ObjectiveTo evaluate four triage methods including START, Care-Flight, rapid emergency medicinescore (REMS) and Sacco score for the length of hospital stay, length of ICU stay and the severity of injury in Lushan earthquake victims.MethodsA retrospective analysis was performed in 41 cases of critical earthquake victims in the emergency department of West China Hospital from April 20th to April 26th, 2013 in Lushan earthquake. The length of hospital stay and length of ICU stay were compared for four triage methods. The correlation between four triage methods and length of hospital stay, length of ICU stay and injury severity score (ISS) were also analyzed.ResultsThe length of ICU stay for victims whose triage level were red by START triage method or Care-Flight triage method was longer than whose triage levels were yellow. But the length of hospital stay for victims between the two triage levels had no significant difference. In addition, there was a correlation between critical victims and the length of ICU stay in the classification of START triage method and Care-Flight triage method.ConclusionThe length of ICU stay of the victims, whose triage level are red by START triage or Care-Flight triage methods, are longer than whose triage level are yellow. The levels of START and Care-Flight triage are correlated to length of ICU stay.
Objective To analyze the risk factors associated with prolonged length of hospital stay (PLOS) after lobectomy for lung cancer patients. Methods The clinical records of 771 lung cancer patients undergoing lobectomy between May 2012 and June 2016 in the Second Affiliated Hospital of Harbin Medical University were retrospectively analyzed. According to different length of hospital stay (LOS), 771 patients were divided into two groups, a normal LOS group and a PLOS group. In the normal LOS group, there were 551 patients including 234 females and 317 males with a median age of 59 years, whose LOS was shorter than 8.0 days. In the PLOS group, there were 220 patients including 72 females and 148 males with a median age of 60 years, whose LOS was no less than 8.0 days. Then, we analyzed the independent risk factors of PLOS by multivariate logistic regression analysis. Results Univariate analysis showed that risk factors for PLOS included male, arrhythmias and atrioventricular block, smaller FVC%, unilateral pneumonectomy, operation and anesthesia duration, intraoperative blood loss and number of lymph node dissection in the operation (P<0.05). Multivariate logistic regression analysis showed that the age ≥75 years (OR=4.100, 95%CI 1.677 to 10.026), unilateral pneumonectomy (OR=2.563, 95%CI 1.473 to 4.460), FVC% < 89.05% (OR=1.500, 95%CI 1.020 to 2.206), numbers of lymph node dissection≥ 13.5 (OR=1.826, 95%CI 1.262 to 2.642), operation duration≥126.5 min (OR=1.858, 95%CI 1.200 to 2