and costs. In 2008, the Danish regulators agreed to create a new tariff...... for the remuneration of POCT of HbA1c in primary care. Aim: The aim of this study is to assess whether there is an association between the use of POCT of HbA1c and preventable hospital admissions among diabetes patients in general practice. Method: We apply logistic regression analyses to examine whether...... there is a link between preventable hospital admissions and POCT of HbA1c in general practice. Preventable hospital admissions were assessed through the ambulatory care sensitive conditions (ACSCs) classification of hospital admissions. We include independent variables such as gender, age, ethnicity...

  2. Effects of Coarse Particulate Matter on Emergency Hospital Admissions for Respiratory Diseases: A Time-Series Analysis in Hong Kong

    OpenAIRE

    Qiu, Hong; Yu, Ignatius Tak-sun; Tian, Linwei; Wang, Xiaorong; Tse, Lap Ah; Tam, Wilson; Wong, Tze Wai

    2012-01-01

    Background: Many epidemiological studies have linked daily counts of hospital admissions to particulate matter (PM) with an aerodynamic diameter ≤ 10 μm (PM 10) and ≤ 2.5 μm (PM 2.5), but relatively few have investigated the relationship of hospital admissions with coarse PM (PM c; 2.5-10 μm aerodynamic diameter). Objectives: We conducted this study to estimate the health effects of PM c on emergency hospital admissions for respiratory diseases in Hong Kong after controlling for PM 2.5 and ga...

  3. Impacts of hot and cold temperature extremes on hospital admissions for cardiovascular diseases

    Science.gov (United States)

    Davídkovová, H.; Kyselý, J.; Kříž, B.

    2010-09-01

    Elevated mortality associated with high ambient temperatures in summer represents one of the main impacts of weather extremes on human society. Increases in mortality during heat waves were examined in many European countries; much less is known about the effects of heat waves on morbidity, measured for example by the number of hospital admissions. Relatively less understood is also cold-related mortality and morbidity in winter, when the relationships between weather and human health are more complex, less direct, and confounded by other factors such as epidemics of influenza/acute respiratory infections. The present study examines links between hot and cold temperature extremes and daily hospital admissions for cardiovascular diseases in the population of the Czech Republic over 1994-2007. We make use of a recently completed database of all admissions for cardiovascular diseases to hospitals in the area of the Czech Republic since 1994, with a detailed classification of diseases and detailed information concerning each patient (in total 1,467,675 hospital admissions over 1994-2007). The main goals of the study are (i) to identify excess/deficit morbidity during and after periods of heat waves in summer and cold spells in winter, (ii) to compare the links for individual diseases (e.g. acute myocardial infarction, I21; angina pectoris, I20; cerebral infarction, I63; brain ischemia, I64) and to identify those diagnoses that are most closely linked to weather, (iii) to identify population groups most vulnerable to temperature extremes, and (iv) to compare the links to temperature extremes for morbidity and mortality. Periods when morbidity data were affected by epidemics of influenza and acute respiratory infections in winter were excluded from the analysis.

  4. Factors associated with hospital admissions and repeat emergency department visits for adults with asthma

    OpenAIRE

    Adams, R; B. Smith; Ruffin, R

    2000-01-01

    BACKGROUND—A small proportion of patients with asthma account for a disproportionate number of acute health service events. To identify whether factors other than severity and low socioeconomic status were associated with this disproportionate use, a prospective study was undertaken to examine management and psychosocial factors associated with increased risk for admission to hospital with asthma and repeat visits to the emergency department over a 12month period.
METHODS...

  5. Cause-Specific Hospital Admissions on Hot Days in Sydney, Australia

    OpenAIRE

    Vaneckova, Pavla; Bambrick, Hilary

    2013-01-01

    Background While morbidity outcomes for major disease categories during extreme heat have received increasing research attention, there has been very limited investigation at the level of specific disease subcategories. Methodology/Principal Findings We analyzed daily hospital admissions for cardiovascular (CVD), respiratory (RD), genitourinary (GU) and mental diseases (MD), diabetes (DIA), dehydration (DEH) and ‘the effects of heat and light’ (HEAT) in Sydney between 1991 and 2009. We furthe...

  6. Hospital Admissions, Transfers and Costs of Guillain-Barré Syndrome

    OpenAIRE

    van Leeuwen, Nikki; Lingsma, Hester F.; Vanrolleghem, Ann M.; Sturkenboom, Miriam C. J. M.; van Doorn, Pieter A.; Steyerberg, Ewout W; Jacobs, Bart C.

    2016-01-01

    Background Guillain-Barré syndrome (GBS) has a highly variable clinical course, leading to frequent transfers within and between hospitals and high associated costs. We defined the current admissions, transfers and costs in relation to disease severity of GBS. Methods Dutch neurologists were requested to report patients diagnosed with GBS between November 2009 and November 2010. Information regarding clinical course and transfers was obtained via neurologists and general practitioners. Result...

  7. Spirometry for patients in hospital and one month after admission with an acute exacerbation of COPD

    OpenAIRE

    Rea H; Kenealy T; Adair J; Robinson E; Sheridan N

    2011-01-01

    Harry Rea1, Timothy Kenealy1, Jacqui Adair1, Elizabeth Robinson2, Nicolette Sheridan31Section of Integrated Care, South Auckland Clinical School, University of Auckland, 2Biostatistics and Epidemiology, School of Population Health, University of Auckland, 3Section of Integrated Care, South Auckland Clinical School and School of Nursing, University of Auckland, Auckland, New ZealandAim: To assess whether spirometry done in hospital during an admission for an acute exacerbation of chronic obstr...

  8. Social Welfare Centers Protect Outpatients with Mood Disorders from Risk of Hospital Admission.

    Directory of Open Access Journals (Sweden)

    Kyu-Tae Han

    Full Text Available South Korea faces difficulties in the management of mental disorders, and those difficulties are expected to gradually worsen. Therefore, we analyzed the relationship between social welfare centers and hospital admission after outpatient treatment for mood disorders.We used data from the National Health Insurance Service National Sample Cohort 2002-2013, which included all medical claims filed for the 50,160 patients who were newly diagnosed with a mood disorder among the 1,025,340 individuals in a nationally representative sample. We performed a logistic regression analysis using generalized estimating equation (GEE models to examine the relationship between social welfare centers and hospital admission after outpatient treatment for mood disorders (ICD-10: F3.There was a 3.9% admission rate among a total of 99,533 person-years. Outpatients who lived in regions with more social welfare centers were less likely to be admitted to a hospital (per increase of five social welfare centers per 100,000 people; OR: 0.958; 95% CI: 0.919-0.999. Social welfare centers had an especially strong protective effect on patients with relatively mild mood disorders and those who were vulnerable to medical expenditures.Considering the protective role of social welfare centers in managing patients with mood disorders, health-policy makers need to consider strategies for activating mental healthcare.

  9. Coarse and fine particles but not ultrafine particles in urban air trigger hospital admission for asthma in children

    DEFF Research Database (Denmark)

    Iskandar, Amne; Andersen, Zorana Jovanovic; Bønnelykke, Klaus;

    2012-01-01

    BackgroundShort-term exposure to air pollution can trigger hospital admissions for asthma in children, but it is not known which components of air pollution are most important. There are no available studies on the particular effect of ultrafine particles (UFPs) on paediatric admissions for asthma.......AimTo study whether short-term exposure to air pollution is associated with hospital admissions for asthma in children. It is hypothesised that (1) the association between asthma admissions and air pollution is stronger with UFPs than with coarse (PM(10)) and fine (PM(2.5)) particles, nitrogen oxides (NO......(x)) or nitrogen dioxide (NO(2)); and (2) infants are more susceptible to the effects of exposure to air pollution than older children.MethodDaily counts of admissions for asthma in children aged 0-18 years to hospitals located within a 15 km radius of the central fixed background urban air pollution...

  10. Effect of air pollution on pediatric respiratory emergency room visits and hospital admissions

    OpenAIRE

    S.C.L. Farhat; R.L.P. Paulo; T.M. Shimoda; G.M.S. Conceição; Lin, C. A.; A.L.F. Braga; M.P.N. Warth; Saldiva, P H N

    2005-01-01

    In order to assess the effect of air pollution on pediatric respiratory morbidity, we carried out a time series study using daily levels of PM10, SO2, NO2, ozone, and CO and daily numbers of pediatric respiratory emergency room visits and hospital admissions at the Children's Institute of the University of São Paulo Medical School, from August 1996 to August 1997. In this period there were 43,635 hospital emergency room visits, 4534 of which were due to lower respiratory tract disease. The to...

  11. The experience of admission to psychiatric hospital among Chinese adult patients in Hong Kong

    Directory of Open Access Journals (Sweden)

    Lam Linda

    2008-10-01

    Full Text Available Abstract Background The paper reports on a study to evaluate the psychometric properties and cultural appropriateness of the Chinese translation of the Admission Experience Survey (AES. Methods The AES was translated into Chinese and back-translated. Content validity was established by focus groups and expert panel review. The Chinese version of the Admission Experience Survey (C-AES was administered to 135 consecutively recruited adult psychiatric patients in the Castle Peak Hospital (Hong Kong SAR, China within 48 hours of admission. Construct validity was assessed by comparing the scores from patients admitted voluntarily versus patients committed involuntarily, and those received physical or chemical restraint versus those who did not. The relationship between admission experience and psychopathology was examined by correlating C-AES scores with the Brief Psychiatric Rating Scale (BPRS scores. Results Spearman's item-to-total correlations of the C-AES ranged from 0.50 to 0.74. Three factors from the C-AES were extracted using factor analysis. Item 12 was omitted because of poor internal consistency and factor loading. The factor structure of the Process Exclusion Scale (C-PES corresponded to the English version, while some discrepancies were noted in the Perceived Coercion Scale (C-PCS and the Negative Pressure Scale (C-NPS. All subscales had good internal consistencies. Scores were significantly higher for patients either committed involuntarily or subjected to chemical or physical restrain, independent on severity of psychotic symptoms. Conclusion The Chinese AES is a psychometrically sound instrument assessing the three different aspects of the experience of admission, namely "negative pressure, "process exclusion" and "perceived coercion". The potential of C-AES in exploring subjective experience of psychiatric admission and effects on treatment adherence should be further explored.

  12. Monitoring Child Abuse and Neglect at a Population Level: Patterns of Hospital Admissions for Maltreatment and Assault

    Science.gov (United States)

    O'Donnell, Melissa; Nassar, Natasha; Leonard, Helen; Mathews, Richard; Patterson, Yvonne; Stanley, Fiona

    2010-01-01

    Objectives: To investigate the prevalence, trends, and characteristics of maltreatment and assault related hospital admissions and deaths among children; and identify common injuries and conditions associated with these admissions using routinely collected morbidity and mortality data. Methods: A retrospective cohort study of all children aged…

  13. Assessing the need for hospital admission by the Cape Triage discriminator presentations and the simple clinical score.

    LENUS (Irish Health Repository)

    Emmanuel, Andrew

    2010-11-01

    There is uncertainty about how to assess unselected acutely ill medical patients at the time of their admission to hospital. This study examined the use of the Simple Clinical Score (SCS) and the medically relevant Cape Triage discriminator clinical presentations to determine the need for admission to an acute medical unit.

  14. Baseline characteristics, time-to-hospital admission and in-hospital outcomes of patients hospitalized with ST-segment elevation acute coronary syndromes, 2002 to 2005

    OpenAIRE

    Pehnec, Zlatko; Sinkovič, Andreja; Kamenik, Borut; Marinšek, Martin; Svenšek, Franci

    2009-01-01

    Objective. The purpose of this study was to retrospectively determine baseline patient characteristics, time-to-hospital admission, utilization of reperfusion therapy and outcomes of patients hospitalized with ST-segment elevation acute coronary syndromes (ACS) between 2002 and 2005, particularly after 24-h primary percutaneous coronary intervention (PCI) was introduced in 2004. Methods. Included were all patients admitted to the intensive care unit (ICU) from 2002 to 2005 who met the crit...

  15. A qualitative examination of inappropriate hospital admissions and lengths of stay

    Directory of Open Access Journals (Sweden)

    Hammond Christina L

    2009-03-01

    Full Text Available Abstract Background Research has shown that a number of patients, with a variety of diagnoses, are admitted to hospital when it is not essential and can remain in hospital unnecessarily. To date, research in this area has been primarily quantitative. The purpose of this study was to explore the perceived causes of inappropriate or prolonged lengths of stay and focuses on a specific population (i.e., patients with long term neurological conditions. We also wanted to identify interventions which might avoid admission or expedite discharge as periods of hospitalisation pose particular risks for this group. Methods Two focus groups were conducted with a convenience sample of eight primary and secondary care clinicians working in the Derbyshire area. Data were analysed using a thematic content approach. Results The participants identified a number of key causes of inappropriate admissions and lengths of stay, including: the limited capacity of health and social care resources; poor communication between primary and secondary care clinicians and the cautiousness of clinicians who manage patients in community settings. The participants also suggested a number of strategies that may prevent inappropriate admissions or reduce length of stay (LoS, including: the introduction of new sub-acute care facilities; the introduction of auxiliary nurses to support specialist nursing staff and patient held summaries of specialist consultations. Conclusion Clinicians in both the secondary and primary care sectors acknowledged that some admissions were unnecessary and some patients remain in hospital for a prolonged period. These events were attributed to problems with the current capacity or structuring of services. It was noted, for example, that there is a shortage of appropriate therapeutic services and that the distribution of beds between community and sub-acute care should be reviewed.

  16. Effect of tele health care on exacerbations and hospital admissions in patients with chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Ringbæk, Thomas; Green, Allan; Laursen, Lars Christian;

    2015-01-01

    BACKGROUND AND OBJECTIVE: Tele monitoring (TM) of patients with chronic obstructive pulmonary disease (COPD) has gained much interest, but studies have produced conflicting results. Our aim was to investigate the effect of TM with the option of video consultations on exacerbations and hospital...... during the study period. RESULTS: Most of the enrolled patients had severe COPD (forced expiratory volume in 1 second <50%pred in 86% and ≥hospital admission for COPD in the year prior to enrollment in 45%, respectively, of the patients). No difference in drop-out rate and mortality was found between the...... groups. With regard to the primary outcome, no significant difference was found in hospital admissions for COPD between the groups (P=0.74), and likewise, no difference was found in time to first admission or all-cause hospital admissions. Compared with the control group, TM group patients had more...

  17. Coarse Particulate Air Pollution Associated with Increased Risk of Hospital Admissions for Respiratory Diseases in a Tropical City, Kaohsiung, Taiwan

    Directory of Open Access Journals (Sweden)

    Meng-Hsuan Cheng

    2015-10-01

    Full Text Available This study was undertaken to determine whether there was an association between coarse particles (PM2.5–10 levels and frequency of hospital admissions for respiratory diseases (RD in Kaohsiung, Taiwan. Hospital admissions for RD including chronic obstructive pulmonary disease (COPD, asthma, and pneumonia, and ambient air pollution data levels for Kaohsiung were obtained for the period from 2006 to 2010. The relative risk of hospital admissions for RD was estimated using a case-crossover approach, controlling for weather variables, day of the week, seasonality, and long-term time trends. For the single pollutant model (without adjustment for other pollutants, increased rate of admissions for RD were significantly associated with higher coarse PM levels only on cool days (<25 °C, with a 10 µg/m3 elevation in PM2.5–10 concentrations associated with a 3% (95% CI = 1%–5% rise in COPD admissions, 4% (95% CI = 1%–7% increase in asthma admissions, and 3% (95% CI = 2%–4% rise in pneumonia admissions. No significant associations were found between coarse particle levels and the number of hospital admissions for RD on warm days. In the two-pollutant models, PM2.5–10 levels remained significantly correlated with higher rate of RD admissions even controlling for sulfur dioxide, nitrogen dioxide, carbon monoxide, or ozone on cool days. This study provides evidence that higher levels of PM2.5–10 enhance the risk of hospital admissions for RD on cool days.

  18. Clinical pharmacist’s contribution to medication reconciliation on admission to hospital in Ireland

    LENUS (Irish Health Repository)

    Galvin, Mairead

    2012-10-08

    Background Medication reconciliation has been mandated by the Irish government at transfer of care. Research is needed to determine the contribution of clinical pharmacists to the process. Objective To describe the contribution of emergency department based clinical pharmacists to admission medication reconciliation in Ireland. Main Outcome Measure Frequency of clinical pharmacist\\'s activities. Setting Two public university teaching hospitals. Methodology Adults admitted via the accident and emergency department, from a non-acute setting, reporting the use of at least three regular prescription medications, were eligible for inclusion. Medication reconciliation was provided by clinical pharmacists to randomly-selected patients within 24-hours of admission. This process includes collecting a gold-standard pre-admission medication list, checking this against the admission prescription and communicating any changes. A discrepancy was defined as any difference between the gold-standard pre-admission medication list and the admission prescription. Discrepancies were communicated to the clinician in the patient\\'s healthcare record. Potentially harmful discrepancies were also communicated verbally. Pharmacist activities and unintentional discrepancies, both resolved and unresolved at 48-hours were measured. Unresolved discrepancies were confirmed verbally by the team as intentional or unintentional. A reliable and validated tool was used to assess clinical significance by medical consultants, clinical pharmacists, community pharmacists and general practitioners. Results In total, 134 patients, involving 1,556 medications, were included in the survey. Over 97 % of patients (involving 59 % of medications) experienced a medication change on admission. Over 90 % of patients (involving 29 % of medications) warranted clinical pharmacy input to determine whether such changes were intentional or unintentional. There were 447 interventions by the clinical pharmacist regarding

  19. The impact of ice-skating injuries on orthopaedic admissions in a regional hospital.

    LENUS (Irish Health Repository)

    Dillon, J P

    2012-02-03

    Since the opening of a temporary ice-rink in our hospital\\'s catchment area, we have observed an increase in patients requiring in-patient treatment for orthopaedic intervention. The authors performed a prospective analysis of all patients admitted to our unit over a one-month period. Epidemiological data, wearing of protective gear and skater experience were collected. Fracture type, treatment required, average length of hospital stay and number of days missed from work was also recorded. Ice-skating injuries accounted for 7.7% of our total admissions over the study period. There was a significant variation noted in the types of fracture sustained ranging from comminuted fractures of the radial head to spiral fractures of the tibia. The average length of hospital stay was 2.6 days and average time missed from work was 6.1 weeks. This paper highlights the potential serious injuries that can occur in ice-skating and their impact on admissions to our orthopaedic unit.

  20. Expiratory flow limitation relates to symptoms during COPD exacerbations requiring hospital admission

    Directory of Open Access Journals (Sweden)

    Jetmalani K

    2015-05-01

    Full Text Available Kanika Jetmalani,1,2 Sophie Timmins,1,3,4 Nathan J Brown,1,4 Chantale Diba,1,4 Norbert Berend,1,4,5 Cheryl M Salome,1,2,4 Fu-Qiang Wen,6 Peng Chen,6 Gregory G King,1-4 Claude S Farah1,2,7 1Woolcock Institute of Medical Research, 2Sydney Medical School, University of Sydney, 3Department of Respiratory Medicine, Royal North Shore Hospital, 4Cooperative Research Centre for Asthma and Airways, 5Department of Respiratory Research, George Institute of Global Health, Sydney, NSW, Australia; 6Department of Medicine, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, People’s Republic of China; 7Department of Respiratory Medicine, Concord Hospital, Sydney, NSW, Australia Background: Expiratory flow limitation (EFL is seen in some patients presenting with a COPD exacerbation; however, it is unclear how EFL relates to the clinical features of the exacerbation. We hypothesized that EFL when present contributes to symptoms and duration of recovery during a COPD exacerbation. Our aim was to compare changes in EFL with symptoms in subjects with and without flow-limited breathing admitted for a COPD exacerbation.Subjects and methods: A total of 29 subjects with COPD were recruited within 48 hours of admission to West China Hospital for an acute exacerbation. Daily measurements of postbronchodilator spirometry, resistance, and reactance using the forced oscillation technique and symptom (Borg scores until discharge were made. Flow-limited breathing was defined as the difference between inspiratory and expiratory respiratory system reactance (EFL index greater than 2.8 cmH2O·s·L-1. The physiological predictors of symptoms during recovery were determined by mixed-effect analysis.Results: Nine subjects (31% had flow-limited breathing on admission despite similar spirometry compared to subjects without flow-limited breathing. Spirometry and resistance measures did not change between enrolment and discharge. EFL index values improved

  1. Factors affecting length of stay in forensic hospital setting: need for therapeutic security and course of admission.

    LENUS (Irish Health Repository)

    Davoren, Mary

    2015-01-01

    Patients admitted to a secure forensic hospital are at risk of a long hospital stay. Forensic hospital beds are a scarce and expensive resource and ability to identify the factors predicting length of stay at time of admission would be beneficial. The DUNDRUM-1 triage security scale and DUNDRUM-2 triage urgency scale are designed to assess need for therapeutic security and urgency of that need while the HCR-20 predicts risk of violence. We hypothesized that items on the DUNDRUM-1 and DUNDRUM-2 scales, rated at the time of pre-admission assessment, would predict length of stay in a medium secure forensic hospital setting.

  2. Expiratory flow limitation relates to symptoms during COPD exacerbations requiring hospital admission

    Science.gov (United States)

    Jetmalani, Kanika; Timmins, Sophie; Brown, Nathan J; Diba, Chantale; Berend, Norbert; Salome, Cheryl M; Wen, Fu-Qiang; Chen, Peng; King, Gregory G; Farah, Claude S

    2015-01-01

    Background Expiratory flow limitation (EFL) is seen in some patients presenting with a COPD exacerbation; however, it is unclear how EFL relates to the clinical features of the exacerbation. We hypothesized that EFL when present contributes to symptoms and duration of recovery during a COPD exacerbation. Our aim was to compare changes in EFL with symptoms in subjects with and without flow-limited breathing admitted for a COPD exacerbation. Subjects and methods A total of 29 subjects with COPD were recruited within 48 hours of admission to West China Hospital for an acute exacerbation. Daily measurements of post-bronchodilator spirometry, resistance, and reactance using the forced oscillation technique and symptom (Borg) scores until discharge were made. Flow-limited breathing was defined as the difference between inspiratory and expiratory respiratory system reactance (EFL index) greater than 2.8 cmH2O·s·L−1. The physiological predictors of symptoms during recovery were determined by mixed-effect analysis. Results Nine subjects (31%) had flow-limited breathing on admission despite similar spirometry compared to subjects without flow-limited breathing. Spirometry and resistance measures did not change between enrolment and discharge. EFL index values improved in subjects with flow-limited breathing on admission, with resolution in four patients. In subjects with flow-limited breathing on admission, symptoms were related to inspiratory resistance and EFL index values. In subjects without flow-limited breathing, symptoms related to forced expiratory volume in 1 second/forced vital capacity. In the whole cohort, EFL index values at admission was related to duration of stay (Rs=0.4, P=0.03). Conclusion The presence of flow-limited breathing as well as abnormal respiratory system mechanics contribute independently to symptoms during COPD exacerbations. PMID:25999709

  3. The epidemiology of multiple sclerosis in Scotland: inferences from hospital admissions.

    Directory of Open Access Journals (Sweden)

    Adam E Handel

    Full Text Available BACKGROUND: Multiple sclerosis (MS is a neurological disorder with a highly characteristic disease distribution. Prevalence and incidence in general increase with increasing distance from the equator. Similarly the female to male sex ratio increases with increasing latitude. Multiple possible risk factors have been hypothesised for this epidemiological trend, including human leukocyte antigen allele frequencies, ultraviolet exposure and subsequent vitamin D levels, smoking and Epstein-Barr virus. In this study we undertook a study of medical records across Scotland on an NHS health board level of resolution to examine the epidemiology of MS in this region. METHODS AND RESULTS: We calculated the number and rate of patient-linked hospital admissions throughout Scotland between 1997 and 2009 from the Scottish Morbidity Records. We used weighted-regression to examine correlations between these measures of MS, and latitude and smoking prevalence. We found a highly significant relationship between MS patient-linked admissions and latitude (r weighted by standard error (r(sw = 0.75, p = 0.002. There was no significant relationship between smoking prevalence and MS patient-linked admissions. DISCUSSION: There is a definite latitudinal effect on MS risk across Scotland, arising primarily from an excess of female MS patients at more Northerly latitudes. Whether this is a true gradient or whether a threshold effect may apply at particular latitude will be revealed only by further research. A number of genetic and environmental factors may underlie this effect.

  4. Air pollution from biomass burning and asthma hospital admissions in a sugar cane plantation area in Brazil

    Science.gov (United States)

    Arbex, Marcos Abdo; Martins, Lourdes Conceição; de Oliveira, Regiani Carvalho; Pereira, Luiz Alberto Amador; Arbex, Flávio Ferlin; Cançado, José Eduardo Delfini; Saldiva, Paulo Hilário Nascimento; Braga, Alfésio Luís Ferreira

    2007-01-01

    Objective To evaluate the association between the total suspended particles (TSPs) generated from preharvest sugar cane burning and hospital admission due to asthma (asthma hospital admissions) in the city of Araraquara. Design An ecological time‐series study. Total daily records of asthma hospital admissions (ICD 10th J15) were obtained from one of the main hospitals in Araraquara, São Paulo State, Brazil, from 23 March 2003 to 27 July 2004. The daily concentration of TSP (μg/m3) was obtained using Handi‐vol equipment (Energética, Brazil) placed in downtown Araraquara. The local airport provided the daily mean figures of temperature and humidity. The daily number of asthma hospital admissions was considered as the dependent variable in Poisson's regression models and the daily concentration of TSP was considered the independent variable. The generalised linear model with natural cubic spline was adopted to control for long‐time trend. Linear terms were used for weather variables. Results TSP had an acute effect on asthma admissions, starting 1 day after TSP concentrations increased and remaining almost unchanged for the next four days. A 10 μg/m3 increase in the 5‐day moving average (lag1–5) of TSP concentrations was associated with an increase of 11.6% (95% CI 5.4 to 17.7) in asthma hospital admissions. Conclusion Increases in TSP concentrations were definitely associated with asthma hospital admissions in Araraquara and, despite using sugar cane alcohol to reduce air pollution from automotive sources in large Brazilian urban centres, the cities where sugar cane is harvested pay a high toll in terms of public health. PMID:17435205

  5. Seasonal variation in objectively measured physical activity, sedentary time, cardio-respiratory fitness and sleep duration among 8–11 year-old Danish children: a repeated-measures study

    OpenAIRE

    Hjorth, Mads F.; Chaput, Jean-Philippe; Michaelsen, Kim; Astrup, Arne; Tetens, Inge; Sjödin, Anders

    2013-01-01

    BACKGROUND: Understanding fluctuations in lifestyle indicators is important to identify relevant time periods to intervene in order to promote a healthy lifestyle; however, objective assessment of multiple lifestyle indicators has never been done using a repeated-measures design. The primary aim was, therefore, to examine between-season and within-week variation in physical activity, sedentary behaviour, cardio-respiratory fitness and sleep duration among 8–11 year-old children. METHODS: A to...

  6. A retrospective population-based study of childhood hospital admissions with record linkage to a birth defects registry

    OpenAIRE

    Bower Carol; Colvin Lyn

    2009-01-01

    Abstract Background Using population-based linked records of births, deaths, birth defects and hospital admissions for children born 1980–1999 enables profiles of hospital morbidity to be created for each child. Methods This is an analysis of a state-based registry of birth defects linked to population-based hospital admission data. Transfers and readmissions within one day could be taken into account and treated as one episode of care for the purposes of analyses (N = 485,446 children; 742,8...

  7. The potential economic value of screening hospital admissions for Clostridium difficile.

    Science.gov (United States)

    Bartsch, S M; Curry, S R; Harrison, L H; Lee, B Y

    2012-11-01

    Asymptomatic Clostridium difficile carriage has a prevalence reported as high as 51-85 %; with up to 84 % of incident hospital-acquired infections linked to carriers. Accurately identifying carriers may limit the spread of Clostridium difficile. Since new technology adoption depends heavily on its economic value, we developed an analytic simulation model to determine the cost-effectiveness screening hospital admissions for Clostridium difficile from the hospital and third party payer perspectives. Isolation precautions were applied to patients testing positive, preventing transmission. Sensitivity analyses varied Clostridium difficile colonization rate, infection probability among secondary cases, contact isolation compliance, and screening cost. Screening was cost-effective (i.e., incremental cost-effectiveness ratio [ICER] ≤ $50,000/QALY) for every scenario tested; all ICER values were ≤ $256/QALY. Screening was economically dominant (i.e., saved costs and provided health benefits) with a ≥10.3 % colonization rate and ≥5.88 % infection probability when contact isolation compliance was ≥25 % (hospital perspective). Under some conditions screening led to cost savings per case averted (range, $53-272). Clostridium difficile screening, coupled with isolation precautions, may be a cost-effective intervention to hospitals and third party payers, based on prevalence. Limiting Clostridium difficile transmission can reduce the number of infections, thereby reducing its economic burden to the healthcare system. PMID:22752150

  8. Hospital Admissions, Biological Therapy, and Surgery in Familial and Sporadic Cases of Inflammatory Bowel Disease

    DEFF Research Database (Denmark)

    Trier Moller, Frederik; Andersen, Vibeke; Andersson, Mikael;

    2015-01-01

    -related hospitalization, biological treatment, and surgery in familial versus sporadic cases of IBD. RESULTS: A total of 27,886 IBD cases, including 1006 IBD-relative pairs, were followed-up for up to 16 years, totaling 164,979 person-years. We observed no difference in risk of hospital admissions between familial and......BACKGROUND: Easily accessible predictors of disease course in inflammatory bowel disease (IBD) are scarce, and it remains largely unknown whether a family history of IBD predicts the course of Crohn's disease (CD) and ulcerative colitis (UC). We aimed to compare the course of disease in familial...... and sporadic cases of IBD in a nationwide cohort study. METHODS: From national registries, covering a population of 8,295,773 individuals, we obtained information on date and year of diagnosis of IBD cases, gender, age, and family ties. Using Cox regression, we estimated hazard ratios for IBD...

  9. Causes of Acute Poisoning Hospital admission in Shahid Beheshti Hospital of Yasuj, 2008

    Directory of Open Access Journals (Sweden)

    S Mohammad Hosseini

    2012-08-01

    Full Text Available Background & aim: About 7% of patient referred to hospital are various forms of poisoning. This study was performed to determine the major causes of acute poisoning leading to Hospitalization at Shahid Beheshti Hospital of Yasuj, Iran. Methods: This descriptive study was performed from August 2007 to July 2008 on 470 cases of poisonings referred to Shahid Beheshti hospital of Yasuj. Demographic characteristics, time of poisoning, poisoning factor, history of previous poisoning, history of psychiatric disease, medication and other therapeutic intervention based on questionnaires and interviews with patients or companions of patients were recorded. Data were analyzed by Chi-Square Test. Results: Majority of poisoned patients were single females, in the age range of 21-30 years, unemployed, lived in urban areas, and had at least a diploma. The majority of cases were intentional poisoning with a history of depression, previous poisoning and attempted suicide. Significant relationship were seen between poisoning, age, sex, and job, (p0.05. Conclusion: With respect to the results of this study, the majority of these poisonings occurred among young, single and unemployed females due to suicide and drug intoxication. Necessary actions should be done in drug usage and maintenance, taking action against non-prescription drugs and giving proper public education to families.

  10. Air pollution and hospital admissions for respiratory diseases in Lanzhou, China

    International Nuclear Information System (INIS)

    Lanzhou is among the most seriously air-polluted cities in China as a whole, due to its unique topography, climate, industrial structure and so on. We studied the relationship between different air pollution and respiratory hospitalizations from 2001 to 2005, the total of respiratory hospital admissions were 28,057. The data were analyzed using Poisson regression models after controlling for the long time trend for air pollutants, the “day of week” effect and confounding meteorological factors. Three air pollutants (PM10, SO2, NO2) had a lag effect, the lag was 3–5 days for PM10, 1–3 days for SO2 and 1–4 days for NO2. The relative risks were calculated for increases in the inter-quartile range of the pollutants (139 μg/m3 in PM10, 61 μg/m3 in SO2 and 31 μg/m3 in NO2). Results showed that there were significant associations between air pollutants and respiratory hospital admissions, and stronger effects were observed for females and aged ≥65 yrs in Lanzhou. -- There were significant associations between air pollutants and respiratory diseases with lag effect, and the aged and female people are more vulnerable to air pollutants. -- Highlights: • We assess the association between different air pollutants and respiratory diseases in 2001–2005. • The associations are significant and show a lag effect. • The lag was 3–5 days for PM10, 1–3 days for SO2 and 1–4 days for NO2

  11. Hospital admissions and pharmacotherapy before out-of-hospital cardiac arrest according to age

    DEFF Research Database (Denmark)

    Weeke, Peter; Folke, Fredrik; Gislason, Gunnar H; Lippert, Freddy K; Olesen, Jonas B; Andersson, Charlotte; Wissenberg, Mads; Poulsen, Henrik E; Nielsen, Søren L; Køber, Lars; Torp-Pedersen, Christian

    2012-01-01

    BACKGROUND: The underlying etiology of sudden cardiac death varies with age and is likely to be reflected in type and number of healthcare contacts. We aimed to determine the specific type of healthcare contact shortly before out-of-hospital cardiac arrest (OHCA) across ages. METHODS: OHCA patients...... were identified in the nationwide Danish Cardiac Arrest Register and Copenhagen Medical Emergency Care Unit (2001-2006). We matched every OHCA patients with 10 controls on sex and age. Healthcare contacts were evaluated 30 days before event by individual-level-linkage of nationwide registers. RESULTS......: We identified 16,924 OHCA patients, median age 70.0 years (Q1-Q3: 59-80). OHCA patients had a higher number of hospitalizations and received more pharmacotherapy compared to the control population across all ages (p for difference 89) were...

  12. Prevalence of Methicillin-resistant Staphyloccocus Aureus and associated risk factors on admission to a specialist care eye hospital

    International Nuclear Information System (INIS)

    Staphyloccocus aureus is known to be a frequent pathogen in hospital settings, with its well-known and resistant forms to the anti-staphylococcal penicillins. Reports on community carriage outside hospital settings have been feared to be on the increase due to the due to the frequency of reported cases on admission to hospitals. We undertook this study to determine the prevalence of and to establish predictors for, nasal carriage of methicillin-resistant S.aureus (MRSA) at the time of admission to a specialist care eye hospital. A prospective survey was conducted at King Khaled Eye Specialist Hospital (KKESH), Riyadh during the three differing weeks randomly selected from the year 1999. The first 100 patients admitted during those three weeks were selected according to inclusion criteria. The hospital is a 220-bed tertiary ophthalmic care facility, with an average 7,500admission per year. Nasal bacterial swabs were taken within 48 hours of admission and tested for all strains of S.aureus and sensitivity to methicillin. Detailed interviews were conducted about medical history and habitual environment. Of 306 nasal cultures tested, none was isolated for MRSA and 102 (33%) were sensitive to methicillin (MSSA).We found 0% nasal carriage rate for MRSA. Respondents have difficulty with questions related to antibiotic administration. No identifiable medical or environmental risk factors could be found. Nasal swabs of patients admitted to KKESH did not reveal MRSA colonization, indicating that MRSA may not be prevalent in the community at present. (author)

  13. Mortality and Incidence of Hospital Admissions for Stroke among Brazilians Aged 15 to 49 Years between 2008 and 2012

    Science.gov (United States)

    Adami, Fernando; Figueiredo, Francisco Winter dos Santos; Paiva, Laércio da Silva; de Sá, Thiago Hérick; Santos, Edige Felipe de Sousa; Martins, Bruno Luis; Valenti, Vitor Engrácia; de Abreu, Luiz Carlos

    2016-01-01

    Introduction The objective was to analyze rates of stroke-related mortality and incidence of hospital admissions in Brazilians aged 15 to 49 years according to region and age group between 2008 and 2012. Methods Secondary analysis was performed in 2014 using data from the Hospital and Mortality Information Systems and the Brazilian Institute of Geography and Statistics. Stroke was defined by ICD, 10th revision (I60–I64). Crude and standardized mortality (WHO reference) and incidence of hospital admissions per 100,000 inhabitants, stratified by region and age group, were estimated. Absolute and relative frequencies; and linear regression were also used. The software used was Stata 11.0. Results There were 35,005 deaths and 131,344 hospital admissions for stroke in Brazilians aged 15–49 years old between 2008 and 2012. Mortality decreased from 7.54 (95% CI 7.53; 7.54) in 2008 to 6.32 (95% CI 6.31; 6.32) in 2012 (β = -0.27, p = 0.013, r2 = 0.90). During the same time, incidence of hospital admissions stabilized: 24.67 (95% CI 24.66; 24.67) in 2008 and 25.11 (95% CI 25.10; 25.11) in 2012 (β = 0.09, p = 0.692, r2 = 0.05). There was a reduction in mortality in all Brazilian regions and in the age group between 30 and 49 years. Incidence of hospitalizations decreased in the South, but no significant decrease was observed in any age group. Conclusion We observed a decrease in stroke-related mortality, particularly in individuals over 30 years old, and stability of the incidence of hospitalizations; and also regional variation in stroke-related hospital admission incidence and mortality among Brazilian young adults. PMID:27332892

  14. Analysis of the Spatial Variation of Hospitalization Admissions for Hypertension Disease in Shenzhen, China

    Directory of Open Access Journals (Sweden)

    Zhensheng Wang

    2014-01-01

    Full Text Available In China, awareness about hypertension, the treatment rate and the control rate are low compared to developed countries, even though China’s aging population has grown, especially in those areas with a high degree of urbanization. However, limited epidemiological studies have attempted to describe the spatial variation of the geo-referenced data on hypertension disease over an urban area of China. In this study, we applied hierarchical Bayesian models to explore the spatial heterogeneity of the relative risk for hypertension admissions throughout Shenzhen in 2011. The final model specification includes an intercept and spatial components (structured and unstructured. Although the road density could be used as a covariate in modeling, it is an indirect factor on the relative risk. In addition, spatial scan statistics and spatial analysis were utilized to identify the spatial pattern and to map the clusters. The results showed that the relative risk for hospital admission for hypertension has high-value clusters in the south and southeastern Shenzhen. This study aimed to identify some specific regions with high relative risk, and this information is useful for the health administrators. Further research should address more-detailed data collection and an explanation of the spatial patterns.

  15. Medicare Home Visit Program Associated With Fewer Hospital And Nursing Home Admissions, Increased Office Visits.

    Science.gov (United States)

    Mattke, Soeren; Han, Dan; Wilks, Asa; Sloss, Elizabeth

    2015-12-01

    Clinical home visit programs for Medicare beneficiaries are a promising approach to supporting aging in place and avoiding high-cost institutional care. Such programs combine a comprehensive geriatric assessment by a clinician during a home visit with referrals to community providers and health plan resources to address uncovered issues. We evaluated UnitedHealth Group's HouseCalls program, which has been offered to Medicare Advantage plan members in Arkansas, Georgia, Missouri, South Carolina, and Texas since January 2008. We found that, compared to non-HouseCalls Medicare Advantage plan members and fee-for-service beneficiaries, HouseCalls participants had reductions in admissions to hospitals (1 percent and 14 percent, respectively) and lower risk of nursing home admission (0.67 percent and 1.3 percent, respectively). In addition, participants' numbers of office visits--chiefly to specialists--increased 2-6 percent (depending on the comparison group). The program's effects on emergency department use were mixed. These results indicate that a thorough home-based clinical assessment of a member's health and home environment combined with referral services can support aging in place, promote physician office visits, and preempt costly institutional care. PMID:26643635

  16. Winter circulation weather types and hospital admissions for respiratory diseases in Galicia, Spain

    Science.gov (United States)

    Royé, D.; Taboada, J. J.; Martí, A.; Lorenzo, M. N.

    2016-04-01

    The link between various pathologies and atmospheric conditions has been a constant topic of study over recent decades in many places across the world; knowing more about it enables us to pre-empt the worsening of certain diseases, thereby optimizing medical resources. This study looked specifically at the connections in winter between respiratory diseases and types of atmospheric weather conditions (Circulation Weather Types, CWT) in Galicia, a region in the north-western corner of the Iberian Peninsula. To do this, the study used hospital admission data associated with these pathologies as well as an automatic classification of weather types. The main result obtained was that weather types giving rise to an increase in admissions due to these diseases are those associated with cold, dry weather, such as those in the east and south-east, or anticyclonic types. A second peak was associated with humid, hotter weather, generally linked to south-west weather types. In the future, this result may help to forecast the increase in respiratory pathologies in the region some days in advance.

  17. Quetiapine may reduce hospital admission rates in patients with mental health problems and alcohol addiction.

    Science.gov (United States)

    Kong, C; Chiu, W; Davies, A; Keating, J

    2013-01-01

    A 64-year-old man presented with 40 years history of chronic alcohol excess. On average, he had six hospital admissions a year with alcohol-related problems for at least a 10-year period. In 2009, he considered reducing his alcohol intake. He was noted to have mood disturbances, was seen by a psychogeriatrician who diagnosed bipolar disorder. He tried various bipolar medications including lithium and sodium valproate which was unsuccessful. He was then started on quetiapine 600 mg a day in divided doses. Subsequently this has not only controlled the bipolar disorder but also resulted in significant reduction in alcohol intake. He now shares a bottle of wine with his wife while in the past he was consuming a bottle of scotch daily. This case illustrates the benefits of quetiapine in assisting with this man's addiction to alcohol. PMID:23925678

  18. Examining the relationship between anxiety and depression and exacerbations of COPD which result in hospital admission: a systematic review

    Directory of Open Access Journals (Sweden)

    Pooler A

    2014-03-01

    Full Text Available Alison Pooler,1,2 Roger Beech21School of Nursing and Midwifery, Clinical Education Centre, University Hospital of North Staffordshire NHS Trust, Stoke-on-Trent, UK; 2Health Services Research, Research Institute of Primary Care and Health Sciences, Keele University, Keele, UK Objectives: Exacerbations of chronic obstructive pulmonary disease (COPD are the third largest cause of emergency hospital admissions in the UK. This systematic literature review explored the relationship between the hospitalization rates and the COPD comorbidities, anxiety, and depression.Methods: The Centre for Research Dissemination's framework for systematic reviews was followed using search terms relating to COPD, anxiety, depression, and hospital admission. Papers identified were assessed for relevance and quality, using a suitable Critical Appraisal Skills Programme tool and Mixed Methods Assessment Tool.Results: Twenty quantitative studies indicated that anxiety and depression led to a statistically significant increase in the likelihood of COPD patients being hospitalized. These comorbidities also led to an increased length of stay and a greater risk of mortality postdischarge. Other significant factors included lower Body-Mass Index, Airflow Obstruction, Dyspnea, and Exercise scores, female gender, lower socioeconomic status, poorer patient perceived quality of life, increased severity of lung function, and less improvement in dyspnea from admission to discharge. It was also highlighted that only 27%–33% of those with depression were being treated for it. Four qualitative studies revealed that patients saw anxiety and depression as a major factor that affected their ability to cope with and self-manage their condition.Implications: Findings from the systematic review have highlighted a need for better recognition and treatment of anxiety and depression amongst individuals with COPD. Ongoing research will develop and test strategies for promoting better management

  19. Validation of de-identified record linkage to ascertain hospital admissions in a cohort study

    Directory of Open Access Journals (Sweden)

    English Dallas R

    2011-04-01

    Full Text Available Abstract Background Cohort studies can provide valuable evidence of cause and effect relationships but are subject to loss of participants over time, limiting the validity of findings. Computerised record linkage offers a passive and ongoing method of obtaining health outcomes from existing routinely collected data sources. However, the quality of record linkage is reliant upon the availability and accuracy of common identifying variables. We sought to develop and validate a method for linking a cohort study to a state-wide hospital admissions dataset with limited availability of unique identifying variables. Methods A sample of 2000 participants from a cohort study (n = 41 514 was linked to a state-wide hospitalisations dataset in Victoria, Australia using the national health insurance (Medicare number and demographic data as identifying variables. Availability of the health insurance number was limited in both datasets; therefore linkage was undertaken both with and without use of this number and agreement tested between both algorithms. Sensitivity was calculated for a sub-sample of 101 participants with a hospital admission confirmed by medical record review. Results Of the 2000 study participants, 85% were found to have a record in the hospitalisations dataset when the national health insurance number and sex were used as linkage variables and 92% when demographic details only were used. When agreement between the two methods was tested the disagreement fraction was 9%, mainly due to "false positive" links when demographic details only were used. A final algorithm that used multiple combinations of identifying variables resulted in a match proportion of 87%. Sensitivity of this final linkage was 95%. Conclusions High quality record linkage of cohort data with a hospitalisations dataset that has limited identifiers can be achieved using combinations of a national health insurance number and demographic data as identifying variables.

  20. Borderline Personality Disorder and Posttraumatic Stress Disorder at Psychiatric Discharge Predict General Hospital Admission for Self-Harm.

    Science.gov (United States)

    Mellesdal, Liv; Gjestad, Rolf; Johnsen, Erik; Jørgensen, Hugo A; Oedegaard, Ketil J; Kroken, Rune A; Mehlum, Lars

    2015-12-01

    We investigated whether posttraumatic stress disorder (PTSD) was predictor of suicidal behavior even when adjusting for comorbid borderline personality disorder (BPD) and other salient risk factors. To study this, we randomly selected 308 patients admitted to a psychiatric hospital because of suicide risk. Baseline interviews were performed within the first days of the stay. Information concerning the number of self-harm admissions to general hospitals over the subsequent 6 months was retrieved through linkage with the regional hospital registers. A censored regression analysis of hospital admissions for self-harm indicated significant associations with both PTSD (β = .21, p treatment targets for a reduction in the risk of severe self-harm in high-risk psychiatric patients. PMID:26581019

  1. Admission Patterns and Outcomes of Paediatric Patients Admitted at the Diarrhea Unit of Muhimbili National Hospital (MNH )

    OpenAIRE

    Sanyiwa, John; Penza, Nuru

    2008-01-01

    To determine patterns of admissions due to diarrhea and their outcomes of paediatric patients at uhimbili National Hospital (MNH). A hospital-based prospective study including all children admitted to the Diarrhea Unit during the study period. Data was collected using content analysis checklists. Ethical clearance was sought from MNH and confidentiality in handling the information was observed. Data was analyzed using Epi-info 2002 statistical software. A total of 50 children were admitted d...

  2. The effect of testosterone and a nutritional supplement on hospital admissions in under-nourished, older people

    OpenAIRE

    Cameron Ian D; Hunter Peter; Naganathan Vasi; Visvanathan Renuka; Piantadosi Cynthia; Lange Kylie; Karnon Jonathan; Chapman Ian M

    2011-01-01

    Abstract Background Weight loss and under-nutrition are relatively common in older people, and are associated with poor outcomes including increased rates of hospital admissions and death. In a pilot study of 49 undernourished older, community dwelling people we found that daily treatment for one year with a combination of testosterone tablets and a nutritional supplement produced a significant reduction in hospitalizations. We propose a larger, multicentre study to explore and hopefully conf...

  3. Report of thirty one admissions due to adverse drug reactions inBo-Ali Sina hospital, Sari, Iran

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    Mohammad Reza Rafati

    2009-01-01

    Full Text Available , (Received 16 May, 2009 ; Accepted 8 July, 2009AbstractBackground and purpose: Adverse drug reactions (ADRs are one of the leading causes of morbidity and mortality, worldwide. Mortality rate due to ADRs are ahead of pulmonary disease, AIDS, pneumonia and automobile accidents. This study evaluated the admission rates in a University teaching hospital related to ADRs.Materials and methods: During this retrospective study between 2001 and 2007, all patients admitted due to adverse drug reaction in Sari Bo-Ali Sina Hospital were evaluated.Results: In these years, 31 patients out of 71,680 were admitted, due to ADRs. Most common ADRs were skin reaction (74% and fever (22%. Phenobarbital and penicillin were the most common drugs causing ADRs.Conclusion: Only 0.04% of hospital admissions were drug related, while reported admission due to ADRs in other countries were 2.4 to 6.2%. It appears that less drug-depended hospital admissions in Iran rational drug administration, but are due to lack of enough detection, records and reporting procedures.J Mazand Univ Med Sci 2009; 19(71: 67-70 (Persian.

  4. Predicting carriage with extended-spectrum beta-lactamase-producing bacteria at hospital admission : A cross-sectional study

    NARCIS (Netherlands)

    Platteel, T. N.; Leverstein-van Hall, M. A.; Cohen Stuart, J. W.; Thijsen, S. F T; Mascini, E. M.; van Hees, B. C.; Scharringa, J.; Fluit, A. C.; Bonten, M. J M

    2015-01-01

    The prevalence of patients colonized with extended-spectrum beta-lactamase (ESBL)-producing bacteria increases, especially in long-term-care facilities (LTCFs). Identification of ESBL carriers at hospital admission is relevant for infection control measures and antibiotic therapy for nosocomial infe

  5. Admissions for drug-related problems at the Emergency Department of a University Hospital in the Kingdom of Saudi Arabia

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    Mastour S Alghamdy

    2015-01-01

    Full Text Available Background and Aim: Medication Errors can result in drug-related problems (DRPs. Insight into the frequency, type, and severity of DRPs could help reduce their incidence. The aim of the present study was to estimate the prevalence of admissions as a result of DRPs at the Emergency Department (ED of a university hospital in the Kingdom of Saudi Arabia. Materials and Methods: Files of suspected cases of DRPs reporting to ED in the year 2012 were scrutinized. Suspicion arose from the hospital record system based on Diagnosis Code Numbers (ICD-9-CM, Professional 2010 and from triggers, such as some drugs, laboratory tests, and signs and symptoms pointing to DRPs. Results: Of 5574 admissions, 253 (4.5% were DRPs and were categorized as: Overdose toxicity and side effects of drugs 50 (19.8%, drug-interactions 29 (11.5%, accidental and suicidal drug ingestions 26 (10.3%, drug abuse 18 (7.1%, drug allergy 10 (4%, super-infections 8 (3.2%, and noncompliance to treatment 112 (44.3%. About 70% of DRPs were preventable; 67 (26.5% required hospital admission for 7-102 days and 10 (4% died. Conclusions: Noncompliance to treatment, overdose toxicity, drug interactions, and drug abuse are important causes of hospital admissions as a result of DRPs. Awareness of prescribers to the problem and their education would help to prevent them and improve patient care.

  6. Epidemiology of Hospital Admissions with Influenza during the 2013/2014 Northern Hemisphere Influenza Season: Results from the Global Influenza Hospital Surveillance Network.

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    Joan Puig-Barberà

    Full Text Available The Global Influenza Hospital Surveillance Network was established in 2012 to obtain valid epidemiologic data on hospital admissions with influenza-like illness. Here we describe the epidemiology of admissions with influenza within the Northern Hemisphere sites during the 2013/2014 influenza season, identify risk factors for severe outcomes and complications, and assess the impact of different influenza viruses on clinically relevant outcomes in at-risk populations.Eligible consecutive admissions were screened for inclusion at 19 hospitals in Russia, Turkey, China, and Spain using a prospective, active surveillance approach. Patients that fulfilled a common case definition were enrolled and epidemiological data were collected. Risk factors for hospitalization with laboratory-confirmed influenza were identified by multivariable logistic regression.5303 of 9507 consecutive admissions were included in the analysis. Of these, 1086 were influenza positive (534 A(H3N2, 362 A(H1N1, 130 B/Yamagata lineage, 3 B/Victoria lineage, 40 untyped A, and 18 untyped B. The risk of hospitalization with influenza (adjusted odds ratio [95% confidence interval] was elevated for patients with cardiovascular disease (1.63 [1.33-2.02], asthma (2.25 [1.67-3.03], immunosuppression (2.25 [1.23-4.11], renal disease (2.11 [1.48-3.01], liver disease (1.94 [1.18-3.19], autoimmune disease (2.97 [1.58-5.59], and pregnancy (3.84 [2.48-5.94]. Patients without comorbidities accounted for 60% of admissions with influenza. The need for intensive care or in-hospital death was not significantly different between patients with or without influenza. Influenza vaccination was associated with a lower risk of confirmed influenza (adjusted odds ratio = 0.61 [0.48-0.77].Influenza infection was detected among hospital admissions with and without known risk factors. Pregnancy and underlying comorbidity increased the risk of detecting influenza virus in patients hospitalized with influenza

  7. Epidemiology of Hospital Admissions with Influenza during the 2013/2014 Northern Hemisphere Influenza Season: Results from the Global Influenza Hospital Surveillance Network

    Science.gov (United States)

    Puig-Barberà, Joan; Natividad-Sancho, Angels; Trushakova, Svetlana; Sominina, Anna; Pisareva, Maria; Ciblak, Meral A.; Badur, Selim; Yu, Hongjie; Cowling, Benjamin J.; El Guerche-Séblain, Clotilde; Mira-Iglesias, Ainara; Kisteneva, Lidiya; Stolyarov, Kirill; Yurtcu, Kubra; Feng, Luzhao; López-Labrador, Xavier; Burtseva, Elena

    2016-01-01

    Background The Global Influenza Hospital Surveillance Network was established in 2012 to obtain valid epidemiologic data on hospital admissions with influenza-like illness. Here we describe the epidemiology of admissions with influenza within the Northern Hemisphere sites during the 2013/2014 influenza season, identify risk factors for severe outcomes and complications, and assess the impact of different influenza viruses on clinically relevant outcomes in at-risk populations. Methods Eligible consecutive admissions were screened for inclusion at 19 hospitals in Russia, Turkey, China, and Spain using a prospective, active surveillance approach. Patients that fulfilled a common case definition were enrolled and epidemiological data were collected. Risk factors for hospitalization with laboratory-confirmed influenza were identified by multivariable logistic regression. Findings 5303 of 9507 consecutive admissions were included in the analysis. Of these, 1086 were influenza positive (534 A(H3N2), 362 A(H1N1), 130 B/Yamagata lineage, 3 B/Victoria lineage, 40 untyped A, and 18 untyped B). The risk of hospitalization with influenza (adjusted odds ratio [95% confidence interval]) was elevated for patients with cardiovascular disease (1.63 [1.33–2.02]), asthma (2.25 [1.67–3.03]), immunosuppression (2.25 [1.23–4.11]), renal disease (2.11 [1.48–3.01]), liver disease (1.94 [1.18–3.19], autoimmune disease (2.97 [1.58–5.59]), and pregnancy (3.84 [2.48–5.94]). Patients without comorbidities accounted for 60% of admissions with influenza. The need for intensive care or in-hospital death was not significantly different between patients with or without influenza. Influenza vaccination was associated with a lower risk of confirmed influenza (adjusted odds ratio = 0.61 [0.48–0.77]). Conclusions Influenza infection was detected among hospital admissions with and without known risk factors. Pregnancy and underlying comorbidity increased the risk of detecting influenza

  8. The effect of temperature on cardiovascular disease hospital admissions among elderly people in Thai Nguyen Province, Vietnam

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    Pham Ngan Giang

    2014-12-01

    Full Text Available Background: Projected increases in weather variability due to climate change will have severe consequences on human health, increasing mortality, and disease rates. Among these, cardiovascular diseases (CVD, highly prevalent among the elderly, have been shown to be sensitive to extreme temperatures and heat waves. Objectives: This study aimed to find out the relationship between daily temperature (and other weather parameters and daily CVD hospital admissions among the elderly population in Thai Nguyen province, a northern province of Vietnam. Methods: Retrospective data of CVD cases were obtained from a data base of four hospitals in Thai Nguyen province for a period of 5 years from 2008 to 2012. CVD hospital admissions were aggregated by day and merged with daily weather data from this period. Distributed lag non-linear model (DLNM was used to derive specific estimates of the effect of weather parameters on CVD hospital admissions of up to 30 days, adjusted for time trends using b-splines, day of the week, and public holidays. Results: This study shows that the average point of minimum CVD admissions was at 26°C. Above and below this threshold, the cumulative CVD admission risk over 30 lag days tended to increase with both lower and higher temperatures. The cold effect was found to occur 4–15 days following exposure, peaking at a week's delay. The cumulative effect of cold exposure on CVD admissions was statistically significant with a relative risk of 1.12 (95% confidence interval: 1.01–1.25 for 1°C decrease below the threshold. The cumulative effect of hot temperature on CVD admissions was found to be non-significant and was estimated to be at a relative risk of 1.17 (95% confidence interval: 0.90–1.52 for 1°C increase in the temperature. No significant association was found between CVD admissions and the other weather variables. Conclusion: Exposure to cold temperature is associated with increasing CVD admission risk among the

  9. Association between air pollution and daily mortality and hospital admission due to ischaemic heart diseases in Hong Kong

    Science.gov (United States)

    Tam, Wilson Wai San; Wong, Tze Wai; Wong, Andromeda H. S.

    2015-11-01

    Ischaemic heart disease (IHD) is one of the leading causes of death worldwide. The effects of air pollution on IHD mortalities have been widely reported. Fewer studies focus on IHD morbidities and PM2.5, especially in Asia. To explore the associations between short-term exposure to air pollution and morbidities and mortalities from IHD, we conducted a time series study using a generalized additive model that regressed the daily numbers of IHD mortalities and hospital admissions on daily mean concentrations of the following air pollutants: nitrogen dioxide (NO2), particulate matter with an aerodynamic diameter less than 10 μm (PM10), particulate matter with an aerodynamic diameter less than 2.5 μm (PM2.5), ozone (O3), and sulfur dioxide (SO2). The relative risks (RR) of IHD deaths and hospital admissions per 10 μg/m3 increase in the concentration of each air pollutant were derived in single pollutant models. Multipollutant models were also constructed to estimate their RRs controlling for other pollutants. Significant RRs were observed for all five air pollutants, ranging from 1.008 to 1.032 per 10 μg/m3 increase in air pollutant concentrations for IHD mortality and from 1.006 to 1.021 per 10 μg/m3 for hospital admissions for IHD. In the multipollutant model, only NO2 remained significant for IHD mortality while SO2 and PM2.5 was significantly associated with hospital admissions. This study provides additional evidence that mortalities and hospital admissions for IHD are significantly associated with air pollution. However, we cannot attribute these health effects to a specific air pollutant, owing to high collinearity between some air pollutants.

  10. Non-Polio Enteroviruses Aseptic Meningitis:Embaba Fever Hospital Admissions 2010-2011

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    Raafat A. Abdel-Twab¹, Kouka S. Abdel-Wahab2. Ahmed O. El-Kafrawi3, Moustafa A. Aly3, Laila A. EL-Bassiony4, May EL-Maamoun4, Caroline Fayez5

    2013-07-01

    Full Text Available Human enteroviruses (EV cause a wide spectrum of both common and uncommon illnesses among all age groups. Enterically transmitted. The objective of this study was to identify non-poliovirus EV as a cause of viral aseptic meningitis (VAM by two methods (cell culture and Real time PCR. From October 2010 to August 2011 cerebrospinal fluid (CSF samples were collected from 85 patients Embaba fever hospital admitted with symptoms of aseptic meningitis of any age and both sexes. The 85 CSF samples were inoculated into RD (human rhabdomyosarcoma cell line in three blind passages to amplify isolates producing EV-like CPE. A total of 14 (16.5% out of 85 CSF samples showed EV-like CPE. By Real time PCR 11 out of the 14 culture positive samples and 5 out of the 14 source of virus isolation original CSF were non polio EV positive. The frequency of non-polio EV meningitis hospital admissions was in the summer season (50%, spring (25%, late autumn (16.6% and least frequency in winter (8.4%. non-polio EV meningitis was detected in 6 out of 41 male patients (14.5% and in 6 out of 44 female patients (13.5%. Also non-polio EV meningitis was detected in all ages with marked increase of incidence in young children (41.6% and old age (50% and less in adult (8.4%. . In conclusionOur data showed that the non-polioviruses EV was associated with the majority of VAM during 2010 – 2011 at the Embaba fever hospital which serves Embaba, Shoubra Elkheema, Qualyba and neighbors localities in Egypt. Rapid detection of non-polio EV meningitis is essential for making decisions about patient management and treatment

  11. Delay in admission for elective coronary-artery bypass grafting is associated with increased in-hospital mortality

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    Levy Adrian R

    2008-09-01

    Full Text Available Abstract Background Many health care systems now use priority wait lists for scheduling elective coronary artery bypass grafting (CABG surgery, but there have not yet been any direct estimates of reductions in in-hospital mortality rate afforded by ensuring that the operation is performed within recommended time periods. Methods We used a population-based registry to identify patients with established coronary artery disease who underwent isolated CABG in British Columbia, Canada. We studied whether postoperative survival during hospital admission for CABG differed significantly among patients who waited for surgery longer than the recommended time, 6 weeks for patients needing semi-urgent surgery and 12 weeks for those needing non-urgent surgery. Results Among 7316 patients who underwent CABG, 97 died during the same hospital admission, for a province-wide death rate at discharge of 1.3%. The observed proportion of patients who died during the same admission was 1.0% (27 deaths among 2675 patients for patients treated within the recommended time and 1.5% (70 among 4641 for whom CABG was delayed. After adjustment for age, sex, anatomy, comorbidity, calendar period, hospital, and mode of admission, patients with early CABG were only 2/3 as likely as those for whom CABG was delayed to experience in-hospital death (odds ratio 0.61; 95% confidence interval [CI] 0.39 to 0.96. There was a linear trend of 5% increase in the odds of in-hospital death for every additional month of delay before surgery, adjusted OR = 1.05 (95% CI 1.00 to 1.11. Conclusion We found a significant survival benefit from performing surgical revascularization within the time deemed acceptable to consultant surgeons for patients requiring the treatment on a semi-urgent or non-urgent basis.

  12. [Cognitive Behavioral Therapy and Assertive Community Treatment Reduces Days in Hospital and Delays Hospital Admission in Severe Psychotic Disorders].

    Science.gov (United States)

    Müller, H; Haag, I; Jessen, F; Kim, E H; Klaus, J; Konkol, C; Bechdolf, A

    2016-02-01

    The primary aim of this study was to assess the effectiveness of integrated home treatment (IV, i. e. intensive cognitive behavioral therapy and pharmacotherapy provided within a framework of assertive community treatment) in individuals with severe mental disorders (n = 13) within the German healthcare system. A treatment-as-usual group (TAU, n = 13) was identified by propensity score matching. Symptoms (CGI), functioning (GAF) and service engagement (SES) were assessed. Quality of life (MSLQ-R) was rated by the IV patients. A reduction of days spent in hospital [IV: 2.3 (6.1); TAU: 33.6 (53.6); Z = 45; p = 0.044], time to admission (IV: 384 days 95 % CI 309 - 459.1; TAU: 234.9 days 95 % CI 127.2 - 342.5; log rank: Chi-square = 4.31, p methodological limitation is that symptom ratings were not performed by independent and blinded raters. PMID:26953546

  13. Hospital admissions in children with down syndrome: experience of a population-based cohort followed from birth.

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    Patrick Fitzgerald

    Full Text Available OBJECTIVE: Children with Down syndrome, the most common genetic cause of intellectual disability, are prone to multiple and varied health-related problems. This study describes patterns of hospitalisations for children and young people with Down syndrome in Western Australia. METHODS: Birth records were linked to the Western Australian population-based Intellectual Disability database to identify all children born with Down syndrome in Western Australia between 1 January, 1983 and 31 December, 1999. These records were linked to the Hospital Morbidity Data System to provide information on all hospitalisations up to 31 December, 2004. Hospitalisation data, coded using ICD-9CM or ICD-10 (v0.5 were grouped into clinically relevant categories using the primary diagnosis. Rates of hospital admission for all and specific diagnoses were expressed in 1000-person-years at-risk and median age at first admission and length of stay were calculated. RESULTS: Of the 405 children, 395 had one or more hospital admissions, totalling 3786 admissions for all children and an estimated 39.5 person-years in hospital. On average, children were admitted 9.7 times, with an estimated rate of 757.2 admissions per 1000pyr (95% CI: 680, 843. A quarter of all admissions occurred in the first year of life. The average hospital length of stay was 3.8 days (95% CI: 3.7, 4.1. Upper respiratory tract conditions affected the most children (58.5% and accounted for 12.1% of all admissions. Other disorders which affected a high percentage of children were ear/hearing conditions (50.6%, disorders of the oral cavity (38.0% and lower respiratory tract conditions (37.5%. Overall, children with Down syndrome were hospitalised at a rate five times (95% CI = 4.3-6.2 that of the general population. CONCLUSION: Children with Down syndrome are at increased risk of morbidity for varied causes underlining the importance of comprehensive and targeted primary care for this group.

  14. Alcohol and cardio-respiratory deaths in Chinese: a population-based case-control study of 32,462 older Hong Kong adults

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    Mak Kwok

    2009-02-01

    Full Text Available Abstract Background In observational studies moderate alcohol use reduces cardio-respiratory mortality. However observational studies may be biased by many factors including residual confounding by unmeasured differences between moderate alcohol users and other groups or by changes in alcohol use with ill-health and aging. We used two different analytic strategies in an under-studied population, i.e. southern Chinese, to provide an assessment of the specific impact of moderate alcohol use on mortality from ischemic heart disease (IHD and chronic obstructive pulmonary diseases (COPD. Methods In a population-based case-control study of all adult deaths in Hong Kong Chinese in 1998, we used adjusted logistic regression to compare alcohol use in decedents aged ≥ 60 years from IHD (2270 and COPD (1441 with 10,320 living and 9043 dead controls (all non-alcohol related deaths. We also examined whether the association of alcohol use with death from IHD or COPD varied with sex or smoking status. Results Using living controls and adjusted for age, socio-economic status and lifestyle, occasional and moderate alcohol use were generally associated with lower mortality from IHD and COPD. However, using dead controls the protection of occasional and moderate alcohol use appeared to be limited to ever-smokers for IHD (odds ratio (OR 0.58, 95% confidence interval (CI 0.46 to 0.73 for moderate compared to never-use in ever-smokers, but OR 1.07, 95% CI 0.76 to 1.50 in never-smokers, and possibly to men for COPD. High alcohol use was associated with lower IHD mortality and possibly with lower COPD mortality. Conclusion High levels of alcohol use in an older Chinese population were associated with lower IHD mortality. Moderate alcohol use was less consistently protective against IHD mortality. Alcohol use was associated with lower COPD mortality particularly in men, either due to some yet to be clarified properties of alcohol or as the artefactual result of

  15. Hospital admission following induced abortion in Eastern Highlands Province, Papua New Guinea--a descriptive study.

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    Lisa M Vallely

    Full Text Available In Papua New Guinea abortion is restricted under the Criminal Code Act. While safe abortions should available in certain situations, frequently they are not available to the majority of women. Sepsis from unsafe abortion is a leading cause of maternal mortality. Our findings form part of a wider, mixed methods study designed to identify complications requiring hospital treatment for post abortion care and to explore the circumstances surrounding unsafe abortion.Through a six month prospective study we identified all women presenting to the Eastern Highlands Provincial Hospital following spontaneous and induced abortions. We undertook semi-structured interviews with women and reviewed individual case notes, extracting demographic and clinical information.Case notes were reviewed for 56% (67/119 of women presenting for post abortion care. At least 24% (28/119 of these admissions were due to induced abortion. Women presenting following induced abortions were significantly more likely to be younger, single, in education at the time of the abortion and report that the baby was unplanned and unwanted, compared to those reporting spontaneous abortion. Obtained illegally, misoprostol was the method most frequently used to end the pregnancy. Physical and mechanical means and traditional herbs were also widely reported.In a country with a low contraceptive prevalence rate and high unmet need for family planning, all reproductive age women need access to contraceptive information and services to avoid, postpone or space pregnancies. In the absence of this, women are resorting to unsafe means to end an unwanted pregnancy, putting their lives at risk and putting an increased strain on an already struggling health system. Women in this setting need access to safe, effective means of abortion.

  16. Increased risk of emergency hospital admissions for children with renal diseases during heatwaves in Brisbane, Australia

    Institute of Scientific and Technical Information of China (English)

    Xiao-Yu Wang; Adrian Barnett; Yu-Ming Guo; Wei-Wei Yu; Xiao-Ming Shen; Shi-Lu Tong

    2014-01-01

    Background: Heatwaves have a significant impact on population health including both morbidity and mortality. In this study we examined the association between heatwaves and emergency hospital admissions (EHAs) for renal diseases in children (aged 0-14 years) in Brisbane, Australia. Methods: Daily data on EHAs for renal diseases in children and exposure to temperature and air pollution were obtained for Brisbane city from January 1, 1996 to December 31, 2005. A time-stratified case-crossover design was used to compare the risks for renal diseases between heatwave and non-heatwave periods. Results: There were 1565 EHAs for renal diseases in children during the study period. Heatwaves exhibited a signifi cant impact on EHAs for renal diseases in children after adjusting for confounding factors (odds ratio: 3.6; 95% confidence interval: 1.4-9.5). The risk estimates differed with lags and the use of different heatwave defi nitions. Conclusions: There was a significant increase in EHAs for renal diseases in children during heatwaves in Brisbane, a subtropical city where people are well accustomed to warm weather. This finding may have significant implications for pediatric renal care, particularly in subtropical and tropical regions.

  17. Length of Hospital Stay Prediction at the Admission Stage for Cardiology Patients Using Artificial Neural Network

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    Pei-Fang (Jennifer Tsai

    2016-01-01

    Full Text Available For hospitals’ admission management, the ability to predict length of stay (LOS as early as in the preadmission stage might be helpful to monitor the quality of inpatient care. This study is to develop artificial neural network (ANN models to predict LOS for inpatients with one of the three primary diagnoses: coronary atherosclerosis (CAS, heart failure (HF, and acute myocardial infarction (AMI in a cardiovascular unit in a Christian hospital in Taipei, Taiwan. A total of 2,377 cardiology patients discharged between October 1, 2010, and December 31, 2011, were analyzed. Using ANN or linear regression model was able to predict correctly for 88.07% to 89.95% CAS patients at the predischarge stage and for 88.31% to 91.53% at the preadmission stage. For AMI or HF patients, the accuracy ranged from 64.12% to 66.78% at the predischarge stage and 63.69% to 67.47% at the preadmission stage when a tolerance of 2 days was allowed.

  18. Air pollution and hospital emergency room admissions for chronic obstructive pulmonary disease in Valencia, Spain.

    Science.gov (United States)

    Tenías, José Maria; Ballester, Ferran; Pérez-Hoyos, Santiago; Rivera, María Luisa

    2002-01-01

    The short-term relationship between levels of air pollution and emergency room admissions for chronic obstructive pulmonary disease was assessed in Valencia, Spain. The design was an ecological time-series study in which daily variation in air pollution was related to emergency chronic obstructive pulmonary disease visits to one of the city's hospitals. The pollutants under investigation were Black Smoke, sulfur dioxide, nitrogen dioxide, carbon monoxide, and ozone. The degree of association was analyzed with Poisson autoregressive regression, for which trend, seasonal patterns, temperature, humidity, days of the week, and incidence of influenza were controlled. Increases of 10 microg/m3 in ozone levels (lag 5) and of 1 mg/m3 in carbon monoxide (lag 1) were associated with increases of 6.1% (95% confidence interval [CI] = 2.2%, 10.1%) and of 3.9% (95% CI = 1.4%, 6.6%), respectively, in the expected chronic obstructive pulmonary disease cases. There was no significant association for the remainder of the pollutants. The described effects persisted even when the authors used models of differing specifications and when generalized additive models were used. The authors concluded that the results of this investigation, together with results of earlier research, demonstrate the significant effect of pollution on various health indicaors within Valencia. PMID:12071359

  19. Validity of the International Classification of Diseases 10th revision code for hyperkalaemia in elderly patients at presentation to an emergency department and at hospital admission

    OpenAIRE

    Fleet, Jamie L; Shariff, Salimah Z; Gandhi, Sonja; Matthew A Weir; Jain, Arsh K; Garg, Amit X.

    2012-01-01

    Objectives Evaluate the validity of the International Classification of Diseases, 10th revision (ICD-10) code for hyperkalaemia (E87.5) in two settings: at presentation to an emergency department and at hospital admission. Design Population-based validation study. Setting 12 hospitals in Southwestern Ontario, Canada, from 2003 to 2010. Participants Elderly patients with serum potassium values at presentation to an emergency department (n=64 579) and at hospital admission (n=64 497). Primary o...

  20. Adverse Drug Reactions Causing Admission to Medical Wards: A Cross-Sectional Survey at 4 Hospitals in South Africa.

    Science.gov (United States)

    Mouton, Johannes P; Njuguna, Christine; Kramer, Nicole; Stewart, Annemie; Mehta, Ushma; Blockman, Marc; Fortuin-De Smidt, Melony; De Waal, Reneé; Parrish, Andy G; Wilson, Douglas P K; Igumbor, Ehimario U; Aynalem, Getahun; Dheda, Mukesh; Maartens, Gary; Cohen, Karen

    2016-05-01

    Limited data exist on the burden of serious adverse drug reactions (ADRs) in sub-Saharan Africa, which has high HIV and tuberculosis prevalence. We determined the proportion of adult admissions attributable to ADRs at 4 hospitals in South Africa. We characterized drugs implicated in, risk factors for, and the preventability of ADR-related admissions.We prospectively followed patients admitted to 4 hospitals' medical wards over sequential 30-day periods in 2013 and identified suspected ADRs with the aid of a trigger tool. A multidisciplinary team performed causality, preventability, and severity assessment using published criteria. We categorized an admission as ADR-related if the ADR was the primary reason for admission.There were 1951 admissions involving 1904 patients: median age was 50 years (interquartile range 34-65), 1057 of 1904 (56%) were female, 559 of 1904 (29%) were HIV-infected, and 183 of 1904 (10%) were on antituberculosis therapy (ATT). There were 164 of 1951 (8.4%) ADR-related admissions. After adjustment for age and ATT, ADR-related admission was independently associated (P ≤ 0.02) with female sex (adjusted odds ratio [aOR] 1.51, 95% confidence interval [95% CI] 1.06-2.14), increasing drug count (aOR 1.14 per additional drug, 95% CI 1.09-1.20), increasing comorbidity score (aOR 1.23 per additional point, 95% CI 1.07-1.41), and use of antiretroviral therapy (ART) if HIV-infected (aOR 1.92 compared with HIV-negative/unknown, 95% CI 1.17-3.14). The most common ADRs were renal impairment, hypoglycemia, liver injury, and hemorrhage. Tenofovir disoproxil fumarate, insulin, rifampicin, and warfarin were most commonly implicated, respectively, in these 4 ADRs. ART, ATT, and/or co-trimoxazole were implicated in 56 of 164 (34%) ADR-related admissions. Seventy-three of 164 (45%) ADRs were assessed as preventable.In our survey, approximately 1 in 12 admissions was because of an ADR. The range of ADRs and implicated drugs reflect South Africa's high HIV

  1. Atmospheric particulate matter and hospital admission due to lower respiratory tract infection: a case-cross study in Shijiazhuang, China

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    Zi-na BAI

    2016-03-01

    Full Text Available Objective  To explore the association between atmospheric particulate matter (PM10/PM2.5 levels and hospital admissions due to lower respiratory tract infection in Shijiazhuang. Methods  Data of air pollution, meteorologic data, and the data of patients admitted to hospital due to lower respiratory tract infection were retrospectively analyzed. Pearson's correlation coefficients were calculated to analyze correlations between atmospheric particulate matter and meteorologic factors. Data of hospital admission due to lower respiratory tract infection and of atmospheric air pollution levels in Shijiazhuang were obtained, a bidirectional case-crossover design was used to investigate the association between hospital admissions due to lower respiratory tract infection and levels of atmospheric particles. Stratified analyses of exposure based on age, gender, complications and season were performed to evaluate the effect. Results  Pearson's correlation analysis showed positive correlations among PM2.5, PM10, SO2, NO2 and CO. The concentration of all these five pollutants were negatively correlated with O3 and daily mean temperature, while a positive correlation was found between concentrations of the 5 pollutants and daily average temperature and O3. In single-pollutant model, every 10μg/m3 increase in PM2.5 and PM10 at lag5 brought the corresponding OR values (95%CI up to 1.010(1.005-1.015 and 1.006(1.003-1.009 respectively. In the multi-pollutant models, the observed effects of PM2.5 remained significant. Stratified analysis based on gender, age, season and comorbidities showed that the effect of PM2.5 exposure on lower respiratory tract infection admissions was stronger in males, persons younger than 60 years of age and persons without comorbidities, and even more stronger in cold season. The effect of PM10 exposure on lower respiratory tract infection admissions was stronger in females, persons older than 60 years of age and persons with

  2. Regular physical activity reduces hospital admission and mortality in chronic obstructive pulmonary disease: a population based cohort study

    DEFF Research Database (Denmark)

    Garcia-Aymerich, J; Lange, Peter; Benet, M; Schnohr, P; Antó, J M

    2006-01-01

    BACKGROUND: Information about the influence of regular physical activity on the course of chronic obstructive pulmonary disease (COPD) is scarce. A study was undertaken to examine the association between regular physical activity and both hospital admissions for COPD and all-cause and specific...... mortality in COPD subjects. METHODS: From a population-based sample recruited in Copenhagen in 1981-3 and 1991-4, 2386 individuals with COPD (according to lung function tests) were identified and followed until 2000. Self-reported regular physical activity at baseline was classified into four categories....... RESULTS: After adjustment for relevant confounders, subjects reporting low, moderate or high physical activity had a lower risk of hospital admission for COPD during the follow up period than those who reported very low physical activity (incidence rate ratio 0.72, 95% confidence interval (CI) 0.53 to 0...

  3. PM[sub 10] ozone, and hospital admissions for the elderly in Minneapolis-St. Paul, Minnesota

    Energy Technology Data Exchange (ETDEWEB)

    Schwartz, J. (Harvard School of Public Health, Boston, MA (United States))

    Several recent studies have reported associations between airborne particles and/or ozone and hospital admissions for respiratory disease. PM[sub 10] has rarely been used as the particle exposure measure, however. This study examined whether such an association could be seen in Minneapolis-St. Paul, Minnesota, which has daily monitoring data for PM[sub 10]. Data on hospital admissions in persons aged 65 y and older were obtained from Medicare records for the years 1986 through 1989. Daily counts of admissions, by admit date, were computed for pneumonia (ICD9 480-487) and chronic obstructive pulmonary disease (COPD) (ICD9 490-496). Classification was by discharge diagnosis. Daily air pollution data from all monitoring stations for ozone and PM[sub 10] in Minneapolis-St. Paul were obtained, and the daily average for each pollutant was computed. An average of approximately six pneumonia admissions and two admissions for chronic obstructive pulmonary disease occurred each day. Poisson regression analysis was used to control for time trends, seasonal fluctuations, and weather. PM[sub 10] was a risk factor for pneumonia admissions (relative risk [RR] = 1.17, 95% confidence interval [CI] = 1.33-1.02) and COPD admissions (RR = 1.57, 95% CI = 2.06-1.20). Ozone was also associated with pneumonia admissions (RR = 1.15, 95% CI = 1.36-0.97). The relative risks are for an increase of 100 [mu]g/m[sup 3] in daily PM[sub 10] and 50 ppb in daily ozone concentration. Several alternative methods for controlling for seasonal patterns and weather were used, including nonparametric regression techniques. The results were not sensitive to the methods. When days exceeding the National Ambient Air Quality Standard for either pollutant were excluded, the association remained for both pneumonia (RR = 1.18, 95% CI = 1.34-1.03 for PM[sub 10] and RR = 1.18, 95% CI = 1.41-0.99 for ozone) and COPD (RR = 1.54, 95% CI = 2.06-1.16 for PM[sub 10]). 48 refs., 6 figs., 5 tabs.

  4. The effects of daily weather variables on psychosis admissions to psychiatric hospitals.

    LENUS (Irish Health Repository)

    McWilliams, Stephen

    2012-08-02

    Several studies have noted seasonal variations in admission rates of patients with psychotic illnesses. However, the changeable daily meteorological patterns within seasons have never been examined in any great depth in the context of admission rates. A handful of small studies have posed interesting questions regarding a potential link between psychiatric admission rates and meteorological variables such as environmental temperature (especially heat waves) and sunshine. In this study, we used simple non-parametric testing and more complex ARIMA and time-series regression analysis to examine whether daily meteorological patterns (wind speed and direction, barometric pressure, rainfall, sunshine, sunlight and temperature) exert an influence on admission rates for psychotic disorders across 12 regions in Ireland. Although there were some weak but interesting trends for temperature, barometric pressure and sunshine, the meteorological patterns ultimately did not exert a clinically significant influence over admissions for psychosis. Further analysis is needed.

  5. Relation between admission blood glucose levels and in-hospital and one year mortality in non-diabetic acute myocardial infarction patients

    OpenAIRE

    A Andishmand; MH Soltani; Emami, M; Shariat, N; L. Bahadorzadeh; M Rafiei; M Sadr-Bafghi; M Motafaker; Namayandeh, M.

    2006-01-01

    Introduction: Several studies have evaluated the association of admission blood glucose levels and short and long term mortality after myocardial infarction and have had different results. The aim of this study was evaluation of association between admission blood glucose levels and in-hospital and one year mortality in non-diabetic patients with AMI. Methods: In this study, demographic, clinical and Para clinical data of 120 non-diabetic patients with AMI on admission was collected and analy...

  6. Identifying patients harboring extended-spectrum-beta-lactamase-producing Enterobacteriaceae on hospital admission: derivation and validation of a scoring system.

    Science.gov (United States)

    Tumbarello, Mario; Trecarichi, Enrico Maria; Bassetti, Matteo; De Rosa, Francesco Giuseppe; Spanu, Teresa; Di Meco, Eugenia; Losito, Angela Raffaella; Parisini, Andrea; Pagani, Nicole; Cauda, Roberto

    2011-07-01

    Increases in community-acquired infections caused by extended-spectrum-β-lactamase (ESBL)-producing Enterobacteriaceae have important implications for hospital infection control and empirical antibiotic therapy protocols. We developed and validated a tool for identifying patients harboring these organisms at hospital admission. We retrospectively analyzed chart data for 849 adult inpatients. The derivation cohort included 339 patients admitted to a large hospital in Rome during 2008, with (n = 113) or without (n = 226) culture positivity for ESBL-producing Escherichia coli, Klebsiella spp., or Proteus mirabilis within 48 h after admission. Logistic-regression-based prediction scores were calculated based on variables independently associated with the outcome. The model was validated in a second cohort (n = 510) selected with identical criteria in hospitals in Genoa and Turin during 2009. Prediction scores were based on the following six variables (reported with odds ratio for study outcome and the 95% confidence intervals in brackets): recent (≤ 12 months before admission) hospitalization (5.69 [2.94 to 10.99]), transfer from another health care facility (5.61 [1.65 to 19.08]), Charlson comorbidity score ≥ 4 (3.80 [1.90 to 7.59]), recent (≤ 3 months before admission) β-lactam and/or fluoroquinolone treatment (3.68 [1.96 to 6.91]), recent urinary catheterization (3.52 [1.96 to 6.91]), and age ≥ 70 years (3.20 [1.79 to 5.70]). The model displayed good calibration and good-to-excellent discrimination in the derivation and validation sets (Hosmer-Lemshow χ(2) = 15.28 and 14.07; P = 0.17 and 0.23; areas under the receiver-operating characteristic curve, 0.83 and 0.92). It reliably identified patients likely to be harboring ESBL-producing Enterobacteriaceae at hospital admission who may need special infection control measures. Further study is needed to confirm this model's potential as a guide for prescribing empirical antibiotic therapy. PMID:21537020

  7. Survival to admission after out-of-hospital cardiac arrest in Seoul, South Korea

    Directory of Open Access Journals (Sweden)

    Kim JH

    2014-09-01

    Full Text Available Jin-Hue Kim,1 Tai-Hwan Uhm2 1Department of Emergency Medical Technology, Sun Moon University, Asan-si, Chungnam, South Korea; 2Department of Emergency Medical Services, Eulji University, Seongnam-si, Gyeonggi-do, South Korea Purpose: Out-of-hospital cardiac arrest (OHCA data derived according to the Utstein Style guidelines was used to try to determine factors influencing survival to admission (STA and epidemiological rates of OHCA. Patients and methods: This was an observational study of all age groups based on data from prehospital care reports in Seoul, South Korea. The collected data were reported according to the Utstein Style template for OHCA and analyzed in order to compare STA with non-STA. Univariate analysis was conducted using a binomial logistic regression model to identify predictors associated with trauma patients. Results: Eighty-three (4.8% OHCA survivors were admitted to the emergency department with carotid pulse. The median time from arrest to emergency medical personnel defibrillation was statistically significantly shorter in STA cases (8.0 minutes than in non-STA cases (12.0 minutes; P<0.001. Factors independently associated with better prognosis in terms of trauma patients were female sex (odds ratio [OR]: 0.67; 95% confidence interval [95% CI]: 0.50–0.91; P=0.01, arrest at home (OR: 0.36; 95% CI: 0.27–0.49; P<0.001, and witnessed arrest (OR: 2.64; 95% CI: 1.94–3.39; P<0.001. Conclusion: Early basic life support, performed by either a layperson or emergency medical personnel, had a positive effect on STA. Male sex, arrest outside of the home, and witnessed arrest are significantly associated with trauma. Keywords: Utstein Style, prehospital, defibrillation, basic life support

  8. Fatores associados às internações hospitalares no Brasil Analysis of hospital admissions associated factors in Brazil

    Directory of Open Access Journals (Sweden)

    Mônica Silva Monteiro de Castro

    2002-01-01

    Full Text Available O objetivo foi identificar fatores associados às admissões hospitalares no Brasil, analisando se essa utilização é eqüitativa e identificando características associadas aos grandes usuários. A PNAD/1998 foi analisada, utilizando regressão logística e regressão logística multinomial, com pesos normalizados e técnicas estatísticas para correção do efeito de desenho. O modelo teórico utilizado foi o Comportamental de Andersen. No modelo ajustado por necessidade de saúde e fatores capacitantes, pessoas com menor renda apresentaram maior chance de se internar; o contrário ocorreu no modelo ajustado somente por necessidade de saúde. Todas as variáveis de necessidade mostraram-se menos relacionadas ao uso nas pessoas com duas internações, em comparação com aquelas com mais do que duas internações. Não houve associação entre variáveis sociais e ocorrência de duas internações, mas essa associação ocorreu para três ou mais internações. A redução das desigualdades sociais nos aspectos que "capacitam" ao uso de admissões hospitalares reduziria as desigualdades neste uso. Um sistema de saúde que ofereça um "serviço de uso regular", além de baixo ou nenhum pagamento no ato do consumo, seriam medidas de impacto positivo na eqüidade do consumo de serviços hospitalares no Brasil.The objective was to identify hospital admission associated factors in Brazil, analyzing if that utilization is equitable and identifying which characteristics are associated with heavy users. We analyzed data from the 1998 National Household Survey, using logistic regression and multinomial logistic regression, with normalized weights and statistical techniques to correct for design effect. We used Andersen's Behavioral Model as the theoretical model for this analysis. In model adjusted for health needs and enabling factors, people with smaller income had more chance of being admitted to hospital; and in model adjusted only for health

  9. Incidence and Predictors of 30-Day Hospital Re-Admission Rate Following Percutaneous Coronary Intervention (From the National Heart, Lung, and Blood Institute Dynamic Registry)

    Science.gov (United States)

    Ricciardi, Mark J.; Selzer, Faith; Marroquin, Oscar C.; Holper, Elizabeth M.; Venkitachalam, Lakshmi; Williams, David O.; Kelsey, Sheryl F.; Laskey, Warren K.

    2012-01-01

    Post-discharge outcomes following percutaneous coronary intervention (PCI) are important measures of quality of care and complement in-hospital measures. We sought to assess in-hospital and post-discharge PCI outcomes to 1) better understand the relationship between acute and 30 day outcomes, 2) identify predictors of 30-day hospital re-admission, and 3) determine the prognostic significance of 30-day hospital readmission. We analyzed in-hospital death and length of stay (LOS) and non-elective cardiac-related re-hospitalization following discharge in 10,965 patients following PCI in the Dynamic Registry. From 1999–2006, in-hospital death rate and LOS declined. The 30-day cardiac re-admission rate was 4.6%, with considerable variability over time and among hospitals. The risk of re-hospitalization was greater in women, those with CHF, unstable angina, multiple lesions and emergency PCI. Conversely, a lower risk of re-hospitalization was associated with a higher number of treated lesions. Patients re-admitted within 30 days had higher one-year mortality than those free from hospital readmission. In conclusion, while in-hospital mortality and LOS following PCI have decreased over time, the observed 30 day cardiac re-admission rate was highly variable and the risk of re-admission was more closely associated with underlying patient characteristics than procedural characteristics. PMID:22853982

  10. Incidence and Predictors of 30-Day Hospital Re-Admission Rate Following Percutaneous Coronary Intervention (From the National Heart, Lung, and Blood Institute Dynamic Registry)

    OpenAIRE

    Ricciardi, Mark J.; Selzer, Faith; Marroquin, Oscar C.; Holper, Elizabeth M.; Venkitachalam, Lakshmi; Williams, David O; Kelsey, Sheryl F.; Laskey, Warren K.

    2012-01-01

    Post-discharge outcomes following percutaneous coronary intervention (PCI) are important measures of quality of care and complement in-hospital measures. We sought to assess in-hospital and post-discharge PCI outcomes to 1) better understand the relationship between acute and 30 day outcomes, 2) identify predictors of 30-day hospital re-admission, and 3) determine the prognostic significance of 30-day hospital readmission. We analyzed in-hospital death and length of stay (LOS) and non-electiv...

  11. Effects of Italian smoking regulation on rates of hospital admission for acute coronary events: a country-wide study.

    Directory of Open Access Journals (Sweden)

    Francesco Barone-Adesi

    Full Text Available BACKGROUND: Several studies have reported a reduction in acute coronary events (ACEs in the general population after the enforcement of smoking regulations, although there is uncertainty concerning the magnitude of the effect of such interventions. We conducted a country-wide evaluation of the health effects of the introduction of a smoking ban in public places, using data on hospital admissions for ACEs from the Italian population after the implementation of a national smoking regulation in January 2005. METHODS AND FINDINGS: Rates of admission for ACEs in the 20 Italian regions from January 2002 to November 2006 were analysed using mixed-effect regression models that allowed for long-term trends and seasonality. Standard methods for interrupted time-series were adopted to assess the immediate and gradual effects of the smoking ban. Effect modification by age was investigated, with the assumption that exposure to passive smoking in public places would be greater among young people. In total, 936,519 hospital admissions for ACEs occurred in the Italian population during the study period. A 4% reduction in hospital admissions for ACEs among persons aged less than 70 years was evident after the introduction of the ban (Rate Ratio [RR], 0.96; 95% Confidence Interval [CI], 0.95-0.98. No effect was found among persons aged at least 70 years (RR 1.00; 95% CI 0.99-1.02. Effect modification by age was further suggested by analyses using narrower age categories. CONCLUSIONS: Smoke-free policies can constitute a simple and inexpensive intervention for the prevention of cardiovascular diseases and thus should be included in prevention programmes.

  12. Common causes of morbidity and mortality amongst diabetic admissions at the university of Benin teaching hospital, Benin city, Nigeria

    International Nuclear Information System (INIS)

    Diabetes mellitus is associated with significant morbidity and mortality worldwide and Nigeria is no exception. To determine the morbidity and mortality in patients admitted with Diabetes Mellitus in a tertiary teaching hospital of Nigeria, through retrospective analysis of admission and death records. Admission and death certificate records from the medical wards of the University of Benin Teaching Hospital, Benin City, Nigeria, were retrospectively analysed from 1, August 2003 to 31, July 2004. Data included age, gender, total numbers of admissions and those due to Diabetes Mellitus, the indications for admissions, presenting symptoms and method of diagnoses in diabetic patients, mortality rates and causes of death. Data obtained were analysed using chi square. Out of 1567 medical admissions, 852(54.4%) were males and 715(45.6%) females. Diabetes was detected in 145(9.3%) patients [81(55.9%) males, 64(44.1%) females]. The mean age of diabetic patients was 53.6+16.1 years (range 18 - 94 years). Poor glycaemic control (29%) and diabetic foot syndrome (23.4%) were the most common reasons for admission in diabetic cases. The overall mortality rate among medical admissions was 21.8%, with diabetes accounting for 6.7% deaths. Within the cohort of diabetic cases, mortality was 15.9%, with significantly higher mortality in those aged > 65 years (p < 0.05). The most common causes of death in diabetic cases were Cerebrovascular disease and complications associated with the foot syndrome, accounting for 26.1% and 21.7% of deaths respectively; the least common causes of death in diabetic patients were Malaria, Hepatic Encephalopathy, and Carcinoma of the Cervix, accounting for 4.4% of deaths. Cerebrovascular disease was the most frequent cause of mortality among admitted diabetic patients with diabetic foot syndrome (a preventable complication) as the second most frequent cause of mortality. Increased screening for diabetes mellitus morbidities in the clinic and community

  13. Effects of air pollution on daily hospital admissions for respiratory disease in London between 1987-88 and 1991-92.

    OpenAIRE

    Ponce de Leon, A.; Anderson, H R; Bland, J. M.; Strachan, D. P.; Bower, J.

    1996-01-01

    STUDY OBJECTIVE: To investigate whether air pollution levels in London have short term effects on hospital admissions for respiratory disease. DESIGN: Poisson regression analysis of daily counts of hospital admissions, adjusting for effects of trend, seasonal and other cyclical factors, day of the week, holidays, influenza epidemic, temperature, humidity, and autocorrelation. Pollution variables were particulates (black smoke: BS), sulphur dioxide (SO2), ozone (O3), and nitrogen dioxide (NO2)...

  14. The effect of a smoking ban on exposure and cardio-respiratory health of non-smoking hospitality workers in Switzerland

    OpenAIRE

    Rajkumar, Sarah Priya

    2014-01-01

    Summary: Background The first scientific studies on negative health effects of passive smoking published in the 1980s instigated an intense battle between the tobacco industry, who fear the loss of social acceptance of smoking and resultant financial damages, and diverse interest groups defending the health of the non-smoking population. In 2003 the World Health Organisation issued a Framework Convention for Tobacco Control, which was signed by 168 member states and has been...

  15. The effect of testosterone and a nutritional supplement on hospital admissions in under-nourished, older people

    Directory of Open Access Journals (Sweden)

    Cameron Ian D

    2011-10-01

    Full Text Available Abstract Background Weight loss and under-nutrition are relatively common in older people, and are associated with poor outcomes including increased rates of hospital admissions and death. In a pilot study of 49 undernourished older, community dwelling people we found that daily treatment for one year with a combination of testosterone tablets and a nutritional supplement produced a significant reduction in hospitalizations. We propose a larger, multicentre study to explore and hopefully confirm this exciting, potentially important finding (NHMRC project grant number 627178. Methods/Design One year randomized control trial where subjects are allocated to either oral testosterone undecanoate and high calorie oral nutritional supplement or placebo medication and low calorie oral nutritional supplementation. 200 older community-dwelling, undernourished people [Mini Nutritional Assessment score 2: 7.5% over 3 months]. Hospital admissions, quality-adjusted life years, functional status, nutritional health, muscle strength, body composition and other variables will be assessed. Discussion The pilot study showed that combined treatment with an oral testosterone and a supplement drink was well tolerated and safe, and reduced the number of people hospitalised and duration of hospital admissions in undernourished, community dwelling older people. This is an exciting finding, as it identifies a treatment which may be of substantial benefit to many older people in our community. We now propose to conduct a multi-centre study to test these findings in a substantially larger subject group, and to determine the cost effectiveness of this treatment. Trial registration Australian Clinical Trial Registry: ACTRN 12610000356066

  16. Hora da admissão na unidade de emergência e mortalidade hospitalar na síndrome coronária aguda Emergency service admission time and in-hospital mortality in acute coronary syndrome

    Directory of Open Access Journals (Sweden)

    Julio Yoshio Takada

    2012-02-01

    Full Text Available FUNDAMENTO: Há controvérsias sobre a hora da admissão e os desfechos hospitalares da síndrome coronária aguda (SCA. A admissão em horários não regulares seria associada ao pior prognóstico dos pacientes. OBJETIVO: Analisar a influência da hora da admissão na internação prolongada e na mortalidade de pacientes com SCA, segundo os períodos diurno (das 7h às 19h e noturno (das 19h às 7h. MÉTODOS: Foram avaliados, prospectivamente, 1.104 pacientes consecutivos com SCA. O óbito intra-hospitalar e a internação igual ou superior a cinco dias foram os desfechos analisados. RESULTADOS: A admissão no período diurno foi maior em comparação ao noturno (63% vs. 37%; p BACKGROUND: The relationship between admission time to an emergency service and in-hospital outcomes in acute coronary syndrome (ACS is controversial. Admission during off-hours would be associated with worse prognosis. OBJECTIVE: To assess the influence of admission time on prolonged hospitalization and mortality for ACS patients, regarding regular hours (7AM-7PM and off-hours (7PM-7AM. METHODS: The study assessed prospectively 1,104 consecutive ACS patients. In-hospital mortality and length of hospital stay > 5 days were the outcomes analyzed. RESULTS: Admission during regular hours was greater as compared with that during off-hours (63% vs. 37%; p 5 days were as follows: age [OR 1.042 (95%CI: 1.025 - 1.058, p < 0.001]; ejection fraction (EF [OR 0.977 (95%CI: 0.966 - 0.988, p < 0.001]; NSTEMI [OR 1.699 (95%CI: 1.221 - 2.366, p = 0.001]; and smoking [OR 1.723 (95%CI: 1.113 - 2.668, p = 0.014]. Predictive factors for in-hospital mortality were as follows: age [OR 1.090 (95%CI: 1.047 - 1.134, p < 0.001]; EF [OR 0.936 (95%CI: 0.909 - 0.964, p < 0.001]; and surgical treatment [OR 3.781 (95%CI: 1.374 - 10.409, p = 0.01]. CONCLUSION: Prolonged length of hospital stay and in-hospital mortality in ACS patients do not depend on admission time.

  17. From the emergency department to the general hospital: hospital ownership and market factors in the admission of the seriously mentally ill.

    Science.gov (United States)

    Shen, Jay J; Cochran, Christopher R; Moseley, Charles B

    2008-01-01

    General hospitals are becoming the safety net provider for the seriously mentally ill (SMI) in the United States, but these patients are faced with a number of potential barriers when accessing these hospitals. Hospital ownership and market forces are two potential organizational and healthcare system barriers that may affect the SMI patient's access, because the psychiatric and medical services they need are unprofitable services. This study examines the relationship among hospital ownership, market forces, and admission of the SMI patient from the emergency department into the general hospital. This was a cross-sectional study of a large sample of SMI patients from the 2002 State Inpatient Datasets for five states. Multiple logistic regression was applied in the multivariable analysis. After controlling for patient, hospital, and county covariates and when compared with not-for-profit hospitals, public hospitals were more likely to admit while investor-owned hospitals were less likely to admit SMI patients. Hospitals in competitive markets were less likely to admit while hospitals with capitation revenues were slightly less likely to admit these patients. Policy options that can address this "market failure" include strengthening the public psychiatric inpatient care system, making private health insurance coverage of the SMI more equitable, revising Medicare prospective payment system to better reimburse the treatment of the SMI, and allowing not-for-profit hospitals to count care of the SMI as a community benefit. Results of this study will be useful to healthcare managers searching for ways to reduce unnecessary administrative costs while continuing to maintain the level of administrative activities required for the provision of safe, effective, and high-quality care. PMID:18720688

  18. Pediatric hospital admissions from influenza A (H1N1) in Brazil: effects of the 2010 vaccination campaign.

    Science.gov (United States)

    Marcos, Ana Carolina Cavalcanti; Pelissoni, Fernanda D'Angelo Monteiro; Cunegundes, Kelly Simone Almeida; Abramczyk, Marcelo Luiz; Bellei, Nancy Cristina Junqueira; Sanches, Nivea Aparecida Pissaia; Moraes-Pinto, Maria Isabel de

    2012-10-01

    lIn 2009, the influenza A (H1N1) virus spread rapidly around the world, causing the first pandemic of the 21st Century. In 2010, there was a vaccination campaign against this new virus subtype to reduce the morbidity and mortality of the disease in some countries, including Brazil. Herein, we describe the clinical and epidemiological characteristics of patients under 19 years of age who were hospitalized with confirmed influenza A (H1N1) infection in 2009 and 2010. We retrospectively reviewed files from the pediatric patients who were admitted to a university hospital with real-time polymerase chain reaction (RT-PCR) confirmed influenza A (H1N1) infection in 2009 and 2010. There were 37 hospitalized patients with influenza A (H1N1) in 2009 and 2 in 2010. In 2009, many of the hospitalized children had an underlying chronic disease and a lower median age than those not hospitalized. Of the hospitalized patients, 78% had a chronic disease, primarily pneumopathy (48%). The main signs and symptoms of influenza were fever (97%), cough (76%), and dyspnea (59%). Complications occurred in 81% of the patients. The median length of hospitalization was five days; 27% of the patients required intensive care, and two died. In 2010, two patients were hospitalized with influenza A (H1N1): one infant with adenovirus co-infection who had received one previous H1N1 vaccine dose and presented with respiratory sequelae and a 2-month-old infant who had a hospital-acquired infection. An impressive reduction in hospital admissions was observed in 2010 when the vaccination campaign took place in Brazil. PMID:23070350

  19. Pediatric hospital admissions from influenza A (H1N1 in Brazil: effects of the 2010 vaccination campaign

    Directory of Open Access Journals (Sweden)

    Ana Carolina Cavalcanti Marcos

    2012-10-01

    Full Text Available lIn 2009, the influenza A (H1N1 virus spread rapidly around the world, causing the first pandemic of the 21st Century. In 2010, there was a vaccination campaign against this new virus subtype to reduce the morbidity and mortality of the disease in some countries, including Brazil. Herein, we describe the clinical and epidemiological characteristics of patients under 19 years of age who were hospitalized with confirmed influenza A (H1N1 infection in 2009 and 2010. We retrospectively reviewed files from the pediatric patients who were admitted to a university hospital with real-time polymerase chain reaction (RT-PCR confirmed influenza A (H1N1 infection in 2009 and 2010. There were 37 hospitalized patients with influenza A (H1N1 in 2009 and 2 in 2010. In 2009, many of the hospitalized children had an underlying chronic disease and a lower median age than those not hospitalized. Of the hospitalized patients, 78% had a chronic disease, primarily pneumopathy (48%. The main signs and symptoms of influenza were fever (97%, cough (76%, and dyspnea (59%. Complications occurred in 81% of the patients. The median length of hospitalization was five days; 27% of the patients required intensive care, and two died. In 2010, two patients were hospitalized with influenza A (H1N1: one infant with adenovirus co-infection who had received one previous H1N1 vaccine dose and presented with respiratory sequelae and a 2-month-old infant who had a hospital-acquired infection. An impressive reduction in hospital admissions was observed in 2010 when the vaccination campaign took place in Brazil.

  20. Admission of foreign citizens to the general teaching hospital of bologna, northeastern Italy: An epidemiological and clinical survey

    Directory of Open Access Journals (Sweden)

    Sergio Sabbatani

    2006-04-01

    Full Text Available BACKGROUND: The emergency regarding recent immigration waves into Italy makes continued healthcare monitoring of these populations necessary. METHODS: Through a survey of hospital admissions carried out during the last five years at the S. Orsola-Malpighi General Hospital of Bologna (Italy, all causes of admission of these subjects were evaluated, together with their correlates. Subsequently, we focused on admissions due to infectious diseases. All available data regarding foreign citizens admitted as inpatients or in Day-Hospital settings of our teaching hospital from January 1, 1999, to March 31, 2004, were assessed. Diagnosis-related group (DRG features, and single discharge diagnoses, were also evaluated, and a further assessment of infectious diseases was subsequently made. RESULTS: Within a comprehensive pool of 339,051 hospitalized patients, foreign citizen discharges numbered 7,312 (2.15%, including 2,542 males (34.8% and 4,769 females (65.2%. Males had a mean age of 36.8±14.7 years, while females were aged 30.8±12.2 years. In the assessment of the areas of origin, 34.6% of hospitalizations were attributed to patients coming from Eastern Europe, 15.3% from Northern Africa, 7.3% (comprehensively from Western Europe and United States, 6.9% from the Indian subcontinent, 5.9% from sub-Saharan Africa, 5.7% from Latin America, 4.1% from China, 2.5% from the Philippines, and 1.1% from the Middle East. Among women, most hospitalizations (58.8% were due to obstetrical-gynecological procedures or diseases, including assistance with delivery (27.1%, and pregnancy complications (18.7%, followed by psycho-social disturbances (5.9%, malignancies (5.1%, gastrointestinal diseases (4.7%, and voluntary pregnancy interruption (4.4%. Among men, the most frequent causes of admissions were related to trauma (15.9%, followed by gastroenteric disorders (12%, heart-vascular diseases (8.9%, psycho-social disorders (8.4%, respiratory (7.1%, kidney (6.1%, liver

  1. The Changing Pattern of Hospital Admission to Medical Wards; Burden of non-communicable diseases at a hospital in a developing country

    Directory of Open Access Journals (Sweden)

    Sufian K. Noor

    2015-11-01

    Full Text Available Objectives: This study aimed to determine the pattern of hospital admissions and patient outcomes in medical wards at Atbara Teaching Hospital in River Nile State, Sudan. Methods: This retrospective cross-sectional study was conducted from August 2013 to July 2014 and included all patients admitted to medical wards at the Atbara Teaching Hospital during the study period. Morbidity and mortality data was obtained from medical records. Diseases were categorised using the World Health Organization’s International Classification of Diseases (ICD coding system. Results: A total of 2,614 patient records were analysed. The age group with the highest admissions was the 56‒65-year-old age group (19.4% and the majority of patients were admitted for one week or less (86.4%. Non-communicable diseases constituted 71.8% of all cases. According to ICD classifications, patients were admitted most frequently due to infectious or parasitic diseases (19.7%, followed by diseases of the circulatory (16.4%, digestive (16.4% and genito-urinary (13.8% systems. The most common diseases were cardiovascular disease (16.4%, malaria (11.3%, gastritis/peptic ulcer disease (9.8%, urinary tract infections (7.2% and diabetes mellitus (6.9%. The mortality rate was 4.7%. Conclusion: The burden of non-communicable diseases was found to exceed that of communicable diseases among patients admitted to medical wards at the Atbara Teaching Hospital.

  2. Relation between admission blood glucose levels and in-hospital and one year mortality in non-diabetic acute myocardial infarction patients

    Directory of Open Access Journals (Sweden)

    A Andishmand

    2006-01-01

    Full Text Available Introduction: Several studies have evaluated the association of admission blood glucose levels and short and long term mortality after myocardial infarction and have had different results. The aim of this study was evaluation of association between admission blood glucose levels and in-hospital and one year mortality in non-diabetic patients with AMI. Methods: In this study, demographic, clinical and Para clinical data of 120 non-diabetic patients with AMI on admission was collected and analyzed. The patients were followed for one year. Blood glucose level ≥ 140 mg/dl was defined as hyperglycemia. Results: 78% of patients were men. The mean age and admission blood glucose level was 63+13 years and 146+76mg/dl, respectively. Death due to cardio vascular causes was seen in 20% of patients in hospital and 9.8% during the one year follow up. The mean admission blood glucose level in patients who died in hospital was significantly more than live patients and also had an influence on the in-hospital outcome. Every 100mg/dl increase in blood glucose level was associated with 11% increase in in-hospital mortality risk in non-diabetic patients. Conclusion: Our results demonstrate that admission blood glucose level is a good marker for diagnosing patients with worse prognosis after AMI. We suggest that later studies should focus on optimal control of hyperglycemia with insulin in patients with AMI.

  3. Hospital admissions from birth to early adolescence and early-life risk factors: the 11-year follow-up of the 1993 Pelotas (Brazil) birth cohort study

    Science.gov (United States)

    Menezes, Ana M. B.; Noal, Ricardo B.; Cesar, Juraci A.; Hallal, Pedro C.; Araújo, Cora Luiza; Dumith, Samuel C.; Barros, Fernando C.; Victora, Cesar G.

    2013-01-01

    The aim of this prospective analysis was to describe the cumulative incidence of hospital admissions in the first year of life and between 1 and 11 years of age and to explore associated factors. Hospital admissions were collected through regular monitoring in the first year of life, and through maternal report on admissions between 1 and 11 years. Analyses were stratified by sex and adjusted for confounding factors. 18.1% of children were hospitalized in the first year of life, and 30.7% between ages 1 and 11 years. Among boys, hospital admission in the first year was associated with low family income, paternal smoking during pregnancy, preterm delivery, and low birthweight. Among girls, in addition to the variables described for boys, black/mixed skin color was also a risk factor for hospital admission. For admissions between 1 and 11 years of age, low family income and gestational age ≥ 37 weeks were found to be significant risk factors. PMID:20963296

  4. Heart failure re-admission: measuring the ever shortening gap between repeat heart failure hospitalizations.

    Directory of Open Access Journals (Sweden)

    Jeffrey A Bakal

    Full Text Available Many quality-of-care and risk prediction metrics rely on time to first rehospitalization even though heart failure (HF patients may undergo several repeat hospitalizations. The aim of this study is to compare repeat hospitalization models. Using a population-based cohort of 40,667 patients, we examined both HF and all cause re-hospitalizations using up to five years of follow-up. Two models were examined: the gap-time model which estimates the adjusted time between hospitalizations and a multistate model which considered patients to be in one of four states; community-dwelling, in hospital for HF, in hospital for any reason, or dead. The transition probabilities and times were then modeled using patient characteristics and number of repeat hospitalizations. We found that during the five years of follow-up roughly half of the patients returned for a subsequent hospitalization for each repeat hospitalization. Additionally, we noted that the unadjusted time between hospitalizations was reduced ∼40% between each successive hospitalization. After adjustment each additional hospitalization was associated with a 28 day (95% CI: 22-35 reduction in time spent out of hospital. A similar pattern was seen when considering the four state model. A large proportion of patients had multiple repeat hospitalizations. Extending the gap between hospitalizations should be an important goal of treatment evaluation.

  5. Preparedness for admission of patients with suspected Ebola virus disease in European hospitals: a survey, August-September 2014.

    Science.gov (United States)

    de Jong, M D; Reusken, C; Horby, P; Koopmans, M; Bonten, M; Chiche, Jd; Giaquinto, C; Welte, T; Leus, F; Schotsman, J; Goossens, H

    2014-01-01

    In response to the Ebola virus disease (EVD) outbreak in West Africa, the World Health Organization has advised all nations to prepare for the detection, investigation and management of confirmed and suspected EVD cases in order to prevent further spread through international travel. To gain insights into the state of preparedness of European hospitals, an electronic survey was circulated in August–September 2014 to 984 medical professionals representing 736 hospitals in 40 countries. The survey addressed the willingness and capacity to admit patients with suspected EVD as well as specific preparedness activities in response to the current Ebola crisis. Evaluable responses were received from representatives of 254 (32%) hospitals in 38 countries, mostly tertiary care centres, of which 46% indicated that they would admit patients with suspected EVD. Patient transfer agreements were in place for the majority of hospitals that would not admit patients. Compared with non-admitting hospitals, admitting hospitals were more frequently engaged in various preparedness activities and more often contained basic infrastructural characteristics such as admission rooms and laboratories considered important for infection control, but some gaps and concerns were also identified. The results of this survey help to provide direction towards further preparedness activities and prioritisation thereof. PMID:25496571

  6. Antidepressants self-poisoning and ICU admissions in a University Hospital in the Netherlands

    NARCIS (Netherlands)

    Bosch, Tessa M.; van der Werf, Tjip S.; Uges, Donald R.A.; Ligtenberg, Jack .M.J; Fijen, Jan-Willem; Tulleken, Jaap E.; Zijlstra, Jan G.

    2000-01-01

    Objectives: Many overdosed patients are admitted to an ICU. Antidepressants are frequently used. We examined clinical end-points of toxicity recorded during admission to our ICU of all antidepressants used in overdose. Design: Single centre; retrospective analysis, 5 consecutive years (1994 - 1998).

  7. Relationships of daily mortality and hospital admissions to air pollution in Castilla-Leon, Spain

    Energy Technology Data Exchange (ETDEWEB)

    De Pablo, F.; Lopez, A.; Rivas Soriano, L.; Tomas, C. [Facultad de Ciencias, Universidad de Salamanca (Spain)]. E-mail: fpd123@usal.es; Diego, L.; Gonzalez, M. [Instituto Regional de Salud Publica, SACYL Castilla-Leon (Spain); Barrueco, M. [Facultad de Medicina, Universidad de Salamanca (Spain)

    2006-01-15

    We examined the possible relationships between pollutant concentrations and mortality at seven different locations of Castilla-Leon, Spain, and the relationships between such concentration levels and emergency admissions (morbidity) at four hospitals in the region, taking into account the possible masking effect of other atmospheric variables. The study was based on daily mortality and morbidity data from 1995 to 1997 (ICD-9 codes: 390-459 cardiovascular; 460-519 respiratory; 520-579 digestive causes); moreover, data for meteorological variables (air temperature, relative humidity, solar radiation, atmospheric pressure and wind velocity) and air pollution data (SO{sub 2}, O{sub 3}, NO, NO{sub 2} and CO) were used. A minimum set of weather and pollutant predictors was selected using forward inclusion stepwise linear regression methods and these were used to produce a multivariate model of the different causes of mortality and morbidity. For the whole period, the mortality attributable to cardiovascular causes had an incidence higher than the mortality due to respiratory and digestive causes. The frequency distributions corresponding to the different diseases as classified by ages revealed that the population older than 69 is the most affected, the proportion of cardiovascular disease related deaths in this age sector being 7-fold higher than for the rest of the groups. Mortality and morbidity due to respiratory and cardiovascular-related diseases showed a high correlation coefficient with temperature, solar radiation and ozone, and in general significant correlations were also seen with SO{sub 2}. [Spanish] Se analizan las posibles relaciones existentes entre la mortalidad de la poblacion, el numero de admisiones hospitalarias (morbilidad) y los niveles de concentracion de contaminantes medidos en siete localidades y cuatro hospitales de Castilla-Leon, Espana, respectivamente, teniendo en cuenta el posible efecto de enmascaramiento que ejercen las variables

  8. Re-admissions, re-operations and length of stay in hospital after aseptic revision knee replacement in Denmark

    DEFF Research Database (Denmark)

    Lindberg-Larsen, M.; Jørgensen, C. C.; Hansen, Torben Bæk; Solgaard, S.; Odgaard, A.; Kehlet, H.

    information from the Danish Knee Arthroplasty Registry. The 1218 revisions involving 1165 patients were subdivided into total revisions, large partial revisions, partial revisions and revisions of unicondylar replacements (UKR revisions). The mean age was 65.0 years (27 to 94) and the median length of......-admission. The age ranges of 76 to 80 years (p = 0.018) and the large partial revision subgroup (p = 0.073) were related to an increased risk of re-operation. The ages from 76 to 80 years (p < 0.001), age ≥ 81 years (p < 0.001) and surgical time > 120 min (p < 0.001) were related to increased length of hospital...... suggests that a length of hospital stay ≤ four days and discharge home at that time is safe following aseptic knee revision surgery in Denmark....

  9. Risk Factors for Psychiatric Hospital Admission for Participants in California's Full-Service Partnership Program.

    Science.gov (United States)

    Penkunas, Michael J; Hahn-Smith, Stephen

    2016-08-01

    This study investigated the demographic and clinical predictors of psychiatric hospitalization during the first 2 years of treatment for adults participating in the full-service partnership (FSP) program, based on Assertive Community Treatment, in a large county in northern California. Clinical and demographic characteristics, data on prior hospitalizations, length of enrollment, and living situation for 328 FSP participants were collected from the county's internal billing system and the California Department of Health Care Services. In univariate models, the probability of hospitalization varied by diagnosis, age, and hospitalization history. In the multivariate model, younger age and frequent hospitalization prior to enrollment predicted hospitalization during enrollment. Findings support prior research on hospital recidivism and may be beneficial in refining future strategies for meeting the needs of adults with serious mental illness. PMID:25527223

  10. he Effects of Early Admission of Pregnant Women During Latent Phase on Pregnant Outcomes in Tabriz Taleghani Hospital

    Directory of Open Access Journals (Sweden)

    Somayyeh Naghi Zadeh

    2014-04-01

    Full Text Available Objective: The impossibility of determining the exact time of childbirth and measuring the length of latent phase may be the reason of different encounters with this stage of labor. This study investigates the impact of early admission of women in latent phase referred to Tabriz Taleghani Hospital. Materials and Methods: A descriptive study was conducted in 2011 on 250 women during latent phase admitted to Tabriz Taleghani Hospital in which they were randomly selected for the survey. A five part questionnaire was used for data collection aimed to investigate (respectively demographic characteristics, Partograph form, evaluating checklists of second, third and forth stages of labor, the results of a pre-discharge examination and also the first ten days after childbirth Results: According to the findings 187 of the labors were stimulated by oxytocin induction (74.8% while 18.8% of the oxytocin treated women were hypotonic, 139 (55.6% underwent amniotomy, 6.8% of the fetus had FHR abnormalities including Bradicardia and tachycardia. No neonatal deaths were reported and just 2 of the newborns were admitted to the neonatal ward. Of the total 28 (11.2% had prolonged latent phase and 54 (21.6% of the patients had prolonged active phase of labor. The mean drop in hemoglobin and hematocrit rates during admission for delivery was, respectively, 1.35± 1.41 and 3.8 ± 4.1. Conclusion: Admission in the latent phase of labor is associated with increased length of labor and stay in postnatal ward, increased maternal and infant complications and interventions. Therefore it is recommended that all the women should be given adequate training during pregnancy. They also should be advised that in the absence of medical problems it is best to be admitted when active labor begins to prevent many complications .

  11. Apparent Temperature and Cause-Specific Emergency Hospital Admissions in Greater Copenhagen, Denmark

    DEFF Research Database (Denmark)

    Wichmann, Janine; Andersen, Zorana; Ketzel, Matthias;

    2011-01-01

    One of the key climate change factors, temperature, has potentially grave implications for human health. We report the first attempt to investigate the association between the daily 3-hour maximum apparent temperature (Tapp(max)) and respiratory (RD), cardiovascular (CVD), and cerebrovascular (CBD...... IQR (8°C) increase in the 5-day cumulative average of Tapp(max), a 7% (95% CI: 1%, 13%) increase in the RD admission rate was observed in the warm period whereas an inverse association was found with CVD (-8%, 95% CI: -13%, -4%), and none with CBD. There was no association between the 5-day cumulative...... average of Tapp(max) during the cold period and any of the cause-specific admissions, except in some susceptible groups: a negative association for RD in the oldest age group and a positive association for CVD in men and the second highest SES group. In conclusion, an increase in Tapp(max) is associated...

  12. Effect of tele health care on exacerbations and hospital admissions in patients with chronic obstructive pulmonary disease: a randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Ringbæk T

    2015-09-01

    Full Text Available Thomas Ringbæk,1,2 Allan Green,1 Lars Christian Laursen,2,3 Ejvind Frausing,1 Eva Brøndum,1 Charlotte Suppli Ulrik1,2 1Department of Pulmonary Medicine, Hvidovre Hospital, Hvidovre, Denmark; 2Institute of Clinical Medicine, University of Copenhagen; 3Pulmonary Unit, Department of Internal Medicine, Herlev Hospital, Herlev, Denmark Background and objective: Tele monitoring (TM of patients with chronic obstructive pulmonary disease (COPD has gained much interest, but studies have produced conflicting results. Our aim was to investigate the effect of TM with the option of video consultations on exacerbations and hospital admissions in patients with severe COPD.Materials and methods: Patients with severe COPD at high risk of exacerbations were eligible for the study. Of 560 eligible patients identified, 279 (50% declined to participate. The remaining patients were equally randomized to either TM (n=141 or usual care (n=140 for the 6-month study period. TM comprised recording of symptoms, saturation, spirometry, and weekly video consultations. Algorithms generated alerts if readings breached thresholds. Both groups received standard care. The primary outcome was number of hospital admissions for exacerbation of COPD during the study period.Results: Most of the enrolled patients had severe COPD (forced expiratory volume in 1 second <50%pred in 86% and ≥hospital admission for COPD in the year prior to enrollment in 45%, respectively, of the patients. No difference in drop-out rate and mortality was found between the groups. With regard to the primary outcome, no significant difference was found in hospital admissions for COPD between the groups (P=0.74, and likewise, no difference was found in time to first admission or all-cause hospital admissions. Compared with the control group, TM group patients had more moderate exacerbations (ie, treated with antibiotics/corticosteroid, but not requiring hospital admission; P<0.001, whereas the control group

  13. A time series analysis of meteorological factors and hospital outpatient admissions for cardiovascular disease in the Northern district of Guizhou Province, China

    International Nuclear Information System (INIS)

    Findings on the effects of weather on health, especially the effects of ambient temperature on overall morbidity, remain inconsistent. We conducted a time series study to examine the acute effects of meteorological factors (mainly air temperature) on daily hospital outpatient admissions for cardiovascular disease (CVD) in Zunyi City, China, from January 1, 2007 to November 30, 2009. We used the generalized additive model with penalized splines to analyze hospital outpatient admissions, climatic parameters, and covariate data. Results show that, in Zunyi, air temperature was associated with hospital outpatient admission for CVD. When air temperature was less than 10°C, hospital outpatient admissions for CVD increased 1.07-fold with each increase of 1°C, and when air temperature was more than 10°C, an increase in air temperature by 1°C was associated with a 0.99-fold decrease in hospital outpatient admissions for CVD over the previous year. Our analyses provided statistically significant evidence that in China meteorological factors have adverse effects on the health of the general population. Further research with consistent methodology is needed to clarify the magnitude of these effects and to show which populations and individuals are vulnerable

  14. Triumph of hope over experience: learning from interventions to reduce avoidable hospital admissions identified through an Academic Health and Social Care Network

    Directory of Open Access Journals (Sweden)

    Woodhams Victoria

    2012-06-01

    Full Text Available Abstract Background Internationally health services are facing increasing demands due to new and more expensive health technologies and treatments, coupled with the needs of an ageing population. Reducing avoidable use of expensive secondary care services, especially high cost admissions where no procedure is carried out, has become a focus for the commissioners of healthcare. Method We set out to identify, evaluate and share learning about interventions to reduce avoidable hospital admission across a regional Academic Health and Social Care Network (AHSN. We conducted a service evaluation identifying initiatives that had taken place across the AHSN. This comprised a literature review, case studies, and two workshops. Results We identified three types of intervention: pre-hospital; within the emergency department (ED; and post-admission evaluation of appropriateness. Pre-hospital interventions included the use of predictive modelling tools (PARR – Patients at risk of readmission and ACG – Adjusted Clinical Groups sometimes supported by community matrons or virtual wards. GP-advisers and outreach nurses were employed within the ED. The principal post-hoc interventions were the audit of records in primary care or the application of the Appropriateness Evaluation Protocol (AEP within the admission ward. Overall there was a shortage of independent evaluation and limited evidence that each intervention had an impact on rates of admission. Conclusions Despite the frequency and cost of emergency admission there has been little independent evaluation of interventions to reduce avoidable admission. Commissioners of healthcare should consider interventions at all stages of the admission pathway, including regular audit, to ensure admission thresholds don’t change.

  15. Barriers to and enablers of physical activity in patients with COPD following a hospital admission: a qualitative study

    Directory of Open Access Journals (Sweden)

    Thorpe O

    2014-01-01

    clear that health professionals dealing with people suffering from COPD need to actively recognize and address barriers to physical activity and pulmonary rehabilitation. Hospital admission may create an opportunity for implementation of interventions promoting physical activity (such as referral to pulmonary rehabilitation, which may assist in reducing hospital readmission, as well as decreasing morbidity and mortality.Keywords: chronic obstructive pulmonary disease, COPD, physical activity, exercise, hospital admission, patient perspectives

  16. Bacteraemia in sickle cell anaemia is associated with low haemoglobin: a report of 890 admissions to a tertiary hospital in Tanzania.

    OpenAIRE

    Makani, J; Mgaya, J; Balandya, E; Msami, K; Soka, D.; Cox, SE; Komba, AN; Rwezaula, S; Meda, E; Muturi, D; Kitundu, J.; Fegan, G.; Kirkham, FJ; Newton, CR; Snow, RW

    2015-01-01

    Summary Bacteraemia is a leading cause of morbidity in sickle cell anaemia (SCA), but information from studies in Africa is limited. We evaluated 890 admissions from 648 SCA patients at a tertiary hospital in Tanzania. Bacteraemia was present in 43 admissions (4·8%); isolates included Staphylococcus aureus (12/43; 28%), non‐Typhi Salmonella (9/43; 21%), Streptococcus pneumoniae (3/43; 7%) and Salmonella Typhi (2/43; 5%). Compared to SCA patients without bacteraemia, SCA patients with bacterae...

  17. The influence of the winter North Atlantic Oscillation index on hospital admissions through diseases of the circulatory system in Lisbon, Portugal

    Science.gov (United States)

    Almendra, Ricardo; Santana, Paula; Vasconcelos, João; Silva, Giovani; Gonçalves, Fábio; Ambrizzi, Tércio

    2016-07-01

    The aim of this paper is to analyze the relationship between North Atlantic Oscillation (NAO), meteorological variables, air pollutants, and hospital admissions due to diseases of circulatory systems in Lisbon (Portugal) during winter months (2003-2012). This paper is one of the few studies analyzing the impact of NAO on health through its influence on thermal stress and air pollution and is the first to be conducted in Lisbon. This study uses meteorological data (synthetized into a thermal comfort index), air pollutant metrics, and the NAO index (all clustered in 10-day cycles to overcome daily variability of the NAO index). The relationship between morbidity, thermal comfort index, NAO index, and air pollutants was explored through several linear models adjusted to seasonality through a periodic function. The possible indirect effect between the NAO index and hospital admissions was tested, assuming that NAO (independent variable) is affecting hospital admissions (outcome variable) through thermal discomfort and/or pollution levels (tested as individual mediators). This test was conducted through causal mediation analysis and adjusted for seasonal variation. The results from this study suggest a possible indirect relationship between NAO index and hospital admissions. Although NAO is not significantly associated with hospital admissions, it is significantly associated with CO, PM2.5, NO, and SO2 levels, which in turn increase the probability of hospitalization. The discomfort index (built with temperature and relative humidity) is significantly associated with hospital admissions, but its variability is not explained by the NAO index. This study highlights the impacts of the atmospheric circulation patterns on health. Furthermore, understanding the influence of the atmospheric circulation patterns can support the improvement of the existing contingency plans.

  18. Diagnoses, problems and healthcare interventions amongst older people with an unscheduled hospital admission who have concurrent mental health problems: a prevalence study

    OpenAIRE

    Glover, Alex; Bradshaw, Lucy E; Watson, Nicola; Laithwaite, Emily; Goldberg, Sarah E.; Whittamore, Kathy H; Harwood, Rowan H

    2014-01-01

    Background Frail older people with mental health problems including delirium, dementia and depression are often admitted to general hospitals. However, hospital admission may cause distress, and can be associated with complications. Some commentators suggest that their healthcare needs could be better met elsewhere. Methods We studied consecutive patients aged 70 or older admitted for emergency medical or trauma care to an 1800 bed general hospital which provided sole emergency medical and tr...

  19. Identifying Patients Harboring Extended-Spectrum-β-Lactamase-Producing Enterobacteriaceae on Hospital Admission: Derivation and Validation of a Scoring System ▿

    OpenAIRE

    Tumbarello, Mario; Trecarichi, Enrico Maria; Bassetti, Matteo; De Rosa, Francesco Giuseppe; Spanu, Teresa; Di Meco, Eugenia; Losito, Angela Raffaella; Parisini, Andrea; Pagani, Nicole; Cauda, Roberto

    2011-01-01

    Increases in community-acquired infections caused by extended-spectrum-β-lactamase (ESBL)-producing Enterobacteriaceae have important implications for hospital infection control and empirical antibiotic therapy protocols. We developed and validated a tool for identifying patients harboring these organisms at hospital admission. We retrospectively analyzed chart data for 849 adult inpatients. The derivation cohort included 339 patients admitted to a large hospital in Rome during 2008, with (n ...

  20. Uma análise entre índices pressóricos, obesidade e capacidade cardiorrespiratória em escolares Comparison analysis of blood pressure, obesity, and cardio-respiratory fitness in schoolchildren

    Directory of Open Access Journals (Sweden)

    Miria Suzana Burgos

    2010-06-01

    diseases, especially obesity, hypertension, and diabetes mellitus. Early intervention can prevent the development of these complications. OBJECTIVE: To determine the presence of cardiovascular risk (obesity and hypertension in schoolchildren and its potential interactions with cardio-respiratory fitness. METHODS: This was a cross-sectional study conducted in a stratified cluster sample of 1,666 schoolchildren, aged between 7 and 17 years, 873 (52.4% of them male and 793 (47.6% of them female. The following variables were evaluated: systolic blood pressure (SBP, diastolic blood pressure (DBP, body mass index (BMI, body fat percentage (BF %, and cardio-respiratory fitness. SBP and DBP were correlated with waist circumference (WC, waist-hip ratio (WHR, sum of skin folds (ΣSF, and cardio-respiratory fitness. RESULTS: A BMI assessment of the students showed that 26.7% of them were overweight or obese, and 35.9% had body fat percentage over moderately high. As to blood pressure, we found that 13.9% and 12.1% of the students were borderline or hypertensive, for SBP and DBP, respectively. There was an association among hypertension, obesity, and cardio-respiratory fitness. There was a significant correlation of SBP and DBP with all variables, and also a weak to moderate correlation with age, weight, height, BMI, and waist circumference. CONCLUSION: The presence of hypertension associated with obesity and its effects on cardio-respiratory fitness stress the importance of recommending, since childhood, a more active and healthy lifestyle.

  1. Advanced cancer patients' self-assessed physical and emotional problems on admission and discharge from hospital general ward - a questionnaire study

    DEFF Research Database (Denmark)

    Sølver, Lisbeth; Østergaard, Birte; Rydahl Hansen, Susan;

    2012-01-01

    -prolonging or palliative treatment are offered non-specialist palliative services. There is a lack of knowledge about their problem profile. The aim of this article is to describe the incidence of patient-reported physical and emotional problems on admission and discharge from general hospital wards and health......SOELVER L., OESTERGAARD B., RYDAHL-HANSEN S. & WAGNER L. (2012) European Journal of Cancer Care21, 667-676 Advanced cancer patients' self-assessed physical and emotional problems on admission and discharge from hospital general wards - a questionnaire study Most cancer patients receiving life...... between patient-reported problems and reported intervention for physical function, pain, constipation and loss of appetite. Palliative cancer patients' self-reported problem profile on admission and discharge from hospital has not previously been described and the results indicate a need to focus on...

  2. COPD exacerbation: anthropometric characteristics of patients and the frequency of hospital admissions

    Directory of Open Access Journals (Sweden)

    Gashynova K.Y.

    2014-11-01

    Full Text Available Exceptional importance of exacerbations for COPD course prognosing was reflected in the GOLD, 2011, where the number of exacerbations during the past year has been recognized as one of the main criteria of the future risks for patients. The aim of study was to determine the anthropometric indicators that increase the risk of re-hospitalization due to acute exacerbation of COPD. A retrospective analysis of medical records of inpatients who were hospitalized with COPD exacerbation to therapeutic department of CI "Dnipropetrovs’k sixth municipal clinical hospital" of Dnipropetrovsk regional council" during three years was done. It was established that neither sex, nor height, nor weight affect the rate of hospitalization due to COPD exacerbations. Older age is not a factor that increases the risk of hospitalization due to COPD exacerbation (despite the fact that the majority of hospitalized patients were elderly patients, 37% of them were persons of potentially working age. Severe exacerbation of COPD may occur in any patients with, even one year, experience of the disease. Among anthropometric indices, the most important predictor of re-hospitalization due to exacerbation of COPD is BMI<18.5, so its calculation is advisable in long-term observation of patients.

  3. The use of shared medication record as part of medication reconciliation at hospital admission is feasible

    DEFF Research Database (Denmark)

    Munck, Lars K; Hansen, Karina R; Mølbak, Anne Grethe;

    2014-01-01

    studied whether our SMR integration could facilitate medication reconciliation. MATERIAL AND METHODS: Patients admitted to the emergency department for hospitalization were randomised to consultation using EMR with or without the integrated SMR access. Observed time used for medication reconciliation was...... national SMR into a hospital EMR was feasible and useful, and it did not increase time expenditure for medication reconciliation. FUNDING: not relevant. TRIAL REGISTRATION: not relevant....

  4. Frequent hospital admission of older people with chronic disease: a cross-sectional survey with telephone follow-up and data linkage

    Directory of Open Access Journals (Sweden)

    Longman Jo M

    2012-10-01

    Full Text Available Abstract Background The continued increase in hospital admissions is a significant and complex issue facing health services. There is little research exploring patient perspectives or examining individual admissions among patients with frequent admissions for chronic ambulatory care sensitive (ACS conditions. This paper aims to describe characteristics of older, rural patients frequently admitted with ACS conditions and identify factors associated with their admissions from the patient perspective. Methods Patients aged 65+ resident in North Coast NSW with three or more admissions for selected ACS chronic conditions within a 12 month period, were invited to participate in a postal survey and follow up telephone call. Survey and telephone data were linked to admission and health service program data. Descriptive statistics were generated for survey respondents; logistic regression models developed to compare characteristics of patients with 3 or with 4+ admissions; and comparisons made between survey respondents and non-respondents. Results Survey respondents (n=102 had a mean age of 77.1 years (range 66–95 years, and a mean of 4.1 admissions within 12 months; 49% had at least three chronic conditions; the majority had low socioeconomic status; one in five (22% reported some difficulty affording their medication; and 35% lived alone. The majority reported psychological distress with 31% having moderate or severe psychological distress. While all had a GP, only 38% reported having a written GP care plan. 22% of those who needed regular help with daily tasks did not have a close friend or relative who regularly cared for them. Factors independently associated with more frequent (n=4+ relative to less frequent (n=3 admissions included having congestive heart failure (p=0.003, higher social isolation scores (p=0.040 and higher Charlson Comorbidity Index scores (p=0.049. Most respondents (61% felt there was nothing that could have avoided their most

  5. Spatial analysis of drug-related hospital admissions: an auto-Gaussian model to estimate the hospitalization rates in Italy

    Directory of Open Access Journals (Sweden)

    Emanuela Colasante

    2008-12-01

    Full Text Available

    Introduction: The aim of this study is to evaluate, even if partially, how much the drug use phenomenon impacts on the Italian National Heatlh System throughout the estimation at local level (Local Health Unit of the hospitalization rate caused by substance use and abuse such as opiates, barbiturates-sedativeshypnotics, cocaine and cannabis, and keeping in mind the phenomenon distribution in the space and so the fact that what happens in a specific area depends on what is happening in the neighbourhoods close to it (spatial autocorrelation.

    Methods: Data from hospital discharge database were provided by the Ministry of Health and an auto- Gaussian model was fitted. The spatial trend can be a function of other explanatory variables or can simply be modeled as a function of spatial location. Both models were fitted and compared using the number of subjects kept in charge by Drug Addiction Services and the number of beds held by hospitals as covariates.

    Results: Concerning opiates use related hospitalizations, results show areas where the phenomenon was less prominent in 2001 (Lombardy, part of Liguria, Umbria, part of Latium, Campania, Apulia and Sicily. In the following years, the hospitalization rates increased in some areas, such as the north of Apulia, part of Campania and Latium. A dependence of the opiates related hospitalization rates on the rate of subjects kept in charge by the Drug Addiction Services is highlighted. Concerning barbiturates-sedatives-hypnotics consumption, the best model is the one without covariates and estimated hospitalization rates are lower then 3 per thousand. The model with only the covariate “rate of subjects kept in charge by Drug Addiction Services” has been used both for cocaine and cannabis. In these two cases, more than a half of the Local Health Units report hospitalization rates lower than 0.5 per thousand

  6. Early Prediction of Acute Kidney Injury by Clinical Features of Snakebite Patients at the Time of Hospital Admission

    Directory of Open Access Journals (Sweden)

    Jayanta Paul

    2012-01-01

    Full Text Available Background: Snakebite is a major health problem in India. Venomous snakebite, which is an important medical hazard in several tropical countries including India, affects thousands of people per year and some of them develop acute kidney injury (AKI. Aims: This study was performed to find out 1 early clinical predictors for acute kidney injury in snakebite patients at the time of hospital admission and 2 incidence of acute kidney injury in snakebite patients. Materials and Methods: 171 consecutively admitted non-diabetic, non-hypertensive snakebite patients were examined. Multivariate linear regression analysis with 95 percent confidence interval (CI was done for statistical analysis. Analyses were performed by software Statistical Package for the Social Sciences (SPSS (17 th version for Windows. Results: Incidence of acute kidney injury was 43.27%. Development of acute kidney injury was independently associated with 20 min whole blood clotting test (20 min WBCT (P value = 0.029; CI 95%, dark or brown color urine (P value = 0.000; CI 95%, and time interval between snakebite and anti-snake venom administration (P value = 0.000; CI 95%. Age (P value = 0.011; CI 95% and presence of neurological signs (P value = 0.000; CI 95% were negatively correlated with development of acute kidney injury. Conclusion: Incidence of acute kidney injury is slightly higher in our study than previous studies. Early prediction of acute kidney injury development in snakebite patients can be done by presence of black or brown urine, 20 min WBCT > 20 min, and increased time interval between snakebite and administration of anti-snake venom at the time of hospital admission. Young age group of snakebite patients develops acute kidney injury more commonly.

  7. Association between birth order and emergency room visits and acute hospital admissions following pediatric vaccination: a self-controlled study.

    Directory of Open Access Journals (Sweden)

    Steven Hawken

    Full Text Available OBJECTIVE: We investigated the association between a child's birth order and emergency room (ER visits and hospital admissions following 2-,4-,6- and 12-month pediatric vaccinations. METHODS: We included all children born in Ontario between April 1(st, 2006 and March 31(st, 2009 who received a qualifying vaccination. We identified vaccinations, ER visits and admissions using health administrative data housed at the Institute for Clinical Evaluative Sciences. We used the self-controlled case series design to compare the relative incidence (RI of events among 1(st-born and later-born children using relative incidence ratios (RIR. RESULTS: For the 2-month vaccination, the RIR for 1(st-borns versus later-born children was 1.37 (95% CI: 1.19-1.57, which translates to 112 additional events/100,000 vaccinated. For the 4-month vaccination, the RIR for 1(st-borns vs. later-borns was 1.70 (95% CI: 1.45-1.99, representing 157 additional events/100,000 vaccinated. At 6 months, the RIR for 1(st vs. later-borns was 1.27 (95% CI: 1.09-1.48, or 77 excess events/100,000 vaccinated. At the 12-month vaccination, the RIR was 1.11 (95% CI: 1.02-1.21, or 249 excess events/100,000 vaccinated. CONCLUSIONS: Birth order is associated with increased incidence of ER visits and hospitalizations following vaccination in infancy. 1(st-born children had significantly higher relative incidence of events compared to later-born children.

  8. Intervention analysis of introduction of rotavirus vaccine on hospital admissions rates due to acute diarrhea

    Directory of Open Access Journals (Sweden)

    Maria de Lourdes Teixeira Masukawa

    2014-10-01

    Full Text Available The aim of this study is to investigate the impact of rotavirus vaccine on hospitalization rates for acute diarrhea in children younger than 5 years old after the introduction of the vaccine in 2006. A descriptive analytical observational study was carried out of the hospitalization rates occurred between 2000 and 2011 in 22 Regional Health Centers of Paraná State, Brazil. The effect of the vaccine was assessed by applying the SARIMA/Box-Jenkins time series methodology of intervention analysis, which allows verifying the slopes of the series are different after the introduction of the vaccine and estimating the magnitude of these effects for children younger than five years of age, by age group, for each region center. It was verified a statistically significant reduction by center/month on hospitalization rates for children 1 year old and younger, with averages of 47% and 58%, respectively, in December 2011.

  9. Hospital preparations for viral hemorrhagic fever patients and experience gained from admission of an Ebola patient

    NARCIS (Netherlands)

    Haverkort, J. J Mark; Minderhoud, A.L.C (Ben); Wind, Jelte D D; Leenen, Luke P H; Hoepelman, Andy I M; Ellerbroek, Pauline M.

    2016-01-01

    The Major Incident Hospital of the University Medical Centre of Utrecht has a longstanding history of preparing for the management of highly pathogenic and infectious organisms. An assessment of the hospital’s preparations for an outbreak of viral hemorrhagic fever and its experience during admissio

  10. The impact of the Danish smoking ban on hospital admissions for acute myocardial infarction

    DEFF Research Database (Denmark)

    Christensen, Tabita Maria; Møller, Lisbeth; Jørgensen, Torben; Pisinger, Charlotta

    2014-01-01

    Background: Exposure to secondhand smoke is associated with an increased risk of acute myocardial infarction (AMI). The positive impact of a smoking ban on AMI hospitalization rates has been demonstrated both inside and outside Europe. A national smoking ban (SB) was implemented in Denmark on 15...

  11. Length of stay and associated costs of obesity related hospital admissions in Ireland.

    LENUS (Irish Health Repository)

    Vellinga, Akke

    2008-01-01

    BACKGROUND: Obesity is the cause of other chronic diseases, psychological problems, obesity shortens the lifespan and puts strain on health systems. The risk associated with childhood obesity in particular, which will accelerate the development of adult morbidity and mortality, has been identified as an emerging public health problem. METHODS: To estimate the length of stay and associated hospital costs for obesity related illnesses a cost of illness study was set up. All discharges from all acute hospitals in the Republic of Ireland from 1997 to 2004 with a principal or secondary diagnostic code for obesity for all children from 6 to 18 years of age and for adults were collected.A discharge frequency was calculated by dividing obesity related discharges by the total number of diagnoses (principal and secondary) for each year. The hospital costs related to obesity was calculated based on the total number of days care. RESULTS: The discharge frequency of obesity related conditions increased from 1.14 in 1997 to 1.49 in 2004 for adults and from 0.81 to 1.37 for children. The relative length of stay (number of days in care for obesity related conditions per 1000 days of hospital care given) increased from 1.47 in 1997 to 4.16 in 2004 for children and from 3.68 in 1997 to 6.74 in 2004 for adults.Based on the 2001 figures for cost per inpatient bed day, the annual hospital cost was calculated to be 4.4 Euromillion in 1997, increasing to 13.3 Euromillion in 2004. At a 20% variable hospital cost the cost ranges from 0.9 Euromillion in 1997 to 2.7 Euromillion in 2004; a 200% increase. CONCLUSION: The annual increase in the proportion of hospital discharges related to obesity is alarming. This increase is related to a significant increase in economic costs. This paper emphasises the need for action at an early stage of life. Health promotion and primary prevention of obesity should be high on the political agenda.

  12. The mortality of acutely ill medical patients for up to 60 days after admission to a resource poor hospital in sub-Saharan Africa compared with patients of similar illness severity admitted to a Danish Regional Teaching Hospital

    DEFF Research Database (Denmark)

    Nabayigga, Barbara; Kellett, John; Brabrand, Mikkel; Opio, Martin Otyek

    2016-01-01

    60days mortality of 195 Ugandan and 588 Danish acutely ill medical patients that had a NEWS >6 at the time of their admission to the hospital. The association of vital sign changes, alertness and mobility at admission on subsequent outcome was explored. RESULTS: More Kitovu (34.4%) than Danish...... patients (22.1%) died within 60days of admission (OR 1.85, 95% CI 1.27-2.71, p 0.001). However, the survival of non-comatose patients admitted without severely deranged vital signs or who were able to stand without help was identical in both cohorts (Chi square 0.32, p 0.57): these patients made up 50% of...... huge selection and treatment bias found no survival difference at 60days after admission to resource rich and resource poor hospitals for patients without severely deranged vital signs or who were able to stand without help....

  13. Impact of a Chronic Disease Management Program on Hospital Admissions and Readmissions in an Australian Population with Heart Disease or Diabetes

    OpenAIRE

    Hamar, G Brent; Rula, Elizabeth Y.; Wells, Aaron; Coberley, Carter; Pope, James E.; Larkin, Shaun

    2013-01-01

    Chronic disease management programs (CDMPs) were introduced in Australia to reduce unnecessary health care utilization by the growing population with chronic conditions; however, evidence of effectiveness is needed. This study evaluated the impact of a comprehensive CDMP, My Health Guardian (MHG), on rate of hospital admissions, readmissions, and average length of hospital stay (ALOS) for insured individuals with heart disease or diabetes. Primary outcomes were assessed through retrospective ...

  14. Abnormal vital signs are strong predictors for Intensive Care Unit admission and in-hospital mortality in adults triaged in the Emergency Department - A prospective cohort study

    DEFF Research Database (Denmark)

    Barfod, Charlotte; Laurtizen, Marlene Mp; Danker, Jakob K; Söletormos, Georg; Lundager Forberg, Jakob; Berlac, Peter A; Lundstrom, Lars H; Antonsen, Kristian; Lange, Kai Hw; Lippert, Freddy

    2012-01-01

    regression analysis to evaluate the association between the covariates and the outcome measures. RESULTS: The covariates, Tvitals, Tcomplaint and Tfinal were all significantly associated with ICU admission and in-hospital mortality, the odds increasing with the urgency of the triage category. The vital signs...

  15. Acute hospital admission can be disruptive for people with cognitive impairment, and professionals need the skills and resilience to meet their needs

    OpenAIRE

    Nilsson, Anita

    2014-01-01

    Commentary on: Clissett P, Porock D, Harwood HR, et al. The responses of healthcare professionals to the admission of people with cognitive impairment to acute hospital settings: an observational and interview study. J Clin Nurs 2014;23:1820–9.

  16. Evaluation of admissions to the Major Incident Hospital based on a standardized protocol

    OpenAIRE

    Marres, G. M. H.; van der Eijk, J.; Bemelman, M.; Leenen, L.P.H.

    2011-01-01

    Introduction The Major Incident Hospital (MIH) is a unique facility strictly reserved to provide immediate large-scale emergency care for victims of disasters and major incidents. We evaluated the implemented organization to identify strengths and weaknesses, and provide knowledge essential for further improvement of preparedness. Method According to the Protocol for Reports from Major accidents and Disasters (PRMD) and along with our five scenarios for activation, we analyzed all the data fr...

  17. HIV RELATED ADMISSIONS IN A PSYCHIATRIC HOSPITAL A FIVE YEAR PROFILE

    OpenAIRE

    Chandra, P.S.; Krishna, V.A.S.; Ravi, V.; Desai, A.; Puttaram, S.

    1999-01-01

    Recent reports have indicated an increasing prevalence of HIV infection in the mentally ill. Reports have also emphasised the etiological role of HIV infection in psychiatric illness. The aim of this study was to assess the clinical and risk profile of psychiatric inpatients found seropositive for HIV infection. All psychiatric inpatients from a psychiatric hospital who tested positive for HI V infection over a five year period were assessed. The assessments included a detailed clinical histo...

  18. Admissions and costs to acute hospitals resulting from road traffic crashes, 2005-2009.

    LENUS (Irish Health Repository)

    Sheridan, A

    2012-03-01

    Road traffic crashes (RTCs) remain a leading cause of death and injury. The aim of this study was to explore the use of hospital data as a source of RTC-related injury data in Ireland, as current systems are believed to under-estimate the burden. Information on inpatient discharges for years 2005-2009, admitted with RTC-related injuries were extracted from HIPE. There were 14,861 discharges; 9,661 (65.0%) were male, with an average age of 33 years. The median length of stay was two days. The most common diagnosis was head injury (n = 4,644; 31.2%). The average inpatient hospital cost was Euro 6,395 per discharge. 1,498 (10.1%) were admitted to intensive care units. This study has identified 3.5 times more serious injuries (14,861) than identified in the Road Safety Authority (RSA) statistics (4,263) indicating that the extent of road injuries is greater than previously estimated. Hospital data could be used annually in conjunction with RSA and other data; ideally the data should be linked.

  19. Indeterminate EMU admissions: does repeating the admission help?

    Science.gov (United States)

    Zarkou, Srijana; Grade, Madeline; Hoerth, Matthew T; Noe, Katherine H; Sirven, Joseph I; Drazkowski, Joseph F

    2011-04-01

    Epilepsy monitoring unit (EMU) admissions during 2007-2009 at Mayo Clinic Hospital Arizona were reviewed. Of the 106 indeterminate admissions, 13 (12%) went on to have a second admission. During the second admission, 8 (62%) were diagnosed. Five patients went on to have a third or fourth admission, with none of them receiving a diagnosis. Nineteen (18%) patients had ambulatory EEG monitoring after an indeterminate admission, with only one (5%) receiving a diagnosis after ambulatory EEG monitoring. Even in patients who were initially indeterminate, medication management changed 37% of the time. Admission to the EMU was helpful for spell classification, with 80% of the patients receiving a diagnosis after the first admission. Based on this study, a second admission should be considered if no diagnosis is reached after the first admission. If no diagnosis is made after the second EMU admission, subsequent admissions are unlikely to produce a definitive diagnosis. PMID:21441070

  20. Outcomes and hospital admissions during long-term support with a HeartMate II

    DEFF Research Database (Denmark)

    Rossing, Kasper; Jung, Mette Holme; Sander, Kaare;

    2015-01-01

    OBJECTIVES: Continuous-flow left ventricular assist devices like the HeartMate II (HMII) improves survival in severe heart failure but little is known about the incidence and causes of hospitalizations during long-term support which was evaluated in this study. DESIGN: Observational follow-up study...... comprising all patients who received a HMII at our institution either as bridge-to-transplantation (BTT) or destination therapy (DT). All patients were followed from HMII implantation to transplantation, device explantation, death, or May 2015. RESULTS: The HMII was implanted in 66(44 BTT, 22 DT) patients...

  1. Fine Particulate Matter Pollution and Hospital Admissions for Respiratory Diseases in Beijing, China

    OpenAIRE

    Qiulin Xiong; Wenji Zhao; Zhaoning Gong; Wenhui Zhao; Tao Tang

    2015-01-01

    Fine particulate matter has become the premier air pollutant of Beijing in recent years, enormously impacting the environmental quality of the city and the health of the residents. Fine particles with aerodynamic diameters of 0~0.3 μm, 0.3~0.5 μm, and 0.5~1.0 μm, from the yeasr 2007 to 2012, were monitored, and the hospital data about respiratory diseases during the same period was gathered and calculated. Then the correlation between respiratory health and fine particles was studied by spat...

  2. Does Admission to Medicine or Orthopaedics Impact a Geriatric Hip Patient’s Hospital Length of Stay?

    Science.gov (United States)

    Greenberg, Sarah E.; VanHouten, Jacob P.; Lakomkin, Nikita; Ehrenfeld, Jesse; Jahangir, Amir Alex; Boyce, Robert H.; Obremksey, William T.; Sethi, Manish K.

    2016-01-01

    Objectives The aim of our study was to determine the association between admitting service, medicine or orthopaedics, and length of stay (LOS) for a geriatric hip fracture patient. Design Retrospective. Setting Urban level 1 trauma center. Patients/Participants Six hundred fourteen geriatric hip fracture patients from 2000 to 2009. Interventions Orthopaedic surgery for geriatric hip fracture. Main Outcome Measurements Patient demographics, medical comorbidities, hospitalization length, and admitting service. Negative binomial regression used to determine association between LOS and admitting service. Results Six hundred fourteen geriatric hip fracture patients were included in the analysis, of whom 49.2% of patients (n = 302) were admitted to the orthopaedic service and 50.8% (3 = 312) to the medicine service. The median LOS for patients admitted to orthopaedics was 4.5 days compared with 7 days for patients admitted to medicine (P medicine (n = 92, 29.8%) than for those admitted to orthopaedics (n = 70, 23.1%). After controlling for important patient factors, it was determined that medicine patients are expected to stay about 1.5 times (incidence rate ratio: 1.48, P medicine service compared with the orthopaedic service increases a geriatric hip fractures patient’s expected LOS. Since LOS is a major driver of cost as well as a measure of quality care, it is important to understand the factors that lead to a longer hospital stay to better allocate hospital resources. Based on the results from our institution, orthopaedic surgeons should be aware that admission to medicine might increase a patient’s expected LOS. PMID:26371621

  3. The epidemiology of assault-related hospital in-patient admissions and ED attendances.

    LENUS (Irish Health Repository)

    O'Farrell, A

    2013-03-01

    The aim of this study was to describe the epidemiology and impact of serious assault warranting in-patient care over six years and its impact on ED attendances in a large teaching hospital in Dublin over 2 years. There were 16,079 emergency assault-related inpatient hospital discharges reducing from 60.1 per 100,000 population in 2005 to 50.6 per 100,000 population in 2010. The median length of stay was 1 day (1-466) representing 49,870 bed days. The majority were young males (13,921, 86.6%; median age 26 years). Overall crime figures showed a similar reduction. However, knife crimes did not reduce over this period. Data on ED attendances confirmed the age and gender profile and also showed an increase at weekends. Alcohol misuse was recorded in 2,292\\/16079 (14%) of in-patient cases and 242\\/2484 (10%) in ED attendances. An inter-sectoral preventative approach specifically targeting knife crime is required to reduce this burden on health services.

  4. Relationships of physiologically equivalent temperature and hospital admissions due to I30-I51 other forms of heart disease in Germany in 2009-2011.

    Science.gov (United States)

    Shiue, Ivy; Perkins, David R; Bearman, Nick

    2016-04-01

    We aimed to understand relationships of the weather as biometeorological and hospital admissions due to other forms of heart disease by subtypes, which have been paid less attention, in a national setting in recent years. This is an ecological study. Ten percent of daily hospital admissions of the included hospitals (n = 1618) across Germany that were available between 1 January 2009 and 31 December 2011 (n = 5,235,600) were extracted from Statistisches Bundesamt, Germany. We identified I30-I51 other forms of heart disease by the International Classification of Diseases version 10 as the study outcomes. Daily weather data from 64 weather stations that have covered 13 German states, including air temperature, humidity, wind speed, cloud cover, radiation flux and vapour pressure, were obtained and generated into physiologically equivalent temperature (PET). Admissions due to other diseases of pericardium, nonrheumatic mitral valve disorders, nonrheumatic aortic valve disorders, cardiomyopathy, atrioventricular and left bundle-branch block, other conduction disorders, atrial fibrillation and flutter, and other cardiac arrhythmias peaked when PET was between 0 and 10 °C. Complications and ill-defined descriptions of heart disease admissions peaked at PET 0 °C. Cardiac arrest and heart failure admissions peaked when PET was between 0 and -10 °C while the rest did not vary significantly. A common drop of admissions was found when PET was above 10 °C. More medical resources could have been needed for heart health on days when PETs were <10 °C than on other days. Adaptation to such weather change for medical professionals and the general public would seem to be imperative. PMID:26620859

  5. The effect of solar-geomagnetic activity during hospital admission on coronary events within 1 year in patients with acute coronary syndromes

    Science.gov (United States)

    Vencloviene, J.; Babarskiene, R.; Milvidaite, I.; Kubilius, R.; Stasionyte, J.

    2013-12-01

    Some evidence indicates the deterioration of the cardiovascular system during space storms. It is plausible that the space weather conditions during and after hospital admission may affect the risk of coronary events in patients with acute coronary syndromes (ACS). We analyzed the data of 1400 ACS patients who were admitted to the Hospital Lithuanian University of Health Sciences, and who survived for more than 4 days. We evaluated the associations between geomagnetic storms (GS), solar proton events (SPE), and solar flares (SF) that occurred 0-3 days before and after hospital admission and the risk of cardiovascular death (CAD), non-fatal ACS, and coronary artery bypass grafting (CABG) during a period of 1 year; the evaluation was based on the multivariate logistic model, controlling for clinical data. After adjustment for clinical variables, GS occurring in conjunction with SF 1 day before admission increased the risk of CAD by over 2.5 times. GS 2 days after SPE occurred 1 day after admission increased the risk of CAD and CABG by over 2.8 times. The risk of CABG increased by over 2 times in patients admitted during the day of GS and 1 day after SPE. The risk of ACS was by over 1.63 times higher for patients admitted 1 day before or after solar flares.

  6. Impact of Market Competition on Continuity of Care and Hospital Admissions for Asthmatic Children: A Longitudinal Analysis of Nationwide Health Insurance Data 2009-2013.

    Directory of Open Access Journals (Sweden)

    Kyoung Hee Cho

    Full Text Available Ambulatory care-sensitive conditions, including asthma, can be managed with timely and effective outpatient care, thereby reducing the need for hospitalization.This study assessed the relationship between market competition, continuity of care (COC, and hospital admissions in asthmatic children according to their health care provider.A longitudinal design was employed with a 5-year follow-up period, between 2009 and 2013, under a Korean universal health insurance program. A total of 253 geographical regions were included in the analysis, according to data from the Korean Statistical Office. Data from 9,997 patients, aged ≤ 12 years, were included. We measured the COC over a 5-year period using the Usual Provider Continuity (UPC index. Random intercept models were calculated to assess the temporal and multilevel relationship between market competition, COC, and hospital admission rate.Of the 9,997 patients, 243 (2.4% were admitted to the hospital in 2009. In the multilevel regression analysis, as the Herfindahl-Hirschman Index increased by 1,000 points (denoting decreased competitiveness, UPC scores also increased (ß = 0.001; p < 0.0001. In multilevel logistic regression analysis, the adjusted odds ratio (OR for hospital admissions for individuals with lower COC scores (≥ 2 ambulatory visits and a UPC index score of < 1 was 3.61 (95% CI: 2.98-4.38 relative to the reference group (≥ 2 ambulatory visits and a UPC index score of 1.Market competition appears to reduce COC; decreased COC was associated with a higher OR for hospital admissions.

  7. Hospital admissions of hypertension, angina, myocardial infarction and ischemic heart disease peaked at physiologically equivalent temperature 0°C in Germany in 2009-2011.

    Science.gov (United States)

    Shiue, Ivy; Perkins, David R; Bearman, Nick

    2016-01-01

    We aimed to understand and to provide evidence on relationships of the weather as biometeorological and hospital admissions due to hypertension, angina, myocardial infarction and ischemic heart disease in a national setting in recent years that might help indicate when to expect more admissions for health professionals and the general public. This is an ecological study. Ten percent of daily hospital admissions from the included hospitals (n = 1618) across Germany that were available between 1 January 2009 and 31 December 2011 (n = 5,235,600) were extracted from Statistisches Bundesamt, Germany. We identified I11 hypertensive heart disease, I13 hypertensive heart and renal disease, I15 secondary hypertension, I20 angina pectoris, I21 acute myocardial infarction and I25 chronic ischemic heart disease by International Classification of Diseases version 10 as the study outcomes. Daily weather data from 64 weather stations that covered 13 German States including air temperature, humidity, wind speed, cloud cover, radiation flux and vapour pressure were obtained and generated into physiologically equivalent temperature (PET). Two-way fractional-polynomial prediction was plotted with 95% confidence intervals. Hospital admissions of hypertension, angina, myocardial infarction, heart disease peaked in winter and early spring when PETs were around 0°C. Admissions had an apparent drop when PETs reached 10°C. More medical resources could have been needed on days when PETs were around 0°C than on other days. While adaptation to such weather change for health professionals and the general public would seem to be imperative, future research with a longitudinal monitoring would still be needed. PMID:26286805

  8. Fine Particulate Matter Pollution and Hospital Admissions for Respiratory Diseases in Beijing, China

    Directory of Open Access Journals (Sweden)

    Qiulin Xiong

    2015-09-01

    Full Text Available Fine particulate matter has become the premier air pollutant of Beijing in recent years, enormously impacting the environmental quality of the city and the health of the residents. Fine particles with aerodynamic diameters of 0~0.3 μm, 0.3~0.5 μm, and 0.5~1.0 μm, from the yeasr 2007 to 2012, were monitored, and the hospital data about respiratory diseases during the same period was gathered and calculated. Then the correlation between respiratory health and fine particles was studied by spatial analysis and grey correlation analysis. The results showed that the aerial fine particulate matter pollution was mainly distributed in the Zizhuyuan sub-district office. There was a certain association between respiratory health and fine particles. Outpatients with respiratory system disease in this study area were mostly located in the southeastern regions (Balizhuang sub-district office, Ganjiakou sub-district office, Wanshoulu sub-district office, and Yongdinglu sub-district office and east-central regions (Zizhuyuan sub-district office and Shuangyushu sub-district office of the study area. Correspondingly, PM1 (particulate matter with aerodynamic diameter smaller than 1.0 um concentrations in these regions were higher than those in any other regions. Grey correlation analysis results showed that the correlation degree of the fine particle concentration with the number of outpatients is high, and the smaller fine particles had more obvious effects on respiratory system disease than larger particles.

  9. The association of tobacco control policies and the risk of acute myocardial infarction using hospital admissions data.

    Directory of Open Access Journals (Sweden)

    Carmen Jan

    Full Text Available OBJECTIVE: To evaluate the association of a nationwide comprehensive smoking ban (CSB and tobacco tax increase (TTI on the risk of acute myocardial infarctions (AMI in Panama for the period of 2006 - 2010 using hospital admissions data. METHODS: Data of AMI cases was gathered from public and private hospitals in the country for the period of January 1, 2006 to December 31, 2010. The number of AMI cases was calculated on a monthly basis. The risk of AMI was estimated for the pre-CSB period (January 2006 to April 2008 and was used as a reference point. Three post-intervention periods were examined: (1 post-CSB from May 2008 to April 2009 (12 months; (2 post-CSB from May 2009 to November 2009 (7 months; and (3 post-TTI from December 2009 to December 2010 (13 months. Relative risks (RR of AMI were estimated for each post intervention periods by using a Poisson regression model. Mortality registries for the country attributed to myocardial infarction (MI were obtained from January 2001 to December 2012. The annual percentage change (APC of the number of deaths from MI was calculated using Joinpoint regression analysis. RESULTS: A total sample size of 2191 AMI cases was selected (monthly mean number of cases 36.52 ± 8.24 SD. Using the pre-CSB as a reference point (RR = 1.00, the relative risk of AMI during the first CSB period, the second CSB period and post-TTI were 0.982, 1.049, and 0.985, respectively. The APC of deaths from MI from January 2001 to April 2008 was 0.5%. From January 2001 to June 2010 the APC trend was 0.47% and from July 2010 to December 2012 the APC was -0.3%. CONCLUSIONS: The implementation of a CSB and TTI in Panama were associated with a decrease in tobacco consumption and a reduction of the RR of AMI.

  10. Prevalence of deep vein thrombosis (DVT) in non-surgical patients at hospital admission.

    Science.gov (United States)

    Lawall, Holger; Hoffmanns, Wibke; Hoffmanns, Phillip; Rapp, Uli; Ames, Michael; Pira, Alessandro; Paar, W Dieter; Bramlage, Peter; Diehm, Curt

    2007-10-01

    Venous thromboembolism (VTE) is known as a common complication in surgical and non-surgical patients. We hypothesized that according to the underlying risk factors and the acute illness, the prevalence ofVTE in non-surgical patients admitted to hospital is widely underestimated. For three months each patient admitted to the department of internal medicine with an acute illness, but without known deep venous thrombosis (DVT) was investigated by ultrasound compression sonography. Patients' history, risk factors and extent of immobilisation were documented. In patients with newly detected DVT D-dimer and fibrinogen were measured as well as computer tomography scans performed. Follow-up investigations of the DVT population were performed at four weeks and three months. Six hundred seventeen patients (49.3% men) were included. In 16 patients (men = 7) a previously unknown thrombosis (2.6%) was detected, mainly in patients with acute cardio-pulmonary disease (56%) and the elderly (mean age 75.6 years). Eight patients had femoro-popliteal (50.0%), four a femoral (25.0%), and four a popliteal vein thrombosis (25.0%). Five had pulmonary embolism (31.3%). In patients with DVT D-dimer was 875 +/- 1,228 mg/l, fibrinogen 568 +/- 215 mg/dl and C-reactive-protein 58.54 +/- 73.65 mg/dl. One patient died from sepsis during hospitalisation, one died from sudden cardiac death at home. None of the other 14 surviving patients relapsed. The study shows a 2.6% risk for DVT in outpatients with acute illness admitted to the department of internal medicine. These data demonstrate the high risk of DVT is in non-surgical patients. Early prophylaxis has to be considered in internal medicine patients especially in the elderly. PMID:17938799

  11. Pentraxin-3 level at admission is a strong predictor of short-term mortality in a community-based hospital setting

    DEFF Research Database (Denmark)

    Bastrup-Birk, S; Munthe-Fog, L; Skjoedt, M-O; Ma, Y J; Nielsen, H; Køber, L; Nielsen, O W; Iversen, K; Garred, P

    2015-01-01

    BACKGROUND: The pattern recognition molecule pentraxin-3 (PTX3) is a novel potential marker of prognosis, as elevated levels are associated with both disease severity and mortality in patients with a wide range of conditions. However, the usefulness of PTX3 as a prognostic biomarker in a general...... hospital setting is unknown. PATIENTS AND METHODS: The study cohort consisted of 1326 unselected, consecutive patients (age >40 years) admitted to a community hospital in Copenhagen, Denmark. Patients were followed until death or for a median of 11.5 years after admission. The main outcome measure was all......-cause mortality. Serum samples collected from patients at admission and from 192 healthy control subjects were quantified for PTX3 level by enzyme-linked immunosorbent assay. RESULTS: PTX3 was elevated in patients (median 3.7 ng mL(-1) , range 0.5-209.8) compared with healthy nonhospitalized subjects (median 3...

  12. Epidemiologia de internações por doença falciforme no Brasil Epidemiology of sickle cell disease hospital admissions in Brazil

    Directory of Open Access Journals (Sweden)

    Monique Morgado Loureiro

    2005-12-01

    Full Text Available OBJETIVO: A doença falciforme é uma enfermidade hereditária que afeta principalmente a população negra. O estudo teve por objetivo analisar as internações devido às complicações da doença, com enfoque nos aspectos epidemiológicos e clínicos. MÉTODOS: A população estudada foi constituída de 9.349 pacientes com diagnóstico de doença falciforme internados em hospitais da Bahia, Rio de Janeiro e São Paulo, no período de 2000 a 2002. Utilizaram-se os dados do Sistema de Internações Hospitalares do Sistema Único de Saúde. As variáveis respostas foram o óbito e o tempo médio de permanência hospitalar. As covariáveis foram o sexo, a idade, o tipo de admissão e a natureza jurídica do hospital. As proporções foram comparadas utilizando-se o teste qui-quadrado ou de Fischer; e para as variáveis contínuas, foi utilizado o teste Mann-Whitney ou Kruskall-Wallis. RESULTADOS: A mediana de idade variou de 11,0 a 12,0 anos e cerca de 70% das internações foram abaixo dos 20 anos. A mediana de dias de permanência hospitalar variou com a idade e o tipo de admissão. O tipo de admissão mais freqüente foi pela emergência (65,6 a 90,8%. Foi observada maior letalidade hospitalar entre adultos. A mediana da idade do óbito foi baixa (26,5 a 31,5 anos. CONCLUSÕES: Os resultados confirmaram a alta morbidade na população jovem e evidenciaram predominância de óbitos entre adultos jovens.OBJECTIVE: Sickle cell disease is a hereditary disease, which affects mainly the black population. The aim of the present study was to analyze hospital admissions due to acute events resulting from sickle cell disease, at the epidemiological and clinical levels. METHODS: The study population included 9,349 patients with sickle cell disease admitted to hospitals in Bahia, Rio de Janeiro, and Sao Paulo, between 2000 and 2002. The national hospital database of the Brazilian Healthcare System was used. Response variables were death and mean duration

  13. Trend in admissions, clinical features and outcome of preeclampsia and eclampsia as seen from the intensive care unit of the Douala General Hospital, Cameroon

    OpenAIRE

    Priso, Eugene Belley; Njamen, Theophile Nana; Tchente, Charlotte Nguefack; Kana, Albert Justin; Landry, Tchuenkam; Tchawa, Ulrich Flore Nyaga; Hentchoya, Romuald; Beyiha, Gerard; Halle, Marie Patrice; Aminde, Leopold; Dzudie, Anastase

    2015-01-01

    Introduction Hypertensive disorders in pregnancy (HDP) are a major cause of maternal morbidity and mortality. We aimed at determining the trends in admission, profiles and outcomes of women admitted for preeclampsia and eclampsia to an intensive care unit (ICU) in Cameroon. Methods A retrospective study involving 74 women admitted to the ICU of the Douala General Hospital for severe preeclampsia and eclampsia from January 2007 to December 2014. Clinical profiles and outcome data were obtained...

  14. Alcohol and risk of admission to hospital for unintentional cutting or piercing injuries at home: a population-based case-crossover study

    OpenAIRE

    Thornley Simon; Kool Bridget; Robinson Elizabeth; Marshall Roger; Smith Gordon S; Ameratunga Shanthi

    2011-01-01

    Abstract Background Cutting and piercing injuries are among the leading causes of unintentional injury morbidity in developed countries. In New Zealand, cutting and piercing are second only to falls as the most frequent cause of unintentional home injuries resulting in admissions to hospital among people aged 20 to 64 years. Alcohol intake is known to be associated with many other types of injury. We used a case-crossover study to investigate the role of acute alcohol use (i.e., drinking duri...

  15. Hospital admissions due to diseases of arteries and veins peaked at physiological equivalent temperature -10 to 10 °C in Germany in 2009-2011.

    Science.gov (United States)

    Shiue, Ivy; Perkins, David R; Bearman, Nick

    2016-04-01

    We aimed to understand relationships of the weather as biometeorological and hospital admissions due to diseases of arteries and veins by subtypes, which have been scarcely studied, in a national setting in recent years. This is an ecological study. Ten percent of daily hospital admissions from the included hospitals (n = 1,618) across Germany that were available between 1 January 2009 and 31 December 2011 (n = 5,235,600) were extracted from Statistisches Bundesamt, Germany. We identified I70-I79 Diseases of arteries, arterioles and capillaries and I80-I89 Diseases of veins, lymphatic vessels and lymph nodes by International Classification of Diseases version 10 as the study outcomes. Daily weather data from 64 weather stations that covered 13 German states including air temperature, humidity, wind speed, cloud cover, radiation flux and vapour pressure were obtained and generated into physiologically equivalent temperature (PET). Two-way fractional-polynomial prediction was plotted with 95 % confidence intervals. For most of the subtypes from diseases of arteries and veins, hospital admissions slightly peaked in spring and dropped when PET was at 10 °C. There were no other large differences across 12 months. Admissions of peripheral vascular diseases, arterial embolism and thrombosis, phlebitis and thrombophlebitis, oesophageal varices and nonspecific lymphadenitis peaked when PET was between 0 and -10 °C, while others peaked when PET was between 0 and 10 °C. More medical resources could have been needed on days when PETs were at -10 to 10 °C than on other days. Adaptation to such weather change for health professionals and the general public would seem to be imperative. PMID:26631019

  16. Short term effects of air pollution on emergency hospital admissions for respiratory disease: results of the APHEA project in two major cities in The Netherlands, 1977-89.

    OpenAIRE

    Schouten, J. P.; Vonk, J. M.; de Graaf, A

    1996-01-01

    STUDY OBJECTIVE: To assess the short term relationship between air pollution and the daily number of emergency hospital admissions for respiratory disease. DESIGN: Data were analysed using autoregressive Poisson regression allowing for overdispersion and controlling for possible confounding factors such as seasonal and other chronological variables, meteorological factors, and influenza epidemics. SETTING: The two major cities in The Netherlands-Amsterdam (694,700 inhabitants) and Rotterdam (...

  17. A Randomized Trial of a Standard Dose of Edmonston-Zagreb Measles Vaccine Given at 4.5 Months of Age: Effect on Total Hospital Admissions

    OpenAIRE

    Martins, Cesario L.; Benn, Christine S.; Andersen, Andreas; Balé, Carlito; Schaltz-Buchholzer, Frederik; Do, Vu An; Rodrigues, Amabelia; Aaby, Peter; Ravn, Henrik; Whittle, Hilton; Garly, May-Lill

    2014-01-01

    Observational studies and trials from low-income countries indicate that measles vaccine has beneficial nonspecific effects, protecting against non–measles-related mortality. It is not known whether measles vaccine protects against hospital admissions. Between 2003 and 2007, 6417 children who had received the third dose of diphtheria, tetanus, and pertussis vaccine were randomly assigned to receive measles vaccine at 4.5 months or no measles vaccine; all children were offered measles vaccine ...

  18. Drug-Related Hospital Visits and Admissions Associated with Laboratory or Physiologic Abnormalities-A Systematic-Review.

    Directory of Open Access Journals (Sweden)

    Kerry Wilbur

    Full Text Available Countless studies have demonstrated that many emergency-room visits and hospital admissions are drug-related and that a significant proportion of these drug-related visits (DRVs are preventable. It has not been previously studied which DRVs could be prevented through enhanced monitoring of therapy. The objective of the study was to determine the incidence of DRVs attributed to laboratory or physiologic abnormalities. Three authors independently performed comprehensive searches in relevant health care databases using pre-determined search terms. Articles discussing DRV associated with poisoning, substance abuse, or studied among existing in-patient populations were excluded. Study country, year, sample, design, duration, DRV identification method, proportion of DRVs associated with laboratory or physiologic abnormalities and associated medications were extracted. The three authors independently assessed selected relevant articles according to the Strengthening the reporting of observational studies in epidemiology (STROBE as applicable according to the studies' methodology. The initial literature search yielded a total of 1,524 articles of which 30 articles meeting inclusion criteria and reporting sufficient laboratory or physiologic data were included in the overall analysis. Half employed prospective methodologies, which included both chart review and patient interview; however, the overwhelming majority of identified studies assessed only adverse drug reactions (ADRs as a drug-related cause for DRV. The mean (range prevalence of DRVs found in all studies was 15.4% (0.44%-66.7% of which an association with laboratory or physiologic abnormalities could be attributed to a mean (range of 29.4% (4.3%-78.1% of cases. Most laboratory-associated DRVs could be linked to immunosuppressant, antineoplastic, anticoagulant and diabetes therapy, while physiologic-associated DRVs were attributed to cardiovascular therapies and NSAIDs. Significant proportions

  19. Evaluation of the causes of neonatal jaundice, based on the infant’s age at disease onset and age at hospital admission

    Directory of Open Access Journals (Sweden)

    Hassan Boskabadi

    2016-01-01

    Full Text Available Background: Jaundice is the most common cause of neonatal admission within the first month after birth. Therefore, by identifying the causes of jaundice based on the infant’s age at disease onset and age at hospital admission and providing the required training, jaundice can be managed and its associated complications can be prevented. This study was performed to evaluate the causes of neonatal jaundice, based on the infant’s age at disease onset and age at hospital admission. Methods: In this cross-sectional study, out of 3,130 infants with jaundice, referring to Ghaem Hospital, Mashhad, Iran, from 2003 to 2015, 2,658 newborns were selected. Causes of jaundice are determined based on hematocrit, direct and indirect bilirubin, Coombs test, reticulocyte count, blood group and Rh of mother and neonate, thyroid tests, glucose-6-phosphate dehydrogenase (G6PD enzyme testing, urinalysis, urine culture, and If necessary, Na, blood urea nitrogen, creatinine and other tests depending on the doctor's supervision. After confirming jaundice in infants, based on the physician’s diagnosis and laboratory results, a researcher-made questionnaire including the infant’s characteristics, was completed. Results: Based on our study, 27.9% of infants had identified as causes of jaundice. Known causes of jaundice were blood group incompatibility (40%, infection (19%, G6PD enzyme deficiency (12%, endocrine disorders (8%, neonatal hypernatremic dehydration (7%, polycythemia (6%, congenital heart disease (CHD (4%, occult bleeding (3% and Crigler-Najjar syndrome (2%. The most common time of hospital admission of jaundice was 4-6 days after birth due to blood incompatibilities, occult bleeding, endocrine disorders, hypernatremic dehydration, CHD, polycythemia and G6PD enzyme deficiency. Moreover, the most common time of admission due to infection was after the first week of birth. Conclusion: The most common age of onset of jaundice was first three days of birth

  20. Hospital admissions of HIV-infected patients at a Lisbon reference centre: comparison among previously known and in-ward HIV-diagnosed patients

    Directory of Open Access Journals (Sweden)

    A Miranda

    2012-11-01

    Full Text Available Comparison of hospital admission causes for previously known (group A and HIV-infected patients diagnosed during in-ward stay (group B, from 2009 to 2011. Retrospective evaluation of demographic, epidemiologic, clinical, immunologic, virologic and treatment parameters at time of admission. 1167 patients were admitted; of those 617 (52,9% were HIV-infected: 92% HIV-1 and 8% HIV-2. 83% had previously known HIV infection and 15% were diagnosed during hospital stay (missing data in 2%. 66% were male, mean age was 46 years and 52% were Portuguese. The most frequent transmission routes were heterosexual exposure (36% and iv drug use (29%. Mean length of hospital stay was 17 days (group A and 28 days (group B (p = 0,004. At admission, the mean TCD4+ count was 280 cells/mm3 in group A, and 132 cells/mm3 in group B (p<0,001. The majority of group B patients had clinical or immunological AIDS criteria at admission (84% while group A presented a 71% rate for the same parameter (p=0,011. In group A, 52% of patients were on antiretroviral therapy but of those only 33% presented undetectable HIV plasma RNA, non-adherence being an important cause of therapeutic failure identified in 40% of cases. Respiratory infection was the principal cause of hospital admission in both groups (33% in group A vs. 35% in group B. The most prevalent nosological entities were community acquired pneumonia in group A (18,1% vs. 11,5%-p=0,118 and Pneumocystis jirovecii pneumonia in group B (4% vs. 18%-p<0,001. Mycobacterium tuberculosis was frequently identified as an agent of opportunistic infection (10% in group A vs. 24% in group B-p=<0,001. HCV coinfection was a comorbidity found in 37% in group A vs. 11% in group B (p<0,001. Other relevant comorbidities were psychiatric disturbances (16% vs. 3%-p=0,001 and neoplastic conditions (11% vs. 0%-p=0,001, mostly present in group A. Mortality rate was not significantly different between groups (10% group A vs. 11% group B (p=0

  1. Abnormal vital signs are strong predictors for intensive care unit admission and in-hospital mortality in adults triaged in the emergency department - a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Barfod Charlotte

    2012-04-01

    Full Text Available Abstract Background Assessment and treatment of the acutely ill patient have improved by introducing systematic assessment and accelerated protocols for specific patient groups. Triage systems are widely used, but few studies have investigated the ability of the triage systems in predicting outcome in the unselected acute population. The aim of this study was to quantify the association between the main component of the Hillerød Acute Process Triage (HAPT system and the outcome measures; Admission to Intensive Care Unit (ICU and in-hospital mortality, and to identify the vital signs, scored and categorized at admission, that are most strongly associated with the outcome measures. Methods The HAPT system is a minor modification of the Swedish Adaptive Process Triage (ADAPT and ranks patients into five level colour-coded triage categories. Each patient is assigned a triage category for the two main descriptors; vital signs, Tvitals, and presenting complaint, Tcomplaint. The more urgent of the two determines the final triage category, Tfinal. We retrieved 6279 unique adult patients admitted through the Emergency Department (ED from the Acute Admission Database. We performed regression analysis to evaluate the association between the covariates and the outcome measures. Results The covariates, Tvitals, Tcomplaint and Tfinal were all significantly associated with ICU admission and in-hospital mortality, the odds increasing with the urgency of the triage category. The vital signs best predicting in-hospital mortality were saturation of peripheral oxygen (SpO2, respiratory rate (RR, systolic blood pressure (BP and Glasgow Coma Score (GCS. Not only the type, but also the number of abnormal vital signs, were predictive for adverse outcome. The presenting complaints associated with the highest in-hospital mortality were 'dyspnoea' (11.5% and 'altered level of consciousness' (10.6%. More than half of the patients had a Tcomplaint more urgent than Tvitals

  2. Medical comorbidities at admission is predictive for 30-day in-hospital mortality in patients with acute myocardial infarction: analysis of 5161 cases

    Institute of Scientific and Technical Information of China (English)

    Xue-Dong Yang; Yu-Sheng Zhao; Yu-Feng Li; Xin-Hong Guo

    2011-01-01

    Background The present study investigated the prognostic value of medical comorbidities at admission for 30-day in-hospital mortality in patients with acute myocardial infarction (AMI). Methods A total of 5161 patients with AMI were admitted in Chinese PLA General Hospital between January 1. 1993 and December 31, 2007. Medical comorbidities including hypertension, diabetes mellitus,previous myocardial infarction, valvular heart disease, chronic obstructive pulmonary disease (COPD), renal insufficiency, previous stroke,atrial fibrillation and anemia, were identified at admission. The patients were divided into 4 groups based on the number of medical comorbidities at admission (0, 1, 2, and ≥ 3). Cox regression analysis was used to calculate relative risk (RR) and 95% confidence intervals (CI), with adjustment for age, sex, heart failure and percutaneous coronary intervention (PCI). Results The mean age of the studied population was 63.9 ± 13.6 years, and 80.1% of the patients were male. In 74.6% of the patients at least one comorbidity were identified.Hypertension (50.7%), diabetes mellitus (24.0%) and previous myocardial infarction (12%) were the leading common comorbidities at admission. The 30-day in-hospital mortality in patients with 0, I, 2, and ≥ 3 comorbidities at admission (7.2%) was 4.9%, 7.2%, 11.1%, and 20.3%, respectively. The presence of 2 or more comorbidities was associated with higher 30-day in-hospital mortality compared with patients without comorbidity (RR: 1.41, 95% CI: 1.13-1.77, P = 0.003, and RR: 1.95, 95% CI: 1.59-2.39, P = 0.000, respectively).Conclusions Medical comorbidities were frequently found in patients with AMI. AMI patients with more comorbidities had a higher 30-day in-hospital mortality might be predictive of early poor outcome in patients with AMI.J Geriatr Cardiol2011; 8: 31-34. doi: 10.3724/SP.J.1263.2011.00031

  3. A tale of two cities: effects of air pollution on hospital admissions in Hong Kong and London compared.

    OpenAIRE

    Wong, Chit-Ming; Atkinson, Richard W; Anderson, H Ross; Hedley, Anthony Johnson; Ma, Stefan; Chau, Patsy Yuen-Kwan; Lam, Tai-Hing

    2002-01-01

    The causal interpretation of reported associations between daily air pollution and daily admissions requires consideration of residual confounding, correlation between pollutants, and effect modification. If results obtained in Hong Kong and London--which differ in climate, lifestyle, and many other respects--were similar, a causal association would be supported. We used identical statistical methods for the analysis in each city. Associations between daily admissions and pollutant levels wer...

  4. A tale of two cities: effects of air pollution on hospital admissions in Hong Kong and London compared.

    Science.gov (United States)

    Wong, Chit-Ming; Atkinson, Richard W; Anderson, H Ross; Hedley, Anthony Johnson; Ma, Stefan; Chau, Patsy Yuen-Kwan; Lam, Tai-Hing

    2002-01-01

    The causal interpretation of reported associations between daily air pollution and daily admissions requires consideration of residual confounding, correlation between pollutants, and effect modification. If results obtained in Hong Kong and London--which differ in climate, lifestyle, and many other respects--were similar, a causal association would be supported. We used identical statistical methods for the analysis in each city. Associations between daily admissions and pollutant levels were estimated using Poisson regression. Nonparametric smoothing methods were used to model seasonality and the nonlinear dependence of admissions on temperature, humidity, and influenza admissions. For respiratory admissions (> or = 65 years of age), significant positive associations were observed with particulate matter ozone in both cities. These associations tended to be stronger at shorter lags in Hong Kong and at longer lags in London. Associations were stronger in the cool season in Hong Kong and in the warm season in London, periods during which levels of humidity are at their lowest in each city. For cardiac admissions (all ages) in both cities, significant positive associations were observed for PM(10), NO(2), and SO(2) with similar lag patterns. Associations tended to be stronger in the cool season. The associations with NO(2) and SO(2) were the most robust in two-pollutant models. Patterns of association for pollutants with ischemic heart disease were similar in the two cities. The associations between O(3) and cardiac admissions were negative in London but positive in Hong Kong. We conclude that air pollution has remarkably similar associations with daily cardiorespiratory admissions in both cities, in spite of considerable differences between cities in social, lifestyle, and environmental factors. The results strengthen the argument that air pollution causes detrimental short-term health effects. PMID:11781167

  5. Does the duration of smoking cessation have an impact on hospital admission and health-related quality of life amongst COPD patients?

    Directory of Open Access Journals (Sweden)

    Hassan HA

    2014-05-01

    Full Text Available Hazlinda Abu Hassan,1,3 Noorizan Abd Aziz,2,* Yahaya Hassan,2,* Fahmi Hassan2,* 1Malacca Pharmaceutical Services Division, Ministry of Health Malaysia, Ayer Keroh, Malaysia; 2Faculty of Pharmacy, Universiti Teknologi MARA, Puncak Alam, Malaysia; 3Department of Respiratory Medicine, Malacca Hospital, Jalan Mufti Haji Khalil, Malaysia *These authors contributed equally to this work Background: Lack of awareness among ex-smokers on the benefits of sustaining smoking cessation may be the main cause of their smoking relapse. This study explored health-related quality of life (HRQoL and hospital admission amongst chronic obstructive pulmonary disease (COPD patients according to the duration of smoking cessation. Materials and methods: This study recruited COPD patients from a chest clinic who agreed to participate in a medication therapy-adherence program from January to June 2013. They were interviewed during their visits to obtain information regarding their smoking history and HRQoL. They were divided into three groups according to smoking status (sustained quitters, quit ≥5 years; quitters, quit <5 years; and smokers, smoking at least one cigarette/day. The effects of the duration of cessation on HRQoL and hospital admission were analyzed using a multinomial logistic model. Results: A total of 117 participants with moderate COPD met the inclusion criteria, who were comprised of 41 sustained quitters, 40 quitters, and 36 smokers. Several features were similar across the groups. Most of them were married elderly men (aged >64 years with low-to-middle level of education, who smoked more than 33 cigarettes per day and had high levels of adherence to the medication regimen. The results showed that sustained quitters were less likely to have respiratory symptoms (cough, phlegm and dyspnea than smokers (odds ratio 0.02, confidence interval 0–0.12; P<0.001. The hospital admission rate per year was increased in quitters compared to smokers (odds ratio

  6. Implementation of a Trauma Service Activation and Admission Policy for Very Elderly Trauma Patients: Impact on Hospital Efficiency and Patient Outcomes.

    Science.gov (United States)

    Kalina, Michael

    2016-06-01

    Very elderly trauma patients (VETs) were routinely admitted to nonsurgical services at our institution; therefore, a trauma service activation and admission policy was implemented. Our goal was to determine policy success and impact on efficiency and outcomes. VETs, defined as trauma patients aged >89 years, admitted before and after policy implementation were reviewed. Demographics included age, gender, Injury Severity Score, Glasgow Coma Score, admission diagnosis, mechanism of injury, admission service, and comorbidities. Efficiency included intensive care unit length of stay (ICU-LOS) and hospital length of stay (H-LOS). Outcomes included complications, discharge disposition, and mortality. Statistical analysis included Chi square, Fisher's exact test, and regression analyses, significance denoted by P VETs were investigated. Demographic analysis revealed differences in Injury Severity Score (9.4 + 5.4 vs 7.2 + 4.0, P VETs admitted to the trauma service increased from 28.3 per cent to 40.5 per cent, P = 0.02. Efficiency analysis revealed differences in ICU-LOS (4.0 + 4.2 days vs 0.7 + 1.3 days, P VETs led to improved hospital efficiency. PMID:27305879

  7. NT-proBNP and Its Correlation with In-Hospital Mortality in the Very Elderly without an Admission Diagnosis of Heart Failure

    Science.gov (United States)

    Spannella, Francesco; Giulietti, Federico; Fedecostante, Massimiliano; Giordano, Piero; Gattafoni, Pisana; Espinosa, Emma; Busco, Franco; Piccinini, Gina; Dessì-Fulgheri, Paolo

    2016-01-01

    Background The diagnosis of heart failure (HF) is often difficult and underestimated in very elderly comorbid patients, especially when an echocardiographic evaluation is not available or feasible. Aim: to evaluate NT-proBNP values and their correlation with in-hospital mortality in a population of very elderly hospitalized for medical conditions other than HF. Methods We performed a prospective observational study on 403 very elderly admitted to an Internal Medicine and Geriatrics Department. Exclusion criterion was an admission diagnosis of HF. Patients with at least one symptom or sign compatible with HF were tested for NT-proBNP. NT-proBNP values < 300 pg/ml were considered as an age-independent exclusion criterion for HF (high negative predictive value), while NT-proBNP values ≥ 1800 pg/ml were considered as a diagnostic criterion. Main comorbidities and laboratory parameters were considered to adjust regression analyses between NT-proBNP and in-hospital mortality. Results NT-proBNP values ≥ 1800 pg/ml were present in 61.0% of patients and 32.8% of patients laid between 300 ≤ NT-proBNP < 1800 pg/ml values. NT-proBNP values were associated with the main indices of disease severity/organ failure considered such as reduced eGFR, reduced albumin and elevated CRP. NT-proBNP values ≥ 1800 pg/ml and ln(NT-proBNP) values were significantly associated with in-hospital mortality independently from the main comorbidities and lab parameters considered. The patients, who were already taking ACE inhibitors/Angiotensin Receptor Blockers before admission, showed lower in-hospital mortality. Conclusions Testing for NT-proBNP should be strongly recommended in the hospitalized very elderly, because of the very high prevalence of underlying HF and its impact on in-hospital mortality, to identify an underlying cardiac involvement that requires appropriate treatment. PMID:27077910

  8. Effects of short-term exposure to air pollution on hospital admissions of young children for acute lower respiratory infections in Ho Chi Minh City, Vietnam.

    Science.gov (United States)

    Le, Truong Giang; Ngo, Long; Mehta, Sumi; Do, Van Dzung; Thach, T Q; Vu, Xuan Dan; Nguyen, Dinh Tuan; Cohen, Aaron

    2012-06-01

    There is emerging evidence, largely from studies in Europe and North America, that economic deprivation increases the magnitude of morbidity and mortality related to air pollution. Two major reasons why this may be true are that the poor experience higher levels of exposure to air pollution, and they are more vulnerable to its effects--in other words, due to poorer nutrition, less access to medical care, and other factors, they experience more health impact per unit of exposure. The relations among health, air pollution, and poverty are likely to have important implications for public health and social policy, especially in areas such as the developing countries of Asia where air pollution levels are high and many live in poverty. The aims of this study were to estimate the effect of exposure to air pollution on hospital admissions of young children for acute lower respiratory infection (ALRI*) and to explore whether such effects differed between poor children and other children. ALRI, which comprises pneumonia and bronchiolitis, is the largest single cause of mortality among young children worldwide and is responsible for a substantial burden of disease among young children in developing countries. To the best of our knowledge, this is the first study of the health effects of air pollution in Ho Chi Minh City (HCMC), Vietnam. For these reasons, the results of this study have the potential to make an important contribution to the growing literature on the health effects of air pollution in Asia. The study focused on the short-term effects of daily average exposure to air pollutants on hospital admissions of children less than 5 years of age for ALRI, defined as pneumonia or bronchiolitis, in HCMC during 2003, 2004, and 2005. Admissions data were obtained from computerized records of Children's Hospital 1 and Children's Hospital 2 (CH1 and CH2) in HCMC. Nearly all children hospitalized for respiratory illnesses in the city are admitted to one of these two pediatric

  9. Anthropogenic Factors Are the Major Cause of Hospital Admission of a Threatened Species, the Grey-Headed Flying Fox (Pteropus poliocephalus, in Victoria, Australia.

    Directory of Open Access Journals (Sweden)

    Titus Franciscus Scheelings

    Full Text Available To determine the reasons for presentation and outcomes of hospitalised grey-headed flying foxes (Pteropus poliocephalus in Victoria, Australia, a retrospective analysis was performed on 532 records from two wildlife hospitals. Cases were categorised based on presenting signs and outcomes determined. Anthropogenic factors (63.7% were a major cause of flying fox admissions with entanglement in fruit netting the most significant risk for bats (36.8%. Overall the mortality rate for flying fox admissions was 59.3%. This study highlights the effects of urbanisation on wild animal populations and a need for continued public education in order to reduce morbidity and mortality of wildlife, especially threatened species.

  10. DUNDRUM-2: Prospective validation of a structured professional judgment instrument assessing priority for admission from the waiting list for a Forensic Mental Health Hospital.

    LENUS (Irish Health Repository)

    Flynn, Grainne

    2011-07-03

    Abstract Background The criteria for deciding who should be admitted first from a waiting list to a forensic secure hospital are not necessarily the same as those for assessing need. Criteria were drafted qualitatively and tested in a prospective \\'real life\\' observational study over a 6-month period. Methods A researcher rated all those presented at the weekly referrals meeting using the DUNDRUM-1 triage security scale and the DUNDRUM-2 triage urgency scale. The key outcome measure was whether or not the individual was admitted. Results Inter-rater reliability and internal consistency for the DUNDRUM-2 were acceptable. The DUNDRUM-1 triage security score and the DUNDRUM-2 triage urgency score correlated r = 0.663. At the time of admission, after a mean of 23.9 (SD35.9) days on the waiting list, those admitted had higher scores on the DUNDRUM-2 triage urgency scale than those not admitted, with no significant difference between locations (remand or sentenced prisoners, less secure hospitals) at the time of admission. Those admitted also had higher DUNDRUM-1 triage security scores. At baseline the receiver operating characteristic area under the curve for a combined score was the best predictor of admission while at the time of admission the DUNDRUM-2 triage urgency score had the largest AUC (0.912, 95% CI 0.838 to 0.986). Conclusions The triage urgency items and scale add predictive power to the decision to admit. This is particularly true in maintaining equitability between those referred from different locations.

  11. Oral Polio Vaccination and Hospital Admissions With Non-Polio Infections in Denmark: Nationwide Retrospective Cohort Study.

    Science.gov (United States)

    Sørup, Signe; Stensballe, Lone G; Krause, Tyra G; Aaby, Peter; Benn, Christine S; Ravn, Henrik

    2016-01-01

    Background.  Live vaccines may have nonspecific beneficial effects on morbidity and mortality. This study examines whether children who had the live-attenuated oral polio vaccine (OPV) as the most recent vaccine had a different rate of admissions for infectious diseases than children with inactivated diphtheria-tetanus-pertussis-polio-Haemophilus influenzae type b vaccine (DTaP-IPV-Hib) or live measles-mumps-rubella vaccine (MMR) as their most recent vaccine. Methods.  A nationwide, register-based, retrospective cohort study of 137 403 Danish children born 1997-1999, who had received 3 doses of DTaP-IPV-Hib, were observed from 24 months (first OPV dose) to 36 months of age. Results.  Oral polio vaccine was associated with a lower rate of admissions with any type of non-polio infection compared with DTaP-IPV-Hib as most recent vaccine (adjusted incidence rate ratio [IRR], 0.85; 95% confidence interval [CI], .77-.95). The association was separately significant for admissions with lower respiratory infections (adjusted IRR, 0.73; 95% CI, .61-.87). The admission rates did not differ for OPV versus MMR. Conclusions.  Like MMR, OPV was associated with fewer admissions for lower respiratory infections than having DTaP-IPV-Hib as the most recent vaccination. Because OPV is now being phased-out globally, further studies of the potential beneficial nonspecific effects of OPV are warranted. PMID:26885538

  12. A Telephone Support Program to Reduce Costs and Hospital Admissions for Patients at Risk of Readmissions: Lessons from an Evaluation of a Complex Health Intervention.

    Science.gov (United States)

    Morello, Renata T; Barker, Anna L; Watts, Jennifer J; Bohensky, Megan A; Forbes, Andrew B; Stoelwinder, Johannes

    2016-06-01

    This study aimed to evaluate the effectiveness of a telephone health coaching and support service provided to members of an Australian private health insurance fund-Telephonic Complex Care Program (TCCP)-on hospital use and associated costs. A case-control pre-post study design was employed using propensity score matching. Private health insurance members (n=273) who participated in TCCP between April and December 2012 (cases) were matched (1:1) to members who had not previously been enrolled in the program or any other disease management programs offered by the insurer (n=232). Eligible members were community dwelling, aged ≥65 years, and had 2 or more hospital admissions in the 12 months prior to program enrollment. Preprogram variables that estimated the propensity score included: participant demographics, diagnoses, and hospital use in the 12 months prior to program enrollment. TCCP participants received one-to-one telephone support, personalized care plan, and referral to community-based services. Control participants continued to access usual health care services. Primary outcomes were number of hospital admission claims and total benefits paid for all health care utilizations in the 12 months following program enrollment. Secondary outcomes included change in total benefits paid, hospital benefits paid, ancillary benefits paid, and total hospital bed days over the 12 months post enrollment. Compared with matched controls, TCCP did not appear to reduce health care utilization or benefits paid in the 12 months following program enrollment. However, program characteristics and implementation may have impacted its effectiveness. In addition, challenges related to evaluating complex health interventions such as TCCP are discussed. (Population Health Management 2016;19:187-195). PMID:26237303

  13. Estado nutricional al ingreso de los pacientes internados con VIH Nutritional status of hospitalized HIV patients at admission

    Directory of Open Access Journals (Sweden)

    Soledad Freijo

    2010-03-01

    describe the behaviour of nutritional profile components of patients diagnosed with HIV/AIDS who are admitted at Juan A. Fernández General Acute Care Hospital (Argentina. Material and methods: Descriptive, cross-sectional and prospective study. The profile of HIV/AIDS patients admitted at the hospital was analysed. A nutritional assessment form was completed with the components of the assessed nutritional profile: weight loss percentage (WLP, body fat percentage (BFP, protein percentage (PP, Body Mass Index (BMI, Subjective Global Assessment (SGA, Biochemistry Data (BD and Prior Nutrition Appointment (PNA. Results: The sample comprised 22 patients. 32% had a severe WL during the 6 months prior to their admission (CI 95%=12.4 - 61.4. 55.6% of women had a BFP higher than the maximum recommended range (CI 95%=13.6 - 79.1, while 30.8% of men were above the maximum range (CI 95%=9.0 - 61.7. 36% had a low PP (CI 95%: 15.8- 65.6. 63.6% had an adequate BMI (IC 95%=34.3 - 84.1. 59.1% had an inadequate SGA (CI 95%: 30.3 - 80%. Finally, 86.3% stated that they had never attended a nutritional appointment (IC 95%=62.8 - 97.0. Conclusion: The analysis of the nutritional profile components shows that the infected population that is admitted in the unit has an inadequate nutritional profile with alterations in the protein and body fat percentages, which may or may not be justified by the antiretroviral treatment or by the course of the disease itself.

  14. Effect of particulate matter air pollution on hospital admissions and medical visits for lung and heart disease in two southeast Idaho cities.

    Science.gov (United States)

    Ulirsch, Gregory V; Ball, Louise M; Kaye, Wendy; Shy, Carl M; Lee, Carolyn V; Crawford-Brown, Douglas; Symons, Michael; Holloway, Tracey

    2007-08-01

    Few, if any, published time series studies have evaluated the effects of particulate matter air exposures by combining hospital admissions with medical visit data for smaller populations. We investigated the relationship between daily particulate matter (influenza, and day-of-week effects were controlled. In single-pollutant models, respiratory disease admissions and visits increased (7.1-15.4% per 50 microg/m3 PM10) for each age group analyzed, with the highest increases in two groups, children and especially the elderly. Statistical analyses suggest that the results probably did not occur by chance. Sensitivity analyses did not provide strong evidence that the respiratory disease effect estimates were sensitive to reasonable changes in the final degrees of freedom choice for time and weather effects. No strong evidence of confounding by NO2 and SO2 was found from results of multi-pollutant models. Ozone and carbon monoxide data were not available to include multi-pollutant models, but evidence suggests that they were not a problem. Unexpectedly, evidence of an association between PM10 with cardiovascular disease was not found, possibly due to the lifestyles of the mostly Mormon study population. Successful time series analyses can be performed on smaller populations if diverse, centralized databases are available. Hospitals that offer urgent or other primary care services may be a rich source of data for researchers. Using data that potentially represented a wide-range of disease severity, the findings provide evidence that evaluating only hospital admissions or emergency room visit effects may underestimate the overall morbidity due to acute particulate matter exposures. Further work is planned to test this conclusion. PMID:17299531

  15. The impact of 9/11 on the association of ambient air pollution with daily respiratory hospital admissions in a Canada-US border city, Windsor, Ontario

    OpenAIRE

    LUGINAAH, ISAAC; Fung, Karen Y.; GOREY, KEVIN M.; KHAN, SHAHEDUL

    2006-01-01

    The 11 September 2001 (9/11) terrorist attacks in the United States resulted in long lines of trucks at the border crossing in Windsor, Ontario. Public concern about the potential impact of these trucks spewing toxic pollutants into the air drew attention to the need to investigate the impact of 9/11 on the daily levels of air pollutants and respiratory hospitalization. In this study, significant increases in respiratory admissions were found one month and 6 months post-9/11. Mean daily respi...

  16. Long-term exposure to air pollution and hospital admissions for ischemic stroke. A register-based case-control study using modelled NOx as exposure proxy

    OpenAIRE

    Oudin, Anna; Stroh, Emilie; Strömberg, Ulf; Jakobsson, Kristina; Björk, Jonas

    2009-01-01

    Background Long-term exposure to air pollution is a hypothesized risk factor for ischemic stroke. In a large case-control study with a complete study base, we investigated whether hospital admissions for ischemic stroke were associated with residential concentrations of outdoor NOx, as a proxy for exposure to air pollution, in the region of Scania, Southern Sweden. Methods We used a two-phase case-control study design, including as first-phase controls all individuals born between 1923 and 19...

  17. Spatial analysis of hospital admissions for respiratory diseases during summer months in Berlin taking bioclimatic and socio-economic aspects into account

    Directory of Open Access Journals (Sweden)

    Scherber, Katharina

    2014-04-01

    Full Text Available International environmental health studies of the past years have discussed the impacts of heat stress on human health. In particular, respiratory morbidity has shown significant heat effects in European cities. Metropolitan areas such as Berlin are characterised by an intra-urban spatial variability in socio-economic and bioclimatic conditions that is assumed to result in spatial differences in respiratory health risks. In essence, the elderly, children and people with chronic diseases suffer most from heat stress. A spatial epidemiological approach was chosen to map elevated risks for hospital admissions among > 64-year-olds with respiratory diseases (RD during the summer months (June–September from 2000 to 2009 and to link respiratory health risks to bioclimatic and socio-economic conditions in Berlin. The study aims to detect significant clusters with elevated relative risks for hospital admissions among > 64-year-olds with RD in due consideration of socio-economic conditions as a covariate for health outcomes. The findings from the purely spatial analysis show significant intra-urban disparities in the relative risks for hospital admissions among > 64-year-olds with RD. The highest relative risks within significant clusters were basically detected in the north-western and south-eastern city centre based on the study period 2000–2009 and also during the hot months of July and August in 2003 and 2006. The correlation analysis depicted significantly positive relationships between relative risks for hospital admissions among > 64-year-olds with RD and population density, socio-economic conditions and the annual mean number of days with heat loads on the basis of the period 1971–2000 and the average of the periods 1971–2000 and 2021–2050 at the zip code level in Berlin. To specifically implement health care intervention and prevention strategies into urban planning and to apply a directed practice of telemedicine for patients with

  18. Indications to Hospital Admission and Isolation of Children With Possible or Defined Tuberculosis: Systematic Review and Proposed Recommendations for Pediatric Patients Living in Developed Countries. [Corrected].

    Science.gov (United States)

    Lo Vecchio, Andrea; Bocchino, Marialuisa; Lancella, Laura; Gabiano, Clara; Garazzino, Silvia; Scotto, Riccardo; Raffaldi, Irene; Assante, Luca Rosario; Villani, Alberto; Esposito, Susanna; Guarino, Alfredo

    2015-12-01

    Tuberculosis (TB) is a re-emerging health problem in developed countries. This paper is part of large guidelines on the global management of TB in children, by a group of scientific societies. It describes the indications to hospitalization of children with suspected or diagnosed TB, the isolation measures, hospital discharge, and re-admission into the community. Using the Consensus Conference method, relevant publications in English were identified by means of a systematic review of MEDLINE and the Cochrane Database of Systematic Reviews from their inception until 31 December 2014. Available data on indications to hospitalization were mainly indirect and largely derived from observational studies. They include: (1) host-related risk factors, the main being age <12 months, immune deficiencies, and malnutrition; (2) TB-related clinical conditions that resemble those of pneumonia but also include drug-resistance; and (3) social and logistic conditions. The latter are based on opinion and depend on local conditions. Analysis of the literature showed that patients hospitalized with suspected pulmonary TB should be put in precautionary respiratory isolation regardless of their age while they await diagnosis. The general conditions for re-admission into the community are at least 14 days of effective treatment and negative microscopic tests of 3 consecutive samples in previously microscopically positive patients. This is the first paper that provides indications to hospitalization of children with TB. Most recommendations are generally applicable in all developed countries. Some might need an adaptation to local setting, epidemiological, parameters, and availability of specific health-care facilities. PMID:26683914

  19. Predicting hospital admission and discharge with symptom or function scores in patients with schizophrenia: pooled analysis of a clinical trial extension

    Directory of Open Access Journals (Sweden)

    Canuso Carla M

    2010-06-01

    Full Text Available Abstract Background The purpose of this analysis was to evaluate relationships between hospital admission or discharge and scores for symptom or functioning in patients with schizophrenia. Methods Data were from three 52-week open-label extensions of the double-blind pivotal trials of paliperidone extended-release (ER. Symptoms and patient function were measured every 4 weeks using the Personal and Social Performance (PSP scale and the Positive and Negative Syndrome Scale (PANSS. The intent-to-treat analysis set was defined as open-label patients who had at least one post-baseline PSP and PANSS measurement. Time until first hospitalization was evaluated using the Cox proportional hazard model with categorical time-dependent measures for the PSP (1 to 30, 31 to 70, 71 to 100 or PANSS ( Results Of the 1,077 enrolled patients, 1,028 (95.5% met study criteria; of these, 382 (37.2% were hospitalized at open-label baseline. Compared with patients with PSP ≥ 71 group, the hazard for new hospitalization was 8.351 times greater (P = 0.0001 for patients with the poorest functioning (PSP 1 to 30 and 1.977 times greater (P = 0.0295 for patients with PSP of 31-70 compared to the ≥ 71 group. The hazard for new hospitalization was 5.457 times greater (P P = 0.0027 for the ≥ 75 to P P = 0.0012 for the PANSS ≥ 75 to Conclusions Better functioning or being less symptomatic is associated with reduced risk for hospitalization and greater chance for early discharge. Treatments or programs that reduce symptoms or improve function decrease the risk of hospitalization in community patients or increase the chance of discharge for hospitalized patients.

  20. The formation and design of 'The Acute Admission Database'- a database including a prospective, observational cohort of 6279 patients triaged in the Emergency Department in a larger Danish hospital

    DEFF Research Database (Denmark)

    Barfod, Charlotte; Lauritzen, Marlene Mp; Danker, Jakob K;

    2012-01-01

    ABSTRACT: BACKGROUND: Management and care of the acutely ill patient have improved over the last years due to introduction of systematic assessment and accelerated treatment protocols. We have, however, sparse knowledge of the association between patient status at admission to hospital and patient...... Emergency Department at Hillerod Hospital and admitted either to the observationary unit or to a general ward in-hospital were prospectively included during a period of 22 weeks. The triage system used was a Danish adaptation of the Swedish triage system, ADAPT. Data from 3 different data sources was merged...... database of adequate size and data quality. Future studies will focus on the association between patient status at admission and patient outcome, e.g. admission to Intensive Care Unit or in-hospital mortality....

  1. Factors related to length of hospital admission in mild interstitial acute pancreatitis Factores relacionados con la duración de la estancia hospitalaria en pancreatitis aguda intersticial

    Directory of Open Access Journals (Sweden)

    María Francisco

    2013-02-01

    Full Text Available Objectives: to describe the clinical practice and the factors associated with length of hospital stay in mild acute pancreatitis. Methods: we present a retrospective observational study that includes a series of patients admitted to our hospital between January 2007 and December 2009 due to mild acute pancreatitis. Baseline data, treatments and examinations were collected. Variables associated with the length of hospital were determined using a Cox proportional hazards model. Results: 232 patients were included (median age 74.3 years, bedside index for severity in acute pancreatitis score 1, comorbidity Charlson score 1, 52.6 % male. 75.9 % were admitted to the gastroenterology department. Oral diet was reintroduced at 3 (0-11 days and 28 patients (12 % were intolerant to oral re-feeding. Abdominal ultrasound, a magnetic resonance cholangiopancreatography, endoscopic ultrasound, a computed tomographic scan, and endoscopic retrograde cholangiopancreatography were performed in 92.2, 34.5, 9.5, 28.4 and 14.7 % of admissions, respectively. The length of hospital stay was 8 (1-31 days. The variables independently associated with length of admission were: Charlson index ≥ 2 (hazard ratio-HR-1.4, 95 % confidence interval-CI- 1.06-1.84; p: 0.017, admission in gastroenterology department (HR 0.67, 95 % CI 0.49 to 0.93; p: 0.016, fasting period ≥ 3 days (HR 1.37, 95 % CI 1.05-1.78; p: 0.02, intolerance to oral re-feeding (HR 1.8, 95 % CI 1.17-2.77; p: 0.007, performance of computed tomographic scan (HR 2.05, 95 % CI 1.49-2.82; p < 0.001, magnetic resonance cholangiopancreatography (HR 1.87, 95 % CI 1.42-2.49; p < 0.001 and endoscopic retrograde cholangiopancreatography (HR 2.23, 95 % CI 1.51-3.3; p < 0.001. Conclusions: the variables associated with length of hospital stay were comorbidity, department in charge, fasting period, food intolerance and complementary explorations.

  2. Clinical consequences of hospital variation in use of oral anticoagulant therapy after first-time admission for atrial fibrillation

    DEFF Research Database (Denmark)

    Hansen, M L; Gadsbøll, N; Rasmussen, S;

    2009-01-01

    OBJECTIVE: To analyse how hospital factors influence the use of oral anticoagulants (OAC) in atrial fibrillation (AF) patients and address the clinical consequences of hospital variation in OAC use. DESIGN AND SUBJECTS: By linkage of nationwide Danish administrative registers we conducted an obse...... thromboembolic events were observed amongst patients from low OAC use hospitals. Our study emphasizes the need for a continued vigilance on implementation of international AF management guidelines.......OBJECTIVE: To analyse how hospital factors influence the use of oral anticoagulants (OAC) in atrial fibrillation (AF) patients and address the clinical consequences of hospital variation in OAC use. DESIGN AND SUBJECTS: By linkage of nationwide Danish administrative registers we conducted an...... observational study including all patients with a first-time hospitalization for AF between 1995 and 2004 as well as prescription claims for OAC. Multivariable logistic regression analysis was used to evaluate hospital factors associated with prescription of OAC therapy. Cox proportional-hazard models were used...

  3. The Global Contribution of Outdoor Air Pollution to the Incidence, Prevalence, Mortality and Hospital Admission for Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Qingkun Song

    2014-11-01

    Full Text Available Objective: This study aimed to investigate the quantitative effects of outdoor air pollution, represented by 10 µg/m3 increment of PM10, on chronic obstructive pulmonary disease in China, United States and European Union through systematic review and meta-analysis. Methods: Publications in English and Chinese from PubMed and EMBASE were selected. The Cochrane Review Handbook of Generic Inverse Variance was used to synthesize the pooled effects on incidence, prevalence, mortality and hospital admission. Results: Outdoor air pollution contributed to higher incidence and prevalence of COPD. Short-term exposure was associated with COPD mortality increased by 6%, 1% and 1% in the European Union, the United States and China, respectively (p < 0.05. Chronic PM exposure produced a 10% increase in mortality. In a short-term exposure to 10 µg/m3 PM10 increment COPD mortality was elevated by 1% in China (p < 0.05 and hospital admission enrollment was increased by 1% in China, 2% in United States and 1% in European Union (p < 0.05. Conclusions: Outdoor air pollution contributes to the increasing burdens of COPD.10 µg/m3 increase of PM10 produced significant condition of COPD death and exacerbation in China, United States and European Union. Controlling air pollution will have substantial benefit to COPD morbidity and mortality.

  4. Influenza in hospitalized children in Ireland in the pandemic period and the 2010/2011 season: risk factors for paediatric intensive-care-unit admission.

    LENUS (Irish Health Repository)

    Rebolledo, J

    2013-11-11

    SUMMARY Influenza causes significant morbidity and mortality in children. This study\\'s objectives were to describe influenza A(H1N1)pdm09 during the pandemic, to compare it with circulating influenza in 2010\\/2011, and to identify risk factors for severe influenza defined as requiring admission to a paediatric intensive care unit (PICU). Children hospitalized with influenza during the pandemic were older, and more likely to have received antiviral therapy than children hospitalized during the 2010\\/2011 season. In 2010\\/2011, only one child admitted to a PICU with underlying medical conditions had been vaccinated. The risk of severe illness in the pandemic was higher in females and those with underlying conditions. In 2010\\/2011, infection with influenza A(H1N1)pdm09 compared to other influenza viruses was a significant risk factor for severe disease. An incremental relationship was found between the number of underlying conditions and PICU admission. These findings highlight the importance of improving low vaccination uptake and increasing the use of antivirals in vulnerable children.

  5. Effects of Real-time Telemedicine Consultations between Hospital-based Nurses and Patients with Severe COPD discharged after Exacerbation Admissions

    DEFF Research Database (Denmark)

    Sorknæs, Anne Dichmann; Bech, Mickael; Jest, Peder;

    Introduction: Hospitalisation with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) causes a major burden for the COPD patients and is a common cause for admissions and readmissions to medical wards. Objectives: To investigate the effect of one week of daily real-time telemedi......Introduction: Hospitalisation with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) causes a major burden for the COPD patients and is a common cause for admissions and readmissions to medical wards. Objectives: To investigate the effect of one week of daily real......-time telemedicine video consultations (teleconsultation) between hospital-based nurses specialised in respiratory diseases (telenurses) and patients with severe COPD discharged after AECOPD in addition to conventional treatment compared to the effect of conventional treatment. Methods: Patients admitted with AECOPD...... at two different locations were recruited at hospital discharge and randomly assigned (1:1) to either daily teleconsultation for one week in addition to conventional treatment, the TVC group or to conventional treatment, the CT group. The telemedicine equipment consisted of a briefcase with built...

  6. The impact of 9/11 on the association of ambient air pollution with daily respiratory hospital admissions in a Canada-US border city, Windsor, Ontario.

    Science.gov (United States)

    Luginaah, Isaac; Fung, Karen Y; Gorey, Kevin M; Khan, Shahedul

    2006-08-01

    The 11 September 2001 (9/11) terrorist attacks in the United States resulted in long lines of trucks at the border crossing in Windsor, Ontario. Public concern about the potential impact of these trucks spewing toxic pollutants into the air drew attention to the need to investigate the impact of 9/11 on the daily levels of air pollutants and respiratory hospitalization. In this study, significant increases in respiratory admissions were found one month and 6 months post-9/11. Mean daily respiratory admission was also significantly higher than the same period one year earlier and one year later. SO(2) and CO concentration levels were found to be generally higher after 9/11 than one year before and immediately before. Relative risk estimates of respiratory hospitalization after 9/11 showed that SO(2) (RR̂ = 1.15 for two-day, RR̂ = 1.18 for three-day, and RR̂ = 1.21 for five-day averages), NO(2) (RR̂ = 1.10 for current day), and COH (RR̂ = 1.09 for current day, RR̂ = 1.10 for two-day average) had the most significant effects after 9/11. These results suggest the need for more stringent regulatory efforts in air quality in the region in response to the changing transportation dynamics at this Canada-US border crossing. PMID:21234298

  7. Faecal microbiota characterisation of horses using 16 rdna barcoded pyrosequencing, and carriage rate of clostridium difficile at hospital admission

    OpenAIRE

    Rodriguez Diaz, Cristina; Taminiau, Bernard; Brévers, Bastien; Avesani, Véronique; Van Broeck, Johan; Leroux, Aurélia; Gallot, Marjorie; Bruwier, Antoine; Amory, Hélène; Delmée, Michel; Daube, Georges

    2015-01-01

    Background The equine faecal microbiota is very complex and remains largely unknown, while interspecies interactions have an important contribution to animal health. Clostridium difficile has been identified as an important cause of diarrhoea in horses. This study provides further information on the nature of the bacterial communities present in horses developing an episode of diarrhoea. The prevalence of C. difficile in hospitalised horses at the time of admission is also reported. Results B...

  8. Fraction of all hospital admissions and deaths attributable to malnutrition among children in rural Kenya2 3 5

    OpenAIRE

    Bejon, Philip; Mohammed, Shebe; Mwangi, Isaiah; Atkinson, Sarah H; Osier, Faith; Peshu, Norbert; Charles R. Newton; Maitland, Kathryn; Berkley, James A

    2008-01-01

    Background: Malnutrition is common in the developing world and associated with disease and mortality. Because malnutrition frequently occurs among children in the community as well as those with acute illness, and because anthropometric indicators of nutritional status are continuous variables that preclude a single definition of malnutrition, malnutrition-attributable fractions of admissions and deaths cannot be calculated by simply enumerating individual children. Objective: We determined t...

  9. Comparison of Community-Acquired Pneumonia Requiring Admission to Hospital in HIV-and Non-HIV-Infected Patients

    OpenAIRE

    Touchie, Claire; Marrie, Thomas J

    1996-01-01

    OBJECTIVE: To compare community-acquired pneumonia (CAP) in hospitalized human immunodeficiency virus (HIV)-infected patients with that in hospitalized non-HIV-infected patients by assessing presenting characteristics, etiology and outcomes.DESIGN: Retrospective chart review.SETTING: A tertiary care centre in Halifax, Nova Scotia.POPULATION STUDIED: Thirty-two HIV-infected patients requiring hospitalization for treatment of CAP were identified from September 1991 to October 1993 and compared ...

  10. The effects of real-time telemedicine consultations between hospital based nursing and severe COPD patients discharged after exacerbation admission

    DEFF Research Database (Denmark)

    Hounsgaard, Lise; Sorknæs, Anne Dichmann; Madsen, H.;

    2014-01-01

    We investigated the effect of daily real-time teleconsultations for one week between hospital-based nurses specialised in respiratory diseases and patients with severe COPD discharged after acute exacerbation. Patients admitted with acute exacerbation of chronic obstructive pulmonary disease...... (AECOPD) at two hospitals were recruited at hospital discharge. They were randomly assigned to intervention or control. The telemedicine equipment consisted of a briefcase with built-in computer including a web camera, microphone and measurement equipment. The primary outcome was the mean number of total...

  11. Preparedness for admission of patients with suspected Ebola virus disease in European hospitals: a survey, August-September 2014

    OpenAIRE

    De Jong, M D; Reusken, C.; Horby, P; Goossens, H.; et al.

    2014-01-01

    Abstract: In response to the Ebola virus disease (EVD) outbreak in West Africa, the World Health Organization has advised all nations to prepare for the detection, investigation and management of confirmed and suspected EVD cases in order to prevent further spread through international travel. To gain insights into the state of preparedness of European hospitals, an electronic survey was circulated in AugustSeptember 2014 to 984 medical professionals representing 736 hospitals in 40 countries...

  12. Hospitals

    DEFF Research Database (Denmark)

    Mullins, Michael

    2013-01-01

    is to minimize the negative effects of stress inducing environments based on research results. Which stress inducing factors? We can look around at some old hospitals and see they are noisy, confusing, ugly, monotonous, hard, cold, artificial, and dark; qualitative terms which can indicate what we shouldn...... in the navigation experience and wasted time of medical staff in providing directions. Space in hospitals: space can be divided into personal, social and outdoor space. Personal space: single rooms have been well documented in: admission length, mortality rates, comfort levels, sense of privacy, all users......’ satisfaction. Social space: attention to spatial qualities, volume and interior design in terms of encouraging physical contact between users in wards, waiting areas and semi-private rooms. Outdoor space: Landscape and gardens are not enough in themselves; they should be visible, centrally or strategically...

  13. The Real-Life Effectiveness of Palivizumab for Reducing Hospital Admissions for Respiratory Syncytial Virus in Infants Residing in Nunavut

    Directory of Open Access Journals (Sweden)

    Anna Banerji

    2014-01-01

    Full Text Available BACKGROUND/OBJECTIVE: Nunavut has the highest hospitalization rates for respiratory syncytial virus (RSV worldwide, with rates of 166 per 1000 live births per year <1 year of age. Palivizumab was implemented in Nunavut primarily for premature infants, or those with hemodynamically significant cardiac or chronic lung disease; however, the effectiveness of the program is unknown. The objective of the present multisite, hospital-based surveillance study was to estimate the effectiveness of palivizumab in infants <6 months of age in Nunavut for the 2009 and 2010 RSV seasons.

  14. The Association Between Potentially Inappropriate Prescribing and Medication-Related Hospital Admissions in Older Patients: A Nested Case Control Study

    NARCIS (Netherlands)

    van der Stelt, C.A.K.; Vermeulen Windsant-van den Tweel, A.M.A.; Egberts, A.C.G.; van den Bemt, P.M.L.A.; Leendertse, A.J.; Hermens, W.A.J.J.; van Marum, R.J.; Derijks, Jeroen

    2016-01-01

    Introduction: Medication-related problems can cause serious adverse drug events (ADEs) that may lead to hospitalization of the patient. There are multiple screening methods to detect and reduce potentially inappropriate medications (PIMs) and potential prescribing omissions (PPOs). Whether this will

  15. Intentional Poisoning as a Cause of Admission to Accident and Emergency in a Tertiary Care Hospital within a Year

    Directory of Open Access Journals (Sweden)

    Niveditha

    2011-10-01

    Full Text Available Introduction: Poisoning is a common medico social problem nowadays and is often distressing for both family members and medical staff. The present study aims to evaluate the pattern of self poisoning with special preference to psychoactive drugs. Methodology: Study sample comprised of all episodes of self poisoning that had resulted in admission between January to December 2008.Pateints taking any toxic/pharmacological substance by accident or ignorance were excluded. Results: Out of 1206 patients admitted to accident and emergency during the study period, 140 were due to intentional poisoning (11.6% Age of the patients varied from 16-65 years. The maximum incidence was between 21-30 years. The male: female ratio was 1.18:1.Most common substance used was organophosphate compound (OPC (31.7% followed by benzodiazepines (BZD (20.7% and household articles comprised of 18.5%. Multiple drug combinations with alcohol was 30%.Around 13.5% had history of mental illness. Conclusion: At present due to vast development in all fields of life like industries, medicine and agriculture, a significant number of new compounds have appeared as new poisonous substances, which have led to more number of poisoning cases. Although there are restrictions on sale of drugs in India, vulnerability to insecticide cannot be ignored.

  16. Response of first attack of inflammatory bowel disease requiring hospital admission to steroid therapy Respuesta al tratamiento esteroideo del primer brote de enfermedad inflamatoria intestinal que requiere ingreso hospitalario

    OpenAIRE

    M. Abu-Suboh Abadía; F. Casellas; Vilaseca, J; J-R. Malagelada

    2004-01-01

    Introduction: corticoid administration is the usual treatment of Crohn' disease (CD) and ulcerative colitis (UC) attacks. How-ever, information available on response rates and their predictive factors is scarce. Objective: to establish response to steroidal treatment in an homogeneous group of patients with CD or UC during their first admission to hospital. Methods: restrospective analysis of 86 patients who received systemic steroidal treatment for a severe flare-up during their first hospit...

  17. Air Pollution and Acute Myocardial Infarction Hospital Admission in Alberta, Canada: A Three-Step Procedure Case-Crossover Study

    OpenAIRE

    Xiaoming Wang; Warren Kindzierski; Padma Kaul

    2015-01-01

    Adverse associations between air pollution and myocardial infarction (MI) are widely reported in medical literature. However, inconsistency and sensitivity of the findings are still big concerns. An exploratory investigation was undertaken to examine associations between air pollutants and risk of acute MI (AMI) hospitalization in Alberta, Canada. A time stratified case-crossover design was used to assess the transient effect of five air pollutants (carbon monoxide (CO), nitrogen dioxide (NO2...

  18. Oral rehydration therapy in Malawi: impact on the severity of disease and on hospital admissions, treatment practices, and recurrent costs.

    OpenAIRE

    Heymann, D. L.; Mbvundula, M.; Macheso, A.; McFarland, D A; Hawkins, R. V.

    1990-01-01

    In the first 2 years following refresher training of paediatric staff in oral rehydration therapy (ORT) and the establishment of an oral rehydration unit at the Kamuzu Central Hospital, Lilongwe, Malawi, there was a 50% decrease in the number of children admitted to the paediatric ward with the diagnosis of diarrhoeal diseases, a 56% decrease in the use of intravenous fluid to rehydrate such children, a threefold increase in the use of oral rehydration salts (ORS) exclusively to rehydrate chi...

  19. Estado nutricional al ingreso de los pacientes internados con VIH Nutritional status of hospitalized HIV patients at admission

    OpenAIRE

    Soledad Freijo; Analía Mengoni

    2010-01-01

    Introducción: La mayoría de los pacientes con diagnóstico de VIH/SIDA se internan con complicaciones propias de la enfermedad que repercuten en su estado nutricional. Objetivo: Describir el comportamiento de los componentes del perfil nutricional de los pacientes con diagnóstico de VIH/SIDA que se internan en el Hospital General de Agudos Juan A. Fernández (Argentina). Materiales y métodos: Estudio descriptivo, transversal, y prospectivo. Se analizaron los datos correspondientes a pacientes c...

  20. The Efficacy of Written Information Intervention in Reduction of Hospital Re-admission Cost in Patients With Heart Failure; A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Zarea Gavgani Vahideh

    2015-03-01

    Full Text Available Objective: To assess the efficacy of written information versus non written information intervention in reducing hospital readmission cost, if prescribed or presented to the patients with HF. Methods: The study was a systematic review and meta-analysis. We searched Medline (Ovidand Cochrane library during the past 20 years from 1993 to 2013. We also conducted a manual search through Google Scholar and a direct search in the group of related journals in Black Welland Science Direct trough their websites. Two reviewers appraised the identified studies, and meta-analysis was done to estimate the mean saving cost of patient readmission. All the included studies must have been done by randomization to be eligible for study. Result: We assessed the full-texts 3 out of 65 studies with 754 patients and average age of 74.33.The mean of estimated saving readmission cost in intervention group versus control group was US $2751 (95% CI: 2708 – 2794 and the mean of total saving cost in intervention group versus control group was US $2047 (base year 2010 with (95% CI: 2004 – 2089. No publication bias was found by testing the heterogeneity of studies. Conclusion: One of the effective factors in minimizing the healthcare cost and preventing from hospital re-admission is providing the patients with information prescription in a written format.It is suggested that hospital management, Medicare organizations, policy makers and individual physicians consider the prescription of appropriate medical information as the indispensable part of patient’s care process.

  1. Respiratory rate and pulse oximetry derived information as predictors of hospital admission in young children in Bangladesh: a prospective observational study

    Science.gov (United States)

    Garde, Ainara; Zhou, Guohai; Raihana, Shahreen; Dunsmuir, Dustin; Karlen, Walter; Dekhordi, Parastoo; Huda, Tanvir; Arifeen, Shams El; Larson, Charles; Kissoon, Niranjan; Dumont, Guy A; Ansermino, J Mark

    2016-01-01

    Objective Hypoxaemia is a strong predictor of mortality in children. Early detection of deteriorating condition is vital to timely intervention. We hypothesise that measures of pulse oximetry dynamics may identify children requiring hospitalisation. Our aim was to develop a predictive tool using only objective data derived from pulse oximetry and observed respiratory rate to identify children at increased risk of hospital admission. Setting Tertiary-level hospital emergency department in Bangladesh. Participants Children under 5 years (n=3374) presenting at the facility (October 2012–April 2013) without documented chronic diseases were recruited. 1-minute segments of pulse oximetry (photoplethysmogram (PPG), blood oxygen saturation (SpO2) and heart rate (HR)) and respiratory rate were collected with a mobile app. Primary outcome The need for hospitalisation based on expert physician review and follow-up. Methods Pulse rate variability (PRV) using pulse peak intervals of the PPG signal and features extracted from the SpO2 signal, all derived from pulse oximetry recordings, were studied. A univariate age-adjusted logistic regression was applied to evaluate differences between admitted and non-admitted children. A multivariate logistic regression model was developed using a stepwise selection of predictors and was internally validated using bootstrapping. Results Children admitted to hospital showed significantly (prespiratory rate, high HR, low SpO2, young age and male sex. These variables provided a bootstrap-corrected AUC of the receiver operating characteristic of 0.76. Conclusions Objective measurements, easily obtained using a mobile device in low-resource settings, can predict the need for hospitalisation. External validation will be required before clinical adoption. PMID:27534987

  2. Serum bilirubin value predicts hospital admission in carbon monoxide-poisoned patients. Active player or simple bystander?

    Directory of Open Access Journals (Sweden)

    Gianfranco Cervellin

    2015-09-01

    Full Text Available OBJECTIVES: Although carbon monoxide poisoning is a major medical emergency, the armamentarium of recognized prognostic biomarkers displays unsatisfactory diagnostic performance for predicting cumulative endpoints. METHODS: We performed a retrospective and observational study to identify all patients admitted for carbon monoxide poisoning during a 2-year period. Complete demographical and clinical information, along with the laboratory data regarding arterial carboxyhemoglobin, hemoglobin, blood lactate and total serum bilirubin, was retrieved. RESULTS: The study population consisted of 38 poisoned patients (23 females and 15 males; mean age 39±21 years. Compared with discharged subjects, hospitalized patients displayed significantly higher values for blood lactate and total serum bilirubin, whereas arterial carboxyhemoglobin and hemoglobin did not differ. In a univariate analysis, hospitalization was significantly associated with blood lactate and total serum bilirubin, but not with age, sex, hemoglobin or carboxyhemoglobin. The diagnostic performance obtained after combining the blood lactate and total serum bilirubin results (area under the curve, 0.90; 95% CI, 0.81-0.99; p<0.001 was better than that obtained for either parameter alone. CONCLUSION: Although it remains unclear whether total serum bilirubin acts as an active player or a bystander, we conclude that the systematic assessment of bilirubin may, alongside lactate levels, provide useful information for clinical decision making regarding carbon monoxide poisoning.

  3. Association between Air Pollutants and Asthma Emergency Room Visits and Hospital Admissions in Time Series Studies: A Systematic Review and Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Xue-yan Zheng

    Full Text Available Air pollution constitutes a significant stimulus of asthma exacerbations; however, the impacts of exposure to major air pollutants on asthma-related hospital admissions and emergency room visits (ERVs have not been fully determined.We sought to quantify the associations between short-term exposure to air pollutants [ozone (O3, carbon monoxide (CO, nitrogen dioxide (NO2, sulfur dioxide (SO2, and particulate matter ≤10 μm (PM10 and PM2.5] and the asthma-related emergency room visits (ERV and hospitalizations.Systematic computerized searches without language limitation were performed. Pooled relative risks (RRs and 95% confidence intervals (95%CIs were estimated using the random-effect models. Sensitivity analyses and subgroup analyses were also performed.After screening of 246 studies, 87 were included in our analyses. Air pollutants were associated with significantly increased risks of asthma ERVs and hospitalizations [O3: RR(95%CI, 1.009 (1.006, 1.011; I2 = 87.8%, population-attributable fraction (PAF (95%CI: 0.8 (0.6, 1.1; CO: RR(95%CI, 1.045 (1.029, 1.061; I2 = 85.7%, PAF (95%CI: 4.3 (2.8, 5.7; NO2: RR(95%CI, 1.018 (1.014, 1.022; I2 = 87.6%, PAF (95%CI: 1.8 (1.4, 2.2; SO2: RR(95%CI, 1.011 (1.007, 1.015; I2 = 77.1%, PAF (95%CI: 1.1 (0.7, 1.5; PM10: RR(95%CI, 1.010 (1.008, 1.013; I2 = 69.1%, PAF (95%CI: 1.1 (0.8, 1.3; PM2.5: RR(95%CI, 1.023 (1.015, 1.031; I2 = 82.8%, PAF (95%CI: 2.3 (1.5, 3.1]. Sensitivity analyses yielded compatible findings as compared with the overall analyses without publication bias. Stronger associations were found in hospitalized males, children and elderly patients in warm seasons with lag of 2 days or greater.Short-term exposures to air pollutants account for increased risks of asthma-related ERVs and hospitalizations that constitute a considerable healthcare utilization and socioeconomic burden.

  4. Depression After First Hospital Admission for Acute Coronary Syndrome: A Study of Time of Onset and Impact on Survival.

    Science.gov (United States)

    Osler, Merete; Mårtensson, Solvej; Wium-Andersen, Ida Kim; Prescott, Eva; Andersen, Per Kragh; Jørgensen, Terese Sara Høj; Carlsen, Kathrine; Wium-Andersen, Marie Kim; Jørgensen, Martin Balslev

    2016-02-01

    We examined incidence of depression after acute coronary syndrome (ACS) and whether the timing of depression onset influenced survival. All first-time hospitalizations for ACS (n = 97,793) identified in the Danish Patient Registry during 2001-2009 and a reference population were followed for depression and mortality via linkage to patient, prescription, and cause-of-death registries until the end of 2012. Incidence of depression (as defined by hospital discharge or antidepressant medication use) and the relationship between depression and mortality were examined using time-to-event models. In total, 19,520 (20.0%) ACS patients experienced depression within 2 years after the event. The adjusted rate ratio for depression in ACS patients compared with the reference population was 1.28 (95% confidence interval (CI): 1.25, 1.30). During 12 years of follow-up, 39,523 (40.4%) ACS patients and 27,931 (28.6%) of the reference population died. ACS patients with recurrent (hazard ratio (HR) = 1.62, 95% CI: 1.57, 1.67) or new-onset (HR = 1.66, 95% CI: 1.60, 1.72) depression had higher mortality rates than patients with no depression. In the reference population, the corresponding relative estimates for recurrent (HR =1.98, 95% CI: 1.92, 2.05) and new-onset (HR = 2.42, 95% CI: 2.31, 2.54) depression were stronger. Depression is common in ACS patients and is associated with increased mortality independently of time of onset, but here the excess mortality associated with depression seemed to be lower in ACS patients than in the reference population. PMID:26740025

  5. Distinguishing the associations between daily mortality and hospital admissions and nitrogen dioxide from those of particulate matter: a systematic review and meta-analysis

    Science.gov (United States)

    Mills, I C; Atkinson, R W; Anderson, H R; Maynard, R L; Strachan, D P

    2016-01-01

    Objectives To quantitatively assess time-series studies of daily nitrogen dioxide (NO2) and mortality and hospital admissions which also controlled for particulate matter (PM) to determine whether or to what extent the NO2 associations are independent of PM. Design A systematic review and meta-analysis. Methods Time-series studies—published in peer-reviewed journals worldwide, up to May 2011—that reported both single-pollutant and two-pollutant model estimates for NO2 and PM were ascertained from bibliographic databases (PubMed, EMBASE and Web of Science) and reviews. Random-effects summary estimates were calculated globally and stratified by different geographical regions, and effect modification was investigated. Outcome measures Mortality and hospital admissions for various cardiovascular or respiratory diseases in different age groups in the general population. Results 60 eligible studies were identified, and meta-analysis was conducted on 23 outcomes. Two-pollutant model study estimates generally showed that the NO2 associations were independent of PM mass. For all-cause mortality, a 10 µg/m3 increase in 24-hour NO2 was associated with a 0.78% (95% CI 0.47% to 1.09%) increase in the risk of death, which reduced to 0.60% (0.33% to 0.87%) after control for PM. Heterogeneity between geographical region-specific estimates was removed by control for PM (I2 from 66.9% to 0%). Estimates of PM and daily mortality assembled from the same studies were greatly attenuated after control for NO2: from 0.51% (0.29% to 0.74%) to 0.18% (−0.11% to 0.47%) per 10 µg/m3 PM10 and 0.74% (0.34% to 1.14%) to 0.54% (−0.25% to 1.34%) for PM2.5. Conclusions The association between short-term exposure to NO2 and adverse health outcomes is largely independent of PM mass. Further studies should attempt to investigate whether this is a generic PM effect or whether it is modified by the source and physicochemical characteristics of PM. This finding strengthens the argument for

  6. An audit of obstetric admissions to intensive care unit in a medical college hospital of central India: lessons in preventing maternal morbidity and mortality

    Directory of Open Access Journals (Sweden)

    Manisha Jain

    2015-02-01

    Full Text Available Background: The spectrum of causes leading to maternal morbidity and mortality may be well reflected in the clinical profile of obstetric patients admitted to the Intensive Care Unit (ICU. An audit of these patients may help in devising intervention strategies and implementing preventive measures. This is expected to contribute to the ongoing concerted multipronged efforts towards reducing maternal mortality as a step towards the millennium development goals. The aim was to study the clinical and demographic profile of antenatal and postpartum women requiring admission to the ICU, the interventions required in these women and the final outcome. The overall goal is to identify the contributing factors towards maternal morbidity and mortality. Methods: A retrospective analysis of hospital records of all antenatal, post-abortal and postpartum women admitted to the ICU at People's hospital, Bhopal over a period of 3 years (June 2011 to May 2014. Results: A total of 157 records were identified and analyzed: 22 (14% antenatal, seven (4% post-abortion, 114 (73% postpartum, and 14(9% post-laparotomy women. The mean age was 25 years (Range 18-38 years; SD 4.49, two thirds being from rural areas. Majority (78% had no earlier visit. The gestational age at admission to ICU ranged from 6-43 weeks (Mean 31 weeks; SD 9.06. One third (24% of patients had severe anemia, 18 patients needed ventilation, 25 required inotropic support, 4 required dialysis and 17 underwent surgical intervention. Blood or blood component therapy was needed in 60% cases with total blood units transfused being 225. The average duration of stay in intensive care unit was 79 hours. Analyzing as organ-system dysfunctions: Cardiovascular dysfunction (22%, hematological (20%, hepatic (16%, neurological (11%, septicemia (11%, renal (9%. There were 19 maternal deaths. Conclusions: Maternal anemia and consequences still contribute significantly to maternal morbidity. Non-utilization of

  7. Estudo das internações hospitalares por pneumoconioses no Brasil, 1993-2003 Hospital admissions due to pneumoconiosis in Brazil, 1993-2003

    Directory of Open Access Journals (Sweden)

    Hermano Albuquerque de Castro

    2007-09-01

    . OBJECTIVE: to study the frequency and distribution of this disease, in Brazil and its states, through the survey of hospital admissions due to pneumoconiosis in the period between 1993 and 2003, and to discuss the possibilities that these admissions were related to the work processes of each region. METHODS: pneumoconiosis morbidity information was collected from the Hospital Admission Information System of SUS and IBGE (Brazilian Institute of Geography and Statistics, described and analyzed, for the population over 15 years of age in the period between 1993 and 2003, distributed per state and Brazil in the period between 1993 and 2003. ICD-9 (1993-1997 and ICD-10 (1998-2003 were used. RESULTS: a predominance of the states of the South and Southeast was observed, showing a correlation with work processes and access of workers to healthcare. DISCUSSION: The data permitted identifying a difference between the data before and after 1998, which corresponds to the change from ICD-9 to ICD-10, thus indicating a correlation between changes in diagnostic criteria and the form of collecting primary data by the SUS. CONCLUSION: The distribution of hospital admissions is heterogeneous and this possibly reflects the vertex of an inverted pyramid of the total of cases that should in fact occur among Brazilian workers. Facing the situation makes it possible to approach the actual epidemiological status, and thus contribute to the orientation of prophylactic and risk-reduction measures and preparation of the health system.

  8. Prevalencia de desnutrición del adulto mayor al ingreso hospitalario Prevalence of hyponutrition in the elderly at admission to the hospital

    Directory of Open Access Journals (Sweden)

    J. G. Gutiérrez Reyes

    2007-12-01

    % mixta. Conclusiones: La desnutrición al ingreso hospitalario de los adultos mayores es un hallazgo frecuente a partir de los diferentes métodos aplicados. La Mini Valoración Nutricional y la Valoración Global Subjetiva son métodos estructurados de bajo costo que pueden ser fácilmente aplicados y replicados, útiles para establecer la frecuencia de desnutrición en esta población de pacientes. La Mini Valoración Nutricional podría tener más utilidad como predictor de morbi-mortalidad tanto en los ancianos institucionalizados como los hospitalizados.Background: The population older than 60 years in Mexico is growing changing the classic pyramidal demographic structure. This fact is increasing the risk of malnutrition in the elderly, specially under nutrition which is a common problem among elderly people living at home and during hospitalizations, condition that is closely related to the increasing of morbidity, mortality and costs. Objective: Describe the prevalence of malnourished elderly who needs hospital admission. Design: Cross-sectional observational study. Setting: Third-level reference hospital. Subjects: Ninety seven consecutive subjects older than 60 years admitted to hospitalization. Interventions: During the first three days of admission all subjects were evaluated to determine their nutritional status using Mini Nutritional Assessment and Subjective Global Assessment; albumin, total lymphocytes, level of income and school grade were also included. Results: Just 48% of patients have finished primary school and 66% had middle economic incomes. According to Mini Nutritional Assessment 69% of patients had risk associated to malnutrition (18% at high risk and 50% at moderate risk. The short form of the Mini Nutritional Assessment described 73% of patients at risk related to malnutrition in correlation with the complete Mini Nutritional Assessment. 46% and 20% of patients were classified at moderate malnutrition and severe malnutrition respectively using

  9. Estudo das internações hospitalares por pneumoconioses no Brasil, 1984-2003 Hospital admissions due to pneumoconioses in Brazil, 1984-2003

    Directory of Open Access Journals (Sweden)

    Hermano Albuquerque de Castro

    2005-06-01

    ão doenças de elevadas morbidade.INTRODUCTION: pneumoconiosis represents a set of respiratory illnesses, such as silicosis, asbestosis, talcosis, beriliosis and others, which are known by their main causal agent. Its incidence is probably high among exposed workers, but there is no epidemiological information such as historical series on hospitalizations in the several areas of the country. OBJECTIVE: to analyze hospital admissions due to pneumoconiosis in the period between 1984 and 2003 in all the domestic territory. METHOD: morbidity information from the AIH Hospitalization System of DATASUS (National Epidemiology Center of the Ministry of Health was collected, described and analyzed, for the period between 1984 and 2003, including all Brazilian regions and States. IDC-9 (1984-1997 and ICD-10 (1998-2003 criteria were used. RESULTS: Brazil presented a growth trend in hospital admissions between 1984 and 1991 with high rates of hospitalizations in all areas, followed by a reduction in the period between 1992 and 2003. The median of admissions for the period between 1984 and 1991 was higher in the Center-West region and lower in the North region. In the second period, between 1992 and 2003, there was a change, with a lower median in the Northeast and higher rates in the South region. DISCUSSION: The difference between the two periods can be explained by the diagnostic criteria used in these periods and by the way information was collected. The differences among regions probably reflect local work processes and the access of workers to health services. CONCLUSION: The data show that actions to control and prevent these illnesses in the work environment are necessary. Pneumoconiosis is an important Public Health problem whose numbers still do not adequately reflect the problem. If coefficients are calculated on the population effectively exposed, they will certainly disclose high morbidity illnesses.

  10. Association between air pollution and asthma admission among children in Hong Kong

    OpenAIRE

    Lee, S L; Wong, W. H. S.; Lau, Y L

    2006-01-01

    Objective: To examine the association of air pollutants with hospital admission for childhood asthma in Hong Kong. Methods: Data on hospital admissions for asthma, influenza and total hospital admissions in children aged ≤18 years at all Hospital Authority hospitals during 1997-2002 were obtained. Data on daily mean concentrations of particles with aerodynamic diameter

  11. Recusa Escolar em Adolescentes: Caracterização e Situação 27 a 60 Meses Após a Admissão em Hospital de Dia

    OpenAIRE

    Leal, Dora; Marques, João; Vaz, Paula; Pereira, Susana; Matos, António

    2016-01-01

    Introdução: A recusa escolar, definida como ausência escolar por causas emocionais, é o motivo de encaminhamento mais frequente para o Hospital de Dia de Adolescentes da Clínica da Juventude.Objectivos: Este estudo pretendeu caracterizar os jovens admitidos por recusa escolar e avaliar a sua situação 27 a 60 meses após a sua admissão no Hospital de Dia da Clínica da Juventude.Métodos: Consulta dos processos clínicos de todos os doentes admitidos entre 01 de Janeiro de 2010 e 31 de Julho de 20...

  12. Alcohol and risk of admission to hospital for unintentional cutting or piercing injuries at home: a population-based case-crossover study

    Directory of Open Access Journals (Sweden)

    Thornley Simon

    2011-11-01

    Full Text Available Abstract Background Cutting and piercing injuries are among the leading causes of unintentional injury morbidity in developed countries. In New Zealand, cutting and piercing are second only to falls as the most frequent cause of unintentional home injuries resulting in admissions to hospital among people aged 20 to 64 years. Alcohol intake is known to be associated with many other types of injury. We used a case-crossover study to investigate the role of acute alcohol use (i.e., drinking during the previous 6 h in unintentional cutting or piercing injuries at home. Methods A population-based case-crossover study was conducted. We identified all people aged 20 to 64 years, resident in one of three regions of the country (Greater Auckland, Waikato and Otago, who were admitted to public hospital within 48 h of an unintentional non-occupational cutting or piercing injury sustained at home (theirs or another's from August 2008 to December 2009. The main exposure of interest was use of alcohol in the 6-hour period before the injury occurred and the corresponding time intervals 24 h before, and 1 week before, the injury. Other information was collected on known and potential confounders. Information was obtained during face-to-face interviews with cases, and through review of their medical charts. Results Of the 356 participants, 71% were male, and a third sustained injuries from contact with glass. After adjustment for other paired exposures, the odds ratio for injury after consuming 1 to 3 standard drinks of alcohol during the 6-hour period before the injury (compared to the day before, compared to none, was 1.77 (95% confidence interval 0.84 to 3.74, and for four or more drinks was 8.68 (95% confidence interval 3.11 to 24.3. Smokers had higher alcohol-related risks than non-smokers. Conclusions Alcohol consumption increases the odds of unintentional cutting or piercing injury occurring at home and this risk increases with higher levels of drinking.

  13. Identifying patients at risk of emergency admission for colorectal cancer

    OpenAIRE

    Wallace, D.; Walker, K.; Kuryba, A; Finan, P; Scott, N.; Van Der Meulen, J.

    2014-01-01

    Background: Patients whose colorectal cancer is treated after an emergency admission tend to have late-stage cancer and a poor prognosis. We identified risk factors for an emergency admission by linking data from the National Bowel Cancer Audit (NBCA) and the English Hospital Episode Statistics (HES), an administrative database of all admissions to English National Health Service hospitals, which includes data on mode of admission. Methods: We identified all adults included in the NBCA with a...

  14. Primary care consultation, hospital admission, sick leave and disability pension owing to neck and low back pain: a 12-year prospective cohort study in a rural population

    Directory of Open Access Journals (Sweden)

    Holmberg Sara AC

    2006-08-01

    Full Text Available Abstract Background Neck and low back pain are common musculoskeletal complaints generating large societal costs in Western populations. In this study we evaluate the magnitude of long-term health outcomes for neck and low back pain, taking possible confounders into account. Method A cohort of 2,351 Swedish male farmers and rural non-farmers (40–60 years old was established in 1989. In the first survey, conducted in 1990–91, 1,782 men participated. A 12-year follow-up survey was made in 2002–03 and 1,405 men participated at both times. After exclusion of 58 individuals reporting a specific back diagnosis in 1990–91, the study cohort encompassed 1,347 men. The health outcomes primary care consultation, hospital admission, sick leave and disability pension were assessed in structured interviews in 2002–03 (survey 2. Symptoms and potential confounders were assessed at survey 1, with the exception of rating of depression and anxiety, which was assessed at survey 2. Multiple logistic regression generating odds ratios (OR with 95% confidence intervals (95% CI was performed to adjust the associations between reported symptoms and health outcomes for potential confounders (age, farming, workload, education, demand and control at work, body mass index, smoking, snuff use, alcohol consumption, psychiatric symptoms and specific back diagnoses during follow up. Results Of the 836 men reporting current neck and/or low back pain at survey 1, 21% had had at least one primary care consultation for neck or low back problems, 7% had been on sick leave and 4% had disability pension owing to the condition during the 12 year follow up. Current neck and/or low back pain at survey 1 predicted primary care consultations (OR = 4.10, 95% CI 2.24–7.49 and sick leave (OR = 3.22, 95% CI 1.13–9.22 after potential confounders were considered. Lower education and more psychiatric symptoms were independently related to sick leave. Lower education and snuff use

  15. Perfil das admissões em uma unidade de terapia intensiva obstétrica de uma maternidade brasileira Admission profile in an obstetrics intensive care unit in a maternity hospital of Brazil

    Directory of Open Access Journals (Sweden)

    Melania Maria Ramos de Amorim

    2006-05-01

    Full Text Available OBJETIVOS: descrever a experiência de três anos com terapia intensiva em obstetrícia em Unidade de Terapia Intensiva em setor que permite que obstetras continuem conduzindo as pacientes obstétricas criticamente enfermas. MÉTODOS: estudo avaliando 933 pacientes atendidas na UTI obstétrica do Instituto Materno Infantil Prof. Fernando Figueira (IMIP de setembro de 2002 a fevereiro de 2005. As variáveis foram idade, paridade, diagnóstico de admissão, época da admissão, diagnósticos e complicações durante o internamento, procedimentos invasivos empregados e resultado final. RESULTADOS: as três principais causas de internamento foram hipertensão (87%, hemorragia obstétrica (4,9% e infecção (2,1%. A idade média foi 25 anos e 65% dos partos, cesarianas. Anemia foi achado freqüente (58,4%. Outros diagnósticos: insuficiência renal, doença tromboembólica, cardiopatia, edema agudo de pulmão, sepse, choque hemorrágico. Das 814 pacientes admitidas com hipertensão associada à gestação, 65% tinham pré-eclâmpsia grave, 16% pré-eclâmpsia leve e 11% eclâmpsia. Síndrome HELLP ocorreu em 46%. Ventilação mecânica foi necessária em 3,6% e hemotransfusão em 17%. A duração média do internamento foi cinco dias (1-41. A taxa de óbito foi 2,4%. CONCLUSÕES: a taxa de morte foi relativamente baixa, sugerindo que uma UTI conduzida por obstetras pode ser uma estratégia factível para reduzir a mortalidade materna.OBJECTIVES: to describe a three-year experience with obstetric Intensive Care Units (ICU, a unit allowing obstetricians to continue to care for critically ill obstetrics patients. METHODS: the study evaluated all admissions (933 to the Obstetric ICU, in the Instituto Materno Infantil Prof. Fernando Figueira (IMIP, from September 2002 to February 2005. Age, parity, diagnosis, admission time, diagnosis during ICU stay, associated complications, invasive procedures utilized, and final outcome were analyzed. RESULTS

  16. Association of admission serum calcium levels and in-hospital mortality in patients with acute ST-elevated myocardial infarction: an eight-year, single-center study in China.

    Directory of Open Access Journals (Sweden)

    Xin Lu

    Full Text Available OBJECTIVE: The relationship between admission serum calcium levels and in-hospital mortality in patients with acute ST-segment elevation myocardial infarction (STEMI has not been well definitively explored. The objective was to assess the predictive value of serum calcium levels on in-hospital mortality in STEMI patients. METHODS: From 2003 to 2010, 1431 consecutive STEMI patients admitted to the First Affiliated Hospital of Nanjing Medical University were enrolled in the present study. Patients were stratified according to quartiles of serum calcium from the blood samples collected in the emergency room after admission. Between the aforementioned groups,the baseline characteristics, in-hospital management, and in-hospital mortality were analyzed. The association of serum calcium level with in-hospital mortality was calculated by a multivariable Cox regression analysis. RESULTS: Among 1431 included patients, 79% were male and the median age was 65 years (range, 55-74. Patients in the lower quartiles of serum calcium, as compared to the upper quartiles of serum calcium, were older, had more cardiovascular risk factors, lower rate of emergency revascularization,and higher in-hospital mortality. According to univariate Cox proportional analysis, patients with lower serum calcium level (hazard ratio 0.267, 95% confidence interval 0.164-0.433, p<0.001 was associated with higher in-hospital mortality. The result of multivariable Cox proportional hazard regression analyses showed that the Killip's class≥3 (HR = 2.192, p = 0.026, aspartate aminotransferase (HR = 1.001, p<0.001, neutrophil count (HR = 1.123, p<0.001, serum calcium level (HR = 0.255, p = 0.001, and emergency revascularization (HR = 0.122, p<0.001 were significantly and independently associated with in-hospital mortality in STEMI patients. CONCLUSIONS: Serum calcium was an independent predictor for in-hospital mortality in patients with STEMI. This widely

  17. Every seventh acute medical admission is preventable

    DEFF Research Database (Denmark)

    Jepsen, Henrik Koldborg; Hendriksen, Carsten; Nielsen, Henrik; Nybo, Birgitte; Perrild, Hans

    2013-01-01

    The majority of patients who are admitted to the departments of internal medicine are admitted acutely. The aim of this study was to evaluate the appropriateness of admissions to a community hospital in Copenhagen....

  18. Patient Admission Preferences and Perceptions

    Science.gov (United States)

    Wu, Clayton; Melnikow, Joy; Dinh, Tu; Holmes, James F.; Gaona, Samuel D.; Bottyan, Thomas; Paterniti, Debora; Nishijima, Daniel K.

    2015-01-01

    Introduction Understanding patient perceptions and preferences of hospital care is important to improve patients’ hospitalization experiences and satisfaction. The objective of this study was to investigate patient preferences and perceptions of hospital care, specifically differences between intensive care unit (ICU) and hospital floor admissions. Methods This was a cross-sectional survey of emergency department (ED) patients who were presented with a hypothetical scenario of a patient with mild traumatic brain injury (TBI). We surveyed their preferences and perceptions of hospital care related to this scenario. A closed-ended questionnaire provided quantitative data on patient preferences and perceptions of hospital care and an open-ended questionnaire evaluated factors that may not have been captured with the closed-ended questionnaire. Results Out of 302 study patients, the ability for family and friends to visit (83%), nurse availability (80%), and physician availability (79%) were the factors most commonly rated “very important,” while the cost of hospitalization (62%) and length of hospitalization (59%) were the factors least commonly rated “very important.” When asked to choose between the ICU and the floor if they were the patient in the scenario, 33 patients (10.9%) choose the ICU, 133 chose the floor (44.0%), and 136 (45.0%) had no preference. Conclusion Based on a hypothetical scenario of mild TBI, the majority of patients preferred admission to the floor or had no preference compared to admission to the ICU. Humanistic factors such as the availability of doctors and nurses and the ability to interact with family appear to have a greater priority than systematic factors of hospitalization, such as length and cost of hospitalization or length of time in the ED waiting for an in-patient bed. PMID:26587095

  19. Effects of Real-time Telemedicine Consultations between Hospital-based Nurses and Patients with Severe COPD discharged after Exacerbation Admissions

    DEFF Research Database (Denmark)

    Sorknæs, Anne Dichmann; Jest, Peder; Bech, Mickael; Olesen, Finn; Hounsgaard, Lise; Østergaard, Birte

    Introduction: Hospitalisation with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) causes a major burden for the COPD patients and is a common cause for admissions and readmissions to medical wards. Objectives: To investigate the effect of one week of daily real-time telemedi...

  20. Levantamento do custo do processo admissional de técnico de enfermagem de um hospital de ensino Levantamiento del costo del proceso admisional de técnico de enfermería de un hospital de enseñanza Survey on the cost of the admission process of nursing technicians in a teaching hospital

    Directory of Open Access Journals (Sweden)

    Helena Isuku Horibe Okano

    2007-09-01

    Full Text Available Este estudo teve como objetivo contribuir para a gestão de custo do processo admissional de técnicos de enfermagem pelo mapeamento e mensuramento do custo direto das principais atividades desse processo. O estudo exploratório, retrospectivo, documental, na modalidade de estudo de caso foi realizado no Serviço de Apoio Educacional do Hospital Universitário da Universidade de São Paulo. O processo admissional foi dividido em cinco subprocessos: planejamento, recrutamento, seleção, contratação e treinamento admissional. Os resultados mostraram que o custo total direto do processo admissional foi de R$ 6.359,90 e o subprocesso seleção foi o que mais consumiu recurso, com R$ 3.416,40, representando R$ 53,72% do total. Cada candidato contratado custou R$ 635,99.Este estudio tiene como objetivo contribuir para la gestión de costo del proceso ad misional de técnicos de enfermería por el mapa y medición del costo directo de las principales actividades de ese proceso. El estudio exploratorio, retrospectivo, documental, en la modalidad de estudio de caso fue realizado en el Servicio de Apoyo Educacional del hospital Universitario de la Universidad de São Paulo. El proceso ad misional fue dividido en cinco subprocesos: planeamiento, reclutamiento, selección, contratación y entrenamiento ad misional. Los resultados muestran que el costo total directo del proceso ad misional fue de R$ 6.359,90, el sub-proceso de selección fue el que más consumió recurso con R$ 3.416,40 representando R$ 53,72% del total. Cada candidato contratado costó R$ 635,99.This study was aimed at contributing to the cost management of the admission process of nursing technicians by mapping and measuring the direct cost of the main activities in this process. The exploratory, retrospective, documental study on the modality of case study was carried out at the Educational Support Service of the University of São Paulo's Hospital Universitário. The admission process

  1. Epidemiological aspects of the Thule case. Mortality, number of hospital admissions and fertility levels observed amongst the workers employed at the Thule base following the B-52 bomber crash

    International Nuclear Information System (INIS)

    In 1968 an American B-52 bomber carrying nuclear bombs crashed near the Thule Air Base in Greenland. Since 1986 it has been suspected that morbidity was elevated among the workers employed during the following clean-up period. The aim was to elucidate certain following epidemiological aspects including possible hazardous effects on the workers' health measured by death rate, hospital admissions and fertility levels, to analyze the mortality pattern of these workers compared to that of the rest of the Danish population, to discuss alternatives for the analysis of possible hazardous effects on workers' health after the crash and the consequences of the political and media coverage. No significant difference was found in the frequency of live-born children among the workers employed during the clean-up period compared to those employed outside this period and to those in the first-named group involved in a specific clean-up operation. The number of hospital admissions was the same in both groups but there were more admissions of psychiatric cases among the workers employed during the clean-up period, amongst these 75% represented alcoholism. No differences were found between the employed groups and the general Danish population with regard to total mortality or mortality from cancer, circulatory diseases or other natural causes or accidents. Prevalent causes of death were lung cancer, heart disease, alcoholism, liver cirrhosis, suicide and accidents. It is concluded that Thule workers did not suffer excess mortality and there is no basis for the theory of mass sterilization. The crash of may have led to a few cases of illness. (AB) 148 refs

  2. Model-based testing for space-time interaction using point processes: An application to psychiatric hospital admissions in an urban area

    CERN Document Server

    Meyer, Sebastian; Rössler, Wulf; Held, Leonhard

    2015-01-01

    Spatio-temporal interaction is inherent to cases of infectious diseases and occurrences of earthquakes, whereas the spread of other events, such as cancer or crime, is less evident. Statistical significance tests of space-time clustering usually assess the correlation between the spatial and temporal (transformed) distances of the events. Although appealing through simplicity, these classical tests do not adjust for the underlying population nor can they account for a distance decay of interaction. We propose to use the framework of an endemic-epidemic point process model to jointly estimate a background event rate explained by seasonal and areal characteristics, as well as a superposed epidemic component representing the hypothesis of interest. We illustrate this new model-based test for space-time interaction by analysing psychiatric inpatient admissions in Zurich, Switzerland (2007-2012). Several socio-economic factors were found to be associated with the admission rate, but there was no evidence of genera...

  3. Effectiveness of telemonitoring integrated into existing clinical services on hospital admission for exacerbation of chronic obstructive pulmonary disease: researcher blind, multicentre, randomised controlled trial

    OpenAIRE

    Pinnock, Hilary; Hanley, Janet; McCloughan, Lucy; Todd, Allison; Krishan, Ashma; Lewis, Stephanie; Stoddart, Andrew; van der Pol, Marjon; MacNee, William; Sheikh, Aziz; Pagliari, Claudia; McKinstry, Brian

    2013-01-01

    Objective: To test the effectiveness of telemonitoring integrated into existing clinical services such that intervention and control groups have access to the same clinical care. Design: Researcher blind, multicentre, randomised controlled trial. Setting: UK primary care (Lothian, Scotland). Participants: Adults with at least one admission for chronic obstructive pulmonary disease (COPD) in the year before randomisation. We excluded people who had other significant lung disease, who were unab...

  4. Effectiveness of telemonitoring integrated into existing clinical services on hospital admission for exacerbation of chronic obstructive pulmonary disease: researcher blind, multicentre, randomised controlled trial

    OpenAIRE

    Pinnock, Hilary; Hanley, Janet; McCloughan, Lucy; Todd, Allison; Krishan, Ashma; Lewis, Stephanie; Stoddart, Andrew; van der Pol, Marjon; MacNee, William; Sheikh, Aziz; Pagliari, Claudia; McKinstry, Brian

    2013-01-01

    Objective To test the effectiveness of telemonitoring integrated into existing clinical services such that intervention and control groups have access to the same clinical care. Design Researcher blind, multicentre, randomised controlled trial. Setting UK primary care (Lothian, Scotland). Participants Adults with at least one admission for chronic obstructive pulmonary disease (COPD) in the year before randomisation. We excluded people who had other significant lung disease, who were unable t...

  5. An analysis of clinical activity, admission rates, length of hospital stay, and economic impact after a temporary loss of 50% of the non-operative podiatrists from a tertiary specialist foot clinic in the United Kingdom

    Directory of Open Access Journals (Sweden)

    Catherine Gooday

    2013-09-01

    Full Text Available Introduction: Podiatrists form an integral part of the multidisciplinary foot team in the treatment of diabetic foot–related complications. A set of unforeseen circumstances within our specialist diabetes foot service in the United Kingdom caused a loss of 50% of our non-operative podiatry team for almost 7 months during 2010. Some of this time was filled by non-specialist community non-operative podiatrists. Methods: We assessed the economic impact of this loss by examining data for the 5 years prior to this 7-month interruption, and for the 2 years after ‘normal service’ was resumed. Results: Our data show that the loss of the non-operative podiatrists led to a significant rise in the numbers of admissions into hospital, and hospital length of stay also increased. At our institution a single bed day cost is £275. During the time that the numbers of specialist non-operative podiatry staff were depleted, and for up to 6 months after they returned to normal activities, the extra costs increased by just less than £90,000. The number of people admitted directly from specialist vascular and orthopaedic clinics is likely to have increased due to the lack of capacity to manage them in the diabetic foot clinic. Our data were unable to assess these individuals and did not look at the costs saved from avoiding surgery. Thus the actual costs incurred are likely to be higher. Conclusions: Our data suggest that specialist non-operative podiatrists involved in the treatment of the diabetic foot may prevent unwarranted hospital admission and increased hospitalisation rates by providing skilled assessment and care in the outpatient clinical settings.

  6. Hospitals

    Data.gov (United States)

    Department of Homeland Security — This database contains locations of Hospitals for 50 states and Washington D.C. , Puerto Rico and US territories. The dataset only includes hospital facilities and...

  7. The effects of real-time telemedicine consultations between hospital- based nurses and patients with severe COPD discharged after exacerbation admissions

    DEFF Research Database (Denmark)

    Olesen, Finn

    2013-01-01

    We investigated the effect of daily real-time teleconsultations for one week between hospital-based nurses specialised in respiratory diseases and patients with severe COPD discharged after acute exacerbation. Patients admitted with acute exacerbation of chronic obstructive pulmonary disease...... (AECOPD) at two hospitals were recruited at hospital discharge. They were randomly assigned to intervention or control. The telemedicine equipment consisted of a briefcase with built-in computer including a web camera, microphone and measurement equipment. The primary outcome was the mean number of total...

  8. Effects of acute organophosphate poisoning on pituitary target gland hormones at admission, discharge and three months after poisoning: A hospital based pilot study

    Directory of Open Access Journals (Sweden)

    Pinaki Dutta

    2015-01-01

    Full Text Available Background: Organophosphate compound (OPC poisoning is common in the developing countries such as India. The acute and later effects of OPC poisoning on pituitary and target gland hormones is largely unknown. Materials and Methods: This prospective study was conducted at Postgraduate Institute of Medical Education and Research between January 2012 and March 2013. Fourteen patients (8 males, age 18-50 years with acute OPC poisoning were included in the study based on the history and clinical features, documented decreased in plasma cholinesterase activity or presence of the OPC in gastric lavage/blood samples. The hormonal parameters were done at baseline, at the time of discharge and at three months of follow-up. Results: A total of 14 patients out of 46 with the mean age of 30.1 ± 10.3 years were finally eligible for the study. Hormonal alterations at admission were similar to sick euhormonal syndrome. Overall 7 of them had nine hormonal deficits at three months of follow up, 4 having sub normal basal cortisol level and two each had low testosterone and growth hormone and only one had thyroxine deficiency. Conclusion: Acute organophosphate poisoning results in endocrine dysfunction akin to sick euhormonal syndrome. However, in a small subset of patients, varying level of hormonal insufficiency may occur either at admission or later. These observations need re-validation in a larger group of patients with specific OPC.

  9. Swallowing-induced cardio-respiratory responses in man

    Directory of Open Access Journals (Sweden)

    Ballal Mansour

    1998-01-01

    Full Text Available Swallowing transiently increases heart rate. One of the authors developed pronounced bradycardia while breath holding, particularly after an expiration. The objective, therefore, was to study his cardiac responses during swallowing as pronounced bradycardia developed. When, after a maximum inspiration (supine, the heart rate slowly fell below 50 beats min′ well-defined P waves (lead II disappeared. By swallowing 6 times on command after the P waves disappeared his heart rate increased immediately (68 ± I beats min-′; n=6. P waves with similar morphology to those pre-swallowing were recorded 0.7 ± 0.1 s (n=6 after the first swallow. He continued breath holding after swallowing. P waves again disappeared, although at faster heart rates (57 ± I beats min′; n=6. Furthermore, well-defined P waves were observed after the second disappearance at heart rates within the range 30-40 beats min′. Small amplitude P waves continued to be recorded from lead I with P wave disappearance in lead II, suggesting a pacemaker shift, although not to the av node. Autonomic nerves can shift the dominant pacemaker within the sa node. The present report indicates that increased vagal tone may be rapidly reversed by swallowing.

  10. Swallowing-induced cardio-respiratory responses in man

    OpenAIRE

    Ballal Mansour; Sanford Paul

    1998-01-01

    Swallowing transiently increases heart rate. One of the authors developed pronounced bradycardia while breath holding, particularly after an expiration. The objective, therefore, was to study his cardiac responses during swallowing as pronounced bradycardia developed. When, after a maximum inspiration (supine), the heart rate slowly fell below 50 beats min′ well-defined P waves (lead II) disappeared. By swallowing 6 times on command after the P waves disappeared his heart rate increase...

  11. Neural and Cardio-Respiratory Interacting during Anaesthesia

    Czech Academy of Sciences Publication Activity Database

    Musizza, B.; McClintock, P. V. E.; Paluš, Milan; Petrovič, J.; Ribarič, S.; Stefanovska, M.

    Maribor : CAMTP, 2003. s. 25. [Slovenia-Japan Seminar /2./. 28.06.2003-05.07.2003, Maribor] Institutional research plan: AV0Z1030915 Keywords : anaesthesia * EEG * cardiorespiratory interaction Subject RIV: BB - Applied Statistics, Operational Research

  12. Modeling in-Hospital Patient Survival During the First 28 Days After Intensive Care Unit Admission: a Prognostic Model for Clinical Trials in General Critically Ill Patients

    OpenAIRE

    Moreno, R; Metnitz, P; Metnitz, B; Bauer, P.; Afonso de Carvalho, S; Hoechtl, A; SAPS 3 Investigators

    2008-01-01

    OBJECTIVE: The objective of the study was to develop a model for estimating patient 28-day in-hospital mortality using 2 different statistical approaches. DESIGN: The study was designed to develop an outcome prediction model for 28-day in-hospital mortality using (a) logistic regression with random effects and (b) a multilevel Cox proportional hazards model. SETTING: The study involved 305 intensive care units (ICUs) from the basic Simplified Acute Physiology Score (SAPS) 3 cohort. ...

  13. Tempo de permanência de enfermeiros em um hospital-escola e valores monetários despendidos nos processos de admissão, desligamento e provimento de novo profissional Tiempo de permanencia de enfermeras en un hospital-escuela y su relación con el monto gasto en la admisión, salida y provisión de nuevo profesional Time of permanence of nurses at a school-hospital and expenses related to admission, resignation and hiring of a new professional

    Directory of Open Access Journals (Sweden)

    Flávia Lilalva de Holanda

    2005-10-01

    Full Text Available Este estudo descritivo teve como objetivo conhecer o tempo de permanência dos enfermeiros numa instituição hospitalar e sua relação com o valor monetário em horas/salário, referente à admissão, à saída e ao provimento de novo enfermeiro. Foram analisados os registros de saída de 109 enfermeiros de um hospital na zona leste da cidade de São Paulo, no período de 2000 a 2002, fornecidos pelo Departamento de Recursos Humanos em 2003, bem como os valores monetários em horas/salário do pessoal envolvido no processo de seleção, admissão, treinamento e demissão. O estudo mostrou que o tempo de permanência do enfermeiro na instituição foi curto (média de 20 meses e mediana 18; 30,53% dos enfermeiros deixaram o hospital com menos de 1 ano; o valor monetário médio para admissão e desligamento de enfermeiros foi de R$ 881,43 o tempo de permanência breve duplicou o custo para a contratação de novo profissional.Este estudio descriptivo tuvo como objetivo conocer el tiempo de permanencia de los enfermeros en un hospital y su relación con el monto gasto en hora/sueldo referente a la admisión, salida y provisión de nuevo enfermero. Se analizó los registros de salida de 109 enfermeros de un hospital en la zona leste de la ciudad de São Paulo, en el periodo de 2000 a 2002, fornecidos por el Departamento de Recursos Humanos en 2003, bien como los montos gastos en horas/sueldo del personal involucrado en el proceso de selección, admisión capacitación y demisión. El estudio demostró que el tiempo de permanencia del enfermero en la institución fue corto (promedio de 20 meces y mediana de 18; el 30,53% de los enfermeros dejó el hospital con menos de 1 año; el monto promedio gasto para admisión y salida de los enfermeros fue R$ 881,43; el tiempo de permanencia corto duplicó el costo para la contratación de nuevo profesional.This descriptive study aimed to find out how long nurses stay at a hospital institution and the

  14. The relationship between asthma admission rates, routes of admission, and socioeconomic deprivation.

    Science.gov (United States)

    Watson, J P; Cowen, P; Lewis, R A

    1996-10-01

    This study aimed to explore the relationship between hospital admissions for asthma and socioeconomic deprivation. A retrospective study examined one year of hospital admissions for asthma in the West Midlands region of England (n = 10,044), and in one of the region's wealthier districts, Worcester (n = 251). Age standardized admission ratios (SARs) for asthma, and the routes of hospital admission, were compared with the Towns- end Deprivation Index for the place of residence. Asthma SAR was strongly associated with deprivation as measured by the Towns end Index for the district of residence (Spearman rank correlation coefficient rho = 0.65; p = 0.004). Asthma admission rates for all age groups, except those aged over 65 yrs, were higher in poorer districts. A significantly greater proportion of emergency admissions in poorer districts came via Accident and Emergency departments, rather than general practitioner referrals (rho = 0.76; p Townsend Index for the ward of residence (rho = 0.39; p < 0.001). This remained significant after excluding repeat admissions (rho = 0.45; p < 0.001). We conclude that asthma admissions are strongly associated with deprivation in the community. Differences in the health care received during acute exacerbations by asthma patients from different economic backgrounds is likely to be an important factor in this relationship. PMID:8902471

  15. Better health-related quality of life (mental component summary, having a higher level of education, and being less than 75 years of age are predictors of hospital admission among cognitively intact nursing home residents: a 5-year follow-up study

    Directory of Open Access Journals (Sweden)

    Drageset J

    2016-03-01

    Full Text Available Jorunn Drageset,1,2 Geir Egil Eide,3,4 Anette Hylen Ranhoff5,6 1Department of Nursing, Faculty for Health and Social Science, Bergen University College, Bergen, Norway; 2Department of Public Health and Primary Care, University of Bergen, Bergen, Norway; 3Centre for Clinical Research, Western Norway Health Region Authority, Bergen, Norway; 4Research Group for Lifestyle Epidemiology, Department of Public Health and Primary Care, University of Bergen, Bergen, Norway; 5Kavli Research Centre for Ageing and Dementia, Haraldsplass Hospital, Bergen, Norway; 6Department of Clinical Science, University of Bergen, Bergen, Norway Objective: To study whether health-related quality of life (HRQOL, activities of daily living (ADL, and anxiety and depression symptoms affect the risk of hospital admission and potential interactions with having a cancer diagnosis.Methods: This study was a prospective observational study with 5-year follow-up and analyzed the follow-up data on hospital admissions until 2010 using baseline data from 227 cognitively intact nursing home (NH residents (60 of whom had cancer in 2004–2005. Data on HRQOL were collected by using the Short Form-36 Health Survey, divided into physical component summary (PCS and mental component summary (MCS, and symptoms of anxiety and depression were collected by using the Hospital Anxiety and Depression Scale (HADS. ADL were obtained from registered observation and sociodemographic variables, diagnoses, and hospital admissions from the NH records. Personal identification numbers were linked to the record systems of the hospitals, thereby registering all hospital admissions. We analyzed the time elapsing between inclusion and the first hospital admission.Results: Residents with higher HRQOL (MCS had significantly more hospital admissions after adjustment for age, sex, marital status, education, and comorbidity. HRQOL (PCS, ADL, depression, and anxiety symptoms were not associated with hospital admissions

  16. Voluntary self-poisoning as a cause of admission to a tertiary hospital internal medicine clinic in Piraeus, Greece within a year

    OpenAIRE

    Peppas Theodoros A; Kotsini Vasiliki; Skliros Stathis A; Sotiropoulos Alexios; Tountas Charalambos; Tamvakos Elias; Pappas Stavros

    2001-01-01

    Abstract Background Out of 1705 patients hospitalised for various reasons in the 3rd Internal Medicine Department of the Regional General Hospital of Nikaea, in Piraeus, 146(8,5%) persons were admitted for drug intoxication between November 1999 and November 2000. Methods On average, these persons [male 50(34,2%) – female 96(65,8%)] were admitted to the hospital within 3.7 hours after taking the drug. Results The drugs that were more frequently taken, alone or in combination with other drugs,...

  17. [Management of the patient with serious burns at admission].

    Science.gov (United States)

    Meunier, David; Dupré, Aurélie

    2012-01-01

    The first hours of care and treatment are determined by the quality of the preparation on a logistical, organisational and environmental level. The future of a patient with serious burns is at stake in these first few hours. The risk of threat to life is linked to potential vascular compressions, as well as cardio-respiratory failure.The occurrence of these complications can be prevented by the setting up of codified instrumental and clinical monitoring. PMID:22916393

  18. Impact of Combination Evidence-Based Medical Therapy Used at Admission on In-Hospital Mortality in Patients With Non-ST-Elevation Myocardial Infarction

    Czech Academy of Sciences Publication Activity Database

    Monhart, Z.; Faltus, Václav; Grünfeldová, Hana; Janský, P.

    2008-01-01

    Roč. 117, č. 19 (2008), s. 21-22. ISSN 0009-7322. [The 2008 World Congress on Cardiology. 18.05.2008-21.05.2008, Buenos Aires] R&D Projects: GA MŠk(CZ) 1M06014 Institutional research plan: CEZ:AV0Z10300504 Keywords : acute myocardial infarction * risk factors * in-hospital mortality Subject RIV: FA - Cardiovascular Diseases incl. Cardiotharic Surgery

  19. The Global Contribution of Outdoor Air Pollution to the Incidence, Prevalence, Mortality and Hospital Admission for Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis

    OpenAIRE

    Qingkun Song; Christiani, David C.; XiaorongWang; Jun Ren

    2014-01-01

    Objective: This study aimed to investigate the quantitative effects of outdoor air pollution, represented by 10 µg/m3 increment of PM10, on chronic obstructive pulmonary disease in China, United States and European Union through systematic review and meta-analysis. Methods: Publications in English and Chinese from PubMed and EMBASE were selected. The Cochrane Review Handbook of Generic Inverse Variance was used to synthesize the pooled effects on incidence, prevalence, mortality and hospital...

  20. Sources of occupational stress and coping strategies among nurses who work in Admission and Emergency Departments of Hospitals related to Shiraz University of Medical Sciences

    OpenAIRE

    Gholamzadeh, Sakineh; Sharif, Farkhondeh; Rad, Fereshteh Dehghan

    2011-01-01

    BACKGROUND: Occupational stress is a recognized problem in health care workers. Nursing has been identified as an occupation that has high levels of stress. This study aimed to investigate the sources of job stress and the adopted coping strategies of nurses who were working in an Accident and emergency department. METHODS: In this descriptive survey ninety emergency ward nurses from three large teaching hospitals in Shiraz were involved. The data was collected through a self-administered que...

  1. Does case management for patients with heart failure based in the community reduce unplanned hospital admissions?:A systematic review and meta-analysis

    OpenAIRE

    Huntley, Alyson L; Johnson, Rachel A; King, Anna J L; Morris, Richard; Purdy, Sarah

    2016-01-01

    Objectives The aim of this systematic review of randomised controlled trials (RCTs) and controlled trials (NRCTs) is to investigate the effectiveness and related costs of case management (CM) for patients with heart failure (HF) predominantly based in the community in reducing unplanned readmissions and length of stay (LOS). Setting CM initiated either whilst as an inpatient, or on discharge from acute care hospitals, or in the community and then continuing on in the community. Participants A...

  2. The importance of relationships in mental health care: A qualitative study of service users' experiences of psychiatric hospital admission in the UK

    Directory of Open Access Journals (Sweden)

    Slade Mike

    2008-04-01

    Full Text Available Abstract Background While a number of studies have looked at life on service users' experiences of life on psychiatric wards, no research exists that have approached these experiences from the user perspective since the introduction of community care. Methods This user-led study uses a participatory approach to develop an understanding of the processes and themes which define the user experience of hospitalisation. Nineteen service users who had all had inpatient stays in psychiatric hospitals in London were interviewed in the community. Results Relationships formed the core of service users' experiences. Three further codes, treatment, freedom and environment defined the role of hospital and its physical aspects. Themes of communication, safety, trust, coercion, and cultural competency contributed to the concept of relationships. Conclusion Relationships with an individual which comprised effective communication, cultural sensitivity, and the absence of coercion resulted in that person being attributed with a sense of trust. This resulted in the patient experiencing the hospital as a place of safety in terms of risk from other patients and staff. Barriers to positive relationships included ineffective and negative communication, a lack of trust, a lack of safety in terms of staff as ineffective in preventing violence, and as perpetrators themselves, and the use of coercion by staff. This unique perspective both acts as a source of triangulation with previous studies and highlights the importance of the therapeutic relationship in providing a safe and therapeutic milieu for the treatment of people with acute mental health problems.

  3. Size distribution and total number concentration of ultrafine and accumulation mode particles and hospital admissions in children and the elderly in Copenhagen, Denmark

    DEFF Research Database (Denmark)

    Andersen, Zorana Jovanovic; Wåhlin, Peter; Raaschou-Nielsen, O;

    2008-01-01

    in diameter, respectively) and ambient gasses. We utilised data on size distribution to calculate NC(tot) for four modes with median diameters 12, 23, 57 and 212 nm, and NC(100) (number concentration of particles <100 nm in diameter) and examined their associations with health outcomes. We used a...... time series Poisson generalised additive model adjusted for overdispersion, season, day of the week, public holidays, school holidays, influenza, pollen and meteorology, with up to 5 days' lagged exposure. RESULTS AND CONCLUSIONS: The adverse health effects of particulate matter on CVD and RD hospital...

  4. Burden of hospital admission and repeat angiography in angina pectoris patients with and without coronary artery disease: a registry-based cohort study.

    Directory of Open Access Journals (Sweden)

    Lasse Jespersen

    Full Text Available AIMS: To evaluate risk of hospitalization due to cardiovascular disease (CVD and repeat coronary angiography (CAG in stable angina pectoris (SAP with no obstructive coronary artery disease (CAD versus obstructive CAD, and asymptomatic reference individuals. METHODS AND RESULTS: We followed 11,223 patients with no prior CVD having a first-time CAG in 1998-2009 due to SAP symptoms and 5,695 asymptomatic reference individuals from the Copenhagen City Heart Study through registry linkage for 7.8 years (median. In recurrent event survival analysis, patients with SAP had 3-4-fold higher risk of hospitalization for CVD irrespective of CAG findings and cardiovascular comorbidity. Multivariable adjusted hazard ratios(95%CI for patients with angiographically normal coronary arteries was 3.0(2.5-3.5, for angiographically diffuse non-obstructive CAD 3.9(3.3-4.6 and for 1-3-vessel disease 3.6-4.1(range(all P<0.001. Mean accumulated hospitalization time was 3.5(3.0-4.0(days/10 years follow-up in reference individuals and 4.5(3.8-5.2/7.0(5.4-8.6/6.7(5.2-8.1/6.1(5.2-7.4/8.6(6.6-10.7 in patients with angiographically normal coronary arteries/angiographically diffuse non-obstructive CAD/1-, 2-, and 3-vessel disease, respectively (all P<0.05, age-adjusted. SAP symptoms predicted repeat CAG with multivariable adjusted hazard ratios for patients with angiographically normal coronary arteries being 2.3(1.9-2.9, for angiographically diffuse non-obstructive CAD 5.5(4.4-6.8 and for obstructive CAD 6.6-9.4(range(all P<0.001. CONCLUSIONS: Patients with SAP symptoms and angiographically normal coronary arteries or angiographically diffuse non-obstructive CAD suffer from considerably greater CVD burdens in terms of hospitalization for CVD and repeat CAG compared with asymptomatic reference individuals even after adjustment for cardiac risk factors and exclusion of cardiovascular comorbidity as cause. Contrary to common perception, excluding obstructive CAD by CAG in such

  5. The impact of virtual admission on self-efficacy in patients with chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Emme, Christina; Mortensen, Erik L; Rydahl-Hansen, Susan;

    2014-01-01

    AIMS AND OBJECTIVES: To investigate how virtual admission during acute exacerbation influences self-efficacy in patients with chronic obstructive pulmonary disease, compared with conventional hospital admission. BACKGROUND: Telemedicine solutions have been highlighted as a possible way to increas...

  6. Voluntary self-poisoning as a cause of admission to a tertiary hospital internal medicine clinic in Piraeus, Greece within a year

    Directory of Open Access Journals (Sweden)

    Peppas Theodoros A

    2001-10-01

    Full Text Available Abstract Background Out of 1705 patients hospitalised for various reasons in the 3rd Internal Medicine Department of the Regional General Hospital of Nikaea, in Piraeus, 146(8,5% persons were admitted for drug intoxication between November 1999 and November 2000. Methods On average, these persons [male 50(34,2% – female 96(65,8%] were admitted to the hospital within 3.7 hours after taking the drug. Results The drugs that were more frequently taken, alone or in combination with other drugs, were sedatives (67.1%, aspirins and analgesics (mainly paracetamol (43.5%. 38.3% of patients had a mental illness history, 31.5% were in need of psychiatric help and 45.2% had made a previous suicide attempt. No death occurred during the above period and the outcome of the patients' health was normal. After mental state examination, the mental illnesses diagnosed were depression (20.96%, psychosis (15.32%, dysthymic disorder (16,2%, anxiety disorder (22.58% and personality disorder (8.87%. Conclusions Self-poisoning remains a crucial problem. The use of paracetamol and sedatives are particularly important in the population studied. Interpersonal psychiatric therapy may be a valuable treatment after people tried to poison themselves.

  7. Immigration, moving house and psychiatric admissions.

    Science.gov (United States)

    Johansson, L M; Sundquist, J; Johansson, S E; Bergman, B

    1998-08-01

    This study was designed to elucidate psychiatric admission rates for native Swedes and foreign-born individuals during the period 1991-1994, when Sweden had a great influx of refugees. During the same period, and even earlier, psychiatric in-patient care had been reduced. Tests of differences between Swedes and foreign-born individuals in first psychiatric admission rates were performed using Poisson regressions, and the risk of a readmission was assessed using a proportional hazard model. Foreign-born individuals and native Swedes, both males and females, showed a similar admission pattern with regard to the number of admissions. Foreign-born males under 55 years of age and foreign-born females under 35 years of age had significantly higher admission rates than native Swedes. In total, native Swedes, both males and females, were hospitalized for a significantly longer period than the foreign-born subjects. About 43% of the patients were readmitted. The risk of a readmission was significantly increased among those with a high rate of internal migration. The high admission rates for young foreign-born individuals might be explained by a high incidence of mental illness owing to the trauma of being violently forced to migrate, acculturation difficulties, or unsatisfactory social circumstances such as high unemployment. The shorter hospitalization time could be due to undertreatment or less serious mental illness. PMID:9718235

  8. 思维导图在产科患者入院指导中的应用效果%Effect of mind map on obstetric patients′hospital admission guidance

    Institute of Scientific and Technical Information of China (English)

    徐霞萍

    2015-01-01

    Objective To study the effect of mind map on obstetric patients′ hospital admission guidance. Methods A total of 200 cases were chosen from January 2012 to January 2014 and randomly divided into the research group and the control group, with 100 cases in each group. The research group was given the hospital guidance with mind map, while the control group used the conventional oral hospital guidance. Knowledge awareness, treatment compliance and satisfaction were compared between the two groups. Results The score of knowledge of the research group was (18. 65 ± 4. 36), which was significantly higher than that of the control group (15. 51 ± 4. 21),the difference was statistically significant (t =4. 312, P <0. 05). The score of satisfaction in the research group was (19. 73 ± 2. 32), which was significantly higher than that of the control group (17. 64 ± 2. 21), the difference was statistically significant (t=2. 891, P<0. 05). In the research group, 97 cases ( 97. 0%) had regular diets, 95 cases ( 95. 0%) had regular breaks and 98 cases (98. 0%) took medicine regularly, which were significantly higher those of the control group (χ2 =4. 110, 4. 769, 4. 014, 5. 025, respectively;P <0. 05). Conclusions The effect of using mind map for obstetric patients′ hospital admission guidance is remarkable, which is better than previous oral hospital guidance, so it is worthy of clinical promotion.%目的:探讨思维导图对产科患者入院指导效果的影响。方法选取2012年1月—2014年1月200例患者作为研究对象,随机分为研究组和对照组,每组各100例。研究组患者使用思维导图进行入院指导,对照组患者按常规口头宣教形式进行入院指导,并分别对两组患者采用产科治疗相关知识知晓率问卷、入院指导满意度问卷和治疗依从性问卷进行测评。结果研究组患者相关知识掌握得分(18.65±4.36)分,高于对照组的(15.51±4.21)分,差异有统计学意义(t=4.312,P<0.05)。

  9. Internações no sistema de serviços hospitalares, SUS e não SUS: Brasil, 2006 Hospital admissions in the hospital health care system, SUS and non-SUS: Brazil, 2006

    OpenAIRE

    Marizélia Leão Moreira; Hillegonda Maria DutilhNovaes

    2011-01-01

    O objetivo deste estudo foi descrever as admissões, SUS e não SUS, no Sistema de Serviços Hospitalares no Brasil no ano de 2006, adotando o indivíduo internado como unidade de análise. As fontes dos dados foram o Sistema de Informação Hospitalar (SIH/SUS) e de Comunicação de Internação Hospitalar (CIH) referentes a 2006 e 2007. A identificação do indivíduo foi feita pelo método probabilístico de associações de registros (linkage) e para a composição dos dados da internação aplicaram-se algori...

  10. Evaluation of Role of C-Reactive Protein Level on Cardiovascular Events During 14 Days after Admission of Patients with Unstable Angina in the Ekbatan Hospital, Hamadan, 2002

    Directory of Open Access Journals (Sweden)

    B. Naghsh Tabrizi

    2007-01-01

    Full Text Available Introduction & Objective: Unstable angina is in the center of spectrum from chronic stable angina to acute myocardial infarction. Due to high prevalence of unstable angina, it is important to find a factor that predicts prognosis and management modality. We decided to measure CRP level for the items that mentioned above.Materials & Methods: This study was a cross-sectional study that 138 patients who were admitted with unstable angina in the CCU and cardiac ward of Ekbatan Hospital in Hamedan were considered for measuring CRP level. Age, sex, period of disease, and left ventricular ejection fraction percentile were worked out. After quantitative CRP measuring and 14 days follow up, the questionnaire was completed.Results: CRP levels were 116.3 and 124.3 ng/ml in the patients with and without cardiovascular events (whole events respectively during 14 days follow up. Recurrent unstable angina, myocardial infarction and mortality rate were higher in the patients with elevated level of CRP but need to perform coronary angiography was lower.Conclusion: CRP level had no correlation with occurrence of cardiovascular events (whole events during 14 days follow up.

  11. HIV and/or AIDS-related deaths and modifiable risk factors: A descriptive study of medical admissions at Oshakati Intermediate Hospital in Northern Namibia

    Directory of Open Access Journals (Sweden)

    N.K. Mgori

    2015-02-01

    Full Text Available Background: High rates of HIV infection have decreased life expectancy in many African countries. Regardless of worldwide efforts to escalate treatment, care and prevention strategies, the number of deaths due to AIDS-related disorders is still high. Local healthcare workers suspect that there are modifiable factors in the care of HIV and/or AIDS patients which can be identified and improved.Aim: To describe the HIV and/or AIDS-related causes of adult mortality and identify modifiable factors amongst patients admitted to Oshakati Intermediate Hospital, northern Namibia.Methods: Data was extracted retrospectively and coded using the modified CoDe protocol for AIDS. Modifiable factors relating to the patient, health system or clinical care were identified using a standardised data collection tool.Results: A total of 177 HIV and/or AIDS patients were identified, 94 (53.1% were male and 120 (68% had a CD4 count of less than 200 cells/mL. The common HIV-related causes of death were tuberculosis (25.9%, renal failure (15.8%, Pneumocystis jirovecii pneumonia (11.3%, cryptococcal meningitis (9%, HIV wasting syndrome (7.9% and AIDS-defining malignancy (7.9%. The analysis revealed 281 modifiable factors; patient-related factors were the most common (153 [54.4%], followed by health system factors (97 [34.5%] and healthcare personnel factors (31 [11%].Conclusion: Our findings have highlighted the challenges in overall HIV and/or AIDS inpatient care and surrounding primary care facilities. The identification of specific modifiable factors can be used to reduce mortality by providing training as well as rational monitoring, planning and resource allocation.

  12. A Stunning Admission

    Science.gov (United States)

    Hu, Helen

    2012-01-01

    Few people set out to become admissions counselors, say people in the profession. But the field is requiring skills that are more demanding and varied than ever. And at a time when universities are looking especially hard at the bottom line, people in admissions need to constantly learn new things and make themselves indispensable. Counselors…

  13. Six-year outcomes in first admission adolescent inpatients: clinical and cognitive characteristics at admission as predictors.

    Science.gov (United States)

    Pogge, David L; Insalaco, Brie; Bertisch, Hilary; Bilginer, Lale; Stokes, John; Cornblatt, Barbara A; Harvey, Philip D

    2008-07-15

    Persistent functional disability is common after even a single psychiatric admission in people with schizophrenia or bipolar disorder, but less is known about other conditions and about adolescent onset patients. This study examined clinical symptoms and cognitive performance at the time of the first admission for the prediction of 6-year outcomes. First admission adolescent patients with a variety of psychiatric diagnoses were assessed with comprehensive clinical ratings of psychopathology, a neuropsychological assessment, and received clinical diagnoses while experiencing their first psychiatric admission. They were contacted 6 years after discharge and examined with a structured assessment of psychiatric symptoms and functioning. Despite the low levels of overall impairment at follow-up, at least 20% of the variance in depression, psychosis, poor peer relationships and poor school attendance 6 years after the hospital admission were predicted by information collected during the hospitalization. Attentional deficits during admission predicted the presence of psychosis at follow-up more substantially than psychotic symptoms during admission, as well as predicting risk for relapse. Attentional deficits during a first psychiatric admission predicted risk for manifesting psychosis at 6-year follow-up to a more substantial degree than either a psychosis diagnosis or psychotic symptoms at admission. In contrast to psychosis, depression at follow-up was predicted by admission symptomatology, but not by cognitive deficits. PMID:18534688

  14. Comparison of prescribing and adherence patterns of anti-osteoporotic medications post-admission for fragility type fracture in an urban teaching hospital and a rural teaching hospital in Ireland between 2005 and 2008.

    LENUS (Irish Health Repository)

    McGowan, B

    2013-03-13

    INTRODUCTION: Poor adherence reduces the potential benefits of osteoporosis therapy, lowering gains in bone mineral density resulting in increased risk of fractures. AIM: To compare prescribing and adherence patterns of anti-osteoporotic medications in patients admitted to an urban teaching hospital in Ireland with a fragility type fracture to patients admitted to a rural hospital in the North Western region. METHODOLOGY: We identified all patients >55 years admitted to Sligo General Hospital between 2005 and 2008 with a fragility fracture (N = 744) using the hospital in-patient enquiry system (HIPE). The medical card number of those patients eligible for the primary care reimbursement services scheme (PCRS) facilitated the linkage of the HSE-PCRS scheme database to the HIPE database which enabled a study to identify persistence rates of patients prescribed osteoporosis therapy after discharge. The results were compared to the findings of a similar study carried out in St. James\\'s Hospital, Dublin. RESULTS: The 12 months post-fracture prescribing increased from 11.0 % (95 % CI 9.6, 12.4) in 2005 to 47 % (95 % CI 43.6, 50.3) in 2008 in the urban setting and from 25 % (95 % CI 21.5, 28.9) to 39 % (95 % CI 34.5, 42.7) in the rural setting. Adherence levels to osteoporosis medications at 12 months post-initiation of therapy was <50 % in both study groups. Patients on less frequent dosing regimes were better adherers. CONCLUSION: The proportion of patients being discharged on anti-osteoporosis medications post-fragility fracture increased between 2005 and 2008 in both patient groups. Sub-optimal adherence levels to osteoporosis medications continue to be a major concern.

  15. Tratamento compulsório e internações psiquiátricas Compulsory treatment and admission to psychiatric hospital

    Directory of Open Access Journals (Sweden)

    Hildenete Monteiro Fortes

    2010-12-01

    Full Text Available Este artigo traça um perfil histórico das diferentes interpretações da loucura, permitindo vislumbrar a própria história da saúde mental, desde seu caráter mítico inicial até explicações racionais, passando pela tolerância ao diferente até sua caracterização como doença. Na condição de doença mental, passível de tratamento e possível cura, surgem os hospitais psiquiátricos, os quais se tornaram símbolos da exclusão e seqüestro da cidadania. As recorrentes denúncias de violência e desrespeito aos direitos humanos, a partir da década de 1970, impulsionaram a reforma deste modelo de assistência psiquiátrica, pautando-se na desinstitucionalização e no resgate da cidadania e do respeito à singularidade e subjetividade do doente mental. A partir disso, a legislação brasileira passou a garantir os direitos e deveres tanto dos doentes mentais como dos médicos que deles cuidam, garantindo o respeito à dignidade humana em toda sua essência, inclusive no que tange a autonomia do paciente com relação ao tratamento compulsório.This article outlines the history of the various interpretations of madness. This provides an insight into the history of mental health, from initial mythical explanations to more rational modern approaches, from the tolerance of difference to its characterization as disease. The idea of treatable and possibly curable mental illnesses led to the emergence of psychiatric hospitals, which became symbols of incarceration and exclusion from society. Recurrent reports of violence and human rights abuses have, since the 1970s, fuelled calls to reform this model of psychiatric care and led to greater emphasis on care in the community, civil rights, and respect for the subjective and uniquely personal nature of mental illness. As a result, Brazilian law now recognizes the rights and duties both of the mentally ill and of the doctors who care for them, thereby ensuring respect for full human dignity

  16. Acesso à internação e fatores associados ao óbito hospitalar por doenças isquêmicas do coração no SUS Hospital admission and hospital death associated to ischemic heart diseases at the National Health System (SUS

    Directory of Open Access Journals (Sweden)

    Patrícia Alves Evangelista

    2008-02-01

    vulnerabilities and inequity associated to health care access. Ischemic heart diseases will act as models for such assessment. OBJECTIVE: The present study investigates factors associated to the hospital death rate of patients admitted to hospital due to acute myocardial infarction (AMI and heart failure (HF, and whether admittance through Belo Horizonte Municipal Health Office (SMSA-BH Admission Center (AC was in any way associated to hospital death after adjustment of relevant factors. METHODS: Data obtained from the Hospital Admission Authorizations (AIH and requests for hospital beds at SMSA data base on latest hospital admissions based on AMI or HF diagnostic hypotheses. Multivariate analysis was conducted to investigate risk factors for hospital death. RESULTS: No association was found between hospital admittance access and hospital death risk from those causes. Multivariate analysis showed higher death risk for 60 and 60+ year-old patients (OR=2.9, AMI diagnostic hypothesis (OR=3.0, the need for ICU care (OR=1.6, females (OR=1.4, surgery type (OR=1.9, and public health service hospital (OR=3.5. Hospital admissions due to AMI on weekends also showed higher death risk for death (OR=1.7. CONCLUSION: Further investigation is necessary in order to evaluate the kind of medical assistance provided on weekends at public hospitals. Other hospital factors are to be taken into account, as well as patients and assistance procedures, as subsidies for proposals to ensure higher equity and quality standard for public health services.

  17. Response of first attack of inflammatory bowel disease requiring hospital admission to steroid therapy Respuesta al tratamiento esteroideo del primer brote de enfermedad inflamatoria intestinal que requiere ingreso hospitalario

    Directory of Open Access Journals (Sweden)

    M. Abu-Suboh Abadía

    2004-08-01

    Full Text Available Introduction: corticoid administration is the usual treatment of Crohn' disease (CD and ulcerative colitis (UC attacks. How-ever, information available on response rates and their predictive factors is scarce. Objective: to establish response to steroidal treatment in an homogeneous group of patients with CD or UC during their first admission to hospital. Methods: restrospective analysis of 86 patients who received systemic steroidal treatment for a severe flare-up during their first hospital admission between 1995 and 2000. Patients were treated per protocol with fluid therapy, absolute diet, IV 6-methyl-prednisolone 1 mg/kg/day, and enoxaparin at prophylactic doses. Clinical response at 30 days was considered good in case of complete remission, and poor in case of partial or absent remission. Univariate and multivariate analyses according to non-parametric statistics were performed for sociodemographic and biologic variables. Results: 45 patients with CD and 41 with UC were included. Good response rates were 64.4% for CD and 60.9% for UC. The univariate analysis showed that patients with good response have shorter evolution times and fewer previous flare-ups (p Introducción: la administración de corticoides constituye el tratamiento habitual de los brotes de enfermedad de Crohn (EC y colitis ulcerosa (CU. Sin embargo, existe poca información sobre las tasas de respuesta y los factores que puedan predecirla. Objetivo: determinar la respuesta al tratamiento esteroideo en un grupo homogéneo de pacientes de EC y CU que ingresan por primera vez en el hospital. Métodos: análisis retrospectivo de 86 pacientes que en su primer ingreso hospitalario recibieron tratamiento esteroideo sistémico por brote grave de EC o CU entre 1995 y 2000. Fueron tratados de forma protocolizada con sueroterapia, dieta absoluta, 6-metil-prednisolona 1 mg/kg/día IV y enoxaparina a dosis profilácticas. Se ha considerado la respuesta clínica a los 30 días como

  18. Screening, Detecting and Enhancing the Yield of Previously Undiagnosed Hepatitis B and C In Patients with Acute Medical Admissions to Hospital: A Pilot Project Undertaken at the Vancouver General Hospital

    OpenAIRE

    Kapeluto, Jordanna E; Matthew Kadatz; Andrew Wormsbecker; Kiran Sidhu; Yoshida, Eric M

    2014-01-01

    BACKGROUND: Hepatitis B virus (HBV) and hepatitis C virus (HCV) represent an increasing health burden and morbidity in Canada. Viral hepatitis, specifically HCV, has high prevalence among persons born between 1945 and 1965, with 45% to 85% of infected adults asymptomatic and unaware of their infection. Screening has been shown to be cost effective in the detection and treatment of viral hepatitis.OBJECTIVE: To quantify incidence and identify undocumented HBV and HCV infection in hospitalized ...

  19. Ambiente atmosférico urbano e admissão hospitalar de crianças, na cidade de São Paulo, Brasil Urban atmospheric environment and hospital admission for children in the city of Sao Paulo, Brazil Ambiente atmosférico urbano e ingresos hospitalarios de niños en la ciudad de Sâo Paulo, Brasil

    Directory of Open Access Journals (Sweden)

    Edelci Nunes da Silva

    2013-06-01

    bioclimatic index PET (Physiological Equivalent Temperature with hospital admissions. A total of 12,269 admissions of children for respiratory causes were analysed - CID 10, Chapter 10: Respiratory diseases (J00-J32; J40-J47; J80-J99. Daily data about the average, lowest and highest air temperatures (ºC, relative humidity (% and wind speed (m/s were obtained from the meteorological station of Congonhas airport. For control purposes, the air quality indexes were obtained from CETESB (the Sao Paulo State body for transferring technology and monitoring the environment and water quality in Congonhas. Descriptive statistical analysis and regression models were used. Data were organized following a socio-environmental profile. Results indicate a statistical association between atmospheric variables, air pollution, and hospital admissions. There were no significant differences for the group of children with respiratory diseases living in districts with different environmental conditions. Los cambios climáticos constituyen un riesgo para la salud pública. No obstante, pocos estudios han tratado de identificar cómo la dinámica meteorológica afecta a la salud a fin de obtener datos para alimentar modelos de prevención de riesgos. En las ciudades tropicales, estos estudios resultan particularmente escasos. Esta investigación tuvo como objetivo verificar en qué medida las condiciones atmosféricas urbanas afectan a la salud respiratoria de los niños menores de cinco años en el sector sursureste de la ciudad de São Paulo, relacionando las variables meteorológicas y el índice bioclimático PET (Physiological Equivalent Temperature con los ingresos hospitalarios. Se analizaron 12 269 casos de ingresos de niños por enfermedades respiratorias - CIE 10, Capítulo 10 - Enfermedades Respiratorias (J00-J32; J40-J47; J80-J99. Las temperaturas medias, mínima y máxima diarias (ºC, la humedad relativa del aire (% y la velocidad media del viento (m/s fueron obtenidas en la estaci

  20. Unplanned admissions following ambulatory plastic surgery--a retrospective study.

    OpenAIRE

    A. Mandal; Imran, D.; McKinnell, T.; G. S. Rao

    2005-01-01

    INTRODUCTION: Admission for overnight or longer hospital stay from a day-case unit is an unwelcome event. This audit was designed to identify the incidence of unplanned admissions and also to detect the potential factors for such overstays. PATIENTS AND METHODS: Details of plastic surgical day-case patients were obtained from the hospital records for a period of 6 months (February 2002 to July 2002). RESULTS: The total number of unplanned admissions was 28 (3.55%). High rates were recorded in...

  1. THE ANALYSIS OF FACTORS INFLUENCING THE TERMS OF HOSPITAL ADMISSION IN PATIENTS WITH ACUTE CORONARY SYNDROM (ACCORDING TO THE LIS STUDY DATA – LYUBERTSY STUDY ON MORTALITY RATE IN PATIENTS AFTER ACUTE MYOCARDIAL INFARCTION

    Directory of Open Access Journals (Sweden)

    M. L. Ginzburg

    2015-12-01

    Full Text Available Aim. To evaluate main factors influencing admission time to cardiovascular care unit in patients with acute coronary syndrome (ACS. Material and methods. Anonymous questionnaire was used to study factors associated with prehospital delay. A total of 363 patients aged 63.2±12.3 (24-89 years were enrolled into the study: women – 132 (37%, men – 231 (63%. Results. The main reason for emergency call was typical pain syndrome (87%. 52% of the patients experienced the pain syndrome for the first time, the others noted change in the pain characteristics. 28% of the patients did nothing to relieve the chest pain; only one third of the patients used short-acting nitrates. The main reasons for delay in emergency call were the follows: hope that the symptoms will pass off aidless, unwillingness to disturb medical staff, various family circumstances and so on. Almost third part of the patients sought medical attention more than one hour after pain syndrome onset, about half of the patients called an ambulance within the first 40 minutes. Women sought medical advice later than men and used nitroglycerin less often. Experience of myocardial infarctions decreased in time before emergency call and increase in frequency of nitroglycerin intake before ambulance arrival but these correlations were weak (r≤0.25. Conclusion. Very high and high cardiovascular risk patients underestimate severity of possible complications of their disease and necessity for emergency call, they are also not familiar with the first aid algorithm in emergency cases. To reduce prehospital delay hospital and out-patient clinic doctors have to regularly inform high-risk patients and their relatives about the ACS symptoms and methods of the first aid.

  2. Help Desk Answers: Do corticosteroids reduce bronchiolitis hospitalizations?

    Science.gov (United States)

    Jendi, Mohammed R; Scott, Quincy O; Smaga, Sharon A

    2016-05-01

    Corticosteroids alone don't decrease hospital admissions or length of stay among children with bronchiolitis. Combining oral dexamethasone and inhaled epinephrine appears to prevent one hospital admission for every 11 patients treated. PMID:27275940

  3. The association between serum potassium at hospital admission and the case-fatality rate of leptospirosis in men Associação entre potássio sérico na admissão hospitalar e letalidade da leptospirose em homens

    Directory of Open Access Journals (Sweden)

    Antonio Alberto LOPES

    2001-08-01

    Full Text Available Severe leptospirosis affects predominantly males and presents a high susceptibility to hypokalemic acute renal failure. As hypokalemia and hyperkalemia induce severe complications, it is important to evaluate if the initial serum potassium is an independent risk factor for death in leptospirosis. The medical records of 1016 patients hospitalized with the diagnosis of leptospirosis were reviewed. The analysis was restricted to 442, according to the following criteria: male, 18 years or older, information about death or hospital discharge and recorded values of serum potassium, serum creatinine and duration of symptoms at admission. Potassium values lower than 3.5 mEq/L (hypoK, 3.5-5 mEq/L (normoK and above 5 mEq/L (hyperK were detected in 180, 245 and 17 patients, respectively. The death rate increased with serum potassium: 11.1% in the hypoK, 14.7% in the normoK and 47.1% in the hyperK group (p = 0.002. In a logistic regression model (normoK as referent, including age, creatinine and duration of symptoms, hypoK was not associated with increased death rate (odds ratio (OR = 0.80; p > 0.1. On the other hand, hyperK showed a significant association with increased risk of death (OR = 3.95, p = 0.021. In conclusion, in this sample of men with leptospirosis initial serum potassium was positively and independently correlated with the risk of in-hospital death.Leptospirose grave afeta predominantemente os homens e apresenta alta susceptibilidade para insuficiência renal aguda com hipocalemia. Como hipocalemia e hipercalemia induzem complicações graves, é importante avaliar se o potássio sérico é um independente fator de risco de morte na leptospirose. Foram revistos os prontuários de 1016 pacientes internados com o diagnóstico de leptospirose. A análise foi restrita a 442, obedecendo os seguintes critérios: sexo masculino, idade igual ou superior a 18 anos, informação sobre morte ou alta hospitalar e registro dos valores do potássio s

  4. A system-wide approach to explaining variation in potentially avoidable emergency admissions: national ecological study

    OpenAIRE

    O'Cathain, Alicia; Knowles, Emma; Maheswaran, Ravi; Pearson, Tim; Turner, Janette; Hirst, Enid; Goodacre, Steve; Nicholl, Jon

    2013-01-01

    Background Some emergency admissions can be avoided if acute exacerbations of health problems are managed by the range of health services providing emergency and urgent care. Aim To identify system-wide factors explaining variation in age sex adjusted admission rates for conditions rich in avoidable admissions. Design National ecological study. Setting 152 emergency and urgent care systems in England. Methods Hospital Episode Statistics data on emergency admissions were used to calculate an a...

  5. Prediction of re-admissions for critical health conditions : A Machine Learning Approach

    OpenAIRE

    Nizampuram, Pranay

    2015-01-01

    Context. Re-admission is the return hospitalization within 30 days from the date of original admission or discharge from hospital. Thecosts of the unplanned re-admissions were estimated to $25 billion per year alone in the U.S. Re-admission rate also has a huge impact onquality of care provided to the patients, cost of health care, and utilization of hospital resources and the image of the care provider. Studies indicate huge potential of savings that can be achieved with incremental performa...

  6. Admissible and Restrained Revision

    CERN Document Server

    Booth, R; 10.1613/jair.1874

    2011-01-01

    As partial justification of their framework for iterated belief revision Darwiche and Pearl convincingly argued against Boutiliers natural revision and provided a prototypical revision operator that fits into their scheme. We show that the Darwiche-Pearl arguments lead naturally to the acceptance of a smaller class of operators which we refer to as admissible. Admissible revision ensures that the penultimate input is not ignored completely, thereby eliminating natural revision, but includes the Darwiche-Pearl operator, Nayaks lexicographic revision operator, and a newly introduced operator called restrained revision. We demonstrate that restrained revision is the most conservative of admissible revision operators, effecting as few changes as possible, while lexicographic revision is the least conservative, and point out that restrained revision can also be viewed as a composite operator, consisting of natural revision preceded by an application of a "backwards revision" operator previously studied by Papini. ...

  7. Characteristics associated with involuntary versus voluntary legal status at admission and discharge among psychiatric inpatients

    OpenAIRE

    Craw, Jason; Compton, Michael T.

    2006-01-01

    Background The objective of this analysis was to determine the ways in which patients’ legal statuses at hospital admission and discharge are associated with select sociodemographic and clinical variables. This study specifically investigated differences between patients who were voluntary during both admission and discharge, patients who were involuntary on admission but voluntary on discharge (having converted to voluntary status during hospitalization), and patients who were involuntary du...

  8. Using the MDRD value as an outcome predictor in emergency medical admissions.

    LENUS (Irish Health Repository)

    Chin, Jun Liong

    2011-10-01

    Both physiological- and laboratory-derived variables, alone or in combination, have been used to predict mortality among acute medical admissions. Using the Modification of Diet in Renal Disease (MDRD) not as an estimate of glomerular filtration rate but as an outcome predictor for hospital mortality, we examined the relationship between the MDRD value and in-hospital death during an emergency medical admission.

  9. Valoración nutricional al ingreso hospitalario: iniciación al estudio entre distintas metodologías Nutritional assessment at the time of hospital-admission: study initiation smong different methodologies

    Directory of Open Access Journals (Sweden)

    L. Villamayor Blanco

    2006-04-01

    nutritional assessment methods may represent an essential tool for nutritional planning.The aim of this study was applying to a same group of patients different nutritional assessment methods (objective and subjective at the time of hospital admission in order to assess the degree of effectiveness for its clinical application. Setting, Patients and Interventions: A prospective randomized study is designed, in which 50 admitted patients of our hospital are included between October 1st and December 31st of 2004, 9 of them being rejected for laboratory errors. During the first 3 days of hospital staying, anthropometrics (weight, height, arm circumference,and tricipital fold measure, biochemistry (full blood count, albumin, pre-albumin, retinol-bound protein, transferrin, and cholesterol, two nutritional assessment questionnaires (Global Subjective Assessment (GSA and Mini Nutritional Assessment (MNA. Results: The χ² test has been applied to compare the results obtained from the different objective methods, separately and globally, with the MNA and GSA questionnaires, establishing the following anthropometrical comparisons: anthropometrics/MNA, Biochemistry/ MNA, Chang/MNA, anthropometrics/GSA, Biochemistry/GSA, Chang/GSA, and MNA/GSA. Statistical significance has been set at p < 0.05. Statistical analysis has been done with the SPSS v.11 software.We have not observed a statistical significance between any of the three objective parameters studied: biochemistry, anthropometrics and immunology separately considered in the two nutritional assessment questionnaires. However, the significance is positive when we relate the results obtained by the Chang method, which comprises the three types of objective parameters, with those from the MNA and GSA. A statistical significance was also reached when relating both subjective methods between each other: MNA and GSA. Conclusions: Both the GSA and MNA represent a good indicator to determine high-risk patients for developing complications

  10. Quality of life before admission to the intensive care unit

    OpenAIRE

    Tereran, Nathalia Perazzo; Zanei, Suely Sueko Viski; Whitaker, Iveth Yamaguchi

    2012-01-01

    Objective To examine the reliability of the SF-36 general health questionnaire when used to evaluate the health status of critically ill patients before admission to intensive care and to measure their health-related quality of life prior to admission and its relation to severity of illness and length of stay in the intensive care unit. Methods Prospective cohort study conducted in the intensive care unit of a public teaching hospital. Over three months, communicative and oriented patients we...

  11. On admissible canonical mechanics

    International Nuclear Information System (INIS)

    General solution has been derived for the functional c-number equation which determines all admissible realisations of various mechanics with associative (but not necessary realizable by operators) law of multiplication of the observables. The general solution includes the algebras of observables for the classical and for the quantum mechanics. In addition, the solution includes one new algebra which corresponds formally to purely imaginary value to the Planck constant. The mathematical difficulties of treating the new algebra are discussed

  12. Variability of intensive care admission decisions for the very elderly.

    Directory of Open Access Journals (Sweden)

    Ariane Boumendil

    Full Text Available UNLABELLED: Although increasing numbers of very elderly patients are requiring intensive care, few large sample studies have investigated ICU admission of very elderly patients. Data on pre triage by physicians from other specialities is limited. This observational cohort study aims at examining inter-hospital variability of ICU admission rates and its association with patients' outcomes. All patients over 80 years possibly qualifying for ICU admission who presented to the emergency departments (ED of 15 hospitals in the Paris (France area during a one-year period were prospectively included in the study. Main outcome measures were ICU eligibility, as assessed by the ED and ICU physicians; in-hospital mortality; and vital and functional status 6 months after the ED visit. 2646 patients (median age 86; interquartile range 83-91 were included in the study. 94% of participants completed follow-up (n = 2495. 12.4% (n = 329 of participants were deemed eligible for ICU admission by ED physicians and intensivists. The overall in-hospital and 6-month mortality rates were respectively 27.2% (n = 717 and 50.7% (n = 1264. At six months, 57.5% (n = 1433 of patients had died or had a functional deterioration. Rates of patients deemed eligible for ICU admission ranged from 5.6% to 38.8% across the participating centers, and this variability persisted after adjustment for patients' characteristics. Despite this variability, we found no association between level of ICU eligibility and either in-hospital death or six-month death or functional deterioration. In France, the likelihood that a very elderly person will be admitted to an ICU varies widely from one hospital to another. Influence of intensive care admission on patients' outcome remains unclear. TRIAL REGISTRATION: ClinicalTrials.gov NCT00912600.

  13. Increased Guillain-Barre Syndrome Admissions in Shiraz, Southern Iran

    Directory of Open Access Journals (Sweden)

    Seyed Taghi Heydari

    2013-01-01

    Full Text Available Background: Guillain-Barre syndrome (GBS is an acute immune-mediated peripheral neuropathy usually after an incident. This study was performed to investigate the basic epidemiologic features of GBS in south of Iran.Methods: We studied consecutive patients with GBS in Namazi Hospital of Shiraz, southern Iran. Demographic characteristics of the subjects, i.e. age, sex, and length of hospital stay were extracted. Information regarding yearly admissions for the entire hospital was also gathered. The prevalence of GBS per 10,000 hospital admissions was calculated and stratified by sex and year. Yearly prevalence was compared using the odds ratio (OR and 95% confidence intervals (CI.Results: From January 2000 to December 2009, 389 (232 males and 157 females patients with GBS were admitted in our center. The mean age of patients was 29.8 ± 23.0 years and their mean length of hospital stay was 12.9 ± 11.6 days. The overall mortality rate was 6%. The ratio of admissions due to GBS to the total admissions was significantly higher in 2009, the year of an influenza A (H1N1 virus pandemic.Conclusion: There appears to be an increase in the incidence of GBS in Shiraz. This is in parallel with the increasing trend of some other autoimmune diseases.

  14. Experiences of patients with borderline personality disorder with the brief admission intervention: A phenomenological study

    NARCIS (Netherlands)

    Helleman, M.; Goossens, P.J.J.; Kaasenbrood, A.; Achterberg, T. van

    2014-01-01

    Brief admission is a crisis intervention for patients with borderline personality disorder (BPD), and refers to a clinical admission at a psychiatric hospital for a period of 1-5 nights. Patients formulate a treatment plan together with their community mental health nurse about the maximum frequency

  15. Admission medical records made at night time have the same quality as day and evening time

    DEFF Research Database (Denmark)

    Amirian, Ilda; Mortensen, Jacob F; Rosenberg, Jacob;

    2014-01-01

    INTRODUCTION: A thorough and accurate admission medical record is an important tool in ensuring patient safety during the hospital stay. Surgeons' performance might be affected during night shifts due to sleep deprivation. The aim of the study was to assess the quality of admission medical records...... deterioration was not seen in the quality of the medical records....

  16. Finance and performance of Portuguese hospitals

    OpenAIRE

    Lima, Elvira; Whynes, David K

    2003-01-01

    This study analyses the impact of changing systems of finance on the performance of hospitals in Portugal, specifically in terms of costs per admission and per patient day, average length of stay and the number of admissions. The study is based on panel data (36 hospitals over a ten-year period), used to estimate cost functions. It is concluded that costs per admission decreased over the period in question, principally due to declining length of stay.

  17. Issues in College Admissions Testing.

    Science.gov (United States)

    Noble, Julie P.; Camara, Wayne J.

    College admissions tests provide a standardized and objective measure of student achievement and generalized skills. Unlike high school grades or rank, admission tests are a common measure for comparing students who have attended different high schools, completed different courses, received different grades in courses taught by different teachers,…

  18. Implementation of a Diabetes Educator Care Model to Reduce Paediatric Admission for Diabetic Ketoacidosis

    OpenAIRE

    Asma Deeb; Hana Yousef; Layla Abdelrahman; Mary Tomy; Shaker Suliman; Salima Attia; Hana Al Suwaidi

    2016-01-01

    Introduction. Diabetic Ketoacidosis (DKA) is a serious complication that can be life-threatening. Management of DKA needs admission in a specialized center and imposes major constraints on hospital resources. Aim. We plan to study the impact of adapting a diabetes-educator care model on reducing the frequency of hospital admission of children and adolescents presenting with DKA. Method. We have proposed a model of care led by diabetes educators for children and adolescents with diabetes. The ...

  19. Reduced incidence of admissions for myocardial infarction associated with public smoking ban: before and after study

    OpenAIRE

    Sargent, R P; Shepard, R M; Glantz, Stanton A. Ph.D.

    2004-01-01

    Objective To determine whether there was a change in hospital admissions for acute myocardial infarction while a local law banning smoking in public and in workplaces was in effect. Design Analysis of admissions front December 1997 through November 2003 using Poisson analysis. Setting Helena, Montana, a geographical]), isolated community with one hospital serving a population of 68140. Participants All patients admitted for acute myocardial infarction. Main outcome measures Number of monthly ...

  20. Fatores de risco para readmissão hospitalar de crianças e adolescentes asmáticos Risk factors for multiple hospital admissions among children and adolescents with asthma

    OpenAIRE

    Laura Maria de Lima Belizario Facury Lasmar; Paulo Augusto Moreira Camargos; Eugênio Marcos Andrade Goulart; Emília Sakurai

    2006-01-01

    OBJETIVO: Verificar a importância da admissão hospitalar de lactentes jovens na readmissão futura por asma. MÉTODOS: Realizou-se uma avaliação retrospectiva de prontuários de 202 pacientes, menores de quinze anos, registrados em ambulatório de Pneumologia Pediátrica, que foram reinternados uma ou mais vezes. O tempo decorrido entre a primeira hospitalização e a subseqüente readmissão foi analisado pelo método de Kaplan Meier, ao passo que a comparação entre as curvas de sobrevivência para dif...

  1. Paediatric admissions and outcome in a general intensive care unit

    Directory of Open Access Journals (Sweden)

    Embu Henry

    2011-01-01

    Full Text Available Background: It is believed that intensive care greatly improves the prognosis for critically ill children and that critically ill children admitted to a dedicated Paediatric Intensive Care Unit (PICU do better than those admitted to a general intensive care unit (ICU. Methods: A retrospective study of all paediatric (< 16 years admissions to our general ICU from January 1994 to December 2007. Results: Out of a total of 1364 admissions, 302 (22.1% were in the paediatric age group. Their age ranged from a few hours old to 15 years with a mean of 4.9 ± 2.5 years. The male: female ratio was 1.5:1. Postoperative admissions made up 51.7% of the admissions while trauma and burn made up 31.6% of admissions. Medical cases on the other hand constituted 11.6% of admissions. Of the 302 children admitted to the ICU, 193 were transferred from the ICU to other wards or in some cases other hospitals while 109 patients died giving a mortality rate of 36.1%. Mortality was significantly high in post-surgical paediatric patients and in patients with burn and tetanus. The length of stay (LOS in the ICU ranged from less than one day to 56 days with a mean of 5.5 days. Conclusion: We found an increasing rate of paediatric admissions to our general ICU over the years. We also found a high mortality rate among paediatric patients admitted to our ICU. The poor outcome in paediatric patients managed in our ICU appears to be a reflection of the inadequacy of facilities. Better equipping our ICUs and improved man-power development would improve the outcome for our critically ill children. Hospitals in our region should also begin to look into the feasibility of establishing PICUs in order to further improve the standard of critical care for our children.

  2. Predicting Inpatient Readmission and Outpatient Admission in Elderly

    Science.gov (United States)

    Lin, Kun-Pei; Chen, Pei-Chun; Huang, Ling-Ya; Mao, Hsiu-Chen; Chan, Ding-Cheng (Derrick)

    2016-01-01

    Abstract Recognizing potentially avoidable hospital readmission and admissions are important health care quality issues. We develop prediction models for inpatient readmission and outpatient admission to hospitals for older adults In the retrospective cohort study with 2 million sampling file of the National Health Insurance Research Database in Taiwan, older adults (aged ≥65 y/o) with a first admission in 2008 were enrolled in the inpatient cohort (N = 39,156). The outpatient cohort included subjects who had ≥1 outpatient visit in 2008 (N = 178,286). Each cohort was split into derivation (3/4) and validation (1/4) data set. Primary outcome of the inpatient cohort: 30-day readmission from the date of discharge. The outpatient cohort included hospital admissions within the 1-year follow-up period. Candidate risk factors include demographics, comorbidities, and previous health care utilizations. Series of logistic regression models were applied with area under the receiver operating curves (AUCs) to identify the best model. Roughly 1 of 7 (14.6%) of the inpatients was readmitted within 30 days, and 1 of 5 (19.1%) of the outpatient cohort was admitted within 1 year. Age, education, use of home health care, and selected comorbidities (e.g., cancer with metastasis) were included in the final model. The AUC of the inpatient readmission model was 0.655 (95% confidence interval [CI] 0.646–0.664) and outpatient admission model was 0.642 (95% CI 0.639–0.646). Predictive performance was maintained in both validation data sets. The goodness-to-fit model demonstrated good calibration in both groups. We developed and validated practical clinical prediction models for inpatient readmission and outpatient admissions for general older adults with indicators easily obtained from an administrative data set. PMID:27100455

  3. Meta-analysis of the relationship between particulate matter (PM10 and PM2.5)and asthma hospital admissions in children%大气颗粒物与儿童哮喘住院人数相关性的Meta分析

    Institute of Scientific and Technical Information of China (English)

    丁玲; 朱道娟; 彭东红

    2015-01-01

    目的 评价大气颗粒物(PM10、PM2.5)短期暴露对儿童哮喘发作住院人数的影响,获取大气颗粒物与儿童哮喘发作的暴露-反应关系.方法 检索PubMed、Ebsco、Ovid、中国生物医学数据库、中文科技期刊全文数据库、中国知网和万方数据库等,检索时间均为1990年1月1日至2013年12月31日,以“哮喘”“PM10”“PM25”“空气污染”“颗粒物”及“asthma”“air pollution" "air pollutants”“particulate matter”为关键词查找关于颗粒物短期暴露对儿童哮喘住院人数影响的文献.依据文献纳入和排除标准及制定的评价标准,进行文献筛选和质量评价.纳入文献后分别提取PM10、PM25的暴露-反应关系,采用Revman5.2.11软件进行Meta分析,根据异质性结果选择相应的效应模型分析.结果 大气中PM10浓度每上升10μg/m3,短期内儿童哮喘的住院人数平均上升1.75%,而PM25浓度每上升10 μg/m3,短期内儿童哮喘的住院人数平均上升3.45%;亚组分析中病例交叉研究的暴露-反应关系效应值高于时间序列分析.结论 短期内PM10、PM2.5浓度的上升会导致儿童哮喘住院人数增加,且PM2.5引起的发作风险高于PM10.%Objective To systematically review and assess the relationship between particulate matter (PM10 and PM2.5) and children's hospital admissions for asthma,using both time-series and casecrossover analyses.Method The PubMed,Ebsco,Ovid and four Chinese periodical databases were screened for studies related to short-term effects of particulate matter on pediatric asthma hospital admissions published from 1 January 1990 to 31 December 2013.Sixteen studies on PM10 and 10 studies on PM2.5 were selected finally for meta-analysis.Relative risk (RR) or odds ratio(OR) and 95% confidence intervals (CI) of asthrua hospital admissions per 10 μg/m3 increase of daily particulate matter were obtained from each study.RevMan 5.2.11 was used to test the heterogeneity of

  4. Admissibility of logical inference rules

    CERN Document Server

    Rybakov, VV

    1997-01-01

    The aim of this book is to present the fundamental theoretical results concerning inference rules in deductive formal systems. Primary attention is focused on: admissible or permissible inference rules the derivability of the admissible inference rules the structural completeness of logics the bases for admissible and valid inference rules. There is particular emphasis on propositional non-standard logics (primary, superintuitionistic and modal logics) but general logical consequence relations and classical first-order theories are also considered. The book is basically self-contained and

  5. The Effects of Air Pollution on Ischemic Stroke Admission Rate.

    Science.gov (United States)

    Alimohammadi, Hossein; Fakhri, Sara; Derakhshanfar, Hojjat; Hosseini-Zijoud, Seyed-Mostafa; Safari, Saeed; Hatamabadi, Hamid Reza

    2016-01-01

    The present study aimed to determine the relationship between the level of air pollutants and the rate of ischemic stroke (IS) admissions to hospitals. In this retrospective cross-sectional study, stroke admissions (January-March 2012 and 2013) to an emergency department and air pollution and meteorological data were gathered. The relationship between air pollutant levels and hospital admission rates were evaluated using the generalize additive model. In all 379 patients with IS were referred to the hospital (52.5% male; mean age 68.2±13.3 years). Both transient (p<0.001) and long-term (p<0.001) rises in CO level increases the risk of IS. Increased weekly (p<0.001) and monthly (p<0.001) average O3 levels amplifies this risk, while a transient increase in NO2 (p<0.001) and SO2 (p<0.001) levels has the same effect. Long-term changes in PM10 (p<0.001) and PM2.5 (p<0.001) also increase the risk of IS. The findings showed that the level of air pollutants directly correlates with the number of stroke admissions to the emergency department. PMID:26866000

  6. CARDIOTOCOGRAPH: ADMISSION TEST AND OUTCOME

    Directory of Open Access Journals (Sweden)

    Nesam Susana

    2015-12-01

    Full Text Available The main objective of intrapartum fetal monitoring is reduction or prevention of congenital neurological deficit and other intrapartum adverse events by screening for intrapartum hypoxia/acidosis. With an aim of evaluating role of admission test in predicting the adverse fetal outcome in high risk pregnancies in Government Chengalpattu Medical College, a cross-sectional study was designed including 50 high risk patients and 50 low risk patients. All the patients were subjected to a standard clinical evaluation using a proforma and subsequently subjected to admission test for 20 mins and their readings were grouped into 1. Reactive, 2. Suspicious, 3. Ominous. Intervention is planned based on the tracings of the admission test. The data from the admission test were compiled and subjected to statistical analysis. At the end of statistical analysis, it is found that electronic fetal monitoring has high sensitivity and low specificity. Antepartum risk factors are a poor predictors of fetal outcome. A normal tracing carries a predictive value of over 95% for APGAR score of 7 or greater and an abnormal tracing carries a predictive value of about 50% for APGAR score less than 7. In high risk cases admission test is more sensitive and in low risk cases the admission test is more specific. The negative predictive value for both groups were 85.2% and 97.7%

  7. Increased rate of day surgery use for inguinal and femoral hernia repair in a decade of hospital admissions in the Veneto Region (north-east Italy): a record linkage study

    OpenAIRE

    Saia, Mario; Mantoan, Domenico; Buja, Alessandra; Bertoncello, Chiara; Baldovin, Tatjana; Zanardo, Chiara; Callegaro, Giampietro; Baldo, Vincenzo

    2013-01-01

    Background Worldwide, there has been a marked increase in the number of inguinal and femoral hernia repairs performed as day surgery procedures. This study aimed to outline the epidemiology of the procedures for repairing unilateral inguinal and femoral hernia in the Veneto Region, and to analyze the time trends and organizational appropriateness of these procedures. Methods Drawing from the anonymous computerized database of hospital discharge records for the Veneto Region, we identified all...

  8. 44 CFR 68.9 - Admissible evidence.

    Science.gov (United States)

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Admissible evidence. 68.9 Section 68.9 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF... admissible. (b) Documentary and oral evidence shall be admissible. (c) Admissibility of non-expert...

  9. Relation between parasuicide, suicide, psychiatric admissions, and socioeconomic deprivation.

    OpenAIRE

    Gunnell, D. J.; Peters, T. J.; Kammerling, R M; Brooks, J.

    1995-01-01

    OBJECTIVE--To examine the relations between parasuicide, suicide, psychiatric inpatient admissions, and socioeconomic deprivation. DESIGN--Ecological analysis with data from routine information systems and the 1991 census. SETTING--24 localities in the area covered by the Bristol and District Health Authority (population 817,000), consisting of aggregations of neighbouring wards, with an average population of 34,000. SUBJECTS--6089 subjects aged over 10 years admitted to hospital after parasu...

  10. College Admissions: Beyond Conventional Testing

    Science.gov (United States)

    Sternberg, Robert J.

    2012-01-01

    Standardized admissions tests such as the SAT (originally stood for "Scholastic Aptitude Test") and the ACT measure only a narrow segment of the skills needed to become an active citizen and possibly a leader who makes a positive, meaningful, and enduring difference to the world. The problem with these tests is that they promised, under what have…

  11. Admission Conditions and Graduates' Employability

    Science.gov (United States)

    Alexandre, Fernando; Portela, Miguel; Sa, Carla

    2009-01-01

    In a context of increasing competition for students, admission conditions have been used as an instrument in a strategy of differentiation. Such a strategy is guided by short-run concerns, that is, the immediate need to attract more students. This article takes a longer term view, by examining graduates' employability. The authors find that…

  12. Admission to Selective Schools, Alphabetically

    Science.gov (United States)

    Jurajda, Stepan; Munich, Daniel

    2010-01-01

    One's position in an alphabetically sorted list may be important in determining access to over-subscribed public services. Motivated by anecdotal evidence, we investigate the importance of the position in the alphabet of Czech students for their admission chances into over-subscribed schools. Empirical evidence based on the population of students…

  13. Admission to selective schools, alphabetically

    Czech Academy of Sciences Publication Activity Database

    Jurajda, Štěpán; Münich, Daniel

    -, č. 5427 (2006), s. 1-28. ISSN 0265-8003 R&D Projects: GA MŠk LC542 Institutional research plan: CEZ:AV0Z70850503 Keywords : admission chances * schools * alphabet ical listing Subject RIV: AH - Economics http://www.cepr.org/pubs/new-dps/dplist.asp?dpno=5427

  14. Admission to selective schools, alphabetically

    Czech Academy of Sciences Publication Activity Database

    Jurajda, Štěpán; Münich, Daniel

    2010-01-01

    Roč. 29, č. 6 (2010), s. 1100-1109. ISSN 0272-7757 R&D Projects: GA MŠk LC542 Institutional research plan: CEZ:MSM0021620846 Keywords : admissions to school * alphabet ical order * order effects Subject RIV: AH - Economics Impact factor: 1.066, year: 2010

  15. Admission to selective schools, alphabetically

    Czech Academy of Sciences Publication Activity Database

    Jurajda, Štěpán; Münich, Daniel

    -, č. 282 (2005), s. 1-29. ISSN 1211-3298 R&D Projects: GA ČR GA403/03/0340 Institutional research plan: CEZ:AV0Z70850503 Keywords : admission chances * schools * alphabet ical listing Subject RIV: AH - Economics http://www.cerge-ei.cz/pdf/wp/Wp282.pdf

  16. Internações e óbitos e sua relação com a poluição atmosférica em São Paulo, 1993 a 1997 Hospital admissions and mortality: association with air pollution in São Paulo, Brazil, 1993 to 1997

    Directory of Open Access Journals (Sweden)

    Clarice Freitas

    2004-12-01

    Full Text Available OBJETIVO: Investigar efeitos de curto prazo da poluição atmosférica na morbidade respiratória de menores de 15 anos e na mortalidade de idosos. MÉTODOS: O estudo foi realizado na cidade de São Paulo, Brasil. Foram analisadas as contagens diárias de admissões hospitalares, de menores de 15 anos e de mortes de idosos (>64 anos no período de 1993 a 1997, em relação às variações diárias de poluentes atmosféricos (PM10, CO, O3. Foi utilizada para análise a regressão de Poisson em modelos aditivos generalizados. Os modelos foram ajustados para efeitos da tendência temporal, sazonalidade, dias da semana, fatores meteorológicos e autocorrelação. RESULTADOS: Variações do 10° ao 90° percentil dos poluentes foi significativamente associada com o aumento de admissões por doenças respiratórias em menores de 15 anos para PM10 (%RR=10,0, CO (%RR=6,1 e O3 (%RR=2,5. Associação similar foi encontrada para mortalidade em idosos e PM10 (%RR=8,1 e CO (%RR=7,9. CONCLUSÕES: Os resultados encontrados são coerentes com os estudos que apontam associação entre variações de curto prazo dos poluentes atmosféricos e incremento na morbidade e mortalidade nos grandes centros urbanos.OBJECTIVE: To investigate short-term effects of air pollution on respiratory morbidity of children under 15 and elderly mortality. METHODS: The study was carried out in the city of São Paulo, Brazil. Daily hospital admissions due to respiratory conditions in children under 15 and mortality of adults over 64 years of age were obtained for the period ranging from 1993 to 1997. Daily levels of PM10, CO and O3 were collected for the same period. Poisson regression analysis was used in generalized additive models, which were adjusted for temporal trends, seasonality, day of the week, temperature and relative humidity as well as serial autocorrelation. RESULTS: A 10th to 90th percentile variation of pollutants was significantly associated with respiratory admissions

  17. Effects of yogic practice in certain cardio respiratory parameters on overweight postmenopausal women

    Directory of Open Access Journals (Sweden)

    Ram Kishore

    2014-10-01

    Full Text Available Objectives: Aim of this study was to evaluate the effects of yogic practice in some cardiovascular and respiratory parameters of overweight females after menopause. Background: Non pharmacological management of cardiorespiratory efficiency on overweight postmenopausal women. Materials and Methods: A total of 15 overweight (BMI > 25 kg/m2 and < 30 kg/m2 females after menopause (age 53.7 ± 1.04, Mean ± SEM were participated in a 03 weeks of yoga program for 06 days a week for 1 hour daily. Blood pressure and heart rate was recorded using Omron BP monitor. Rate pressure product and double product was measured using standard formula. Respiratory rate and breath – hold time was recorded using standard protocol. Paired t-test was performed to find out any significant different between the data collected before and after yogic practice. Results: A significant decrement was noted in body weight (p<0.01 and body mass index (p<0.05 following yogic practice. Systolic (p< 0.001 and mean (p< 0.01 blood pressure was decreased significantly after yogic practice. RPP an index of myocardial oxygen consumption and double product an index of load on the heart was decreased significantly (p<0.001 following yogic practice. Resting heart rate and Respiratory rate was decreased significantly (p<0.001 following yogic practice. Breath-hold time was increased significantly (p<0.001 following yogic practice. Conclusions: This particular yogic package when practiced 03 weeks 06 days a week for 01 hour daily is beneficial for cardiovascular improvements of overweight females after menopause. In addition to that same package is also beneficial for the improvement of respiratory rate and breath – hold time. Apart from that, study is limited within a small no of subjects without any control group, which remains to be studied.

  18. Long-term air pollution exposure and cardio- respiratory mortality: a review

    OpenAIRE

    Hoek, Gerard; Krishnan, Ranjini M; Beelen, Rob; Peters, Annette; Ostro, Bart; Brunekreef, Bert; Kaufman, Joel D.

    2013-01-01

    Current day concentrations of ambient air pollution have been associated with a range of adverse health effects, particularly mortality and morbidity due to cardiovascular and respiratory diseases. In this review, we summarize the evidence from epidemiological studies on long-term exposure to fine and coarse particles, nitrogen dioxide (NO2) and elemental carbon on mortality from all-causes, cardiovascular disease and respiratory disease. We also summarize the findings on potentially suscepti...

  19. CARDIO-RESPIRATORY INTEGRATION IN DIVING BULLFROG Lithobates catesbeianus (Shaw, 1802

    Directory of Open Access Journals (Sweden)

    FERNANDES, Marcelo dos Santos

    2011-11-01

    Full Text Available Cardiac frequency and blood pressure were measured during voluntary diving in the bullfrog,Lithobates catesbeianus, exposed to 15°C or, alternatively, 25°C. Diving caused bradycardia and reduction ofblood pressure. Cardiac frequency was 27.1  2.2 for breath periods and 19.3  2.7 for diving periods at 15°C,and 47.7  4.4 and 35.3  3.6 for 25°C. Systolic blood pressure was 39,6  0,9 for breath periods and 36,2  0,4for diving periods at 15°C, and 42,4  1,0 and 39,8  0,5 at 25°C. Diastolic blood pressure was 32,3  0,6 forbreath periods and 29,5  0,5 for diving periods at 15°C, and 35,3  0,9 and 33,2  0,6 at 25°C. The animal wasartificially ventilated during diving with normoxic, hypoxic (5% O2 and hypercarbic gas mixtures (6% CO2.None of these procedures produced any change of blood pressure or cardiac frequency. Cardio-vascular effectshave, however, been reported in some other studies on amphibians. As a new aspect, we applied artificialventilation during a voluntary dive in the frog. Surfacing, elicited tachycardia and elevated blood pressure, Thesecardiovascular reflexes depend on a stimulus that still needs to be identified.A freqüência cardíaca e a pressão arterial foram medidas durante o mergulho voluntário na rãLithobates catesbeianus, exposto a 15 ° C ou, alternativamente, a 25 ° C. O mergulho causou a bradicardia eredução da pressão arterial. A frequencia cardíaca foi 27.1  2.2 para períodos respiratórios e 19.3  2.7 para osperiodo de mergulho à 15°C, and 47.7  4.4 e 35.3  3.6 à 25°C. A pressão arterial sistólica foi 39,6  0,9 paraos periodos respiratórios e 36,2  0,4 para periods de mergulho à 15°C, e 42,4  1,0 e 39,8  0,5 à 25°C. Apressão diastólica foi 32,3  0,6 para periodos respiratórios e 29,5  0,5 para periodos de mergulho à 15°C, e35,3  0,9 e 33,2  0,6 à 25°C. O animal foi utilizado para ventilação artificial durante o mergulho comnormóxia, hipóxia (5% de O2 e misturas de gases hipercárbica (6% de CO2. Nenhum desses procedimentosproduziu qualquer alteração da pressão arterial ou freqüência cardíaca. Os efeitos cardio-vasculares, no entanto,têm sido relatado em alguns outros estudos sobre os anfíbios. Como um novo aspecto, foi aplicado a ventilaçãoartificial durante um mergulho voluntário no sapo. O ato de toca a superficie resultou em taquicardia e aumentoda pressão arterial. Estes reflexos cardiovasculares dependem de um estímulo que ainda precisa ser identificado.

  20. Vital prognosis after hospitalization for COPD

    DEFF Research Database (Denmark)

    Vestbo, J; Prescott, E; Lange, P;

    1998-01-01

    associated with prognosis. Survival after admission due to COPD did not change significantly over time. CONCLUSION: Compared to previous studies of COPD patients, the present study indicates that prognosis after hospital admission remains virtually unchanged over the last decades. FEV1 is still the strongest...

  1. Impact of urban atmospheric environment on hospital admissions in the elderly Impacto del ambiente atmosférico urbano en las internaciones hospitalarias de ancianos Impacto do ambiente atmosférico urbano nas internações hospitalares de idosos

    Directory of Open Access Journals (Sweden)

    Edelci Nunes da Silva

    2012-08-01

    Full Text Available OBJECTIVE: To analyze the impact of intra-urban atmospheric conditions on circulatory and respiratory diseases in elder adults. METHODS: Cross-sectional study based on data from 33,212 hospital admissions in adults over 60 years in the city of São Paulo, southeastern Brazil, from 2003 to 2007. The association between atmospheric variables from Congonhas airport and bioclimatic index, Physiological Equivalent Temperature, was analyzed according to the district's socioenvironmental profile. Descriptive statistical analysis and regression models were used. RESULTS: There was an increase in hospital admissions due to circulatory diseases as average and lowest temperatures decreased. The likelihood of being admitted to the hospital increased by 12% with 1ºC decrease in the bioclimatic index and with 1ºC increase in the highest temperatures in the group with lower socioenvironmental conditions. The risk of admission due to respiratory diseases increased with inadequate air quality in districts with higher socioenvironmental conditions. CONCLUSIONS: The associations between morbidity and climate variables and the comfort index varied in different groups and diseases. Lower and higher temperatures increased the risk of hospital admission in the elderly. Districts with lower socioenvironmental conditions showed greater adverse health impacts.OBJETIVO: Analizar los efectos de las condiciones climáticas intra-urbanas en las enfermedades circulatorias y respiratorias en ancianos. MÉTODOS: Estudio transversal con 33.212 internaciones hospitalarias de ancianos en la ciudad de Sao Paulo, Sudeste de Brasil. Las variables atmosféricas colectadas en el aeropuerto de Congonhas y el índice bioclimático Physiological Equivalent Temperature fueron analizados según el perfil socioeconómico del vecindario. Se utilizaron análisis estadístico descriptivo y modelos de regresión. RESULTADOS: Hubo aumento en las internaciones por enfermedades circulatorias al

  2. Admission clinicopathological data, length of stay, cost and mortality in an equine neonatal intensive care unit

    OpenAIRE

    M.N. Saulez; Gummow, B.; Slovis, N.M.; T.D. Byars; M. Frazer; K. MacGillivray; F.T. Bain

    2007-01-01

    Veterinary internists need to prognosticate patients quickly and accurately in a neonatal intensive care unit (NICU). This may depend on laboratory data collected on admission, the cost of hospitalisation, length of stay (LOS) and mortality rate experienced in the NICU. Therefore, we conducted a retrospective study of 62 equine neonates admitted to a NICU of a private equine referral hospital to determine the prognostic value of venous clinicopathological data collected on admission before th...

  3. Air pollution, pollens, and daily admissions for asthma in London 1987-92

    OpenAIRE

    Anderson, H.; de Leon, A P; Bland, J; Bower, J.; Emberlin, J.; Strachan, D

    1998-01-01

    BACKGROUND—A study was undertaken to investigate the relationship between daily hospital admissions for asthma and air pollution in London in 1987-92 and the possible confounding and modifying effects of airborne pollen.
METHODS—For all ages together and the age groups 0-14, 15-64 and 65+ years, Poisson regression was used to estimate the relative risk of daily asthma admissions associated with changes in ozone, sulphur dioxide, nitrogen dioxide and particles (black smoke), ...

  4. Advising and Admission: Partners in Enrollment Management.

    Science.gov (United States)

    Devine, Joseph E.

    1987-01-01

    Focuses on marketing strategies for college admission and examines the essential interaction between admission and academic units as a means of enhancing retention and producing informed, satisfied consumers/students. (KS)

  5. 10 CFR 2.708 - Admissions.

    Science.gov (United States)

    2010-01-01

    ... admission of the genuineness and authenticity of any relevant document described in or attached to the... document for which an admission of genuineness and authenticity is requested must be delivered with...

  6. Racial Differences In Hospital Use After Acute Myocardial Infarction: Does Residential Segregation Play A Role?: Black Medicare beneficiaries used high-mortality hospitals more often than their white peers, despite their geographic proximity to lower-mortality hospitals

    OpenAIRE

    Sarrazin, Mary Vaughan; Campbell, Mary; Rosenthal, Gary E

    2009-01-01

    This study compares the likelihood of admission to high-mortality hospitals for black and white Medicare patients in 118 health care markets, and whether admission patterns vary if residential racial segregation is greater in the area. Risk of admission to high-mortality hospitals was 35 percent higher for blacks than for whites in markets with high residential segregation. Moreover, blacks were more likely than whites to be admitted to hospitals with high mortality, even in analyses limited ...

  7. Socioeconomic variation in admission for diseases of female genital system and breast in a national cohort aged 15-43.

    OpenAIRE

    Kuh, D; Stirling, S

    1995-01-01

    OBJECTIVE--To investigate socioeconomic variation among young women in the risk of hospital admission for diseases (including neoplasms) of the female genital system and breast and for the common surgical procedures of dilatation and curettage and hysterectomy. DESIGN--Large nationally representative cohort study with individual records of confirmed admissions to NHS and private hospitals since birth and data on occupational and educational experience. SETTING--England, Scotland, and Wales. P...

  8. Admissible Strategies in Semimartingale Portfolio Selection

    OpenAIRE

    Biagini, S; Černý, A.

    2009-01-01

    The choice of admissible trading strategies in mathematical modelling of financial markets is a delicate issue, going back to Harrison and Kreps (1979). In the context of optimal portfolio selection with expected utility preferences this question has been a focus of considerable attention over the last twenty years. We propose a novel notion of admissibility that has many pleasant features - admissibility is characterized purely under the objective measure; each admissible strategy can be app...

  9. Admissibility of Linear Systems in Banach Spaces

    Institute of Scientific and Technical Information of China (English)

    GUO Fa-ming

    2005-01-01

    In this paper, infinite-time p-admissibility of unbounded operators is introduced and the Co-semigroup characterization of the infinite-time p-admissibility of unbounded observation operators is given. Moreover, the analogous result for the infinite-time p-admissibility of unbounded control operators is presented.

  10. Fluid balance of pediatric hematopoietic stem cell transplant recipients and intensive care unit admission.

    Science.gov (United States)

    Benoit, Geneviève; Phan, Véronique; Duval, Michel; Champagne, Martin; Litalien, Catherine; Merouani, Aicha

    2007-03-01

    Fluid administration is essential in patients undergoing hematopoietic stem cell transplant (HSCT). Admission to pediatric intensive care unit (PICU) is required for 11-29% of pediatric HSCT recipients and is associated with high mortality. The objective of this study was to determine if a positive fluid balance acquired during the HSCT procedure is a risk factor for PICU admission. The medical records of 87 consecutive children who underwent a first HSCT were reviewed retrospectively for the following periods: from admission for HSCT to PICU admission for the first group (PICU group), and from admission for HSCT to hospital discharge for the second group (non-PICU group). Fluid balance was determined on the basis of weight gain (WG) and fluid overload (FO). PICU group consisted of 19 patients (21.8%). Among these, 13 (68.4%) developed>or=10% WG prior to PICU admission compared with 15 (22.1%) in the non-PICU group (por=10% FO prior to PICU admission compared with 31 (45.6%) in the non-PICU group (p=0.075). Following multivariate analysis, >or=10% WG (p=0.018) and cardiac dysfunction on admission for HSCT (p=0.036) remained independent risk factors for PICU admission. Smaller children (p=0.033) and patients with a twofold increase in serum creatinine (p=0.026) were at risk of developing>or=10% WG. This study shows that WG is a risk factor for PICU admission in pediatric HSCT recipients. Further research is needed to better understand the pathophysiology of WG in these patients and to determine the impact of WG prevention on PICU admission. PMID:17123119

  11. Obstetric admissions to ICUs in Finland: A multicentre study.

    Science.gov (United States)

    Seppänen, Pia; Sund, Reijo; Roos, Mervi; Unkila, Riitta; Meriläinen, Merja; Helminen, Mika; Ala-Kokko, Tero; Suominen, Tarja

    2016-08-01

    In this study, the objective was to describe and analyse reasons for obstetric admissions to the ICU, severity of illness, level and types of interventions, adverse events and patient outcomes. In a retrospective database study, we identified 291 obstetric patients during pregnancy and puerperium from four Finnish university hospitals. Most were admitted in the post-partum period and hypertensive disorders were the main indications for admissions, followed by obstetric haemorrhage. The median length of stay was 21hours. The most common intervention was blood transfusion and mechanical ventilation was required in nearly one fifth of the patients. Three patients had a prolonged stay and nine had re-admissions. One maternal death was recorded. This study found that severity of illness and organ failure scores describe the obstetric patient as having a good probability of recovery and a short length of stay. However, the obstetric patients reason for admission and their type of delivery were associated with both the severity of illness scores and level of intervention required. Those admitted for non-obstetric reasons and having had a vaginal delivery demonstrated higher severity of illness scores, organ failure scores, and levels of intervention when compared to those admitted for obstetric reasons or those who had delivered by caesarean section. In conclusion, care of these patients can be improved by understanding the severity of illness scores, common ICU interventions and patient outcomes. PMID:27209560

  12. Experiences of patients with borderline personality disorder with the brief admission intervention: a phenomenological study.

    Science.gov (United States)

    Helleman, Marjolein; Goossens, Peter J J; Kaasenbrood, Ad; van Achterberg, Theo

    2014-10-01

    Brief admission is a crisis intervention for patients with borderline personality disorder (BPD), and refers to a clinical admission at a psychiatric hospital for a period of 1-5 nights. Patients formulate a treatment plan together with their community mental health nurse about the maximum frequency allowed for these brief admissions. The purpose of the study was to describe the lived experiences of patients with BPD with use of the brief admission intervention. The study used a phenomenological approach. Inclusion criteria were a diagnosis of BPD, according to the Diagnostic and Statistical Manual of Mental Disorders-IV criteria; experience with brief admission, and sufficient understanding of the Dutch language. A total of 16 female patients and one male patient participated in the study. Thematic analysis of the transcripts of the interviews revealed four major meaning units: (i) organization of the brief admission; (ii) contact with a nurse; (iii) time out from daily life; and (iv) experienced value for the patient. Patients highlighted the quality of the contact with a nurse as the most important aspect of the brief admission. Nurses should be aware of the importance of connecting with patients who have BPD during a brief admission, particularly in light of the interpersonal hypersensitivity that characterizes these patients. PMID:24890615

  13. Admission to selective schools, alphabetically

    Czech Academy of Sciences Publication Activity Database

    Jurajda, Štěpán; Münich, Daniel

    Praha: Česká společnost ekonomická, 2006, s. 1-29. [Výroční konference České společnosti ekonomické /4./. Praha (CZ), 25.11.2006] R&D Projects: GA ČR GA403/03/0340 Institutional research plan: CEZ:AV0Z70850503 Keywords : admission chances * schools * alphabet ical listing Subject RIV: AH - Economics

  14. Evaluation of a Medical and Mental Health Unit compared with standard care for older people whose emergency admission to an acute general hospital is complicated by concurrent 'confusion': a controlled clinical trial. Acronym: TEAM: Trial of an Elderly Acute care Medical and mental health unit

    Directory of Open Access Journals (Sweden)

    Gladman John RF

    2011-05-01

    Full Text Available Abstract Background Patients with delirium and dementia admitted to general hospitals have poor outcomes, and their carers report poor experiences. We developed an acute geriatric medical ward into a specialist Medical and Mental Health Unit over an eighteen month period. Additional specialist mental health staff were employed, other staff were trained in the 'person-centred' dementia care approach, a programme of meaningful activity was devised, the environment adapted to the needs of people with cognitive impairment, and attention given to communication with family carers. We hypothesise that patients managed on this ward will have better outcomes than those receiving standard care, and that such care will be cost-effective. Methods/design We will perform a controlled clinical trial comparing in-patient management on a specialist Medical and Mental Health Unit with standard care. Study participants are patients over the age of 65, admitted as an emergency to a single general hospital, and identified on the Acute Medical Admissions Unit as being 'confused'. Sample size is 300 per group. The evaluation design has been adapted to accommodate pressures on bed management and patient flows. If beds are available on the specialist Unit, the clinical service allocates patients at random between the Unit and standard care on general or geriatric medical wards. Once admitted, randomised patients and their carers are invited to take part in a follow up study, and baseline data are collected. Quality of care and patient experience are assessed in a non-participant observer study. Outcomes are ascertained at a follow up home visit 90 days after randomisation, by a researcher blind to allocation. The primary outcome is days spent at home (for those admitted from home, or days spent in the same care home (if admitted from a care home. Secondary outcomes include mortality, institutionalisation, resource use, and scaled outcome measures, including quality of

  15. Aggressive behavior during the first 24 hours of psychiatric admission

    Directory of Open Access Journals (Sweden)

    Vitor Crestani Calegaro

    2014-09-01

    Full Text Available OBJECTIVE: To investigate the association between aggression in the first 24 hours after admission and severity of psychopathology in psychiatric inpatients.METHODS: This cross-sectional study included psychiatric patients admitted to Hospital Universitário de Santa Maria, in Santa Maria, southern Brazil, from August 2012 to January 2013. At their arrival at the hospital, patients were interviewed to fill in the Brief Psychiatric Rating Scale (BPRS form, and any aggressive episodes in the first 24 hours after admission were recorded using the Overt Aggression Scale (OAS. The Mann-Whitney U test was used to compare patients according to aggressiveness: aggressive versus non-aggressive, hostile versus violent, and aggressive against others only versus self-aggressive.RESULTS: The sample was composed of 110 patients. Aggressive patients in general had higher BPRS total scores (p = 0.002 and individual component scores, and their results showed more activation (p < 0.001 and thinking disorders (p = 0.009, but less anxious-depression (p = 0.008. Violent patients had more severe psychomotor agitation (p = 0.027, hallucinations (p = 0.017 and unusual thought content (p = 0.020. Additionally, self-aggressive patients had more disorientation (p = 0.011 and conceptual disorganization (p = 0.007.CONCLUSIONS: Aggression in psychiatric patients in the first 24 hours after admission is associated with severity of psychopathology, and severity increases with severity of patient psychosis and agitation.

  16. Do general practitioner hospitals reduce the utilisation of general hospital beds? Evidence from Finnmark county in north Norway

    OpenAIRE

    Aaraas, I.; Forde, O. H.; Kristiansen, I S; Melbye, H.

    1998-01-01

    STUDY OBJECTIVE: To assess whether populations with access to general practitioner hospitals (GP hospitals) utilise general hospitals less than populations without such access. DESIGN: Observational study comparing the total rates of admissions and of occupied bed days in general hospitals between populations with and without access to GP hospitals. Comparisons were also made separately for diagnoses commonly encountered in GP hospitals. SETTING: Two general hospitals serving the popula...

  17. Predicting outcome on admission and post-admission for acetaminophen-induced acute liver failure using classification and regression tree models.

    Directory of Open Access Journals (Sweden)

    Jaime Lynn Speiser

    Full Text Available Assessing prognosis for acetaminophen-induced acute liver failure (APAP-ALF patients often presents significant challenges. King's College (KCC has been validated on hospital admission, but little has been published on later phases of illness. We aimed to improve determinations of prognosis both at the time of and following admission for APAP-ALF using Classification and Regression Tree (CART models.CART models were applied to US ALFSG registry data to predict 21-day death or liver transplant early (on admission and post-admission (days 3-7 for 803 APAP-ALF patients enrolled 01/1998-09/2013. Accuracy in prediction of outcome (AC, sensitivity (SN, specificity (SP, and area under receiver-operating curve (AUROC were compared between 3 models: KCC (INR, creatinine, coma grade, pH, CART analysis using only KCC variables (KCC-CART and a CART model using new variables (NEW-CART.Traditional KCC yielded 69% AC, 90% SP, 27% SN, and 0.58 AUROC on admission, with similar performance post-admission. KCC-CART at admission offered predictive 66% AC, 65% SP, 67% SN, and 0.74 AUROC. Post-admission, KCC-CART had predictive 82% AC, 86% SP, 46% SN and 0.81 AUROC. NEW-CART models using MELD (Model for end stage liver disease, lactate and mechanical ventilation on admission yielded predictive 72% AC, 71% SP, 77% SN and AUROC 0.79. For later stages, NEW-CART (MELD, lactate, coma grade offered predictive AC 86%, SP 91%, SN 46%, AUROC 0.73.CARTs offer simple prognostic models for APAP-ALF patients, which have higher AUROC and SN than KCC, with similar AC and negligibly worse SP. Admission and post-admission predictions were developed.• Prognostication in acetaminophen-induced acute liver failure (APAP-ALF is challenging beyond admission • Little has been published regarding the use of King's College Criteria (KCC beyond admission and KCC has shown limited sensitivity in subsequent studies • Classification and Regression Tree (CART methodology allows the

  18. Psychiatric and medical admissions observed among elderly patients with new-onset epilepsy

    Directory of Open Access Journals (Sweden)

    Zeber John E

    2011-04-01

    Full Text Available Abstract Background Inpatient utilization associated with incidence of geriatric new-onset epilepsy has not been characterized in any large study, despite recognized high levels of risk factors (comorbidity. Methods Retrospective study using administrative data (Oct '01-Sep '05 from the Veterans Health Administration from a nationwide sample of 824,483 patients over age 66 in the retrospective observational Treatment In Geriatric Epilepsy Research (TIGER study. Psychiatric and medical hospital admissions were analyzed as a function of patient demographics, comorbid psychiatric, neurological, and other medical conditions, and new-onset epilepsy. Results Elderly patients experienced a 15% hospitalization rate in FY00 overall, but the subset of new-onset epilepsy patients (n = 1,610 had a 52% hospitalization rate. New-onset epilepsy was associated with three-fold increased relative odds of psychiatric admission and nearly five-fold increased relative odds of medical admission. Among new-onset epilepsy patients, alcohol dependence was most strongly associated with psychiatric admission during the first year after epilepsy onset (odds ratio = 5.2; 95% confidence interval 2.6-10.0, while for medical admissions the strongest factor was myocardial infarction (odds ratio = 4.7; 95% confidence interval 2.7-8.3. Conclusion From the patient point of view, new-onset epilepsy was associated with an increased risk of medical admission as well as of psychiatric admission. From an analytic perspective, omitting epilepsy and other neurological conditions may lead to overestimation of the risk of admission attributable solely to psychiatric conditions. Finally, from a health systems perspective, the emerging picture of the epilepsy patient with considerable comorbidity and demand for healthcare resources may merit development of practice guidelines to improve coordinated delivery of care.

  19. Trends of adverse drug reactions related-hospitalizations in Spain (2001-2006

    Directory of Open Access Journals (Sweden)

    de Miguel Gil

    2010-10-01

    Full Text Available Abstract Background Adverse drug reactions (ADR are a substantial cause of hospital admissions. We conducted a nationwide study to estimate the burden of hospital admissions for ADRs in Spain during a six-year period (2001-2006 along with the associated total health cost. Methods Data were obtained from the national surveillance system for hospital data (Minimum Basic Data Set maintained by the Ministry of Health and Consumer Affairs, and covering more than 95% of Spanish hospitals. From these admissions we selected all hospitalization that were code as drug-related (ICD-9-CM codes E, but intended forms of overdoses, errors in administration and therapeutics failure were excluded. The average number of hospitalizations per year, annual incidence of hospital admissions, average length of stay in the hospital, and case-fatality rate, were calculated. Results During the 2001-2006 periods, the total number of hospitalized patients with ADR diagnosis was 350,835 subjects, 1.69% of all acute hospital admissions in Spain. The estimated incidence of admissions due to ADR decreased during the period 2001-2006 (p Conclusions Approximately 1.69% of all acute hospital admissions were associated with ADRs. The rates were much higher for elderly patients. The total cost of ADR-related hospitalization to the Spanish health system is high and has increased between 2001 and 2006. ADRs are an important cause of admission, resulting in considerable use of national health system beds and a significant number of deaths.

  20. Specialty-specific admission: a cost-effective intervention?

    LENUS (Irish Health Repository)

    Slattery, E

    2012-02-01

    INTRODUCTION: Cost effectiveness of healthcare has become an important component in its delivery. Current practices need to be assessed and measured for variations that may lead to financial savings. Speciality specific admission is known not only to lead improved clinical outcomes but also to lead important cost reductions. METHODS: All patients admitted to an Irish teaching hospital via the emergency department over a 2-year period with a gastroenterology (GI) related illness were included in this analysis.GI illness was classified using the Disease related grouping (DRG) system. Mean length of stay (LOS) and patient level costing (PLC) were calculated. Differences between DRGs with respect to speciality (i.e. specialist vs. non-specialist) were calculated for the five commonest DRGs. RESULTS: Significant variations in LOS and PLC were demonstrated in the DRGs. Mean LOS varied with increasing complexity, from 3.2 days for non-complex GI haemorrhage to 14.4 days for complex alcohol related cirrhosis as expected. A substantial difference in LOS within DRG groups was demonstrated by large standard deviations in the mean (up to 8.1 days in some groups) and was independent of complexity of cases. PLC also varied widely in both complex and non-complex cases with standard deviations of up to 17,342 noted. Specialty-specific admission was associated with shorter LOS for most GI admissions. CONCLUSION: Significant disparity exists for both LOS and PLC for most GI diagnoses. Specialty-specific admissions are associated with reduced LOS. Specialty-specific admission would appear to be cost-effective which may also lead to improved clinical outcomes.

  1. Weather, season, and daily stroke admissions in Hong Kong

    Science.gov (United States)

    Goggins, William B.; Woo, Jean; Ho, Suzanne; Chan, Emily Y. Y.; Chau, P. H.

    2012-09-01

    Previous studies examining daily temperature and stroke incidence have given conflicting results. We undertook this retrospective study of all stroke admissions in those aged 35 years old and above to Hong Kong public hospitals from 1999 through 2006 in order to better understand the effects of meteorological conditions on stroke risk in a subtropical setting. We used Poisson Generalized Additive Models with daily hemorrhagic (HS) and ischemic stroke (IS) counts separately as outcomes, and daily mean temperature, humidity, solar radiation, rainfall, air pressure, pollutants, flu consultation rates, day of week, holidays, time trend and seasonality as predictors. Lagged effects of temperature, humidity and pollutants were also considered. A total of 23,457 HS and 107,505 IS admissions were analyzed. Mean daily temperature had a strong, consistent, negative linear association with HS admissions over the range (8.2-31.8°C) observed. A 1°C lower average temperature over the same day and previous 4 days (lags 0-4) being associated with a 2.7% (95% CI: 2.0-3.4%, P < .0.0001) higher admission rate after controlling for other variables. This association was stronger among older subjects and females. Higher lag 0-4 average change in air pressure from previous day was modestly associated with higher HS risk. The association between IS and temperature was weaker and apparent only below 22°C, with a 1°C lower average temperature (lags 0-13) below this threshold being associated with a 1.6% (95% CI:1.0-2.2%, P < 0.0001) higher IS admission rate. Pollutant levels were not associated with HS or IS. Future studies should examine HS and IS risk separately.

  2. How a hospital must face a massive emergency: the case of Martini Hospital, Turin

    OpenAIRE

    Antonio Morra; Lorenzo Odetto; Pierangelo Bozzetto

    2008-01-01

    The terms “disaster” or “surge capability”, referred to hospitals, are often used to define a massive casualty admission. This may be a misleading concept, because emergency may as well arise from inside hospitals, and the last years high figures related to fires in the about 2,000 italian hospitals should suggest a different point of view. In this article the authors describe their experience in hospital preparedness at Ospedale Martini in Turin. Hospital operators re...

  3. Implementation av Network Admission Control

    OpenAIRE

    Sandqvist, Mattias; Johansson, Robert

    2007-01-01

    This examination work is about implementation of Cisco Systems Network Admission Control (NAC) within a leading IT-company in region of Jönköping. NAC is a technique that is used for securing the internal network from the inside. NAC can verify that the client who connects to the network has the latest antivirus updates and latest operative system hotfixes. Clients who don’t meet the criteria can be placed in quarantine VLAN where they only have access to the update servers. There are also fu...

  4. Asma e Gravidez: Tratamento Hospitalar Asthma and Pregnancy: Hospital Admission

    OpenAIRE

    Francisco Mauad Filho; Cleusa Cascaes Dias; Deborah Ramos; Antonio Alberto Nogueira; Aderson Tadeu Berezowski; Geraldo Duarte

    2001-01-01

    Objetivo: avaliar as complicações perinatais decorrentes da associação de asma e gravidez em pacientes que necessitaram hospitalização para controle da crise asmática. Método: análise retrospectiva de 12 casos de asma e gravidez que necessitaram de internação hospitalar e foram assistidos no Departamento de Ginecologia e Obstetrícia da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, no período compreendido entre 1992 e 1996. Os parâmetros analisados foram: idade materna, a...

  5. Prematurity, smallness-for-gestational age and later hospital admissions

    DEFF Research Database (Denmark)

    Á Rogvi, Rasmus; Forman, Julie Lyng; Greisen, Gorm

    2015-01-01

    INTRODUCTION: Being born premature or small for gestational age (SGA) is known to be associated with diseases later in life, such as gestational diabetes, hypertension and pre-eclampsia. In this study we examined the association between being born premature or SGA and all diseases diagnosed during...... ratios for persons born premature or SGA using multivariate logistic regression. RESULTS: A total of 15,059 unique ICD-10 diagnosis codes were represented in the period. Only diagnoses used at least 100 times were included in the analysis (n=4175). Of these 838 showed an odds ratio that was statistically...... significantly different from unity for people born premature or SGA. After correcting for multiple testing, 250 remained significant. The diagnoses covered diseases in most organ systems, including cardiovascular, endocrinological, infectious, neurological/neurosurgical, obstetric, orthopedic, psychiatric, lung...

  6. Hospital-Acquired Conditions (Present on Admission Indica...

    Data.gov (United States)

    U.S. Department of Health & Human Services — On February 8, 2006, the President signed the Deficit Reduction Act (DRA) of 2005. Section 5001(c) of DRA requires the Secretary to identify conditions that are,...

  7. Decreasing Psychiatric Admission Wait Time in the Emergency Department by Facilitating Psychiatric Discharges.

    Science.gov (United States)

    Stover, Pamela R; Harpin, Scott

    2015-12-01

    Limited capacity in a psychiatric unit contributes to long emergency department (ED) admission wait times. Regulatory and accrediting agencies urge hospitals nationally to improve patient flow for better access to care for all types of patients. The purpose of the current study was to decrease psychiatric admission wait time from 10.5 to 8 hours and increase the proportion of patients discharged by 11 a.m. from 20% to 50%. The current study compared pre- and post-intervention data. Plan-Do-Study-Act cycles aimed to improve discharge processes and timeliness through initiation of new practices. Admission wait time improved to an average of 5.1 hours (t = 3.87, p = 0.006). The proportion of discharges occurring by 11 a.m. increased to 46% (odds ratio = 3.42, p planning processes and timeliness in a psychiatric unit significantly decreased admission wait time from the ED, improving access to psychiatric care. PMID:26505524

  8. Epidemiology of systemic inflammatory response syndrome and sepsis in cats hospitalized in a veterinary teaching hospital.

    Science.gov (United States)

    Babyak, Jonathan M; Sharp, Claire R

    2016-07-01

    OBJECTIVE To describe the epidemiology of the systemic inflammatory response syndrome (SIRS) and sepsis in cats hospitalized in a veterinary teaching hospital. DESIGN Observational study. ANIMALS 246 client-owned cats. PROCEDURES During a 3-month period, daily treatment records were evaluated for all hospitalized cats. Information extracted included signalment, temperature, heart rate, respiratory rate, diagnostic test results, diagnosis, duration of hospitalization, and outcome (survival or death). Cats were classified into 1 of 4 disease categories (sepsis [confirmed infection and SIRS], infection [confirmed infection without SIRS], noninfectious SIRS [SIRS without a confirmed infection], and no SIRS [no SIRS or infection]). RESULTS Of the 246 cats, 26 and 3 were hospitalized 2 and 3 times, respectively; thus, 275 hospitalizations were evaluated. When SIRS was defined as the presence of ≥ 2 of 4 SIRS criteria, 17 cats had sepsis, 16 had infections, 81 had noninfectious SIRS, and 161 were classified in the no SIRS category at hospital admission. The prevalence of sepsis at hospital admission was 6.2 cases/100 admissions. Four cats developed sepsis while hospitalized, resulting in a sepsis incidence rate of 1.5 cases/100 hospital admissions. Four of 17 cats with sepsis at hospital admission and 3 of 4 cats that developed sepsis while hospitalized died or were euthanized, resulting in a mortality rate of 33.3% for septic cats; 239 hospitalizations resulted in survival, 28 resulted in euthanasia, and 8 resulted in death. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that many hospitalized cats have evidence of SIRS and some have sepsis. In cats, sepsis is an important clinical entity with a high mortality rate. PMID:27308883

  9. Venous thromboembolism (VTE) risk assessment and prophylaxis in acute orthopaedic admissions: improving compliance with national guidelines

    OpenAIRE

    Watts, Laura; Grant, David

    2013-01-01

    “Each year over 25,000 people die from Venous Thromboembolism (VTE) contracted in hospital. This is more than the combined total of deaths from breast cancer, AIDS and traffic accidents”. (1) Orthopaedic patients are at particular risk of VTE. In 2011, the project team carried out an audit into compliance with national VTE assessment guidelines on all acute trauma and orthopaedic admissions during a two week period at a District General Hospital. The study demonstrated that compliance was ini...

  10. The health and social consequences of an alcohol related admission to critical care: a qualitative study

    OpenAIRE

    McPeake, Joanne; Forrest, Ewan; Quasim, Tara; Kinsella, John; O'Neill, Anna

    2016-01-01

    Objective: To examine the impact of critical care on future alcohol-related behaviour. Further, it aimed to explore patterns of recovery for patients with and without alcohol use disorders beyond the hospital environment. Design: In-depth, semistructured interviews with participants ( patients) 3–7 months post intensive care discharge. Setting: The setting for this study was a 20-bedded mixed intensive care unit (ICU), in a large teaching hospital in Scotland. On admission, patients ...

  11. Health and social consequences of an alcohol-related admission to critical care: a qualitative study

    OpenAIRE

    McPeake, Joanne; Forrest, Ewan; Quasim, Tara; Kinsella, John; O'Neill, Anna

    2016-01-01

    Objective To examine the impact of critical care on future alcohol-related behaviour. Further, it aimed to explore patterns of recovery for patients with and without alcohol use disorders beyond the hospital environment. Design In-depth, semistructured interviews with participants (patients) 3–7 months post intensive care discharge. Setting The setting for this study was a 20-bedded mixed intensive care unit (ICU), in a large teaching hospital in Scotland. On admission, patients were allocate...

  12. Improving medication management for patients: the effect of a pharmacist on post-admission ward rounds

    OpenAIRE

    Fertleman, M; Barnett, N; Patel, T.

    2005-01-01

    

Problem: Medication management in the NHS has been highlighted by the UK Department of Health as an area for improvement. Pharmacist participation on post-take (post-admission) ward rounds was shown to reduce medication errors and reduced prescribing costs in the USA and in UK teaching hospitals, which can contribute to improved medication management. We sought to demonstrate the problem in our hospital by collecting data on prescribing practice from three consecutive general medical post-t...

  13. Analysis of factors influencing admission to intensive care following convulsive status epilepticus in children.

    LENUS (Irish Health Repository)

    Tirupathi, Sandya

    2012-02-01

    OBJECTIVES: To identify clinical features and therapeutic decisions that influence admission to the Intensive Care unit (ICU) in children presenting with convulsive status epilepticus (CSE). METHODS: We evaluated 47 admissions with status epilepticus to a tertiary paediatric hospital A&E over a three year period (2003-2006). Following initial management 23 episodes required admission to ICU and 24 were managed on a paediatric ward. We compared clinical, demographic data and compliance with our CSE protocol between the ICU and ward groups. RESULTS: Median age at presentation in the ICU group was 17 months (range 3 months-11 years) compared to 46 months in the ward group (range 3 months-10 years). Fifty per cent of patients in both groups had a previous history of seizures. Median duration of pre-hospital seizure activity was 30 min in both groups. More than two doses of benzodiazepines were given as first line medication in 62% of the ICU group and 33% of the ward group. Among children admitted to ICU with CSE, 26% had been managed according to the CSE protocol, compared to 66% of children who were admitted to a hospital ward. Febrile seizures were the most common aetiology in both groups. CONCLUSION: Younger age at presentation, administration of more than two doses of benzodiazepines and deviation from the CSE protocol appear to be factors which influence admission of children to ICU. Recognition of pre-hospital administration of benzodiazepines and adherence to therapeutic guidelines may reduce the need for ventilatory support in this group.

  14. A column generation approach for solving the patient admission scheduling problem

    DEFF Research Database (Denmark)

    Range, Troels Martin; Lusby, Richard Martin; Larsen, Jesper

    2014-01-01

    This paper addresses the Patient Admission Scheduling (PAS) problem. The PAS problem entails assigning elective patients to beds, while satisfying a number of hard constraints and as many soft constraints as is possible, and arises at all planning levels for hospital management. There exist a few...

  15. A Column Generation Approach for Solving the Patient Admission Scheduling Problem

    DEFF Research Database (Denmark)

    Range, Troels Martin; Lusby, Richard Martin; Larsen, Jesper

    This paper addresses the Patient Admission Scheduling (PAS) problem. The PAS problem deals with assigning elective patients to beds, satisfying a number of soft and hard constraints. The problem can be seen as part of the functions of hospital management at an operational level. There exists a sm...... produce new best solutions for ve out of six instances from a publicly available repository....

  16. The paradoxical increase in involuntary admissions after the revision of the Civil Commitment Law in Belgium.

    Science.gov (United States)

    Lecompte, D

    1995-01-01

    The revision in 1990 of the Mental Health Commitment Law in Belgium, which was initially intended to decrease the use of civil commitment, has resulted in a paradoxical increase in involuntary hospital admissions. To understand the reasons for this increase, the relative importance of the various factors involved, notably the criteria of mental illness, dangerousness and clinical treatability, is examined. PMID:7666748

  17. Reduced Admissions for Acute Myocardial Infarction Associated with a Public Smoking Ban: Matched Controlled Study

    Science.gov (United States)

    Seo, Dong-Chul; Torabi, Mohammad R.

    2007-01-01

    There has been no research linking implementation of a public smoking ban and reduced incidence of acute myocardial infarction (AMI) among nonsmoking patients. An ex post facto matched control group study was conducted to determine whether there was a change in hospital admissions for AMI among nonsmoking patients after a public smoking ban was…

  18. Off hour admission to an intensivist-led ICU is not associated with increased mortality

    NARCIS (Netherlands)

    I.A. Meynaar; J.I. van der Spoel; J.H. Rommes; M. van Spreuwel-Verheijen; R.J. Bosman; P.E. Spronk

    2009-01-01

    Introduction Caring for the critically ill is a 24-hour-a-day responsibility, but not all resources and staff are available during off hours. We evaluated whether intensive care unit (ICU) admission during off hours affects hospital mortality. Methods This retrospective multicentre cohort study was

  19. Admission criteria to the Danish Brain Cancer Program are moderately associated with magnetic resonance imaging findings

    DEFF Research Database (Denmark)

    Hill, Thomas Winther; Nielsen, Mie Kiszka; Nepper-Rasmussen, Jørgen

    2013-01-01

    The objective of this study was to evaluate the Danish Brain Cancer Program by examining the criteria for admission to the program and the results of magnetic resonance imaging (MRI) of the brain in 359 patients referred to the program at the Odense University Hospital during one year. The...

  20. Simple risk stratification at admission to identify patients with reduced mortality from primary angioplasty

    DEFF Research Database (Denmark)

    Thune, Jens Jakob; Hoefsten, Dan Eik; Lindholm, Matias Greve;

    2005-01-01

    patient group with reduced mortality from an invasive strategy would be important for early triage. The Thrombolysis in Myocardial Infarction (TIMI) risk score is a simple validated integer score that makes it possible to identify high-risk patients on admission to hospital. We hypothesized that a high...

  1. Perfil de internações hospitalares por doenças respiratórias em crianças e adolescentes da cidade de São Paulo, 2000-2004 Perfil de internaciones hospitalares por enfermedades respiratorias en niños y adolescentes de la ciudad de São Paulo, 2000-2004 Hospital admissions due to respiratory diseases in children and adolescents of São Paulo city, 2000-2004

    Directory of Open Access Journals (Sweden)

    Renata Martins de T Natali

    2011-12-01

    digo Internacional de Enfermedades 10ª Revisión J00-J99 en hospitales conveniados al Sistema Único de Salud, ubicados en la ciudad de São Paulo, entre 2000 y 2004. Se describieron las principales características de distribución temporal, por franja de edad y por causa de morbilidad respiratoria en la niñez y adolescencia. RESULTADOS: Las neumonías y bronconeumonías (51%, el asma (18% y las enfermedades agudas y crónicas de las vías aéreas superiores (10% contestan por la mayor parte de las internaciones. Los niños de hasta cinco años son los más internados, independiente de la causa específica. Entre los adolescentes, se observó que las principales causas de internaciones fueron las enfermedades respiratorias que afectan el intersticio pulmonar (0,1% y las afecciones necróticas y supurativas de las vías aéreas inferiores (0,2%. En la franja de edad de los 6 a los 10 años, predominan las internaciones por enfermedades agudas y crónicas de las vías aéreas superiores (10%. Hubo una tendencia de aumento de las internaciones por enfermedades respiratorias a lo largo del periodo analizado, además de la constatación de que el pico de morbilidad se da en el comienzo del otoño. CONCLUSIONES: Las internaciones por enfermedades respiratorias de niños y adolescentes presentan estándar de distribución dependiente de la franja de edad y de la estacionalidad. Cuanto menor sea la franja de edad, mayor será el número de internaciones.OBJECTIVE: To analyze the profile of children and adolescents' hospital admissions due to respiratory diseases in São Paulo (SP, Brazil. METHODS: This is an ecological time series study. Data was obtained on hospital admissions for respiratory diseases (International Classification of Diseases, 10th Revision: J00-J99 in hospitals under the Brazilian Unified Health System located in São Paulo between 2000 and 2004. Main characteristics of the temporal distribution of respiratory morbidity in childhood and adolescence by age and cause are

  2. Acute psychiatric admissions from an out-of-hours Casualty Clinic; how do referring doctors and admitting specialists agree?

    Directory of Open Access Journals (Sweden)

    Hansen Vidje

    2006-03-01

    Full Text Available Abstract Background Over the last decades there has been an increasing pressure on the acute psychiatric wards in Norway. The major contributor to psychiatric acute admissions at the University Hospital of North Norway in the city of Tromsø in 2001 was the GP-based Tromsø Casualty Clinic, only open out-of-hours. We explored all acute psychiatric referrals from Tromsø Casualty Clinic in 2001. The purpose of the study was to characterize the admissions and assess the agreement between the referring doctors and the hospital specialists according to the need for hospitalization, agreement on application of the law and the diagnostic evaluation to assess whether the admissions were appropriate. Methods Retrospective, record based, descriptive study comprising 101 psychiatric acute referrals from the Tromsø Casualty Clinic to the psychiatric acute wards at the University Hospital of North Norway. Results The specialists accepted all referrals except one, they mostly agreed upon the diagnoses suggested by the referring doctors and they mostly confirmed the application of the law. Seventy-five percent of the admissions took place during weekends, public holidays or nighttimes. Diagnoses of psychoses or suicidal attempts accounted for 76 % of the total referrals. Substance abuse was noted for 43 %, and in 22 % of all admissions the patients had stopped taking their psychopharmacological medication. The police assisted the referring doctors in one third of all admissions, and was the legal representative in 52 out of 59 involuntary admissions. Thirty percent of the admissions were first- time admissions. Thirty-two percent of the hospital stays lasted for three days or less. Median length of stay was 6.5 days. Conclusion The casualty clinic physicians and the hospital specialists mostly agreed in their evaluation of patients indicating that most of the admissions were appropriate. The police was more often involved in the involuntary admissions than

  3. Hospitalizations and Costs Incurred at the Facility Level after Scale-up of Malaria Control: Pre-Post Comparisons from Two Hospitals in Zambia

    OpenAIRE

    Comfort, Alison B.; van Dijk, Janneke H.; Mharakurwa, Sungano; Stillman, Kathryn; Gabert, Rose; Korde, Sonali; Nachbar, Nancy; Derriennic, Yann; Musau, Stephen; Hamazakaza, Petan; Zyambo, Khozya D.; Zyongwe, Nancy M.; Hamainza, Busiku; Thuma, Philip E.

    2014-01-01

    There is little evidence on the impact of malaria control on the health system, particularly at the facility level. Using retrospective, longitudinal facility-level and patient record data from two hospitals in Zambia, we report a pre-post comparison of hospital admissions and outpatient visits for malaria and estimated costs incurred for malaria admissions before and after malaria control scale-up. The results show a substantial reduction in inpatient admissions and outpatient visits for mal...

  4. The association between weather conditions and stroke admissions in Turkey

    Science.gov (United States)

    Çevik, Yunsur; Doğan, Nurettin Özgür; Daş, Murat; Ahmedali, Asliddin; Kul, Seval; Bayram, Hasan

    2015-07-01

    Although several factors such as cigarette smoking, blood pressure, diabetes, obesity, hypercholesterolemia, physical inactivity and dietary factors have been well documented to increase the risk for stroke, there are conflicting data about the role of meteorological variables in the etiology of stroke. We conducted a retrospective study to investigate the association between weather patterns, including daily temperature, humidity, wind speed, and air pressure, and stroke admissions to the Emergency Department of Atatürk Training and Research Hospital in Ankara, Turkey, between January 2009 and April 2010. Generalized additive models with logistic link function were used to investigate the relationship between predictors and days with and without stroke admission at lags 0-4. A total of 373 stroke patients were admitted to the emergency department (ED) between January 2009 and April 2010. Of patients, 297 had ischemic stroke (IS), 34 hemorrhagic stroke (HS), and 42 subarachnoidal hemorrhage (SAH). Although we did not find any association between overall admissions due to stroke and meteorological parameters, univariable analysis indicated that there were significantly more SAH cases on days with lower daily mean temperatures of 8.79 ± 8.75 °C as compared to relatively mild days with higher temperatures (mean temperature = 11.89 ± 7.94 °C, p = 0.021). The multivariable analysis demonstrated that admissions due to SAH increased on days with lower daily mean temperatures for the same day (lag 0; odds ratio (OR) [95 % confidence interval (95 % CI)] = 0.93 [0.89-0.98], p = 0.004) and lag 1 (OR [95 % CI] =0.76 [0.67-0.86], p = 0.001). Furthermore, the wind speed at both lag 1 (OR [95 % CI] = 1.63 [1.27-2.09], p = 0.001) and lag 3 (OR [95 % CI] = 1.43 [1.12-1.81], p = 0.004) increased admissions due to HS, respectively. In conclusion, our study demonstrated that there was an association between ED admissions due to SAH and HS and weather conditions suggesting that

  5. Obesity, hospital services use and costs

    DEFF Research Database (Denmark)

    Folmann, Nana Bro; Bossen, Kristine Skovgaard; Willaing, Ingrid;

    2007-01-01

    To quantify the association between obesity and somatic hospital costs and number of overall somatic hospital contacts--number of inpatient admissions, number of outpatient visits, and number of emergency department visits--based on anthropometric measurements of waist circumference (WC) and...

  6. Admission to Law School: New Measures

    Science.gov (United States)

    Shultz, Marjorie M.; Zedeck, Sheldon

    2012-01-01

    Standardized tests have been increasingly controversial over recent years in high-stakes admission decisions. Their role in operationalizing definitions of merit and qualification is especially contested, but in law schools this challenge has become particularly intense. Law schools have relied on the Law School Admission Test (LSAT) and an INDEX…

  7. Grade Inflation and Law School Admissions

    Science.gov (United States)

    Wongsurawat, Winai

    2008-01-01

    Purpose: The purpose of this paper is to evaluate the evidence on whether grade inflation has led to an increasing emphasis on standardized test scores as a criterion for law school admissions. Design/methodology/approach: Fit probabilistic models to admissions data for American law schools during the mid to late 1990s, a period during which…

  8. The Terms and Tasks of "Open Admissions"

    Science.gov (United States)

    Scott, Robert A.

    1976-01-01

    Noting the need to define the terms used for policies which are changing the role of admissions offices, the author defines "open admissions" as "universal opportunity for post-secondary schooling" and points out changes in the core tasks of recruiting, selecting, counseling, and management of student records and data. (JT)

  9. Alphabetical Order Effects in School Admissions

    Science.gov (United States)

    Jurajda, Štepán; Münich, Daniel

    2016-01-01

    If school admission committees use alphabetically sorted lists of applicants in their evaluations, one's position in the alphabet according to last name initial may be important in determining access to selective schools. Jurajda and Münich (2010) "Admission to Selective Schools, Alphabetically". "Economics of Education…

  10. Admissible Unbiased Quantizations: Distributions with Linear Components

    OpenAIRE

    Pötzelberger, Klaus

    2000-01-01

    We show that results on the characterization of admissible quantizations, which have been derived in Potzelberger [3], have to be modified in case the probability distribution has linear components. Furthermore, we provide an example, where the limit of optimal quantizations is not admissible. (author's abstract)

  11. Homecare Nurses' Decision-Making During Admission Care Planning.

    Science.gov (United States)

    Sockolow, Paulina; Bass, Ellen J; Eberle, Carl L; Bowles, Kathryn H

    2016-01-01

    The re-hospitalization rate of homecare patients within 60 days of hospital discharge is 30%. Enhanced care planning based on better information may reduce this rate. However, very little is known about the homecare admission and care planning processes. The research team collected data during observations of three nursing visits to admit homecare patients in Camden NJ, and conducted thematic content analysis on these data. Human factors methods helped to identify nurse decision-making related to selection of the plan of care problems, non-nursing resources, and the nursing visit pattern. They identified how the electronic health record (EHR) assisted the nurse in visit pattern frequency decisions. Major themes that emerged included reduced efficiency due to use of redundant intra-team communication methods to augment EHR documentation, redundant documentation, and workarounds and reorganization of clinical workflow. PMID:27332156

  12. Evidence base and components of Brief Admission as an intervention for patients with borderline personality disorder: a review of the literature

    NARCIS (Netherlands)

    Helleman, M.; Goossens, P.J.J.; Kaasenbrood, A.; Achterberg, T. van

    2014-01-01

    PURPOSE: To review the available evidence-based literature on the components of brief inpatient psychiatric hospital admission as an intervention for patients with borderline personality disorder. DESIGN AND METHOD: Systematic literature search, narrative literature review. Content analysis. FINDING

  13. E-DIP: Early Discharge Project. A Model for Throughput and Early Discharge for 1-Day Admissions

    OpenAIRE

    Cho, Hyung J.; Desai, Neil; Florendo, Angelita; Marshall, Christine; Michalski, Jaime; Lee, Nathan; Dunn, Andrew

    2016-01-01

    Short stay admissions that are outside of observation unit models hold challenges for throughput and decreasing length of stay (LOS). In our institution at Mount Sinai Hospital in New York City, United States, we noticed a lack of communication about potential next-day discharges from the day and night admission teams to the inpatient teams. Our hospitalist division started the Early Discharge Initiation Project (E-DIP), a system of flagging and communicating potential discharges to improve t...

  14. Admission medical records made at night time have the same quality as day and evening time records

    DEFF Research Database (Denmark)

    Amirian, Ilda; Mortensen, Jacob F; Rosenberg, Jacob;

    2014-01-01

    INTRODUCTION: A thorough and accurate admission medical record is an important tool in ensuring patient safety during the hospital stay. Surgeons' performance might be affected during night shifts due to sleep deprivation. The aim of the study was to assess the quality of admission medical records....... CONCLUSION: Night time deterioration was not seen in the quality of the medical records. FUNDING: The study was supported financially by the Tryg Foundation Denmark and The Danish Medical Association. TRIAL REGISTRATION: not relevant....

  15. Trends in elderly psychiatric admissions to the Brazilian public health care system

    Directory of Open Access Journals (Sweden)

    Pedro L. Ritter

    2016-01-01

    Full Text Available Objective: To evaluate trends in psychiatric bed occupancy by elderly inpatients in the Brazilian public health care system between 2000 and 2010 and to determine the leading psychiatric diagnosis for hospital admissions. Methods: Data from all 895,476 elderly psychiatric admissions recorded in the Brazilian Public Health Care Database (DATASUS between January 2000 and February 2010 were analyzed. Polynomial regression models with estimated curve models were used to determine the trends. The number of inpatient days was calculated for the overall psychiatric admissions and according to specific diagnoses. Results: A moderate decreasing trend (p < 0.001 in the number of inpatient days was observed in all geriatric psychiatric admissions (R2 = 0.768 and in admissions for organic mental disorders (R2 = 0.823, disorders due to psychoactive substance use (R2 = 0.767, schizophrenia (R2 = 0.680, and other diagnoses (R2 = 0.770, but not for mood disorders (R2 = 0.472. Most admissions (60 to 65% were due to schizophrenia. Conclusion: There was a decreasing trend in inpatient days for elderly psychiatric patients between 2000 and 2010. The highest bed occupancy was due to schizophrenia, schizotypal, and delusional disorders.

  16. Ambient temperature and emergency room admissions for acute coronary syndrome in Taiwan

    Science.gov (United States)

    Liang, Wen-Miin; Liu, Wen-Pin; Chou, Sze-Yuan; Kuo, Hsien-Wen

    2008-01-01

    Acute coronary syndrome (ACS) is an important public health problem around the world. Since there is a considerable seasonal fluctuation in the incidence of ACS, climatic temperature may have an impact on the onset of this disease. The objective of this study was to assess the relationship between the average daily temperature, diurnal temperature range and emergency room (ER) admissions for ACS in an ER in Taichung City, Taiwan. A longitudinal study was conducted which assessed the correlation of the average daily temperature and the diurnal temperature range to ACS admissions to the ER of the city’s largest hospital. Daily ER admissions for ACS and ambient temperature were collected from 1 January 2000 to 31 March 2003. The Poisson regression model was used in the analysis after adjusting for the effects of holiday, season, and air pollutant concentrations. The results showed that there was a negative significant association between the average daily temperature and ER admissions for ACS. ACS admissions to the ER increased 30% to 70% when the average daily temperature was lower than 26.2°C. A positive association between the diurnal temperature range and ACS admissions was also noted. ACS admissions increased 15% when the diurnal temperature range was over 8.3°C. The data indicate that patients suffering from cardiovascular disease must be made aware of the increased risk posed by lower temperatures and larger changes in temperature. Hospitals and ERs should take into account the increased demand of specific facilities during colder weather and wider temperature variations.

  17. The hospital's lifeline: recruiting well-qualified physicians.

    Science.gov (United States)

    Dismuke, B J

    1989-01-01

    A hospital's success in today's competitive and unstable environment depends directly on its ability to recruit well-qualified physicians. Just consider that a physician controls from 70 to 80 percent of healthcare dollars through admissions and referrals. Even the most creative advertising campaign to attract patients cannot increase admissions if there are no physicians to deliver care. PMID:10304008

  18. Emergency pre-hospital management of patients admitted with acute asthma

    OpenAIRE

    Simpson, A; Matusiewicz, S; Brown, P.; McCall, I; Innes, J; Greening, A.; Crompton, G

    2000-01-01

    BACKGROUND—Little is known about the management of acute asthma prior to hospital admission. Pre-hospital treatment of patients referred to hospital with acute asthma was therefore studied in 150 patients divided into three groups: those in the Edinburgh Emergency Asthma Admission Service (EEAAS) who can contact an ambulance and present directly to respiratory services when symptoms arise (n = 38), those under continuing supervision at a hospital respiratory outpatient cl...

  19. Gender difference in smoking effects on lung function and risk of hospitalization for COPD

    DEFF Research Database (Denmark)

    Prescott, E; Bjerg, A M; Andersen, P K;

    1997-01-01

    hospital admission. A total of 13,897 subjects, born after 1920, from two population studies, 9,083 from the Copenhagen City Heart Study (CCHS) and 4,814 from the Glostrup Population Studies (GPS), were followed for 7-16 yrs. Data were linked with information on hospital admissions caused by COPD. Based on...

  20. Contribuição do uso de medicamentos para a admissão hospitalar

    OpenAIRE

    Patrícia de Carvalho Mastroianni; Fabiana Rossi Varallo; Marina Souza Barg; Ana Regina Noto; José Carlos Fernandez Galduróz

    2009-01-01

    As Reações Adversas a Medicamentos (RAM) podem ser responsáveis por 2,4% a 11,5% das admissões hospitalares. O estudo objetivou conhecer o perfil demográfico dos pacientes internados por possíveis RAM, identificar os medicamentos e as queixas mais freqüentemente relacionadas e estimar a incidência de admissão hospitalar pelo uso de medicamentos. Durante um mês, os pacientes internados em um hospital geral foram entrevistados quanto ao uso de medicamentos antes da internação e as queixas que o...

  1. Frequency of admission in Intensive Care Unit due to road accident

    OpenAIRE

    Vasilios Tziallas; Dimitrios Karagiorgis; Stergios Voutos; Othon Vlachopoulos; Dimitrios Tziallas; Mariana Ntokou

    2011-01-01

    During recent years, it has been noticed a remarkable increase in admission of the young in Intensive Care Unit due to road accident. The aim of the present study was to explore the injuries, the special conditions of admission of young 18-40 years old that were admitted to Intensive Care Unit due to road accident. Method and material: The sample studied consisted of young individuals 18-40 years old that were admitted in the Intensive Care Unit (ICU) of public hospitals in the area of Attica...

  2. Determinants of hospital utilization in the Netherlands.

    Science.gov (United States)

    van der Gaag, J; Rutten, F F; van Praag, B M

    1975-01-01

    Hospital use in the Netherlands is examined in a cross-section analysis of 1969 and 1971 data for 120 service regions. Elasticities of admissions with respect to bed supply and supply of general practitioners are calculated, and the substitutability of first level care (by general practitioners) for hospital care is considered. Substitution effects found indicate that the Dutch government's plan to reduce the ratio of hospital beds to population is feasible. PMID:1225868

  3. Impact of admission blood glucose level on outcomes in community-acquired pneumonia in older adults

    Directory of Open Access Journals (Sweden)

    Bhattacharya RK

    2013-05-01

    Full Text Available Rajib K Bhattacharya, Jonathan D Mahnken, Sally K RiglerUniversity of Kansas School of Medicine, Kansas City, KS, USABackground: Community-acquired pneumonia (CAP is a common cause of morbidity and mortality in older adults. Although diabetes mellitus is a risk factor for pneumonia, the clinical impact of blood glucose level at the time of admission is not clear. Our goal was to examine the association between admission hyperglycemia and subsequent mortality, length of stay, and readmission outcomes in older adults with CAP.Methods: A retrospective observational study was conducted using hospital data for community-acquired pneumonia admissions in 857 persons from January 1, 2008 to December 31, 2010. We examined the effects of admission glucose level on mortality, length of stay, and 30 day readmission, adjusted for demographic factors and comorbidity.Results: The mean age of the sample was 64 years, and 51% of the subjects were female. Inpatient mortality occurred in 4.6% and the median length of stay was 5 days (interquartile range 3–9 days. Readmission within 30 days occurred in 17%. We found little impact of first glucose measures on in-hospital mortality (P = 0.94, length of stay (P = 0.95, and 30-day readmission (P = 0.56. Subjects 65 years and older trended towards higher in-hospital mortality. Older age, cancer, heart failure, and cirrhosis were associated with adverse outcomes.Conclusion: Glucose level upon admission for community-acquired pneumonia was not associated with adverse outcomes within 30 days in older adults.Keywords: community-acquired pneumonia, hyperglycemia, readmission rates, hospital mortality

  4. Frailty score on admission predicts outcomes in elderly burn injury.

    Science.gov (United States)

    Romanowski, Kathleen S; Barsun, Alura; Pamlieri, Tina L; Greenhalgh, David G; Sen, Soman

    2015-01-01

    With longer life expectancy, the number of burn injuries in the elderly continues to increase. Prediction of outcomes for the elderly is complicated by preinjury physical fitness and comorbid illness. The authors hypothesize that admission frailty assessment would be predictive of outcomes in the elderly burn population. Our primary aim was to determine if higher frailty scores were associated with higher risk of mortality for elderly burn patients. The secondary aims were to assess if higher frailty scores were associated with increased length of stay, increased needs for mechanical ventilation and poor discharge disposition. A 2-year retrospective chart review was performed of all admitted acute burn patients 65 years or older. Data collected included: age, gender, %TBSA of burn injury, presence of inhalation injury, in hospital mortality, hospital length of stay, ventilator days, ICU length of stay, surgical procedures, insurance status, and discharge disposition. Frailty scores were assessed from admission data and calculated using the Canadian Study of Health and Aging clinical frailty scale. A total of 89 patients met entry criteria. Mean age was 75.3 ± 8.1 years and consisted of 62 men and 27 women. Mean %TBSA was 9.6 ± 9.1% and mean frailty score (FS) was 4.5 ± 1.2. Eighty patients survived to discharge and nine died. Nonsurvivors had significantly higher FS compared to survivors (5.2 ± 1.2 vs 4.4 ± 1.2). FS were also significantly higher in patients discharged to skilled nursing facilities (SNF) (5.34 ± 0.9) compared to those who were discharged home (4.1 ± 1.2) or to physical rehabilitation facilities (4 ± 1.5). Multivariate linear regression analysis revealed that age (B = 0.04) and discharge to SNF (B = 1.2) are independently associated with higher FS. However, survivors were independently associated with a significantly lower FS (B = -1.3). Multivariate logistic regression analysis revealed high admission FS independently increased the risk of

  5. 16 CFR 3.32 - Admissions.

    Science.gov (United States)

    2010-01-01

    ... ADJUDICATIVE PROCEEDINGS Discovery; Compulsory Process § 3.32 Admissions. (a) At any time after thirty (30... unless the party states that it has made reasonable inquiry and that the information known to or...

  6. Admissible Strategies in Semimartingale Portfolio Selection

    CERN Document Server

    Biagini, Sara

    2009-01-01

    The choice of admissible trading strategies in mathematical modelling of financial markets is a delicate issue, going back to Harrison and Kreps (1979). In the context of optimal portfolio selection with expected utility preferences this question has been a focus of considerable attention over the last twenty years. We propose a novel notion of admissibility that has many pleasant features -- admissibility is characterized purely under the objective measure $P$; the wealth of any admissible strategy is a supermartingale under all pricing measures; local boundedness of the price process is not required; neither strict monotonicity, strict concavity nor differentiability of the utility function are necessary; the definition encompasses both the classical mean-variance preferences and the monotone expected utility. For utility functions finite on the real line, our class represents a minimal set containing simple strategies which also contains the optimizer, under conditions that are substantially milder than th...

  7. Call Admission Control in Mobile Cellular Networks

    CERN Document Server

    Ghosh, Sanchita

    2013-01-01

    Call Admission Control (CAC) and Dynamic Channel Assignments (DCA) are important decision-making problems in mobile cellular communication systems. Current research in mobile communication considers them as two independent problems, although the former greatly depends on the resulting free channels obtained as the outcome of the latter. This book provides a solution to the CAC problem, considering DCA as an integral part of decision-making for call admission. Further, current technical resources ignore movement issues of mobile stations and fluctuation in network load (incoming calls) in the control strategy used for call admission. In addition, the present techniques on call admission offers solution globally for the entire network, instead of considering the cells independently.      CAC here has been formulated by two alternative approaches. The first approach aimed at handling the uncertainty in the CAC problem by employing fuzzy comparators.  The second approach is concerned with formulation of CAC ...

  8. Should Universities lower Admission Requirements for Celebrities?

    Institute of Scientific and Technical Information of China (English)

    2012-01-01

    In recent years, many famous universities lower admission requirements for celebrities. More and more celebrities, especially sports stars, have been admitted to famous universities even without an entry examination. This phenomenon has become a subject of widespread controversy.

  9. On the use of Disease Staging for clinical management: analysis of untimely admissions in the Abruzzo Region, Italy

    Directory of Open Access Journals (Sweden)

    Lamberto Manzoli

    2004-12-01

    Full Text Available

    Background and aims. The process of decentralization which recently occurred within the Italian National Health Service has transferred substantial responsibility and authority for health care administration to the individual regions. The project is aimed at developing regional benchmarks that can be used as a part of an ongoing system for analysis of resource use and quality of care in the Abruzzo Region of Italy.

    Methods. All 286 924 hospital admissions for the year 2001 in the region were analysed. Three diseases were chosen for in-depth review: diabetes mellitus; cholecystitis/cholelithiasis; and bacterial pneumonia. There were a total of 9391 admissions for these diagnoses. Severity, length of hospital stay and hospital mortality were analysed using Disease Staging methodology. In addition, the timeliness of hospitalisation was assessed by grouping admissions in three categories: premature or medically unnecessary, timely and late.

    Results. The rate of medically unnecessary admissions for diabetes mellitus was 72% throughout the region, and the percentage of late hospitalisations for cholelithiasis/cholecystitis was 43%. For both diseases, there were significant variations across Local Health Units in the proportion of late and early admissions. The rate of timely hospitalisations for bacterial pneumonia was higher than 86%.

    Conclusion. The analysis of discharge abstract data using Disease Staging revealed that in the Abruzzo region there are problems of inappropriate hospital admission, both early and late, for all diseases examined excepted bacterial pneumonia.

    Data confirmed the validity of Disease Staging to compare the performance of diverse hospitals in terms of length of stay and in-hospital mortality.

  10. Development of a validation algorithm for 'present on admission' flagging

    Directory of Open Access Journals (Sweden)

    Cheng Diana

    2009-12-01

    Full Text Available Abstract Background The use of routine hospital data for understanding patterns of adverse outcomes has been limited in the past by the fact that pre-existing and post-admission conditions have been indistinguishable. The use of a 'Present on Admission' (or POA indicator to distinguish pre-existing or co-morbid conditions from those arising during the episode of care has been advocated in the US for many years as a tool to support quality assurance activities and improve the accuracy of risk adjustment methodologies. The USA, Australia and Canada now all assign a flag to indicate the timing of onset of diagnoses. For quality improvement purposes, it is the 'not-POA' diagnoses (that is, those acquired in hospital that are of interest. Methods Our objective was to develop an algorithm for assessing the validity of assignment of 'not-POA' flags. We undertook expert review of the International Classification of Diseases, 10th Revision, Australian Modification (ICD-10-AM to identify conditions that could not be plausibly hospital-acquired. The resulting computer algorithm was tested against all diagnoses flagged as complications in the Victorian (Australia Admitted Episodes Dataset, 2005/06. Measures reported include rates of appropriate assignment of the new Australian 'Condition Onset' flag by ICD chapter, and patterns of invalid flagging. Results Of 18,418 diagnosis codes reviewed, 93.4% (n = 17,195 reflected agreement on status for flagging by at least 2 of 3 reviewers (including 64.4% unanimous agreement; Fleiss' Kappa: 0.61. In tests of the new algorithm, 96.14% of all hospital-acquired diagnosis codes flagged were found to be valid in the Victorian records analysed. A lower proportion of individual codes was judged to be acceptably flagged (76.2%, but this reflected a high proportion of codes used Conclusion An indicator variable about the timing of occurrence of diagnoses can greatly expand the use of routinely coded data for hospital quality

  11. Scheduling start time in CDMA burst admission

    OpenAIRE

    Zhuge, L; Li, VOK

    2002-01-01

    Burst transmission protocols have been proposed in the next generation CDMA cellular systems to support short-time high-speed data communications. The existing burst admission algorithm considers only the current interference condition in the system. The burst transmission request will be rejected if the interference in the system will exceed the acceptable level with the burst admitted. In this paper we propose a new burst admission algorithm where a currently-unacceptable burst request can ...

  12. GRADE: Machine Learning Support for Graduate Admissions

    OpenAIRE

    Waters, Austin; University of Texas at Austin; Miikkulainen, Risto; University of Texas at Austin

    2014-01-01

    This article describes GRADE, a statistical machine learning system developed to support the work of the graduate admissions committee at the University of Texas at Austin Department of Computer Science (UTCS). In recent years, the number of applications to the UTCS PhD program has become too large to manage with a traditional review process. GRADE uses historical admissions data to predict how likely the committee is to admit each new applicant. It reports each prediction as a score similar ...

  13. FacilitiesHospitals_HOSPITAL

    Data.gov (United States)

    Vermont Center for Geographic Information — This datalayer contains point locations of all major community, regional, comprehensive health, and healthcare provider hospitals in the state of Vermont. The...

  14. Admission to intensive care can be reliably predicted using only clinical judgment

    DEFF Research Database (Denmark)

    Brabrand, M.

    2015-01-01

    Introduction Not all patients in need of critical care arrive in clinical distress and some deteriorate after arrival. Identifying these patients early in their clinical course could potentially improve outcome. The present study was performed with the aim of assessing whether nursing and physician...... staffwere able to identify patients in need of critical care using only clinical judgment and to compare this with the National Early Warning Score (NEWS). Methods This was a prospective cohort study of all adult patients with a first-time admission to a medical admission unit at a 450-bed regional teaching...... hospital over a 3-month period in 2010. All subspecialties of internal medicine are present as well as a level 2 ICU. Upon first contact with the patient after arrival, nursing staffand physicians were asked to report their estimation of the probability of ICU admission (0 to 100%). Survival status was...

  15. Nosocomial infection in adult admissions with hematological malignancies originating from different lineages: a prospective observational study.

    Directory of Open Access Journals (Sweden)

    Hui Liu

    Full Text Available Nosocomial infection (NI causes prolonged hospital stays, increased healthcare costs, and higher mortality among patients with hematological malignancies (HM. However, few studies have compared the incidence of NI according to the HM lineage.To compare the incidence of NI according to the type of HM lineage, and identify the risk factors for NI.This prospective observational study monitored adult patients with HM admitted for >48 hours to the General Hospital of the People's Liberation Army during 2010-2013. Attack rates and incidences of NI were compared, and multivariable logistic regression was used to control for confounding effects.This study included 6,613 admissions from 1,922 patients. During these admissions, 1,023 acquired 1,136 NI episodes, with an attack rate of 15.47% and incidence of 9.6‰ (95% CI: 9.1-10.2. Higher rates and densities of NIs were observed among myeloid neoplasm (MN admissions, compared to lymphoid neoplasm (LN admissions (28.42% vs. 11.00%, P<0.001 and 11.4% vs. 8.4‰, P<0.001. NI attack rates in acute myeloid leukemia (AML and myelodysplastic/myeloproliferative neoplasm (MDS/MPN were higher than those in MDS (30.69% vs. 20.19%, P<0.001; 38.89% vs. 20.19%, P = 0.003. Attack rates in T/NK-cell neoplasm and B-cell neoplasm were higher than those in Hodgkin lymphoma (15.04% vs. 3.65%; 10.94% vs. 3.65%, P<0.001. Multivariable regression analysis indicated prolonged hospitalization, presence of central venous catheterization, neutropenia, current stem cell transplant, infection on admission, and old age were independently associated with higher NI incidence. After adjusting for these factors, MN admissions still had a higher risk of infection (odds ratio 1.34, 95% CI: 1.13-1.59, P<0.001.Different NI attack rates were observed for HM from different lineages, with MN lineages having a higher attack rate and incidence than LN lineages. Special attention should be paid to MN admissions, especially AML and MDS

  16. 45 CFR 84.42 - Admissions and recruitment.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Admissions and recruitment. 84.42 Section 84.42... Education § 84.42 Admissions and recruitment. (a) General. Qualified handicapped persons may not, on the basis of handicap, be denied admission or be subjected to discrimination in admission or recruitment...

  17. 22 CFR 217.42 - Admissions and recruitment.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Admissions and recruitment. 217.42 Section 217... Admissions and recruitment. (a) General. Qualified handicapped persons may not, on the basis of handicap, be denied admission or be subjected to discrimination in admission or recruitment by a recipient to...

  18. 15 CFR 8b.20 - Admission and recruitment.

    Science.gov (United States)

    2010-01-01

    ... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Admission and recruitment. 8b.20... Secondary Education § 8b.20 Admission and recruitment. (a) General. Qualified handicapped may not, on the basis of handicap, be denied admission or be subjected to discrimination in admission or recruitment...

  19. 34 CFR 104.42 - Admissions and recruitment.

    Science.gov (United States)

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false Admissions and recruitment. 104.42 Section 104.42... ASSISTANCE Postsecondary Education § 104.42 Admissions and recruitment. (a) General. Qualified handicapped... admission or recruitment by a recipient to which this subpart applies. (b) Admissions. In administering...

  20. 43 CFR 41.305 - Preference in admission.

    Science.gov (United States)

    2010-10-01

    ... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Preference in admission. 41.305 Section 41... Basis of Sex in Admission and Recruitment Prohibited § 41.305 Preference in admission. A recipient to which §§ 41.300 through 41.310 apply shall not give preference to applicants for admission, on the...

  1. 28 CFR 54.305 - Preference in admission.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Preference in admission. 54.305 Section... Basis of Sex in Admission and Recruitment Prohibited § 54.305 Preference in admission. A recipient to which §§ 54.300 through 54.310 apply shall not give preference to applicants for admission, on the...

  2. 22 CFR 229.305 - Preference in admission.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Preference in admission. 229.305 Section 229... in Admission and Recruitment Prohibited § 229.305 Preference in admission. A recipient to which §§ 229.300 through 229.310 apply shall not give preference to applicants for admission, on the basis...

  3. 15 CFR 8a.305 - Preference in admission.

    Science.gov (United States)

    2010-01-01

    ... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Preference in admission. 8a.305... on the Basis of Sex in Admission and Recruitment Prohibited § 8a.305 Preference in admission. A recipient to which §§ 8a.300 through 8a.310 apply shall not give preference to applicants for admission,...

  4. 22 CFR 146.305 - Preference in admission.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Preference in admission. 146.305 Section 146... in Admission and Recruitment Prohibited § 146.305 Preference in admission. A recipient to which §§ 146.300 through 146.310 apply shall not give preference to applicants for admission, on the basis...

  5. 31 CFR 28.305 - Preference in admission.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Preference in admission. 28.305... Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 28.305 Preference in admission. A recipient to which §§ 28.300 through 28.310 apply shall not give preference to applicants for admission,...

  6. 49 CFR 25.305 - Preference in admission.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Preference in admission. 25.305 Section 25.305... Admission and Recruitment Prohibited § 25.305 Preference in admission. A recipient to which §§ 25.300 through 25.310 apply shall not give preference to applicants for admission, on the basis of attendance...

  7. 45 CFR 86.22 - Preference in admission.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Preference in admission. 86.22 Section 86.22... on the Basis of Sex in Admission and Recruitment Prohibited § 86.22 Preference in admission. A recipient to which this subpart applies shall not give preference to applicants for admission, on the...

  8. 6 CFR 17.305 - Preference in admission.

    Science.gov (United States)

    2010-01-01

    ... 6 Domestic Security 1 2010-01-01 2010-01-01 false Preference in admission. 17.305 Section 17.305... the Basis of Sex in Admission and Recruitment Prohibited § 17.305 Preference in admission. A recipient to which §§ 17.300 through 17.310 apply shall not give preference to applicants for admission, on...

  9. 40 CFR 5.305 - Preference in admission.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Preference in admission. 5.305 Section... on the Basis of Sex in Admission and Recruitment Prohibited § 5.305 Preference in admission. A recipient to which §§ 5.300 through 5.310 apply shall not give preference to applicants for admission,...

  10. Glycated hemoglobin A: A predictor of outcome in trauma admissions to intensive care unit

    Directory of Open Access Journals (Sweden)

    Karen Ruby Lionel

    2014-01-01

    Full Text Available Background and Aim: Although large studies have demonstrated the association between hyperglycemia and adverse intensive care unit (ICU outcomes, it is yet unclear which subset of patients benefit from tight sugar control in ICU. Recent evidence suggests that stress induced hyperglycemia (SIH and co-incidentally detected diabetes mellitus are different phenomena with different prognoses. Differentiating SIH from diabetic hyperglycemia is challenging in ICU settings. We followed a cohort of trauma patients admitted to a surgical intensive care unit (SICU to evaluate if initial glycated hemoglobin A (HbA 1 c level predicts the outcome of admission. Materials and Methods: A cohort of 120 consecutive admissions to SICU following trauma were recruited and admission blood sugar and HbA 1 c were measured. Outcomes were prospectively measured by blinded ICU doctors. A logistic regression model was developed to assess if HbA 1 c predicts poor outcomes in these settings. Results: Nearly 24% of the participants had HbA 1 c ≥ 6. Those with HbA 1 c ≥ 6 had 3.14 times greater risk of poor outcome at the end of hospital stay when compared to those with HbA 1 c < 6 and this risk increased to an odds ratio of 4.57 on adjusting for other significant predictors: Acute Physiology and Chronic Health Evaluation II, injury severity score, admission blood sugar and age at admission. Conclusions: Substantial proportion of trauma admissions has underlying diabetes. HbA 1 c, a measure of pre admission glycaemic status is an important predictor of ICU outcome in trauma patients.

  11. ENVIRONMENTAL HAZARDS AS A CAUSE OF PEDIATRIC INTENSIVE CARE ADMISSION

    Directory of Open Access Journals (Sweden)

    Nasser Ali Haidar

    2014-12-01

    Full Text Available Background: Children are exposed to several environmental hazards with variable effects from mild to severe manifestations leading to death. The aim of this study is to study the pattern of Pediatric Intensive Care Unit (PICU admission due to environmental hazards and its mortality rate. Methods: This is a hospital-based study conducted during a 5 years period in Al-Madinah Al-Munwarah, Saudi Arabia. Results: Out of total PICU admissions, 9% were due to environmental hazards. Bronchial asthma which is triggered mostly by environmental factors, was the most common (35.3% followed by: trauma (27%, poisoning (15.3% and submersion injuries (9.7%. Males were significantly more exposed to environmental hazard than females (χ2= 13, p = 0.021. Statistical analysis showed a significant difference in the frequency of environmental hazards between summer and winter (χ2= 12, p = 0.033. Trauma, poisoning, submersion injuries, stings and bites were more in summer compared to winter. However, bronchial asthma had higher frequency in winter. The Median length of PICU stay ranges from 1.6 – 12.5 days depending on the type of hazard. Overall mortality rate was 8.8% with the highest rate among trauma followed by submersion injury patients with no fatality in drug ingestion or food poisoning. Conclusion: Environmental hazards represent a preventable major health problem with significant mortality and burden in health economics by long PICU stay and its sequel.

  12. Major Research Efforts of the Law School Admission Council. Law School Admission Research.

    Science.gov (United States)

    Hart, Frederick M.; Evans, Franklin R.

    Research conducted by the Law School Admission Council since the development of the Law School Admission Test (LSAT) in 1948 is described. An overview of the research topics is provided, and relevant published reports are cited in 61 footnotes. The following topics of study are discussed: (1) use and validity of traditional predictors of law…

  13. Assessing Practical Intelligence in Business School Admissions: A Supplement to the Graduate Management Admissions Test

    Science.gov (United States)

    Hedlund, Jennifer; Wilt, Jeanne M.; Nebel, Kristina L.; Ashford, Susan J.; Sternberg, Robert J.

    2006-01-01

    The Graduate Management Admission Test (GMAT) is the most widely used measure of managerial potential in MBA admissions. GMAT scores, although predictive of grades in business school, leave much of the variance in graduate school performance unexplained. The GMAT also produces disparities in test scores between groups, generating the potential for…

  14. Evaluation of obstetric admissions to intensive care unit of a tertiary referral center in coastal India

    Directory of Open Access Journals (Sweden)

    Poornima B Ramachandra Bhat

    2013-01-01

    Full Text Available Background and Aim: To evaluate the occurrence, indications, course, interventions, and outcome of obstetric patients admitted to the intensive care unit (ICU. Design: Retrospective study. Setting: ICU of a Medical College Hospital. Materials and Methods: The data collected were age, parity, obstetric status, primary diagnosis, interventions, and outcome of obstetric patients admitted to the ICU from Jan 2005 to June 2011. Results: Total deliveries were 16,804 in 6.5 years. Obstetric admissions to the ICU were (n = 65 which constitutes 0.39% of deliveries. Majority of the admissions were in the postpartum period (n = 46, 70.8%. The two common indications for admission were obstetric hemorrhage (n = 18, 27.7% and pregnancy related hypertension with its complications (n = 17, 26.2%. The most common intervention was artificial ventilation (n = 41, 63%. The mortality among obstetric admissions in the ICU was (33.8% (22/65. The patients appropriate for High Dependency Unit (HDU care was (32.3% (21/65. The statistical analysis was done by fractional percentage and Chi-square test. Conclusions: Hemorrhage and pregnancy-related hypertension with its complications are the two common indications for ICU admissions. The need for a HDU should be considered.

  15. Brief hospitalizations of elderly patients

    DEFF Research Database (Denmark)

    Strømgaard, Sofie; Rasmussen, Søren Wistisen; Schmidt, Thomas Andersen

    2014-01-01

    BACKGROUND: Crowded departments are a common problem in Danish hospitals, especially in departments of internal medicine, where a large proportion of the patients are elderly. We therefore chose to investigate the number and character of hospitalizations of elderly patients with a duration of less...... than 24 hours, as such short admissions could indicate that the patients had not been severely ill and that it might have been possible in these cases to avoid hospitalization. METHODS: Medical records were examined to determine the number of patients aged 75 or more who passed through the emergency...... department over a period of two months, and the proportion of those patients who were discharged after less than 24 hours. The reasons for the hospitalization, the diagnoses and the treatment given were noted. RESULTS: There was a total of 595 hospitalizations of patients aged 75 or above in the emergency...

  16. Light Atmosphere in Hospital Wards

    DEFF Research Database (Denmark)

    Stidsen, Lone Mandrup

    At the moment, the future of hospital design is a subject of interest and thereby also a subject of discussion. It is a fact that new hospitals have an increased focus on user perspectives and an interest for improving the physical environment in such a way it supports the user needs...... and preferences and thereby the experience of an admission to the hospital. Recent literature such as ‘Hospitals of the senses’ and ‘Healing Architecture’ presents research and design solutions focused on senses and experience of the design. The Danish Regions ask for ‘Evidence Based Design’ to future prove...... the hospitals by research base the design of the buildings. The present PhD project expands the existing knowledge of lighting research by focusing on the experienced light atmosphere. The project uses multi strategies of methodology based on a flexible design to elaborate on the sociocultural aspect of light...

  17. Patients with hematological disorders requiring admission to medical intensive care unit: Characteristics, survival and prognostic factors

    Directory of Open Access Journals (Sweden)

    Subhash H

    2003-01-01

    Full Text Available Background: This retrospective chart review assessed the characteristics and outcome of patients with hematological disorders who required admission to medical intensive care unit over a 4 year period (January 1998 to December 2001. Results: There were a total of 104 patients, 67 (64% male, 37 (36% female subjects, with a mean age of 36.3 ± 15.3 years (range 10 to 65 years. The mean duration from hospital admission to ICU transfer was 11 days. Sixty-nine (66% had malignant and 35 (34% had non-malignant conditions. Respiratory distress was the commonest reason for ICU admission 58 (56%. The other indications were hemodynamic instability 38 (36%, low sensorium 22 (21%, following cardio-pulmonary arrest 12 (11.5% and generalized tonic-clonic seizures 5 (5%. Forty-three (42% patients had absolute neutophil count (ANC less than 500, 48 (47.5% had platelet count < 20000. The mean duration of ICU stay was 4 days (range < 24 hours to 28 days. Sixty-nine (66% patients required mechanical ventilation, 61 (59% required hemodynamic support. Pneumonia or sepsis was diagnosed in 71 (68%. Twenty-five (24% survived ICU stay and 20 (19% survived to hospital discharge. ICU admission following cardio-pulmonary arrest, advanced malignancy, requirement of mechanical ventilation, vasopressor support, ANC count < 500 and platelet count < 20000 were the predictors of adverse outcome. Associated organ dysfunction further increases the mortality.

  18. Patient Referral Patterns and the Spread of Hospital-Acquired Infections through National Health Care Networks

    NARCIS (Netherlands)

    Donker, Tjibbe; Wallinga, Jacco; Grundmann, Hajo

    2010-01-01

    Rates of hospital-acquired infections, such as methicillin-resistant Staphylococcus aureus (MRSA), are increasingly used as quality indicators for hospital hygiene. Alternatively, these rates may vary between hospitals, because hospitals differ in admission and referral of potentially colonized pati

  19. 38 CFR 4.29 - Ratings for service-connected disabilities requiring hospital treatment or observation.

    Science.gov (United States)

    2010-07-01

    ... § 4.29 Ratings for service-connected disabilities requiring hospital treatment or observation. A total... when it is established that a service-connected disability has required hospital treatment in a... hospital admission was for disability not connected with service, if during such hospitalization,...

  20. The therapeutic relationship after psychiatric admission.

    LENUS (Irish Health Repository)

    Roche, Eric

    2014-03-01

    The therapeutic relationship is one of the most central and important factors in the treatment of mental health disorders. A better therapeutic relationship is associated with service engagement, medication adherence, and satisfaction with services. This study aimed to compare the demographic and clinical factors associated with the therapeutic relationship in voluntarily and involuntarily admitted psychiatric service users. We found that individuals who had been admitted involuntarily, who had a diagnosis of a psychotic disorder, and who reported higher levels of perceived pressures on admission were more likely to have a poorer therapeutic relationship with their consultant psychiatrist. Greater levels of insight and treatment satisfaction, together with higher levels of procedural justice experienced on admission, were associated with a better therapeutic relationship. We found that the level of perceived coercion on admission was not related to the therapeutic relationship. Targeted interventions to improve the therapeutic relationship, particularly for involuntarily admitted service users, are discussed.

  1. INCIDENCE OF NICU ADMISSIONS OF NEONATES BORN TO TEENAGE MOTHERS IN EAST GODAVAR I DISTRICT

    Directory of Open Access Journals (Sweden)

    Padmasri Devi

    2015-07-01

    Full Text Available AIM: Although the effect of adolescent pregnancy on perinatal mortality and morbidity is known, data on the neonatal hospitalization rate in these deliveries have not been reported. We aimed to assess the possible effects of adolescent pregnancies on the hospital outcomes of the newborns. METHODS: 238 adolescent mothers under 19 years of age and their singleton newborns were enrolled in this study. RESULTS: Mother age was statistically significantly associated with NICU admissions of neonates (P=0.000. LBW of neonates were statistically significant association with teenage pregnancy (P=0.000. CONCLUSION: In this study it has been observed that teenage pregnancy was one of the major cause of low birth weight and also admission of neonates in NICU. In this study total 238 study subjects, out of them 115 neonates were born with LBW along with various complications due to the teenage pregnancy. In this study neonatal complication were decreased as the mother’s age increases.

  2. FacilitiesHospitals_HOSPITAL

    Data.gov (United States)

    Vermont Center for Geographic Information — This data layer contains point locations of all major community, regional, comprehensive health, and healthcare provider hospitals in the state of Vermont. The...

  3. Hospitals; hospitals13

    Data.gov (United States)

    University of Rhode Island Geospatial Extension Program — Hospital Facilities information was compiled from several various sources. Main source was the RI Department of Health Facilities Regulation database, License 2000....

  4. Admission Control Techniques for UMTS System

    Directory of Open Access Journals (Sweden)

    P. Kejik

    2010-09-01

    Full Text Available Universal mobile telecommunications system (UMTS is one of the 3rd generation (3G cell phone technologies. The capacity of UMTS is interference limited. Radio resources management (RRM functions are therefore used. They are responsible for supplying optimum coverage, ensuring efficient use of physical resources, and providing the maximum planned capacity. This paper deals with admission control techniques for UMTS. An own UMTS simulation program and several versions of proposed admission control algorithms are presented in this paper. These algorithms are based on fuzzy logic and genetic algorithms. The performance of algorithms is verified via simulations.

  5. Sex Difference of In-hospital Mortality in Patients with Acute Myocardial Infarction

    OpenAIRE

    Shiraki, Teruo; Saito, Daiji

    2011-01-01

    Factors contributing to the sex difference of in-hospital mortality after acute myocardial infarction (MI) are still unknown. We compared the clinical characteristics on admission and in-hospital outcome of consecutive 1,354 patients with acute MI between the 2 sexes. Age on admission was about 7 years older in women than in men. In-hospital death was significantly more frequent in women. Pulmonary congestion and hypertension were more likely in women with higher serum levels of total cholest...

  6. The incidence of adverse events in Swedish hospitals: a retrospective medical record review study

    OpenAIRE

    Soop, Michael; Fryksmark, Ulla; Köster, Max; Haglund, Bengt

    2009-01-01

    Objectives To estimate the incidence, nature and consequences of adverse events and preventable adverse events in Swedish hospitals. Design A three-stage structured retrospective medical record review based on the use of 18 screening criteria. Setting Twenty-eight Swedish hospitals. Population A representative sample (n = 1967) of the 1.2 million Swedish hospital admissions between October 2003 and September 2004. Main Outcome Measures Proportion of admissions with adverse events, the proport...

  7. Inpatient child mortality by travel time to hospital in a rural area of Tanzania

    OpenAIRE

    Manongi, Rachel; Mtei, Frank; Mtove, George; Nadjm, Behzad; Muro, Florida; Alegana, Victor; Noor, Abdisalan M; Todd, Jim; Reyburn, Hugh

    2014-01-01

    OBJECTIVE To investigate the association, if any, between child mortality and distance to the nearest hospital. METHODS The study was based on data from a 1-year study of the cause of illness in febrile paediatric admissions to a district hospital in north-east Tanzania. All villages in the catchment population were geolocated, and travel times were estimated from availability of local transport. Using bands of travel time to hospital, we compared admission rates, inpatient case fatality rate...

  8. Lived experiences and challenges of older surgical patients during hospitalization for cancer: An ethnographic fieldwork

    OpenAIRE

    Uhrenfeldt, Lisbeth; Høybye, Mette Terp

    2014-01-01

    This paper explores the lived experiences of older surgical patients’ (aged 74 years and older) experienced challenges during a brief admission to hospital. Age, gender, polypharmacy, and the severity of illness are also factors known to affect the hospitalization process. For an ethnographic study using participant observation and interviews, surgical cancer patients (n9, aged 74 years and older) were recruited during admission to a Danish teaching hospital. Using ethnographic strategies of ...

  9. Using A Natural Language Processing System to Extract and Code Family History Data from Admission Reports

    OpenAIRE

    Friedlin, Jeff; McDonald, Clement J.

    2006-01-01

    We developed a rule-based natural language processing (NLP) system for extracting and coding clinical data from free text reports. We studied the systems ability to accurately extract and code family history data from hospital admission notes. The system searches the family history for 12 diseases (and relative degree). It achieved a sensitivity of .96 and a PPV of .97 for disease extraction, and .96 and .93 respectively for relative categorization.

  10. Effect of "fast track" admission for acute myocardial infarction on delay to thrombolysis.

    OpenAIRE

    Pell, Alastair C. H.; Miller, Hugh C.; Robertson, Colin E; Fox, Keith A

    1992-01-01

    OBJECTIVE:To evaluate the impact of a fast track triage system for patients with acute myocardial infarction.DESIGN:Comparison of delays in admission to hospital and in receiving thrombolytic treatment before and after introducing fast track system with delays recorded in 1987-8. Patients fulfilling clinical and electrocardiographic criteria for myocardial infarction were selected for rapid access to the cardiac care team, bypassing evaluation by the medical registrar.SETTING:Major accident a...

  11. Incidence and time trends of brain metastases admissions among breast cancer patients in Sweden

    OpenAIRE

    Frisk, G; Svensson, T.; Bäcklund, L M; Lidbrink, E.; Blomqvist, P; Smedby, K E

    2012-01-01

    Background: While treatment for breast cancer has been refined and overall survival has improved, there is concern that the incidence of brain metastases has increased. Methods: We identified patients in Sweden with incident breast cancer 1998–2006 in the National Cancer Register, and matched these to the National Patient Register to obtain information on hospital admissions for distant metastases. Hazard ratios (HRs) and 95% confidence intervals (CIs) were computed with Cox regression as est...

  12. Nutrition in the hospital setting.

    OpenAIRE

    Emily Felicia Jan Ee SHEN

    2012-01-01

    Nutrition is essential for human health. Malnutrition in the hospital setting is common, and often underrecognised. Malnutrition increases morbidity, length of stay and mortality in patients, and increases postoperative complications. Patients’ nutritional status should be screened upon admission and if there is evidence of a poor nutritional state, the patient should be referred for further evaluation and management. Nutritional requirements may vary in disease states and the route of feedin...

  13. Depression as a Predictor of Length of Hospital Stay in Elderly Patients Admitted to Ain Shams University Hospitals

    OpenAIRE

    Sherine M. Elbanouby, Sarah A.Hamza,Samia A. Abdel Rahman and Ahmed Kamel Mortagy

    2013-01-01

    Background: Depression among the physically ill is common and frequently under-diagnosed. Elderly patients with depressive symptoms are at higher risk of hospital admission for non psychiatric conditions and are more likely to have longer hospital stays and worse hospital outcomes, compared with non depressed patients. Objectives: The aim of this study was to find out if depression can be considered a predictor of prolonged hospital stay in elderly patients. Design: A prospective cohor...

  14. Preventing compulsory admission to psychiatric inpatient care through psycho-education and crisis focused monitoring

    Directory of Open Access Journals (Sweden)

    Lay Barbara

    2012-09-01

    Full Text Available Abstract Background The high number of involuntary placements of people with mental disorders in Switzerland and other European countries constitutes a major public health issue. In view of the ethical and personal relevance of compulsory admission for the patients concerned and given the far-reaching effects in terms of health care costs, innovative interventions to improve the current situation are much needed. A number of promising approaches to prevent involuntary placements have been proposed that target continuity of care by increasing self-management skills of patients. However, the effectiveness of such interventions in terms of more robust criteria (e.g., admission rates has not been sufficiently analysed in larger study samples. The current study aims to evaluate an intervention programme for patients at high risk of compulsory admission to psychiatric hospitals. Effectiveness will be assessed in terms of a reduced number of psychiatric hospitalisations and days of inpatient care in connection with involuntary psychiatric admissions as well as in terms of cost-containment in inpatient mental health care. The intervention furthermore intends to reduce the degree of patients’ perceived coercion and to increase patient satisfaction, their quality of life and empowerment. Methods/Design This paper describes the design of a randomised controlled intervention study conducted currently at four psychiatric hospitals in the Canton of Zurich. The intervention programme consists of individualised psycho-education focusing on behaviours prior to and during illness-related crisis, the distribution of a crisis card and, after inpatient admission, a 24-month preventive monitoring of individual risk factors for compulsory re-admission to hospital. All measures are provided by a mental health care worker who maintains permanent contact to the patient over the course of the study. In order to prove its effectiveness the intervention programme will be

  15. Fine particulate air pollution and its components in association with cause-specific emergency admissions

    Directory of Open Access Journals (Sweden)

    Koutrakis Petros

    2009-12-01

    Full Text Available Abstract Background Although the association between exposure to particulate matter and health is well established, there remains uncertainty as to whether certain chemical components are more harmful than others. We explored whether the association between cause-specific hospital admissions and PM2.5 was modified by PM2.5 chemical composition. Methods We estimated the association between daily PM2.5 and emergency hospital admissions for cardiac causes (CVD, myocardial infarction (MI, congestive heart failure (CHF, respiratory disease, and diabetes in 26 US communities, for the years 2000-2003. Using meta-regression, we examined how this association was modified by season- and community-specific PM2.5 composition, controlling for seasonal temperature as a surrogate for ventilation. Results For a 10 μg/m3 increase in 2-day averaged PM2.5 concentration we found an increase of 1.89% (95% CI: 1.34- 2.45 in CVD, 2.25% (95% CI: 1.10- 3.42 in MI, 1.85% (95% CI: 1.19- 2.51 in CHF, 2.74% (95% CI: 1.30- 4.2 in diabetes, and 2.07% (95% CI: 1.20- 2.95 in respiratory admissions. The association between PM2.5 and CVD admissions was significantly modified when the mass was high in Br, Cr, Ni, and Na+, while mass high in As, Cr, Mn, OC, Ni, and Na+ modified MI, and mass high in As, OC, and SO42- modified diabetes admissions. For these species, an interquartile range increase in their relative proportion was associated with a 1-2% additional increase in daily admissions per 10 μg/m3 increase in mass. Conclusions We found that PM2.5 mass higher in Ni, As, and Cr, as well as Br and OC significantly increased its effect on hospital admissions. This result suggests that particles from industrial combustion sources and traffic may, on average, have greater toxicity.

  16. An Observational Study of Patient Characteristics Associated with the Mode of Admission to Acute Stroke Services in North East, England

    OpenAIRE

    Price, Christopher; Rae, Victoria; Duckett, Jay; Wood, Ruth; Gray, Joanne; McMeekin, Peter; Rodgers, Helen; Portas, Karen; Ford, Gary

    2013-01-01

    Objective Effective provision of urgent stroke care relies upon admission to hospital by emergency ambulance and may involve pre-hospital redirection. The proportion and characteristics of patients who do not arrive by emergency ambulance and their impact on service efficiency is unclear. To assist in the planning of regional stroke services we examined the volume, characteristics and prognosis of patients according to the mode of presentation to local services. Study design and settin...

  17. Factors associated with involuntary admissions among patients with substance use disorders and comorbidity: a cross-sectional study

    OpenAIRE

    Opsal, Anne; Kristensen, Øistein; Larsen, Tor K.; Syversen, Gro; Rudshaug, Bakke E A; Gerdner, Arne; Clausen, Thomas

    2013-01-01

    Background To investigate factors associated with involuntary admissions to hospital pursuant to a social services act of patients with substance use disorder by comparing the socio-demographic characteristics, substance use, and psychiatric comorbidities with voluntarily admitted patients. Methods This cross-sectional study compared two groups admitted to combined substance use disorder and psychiatr...

  18. Patient referral patterns and the spread of hospital-acquired infections through national health care networks.

    OpenAIRE

    Tjibbe Donker; Jacco Wallinga; Hajo Grundmann

    2010-01-01

    Rates of hospital-acquired infections, such as methicillin-resistant Staphylococcus aureus (MRSA), are increasingly used as quality indicators for hospital hygiene. Alternatively, these rates may vary between hospitals, because hospitals differ in admission and referral of potentially colonized patients. We assessed if different referral patterns between hospitals in health care networks can influence rates of hospital-acquired infections like MRSA. We used the Dutch medical registration of 2...

  19. Patient Referral Patterns and the Spread of Hospital-Acquired Infections through National Health Care Networks

    OpenAIRE

    Donker, Tjibbe; Wallinga, Jacco; Grundmann, Hajo

    2010-01-01

    Rates of hospital-acquired infections, such as methicillin-resistant Staphylococcus aureus (MRSA), are increasingly used as quality indicators for hospital hygiene. Alternatively, these rates may vary between hospitals, because hospitals differ in admission and referral of potentially colonized patients. We assessed if different referral patterns between hospitals in health care networks can influence rates of hospital-acquired infections like MRSA. We used the Dutch medical registration of 2...

  20. Hospital mission and cost differences.

    Science.gov (United States)

    Sorrentino, E A

    1989-01-01

    The results show no significant differences on average length of stay, cost per patient day, or cost per admission among non-profit, government, and for-profit hospitals when controlling for bed capacities, occupancy rates, number of Medicare/Medicaid days, and hospitals without nurseries. For-profit hospital manhours per patient day were significantly lower than non-profit and government hospitals. This is an important finding because patient-care delivery is labor-intensive. A majority of for-profit hospitals do not have nurseries, which means that they should have more manhours per patient day. As indicated earlier, the manhours for hospitals with nurseries are higher than those for hospitals without nurseries. This indicates cost-cutting behavior on the part of a majority of for-profit hospitals. This method of limiting expenditures by decreasing labor costs associated with certain services is consistent with profit-maximization. The findings of this study with regard to cost differences among non-profit and for-profit hospitals contradict previous research. However, a recent study by Kralewski, Gifford and Porter (1988) noted that whereas ownership, when considered alone, differentiates hospitals, when evaluated within each community, most of the investor-owned and non-for-profit hospital differences disappear. Similar questions have been raised as to whether non-profit hospitals truly differ from for-profit hospitals (Pauly 1987). Caution needs to be exercised in attempting to extrapolate the findings of this study, because of the dynamic health care environment. Hospital ownership changes over time, reimbursement rules affect behavior, and internal factors in organizational operation affect outcomes. These should be considered in future studies exploring organizational mission and cost differences. PMID:10293600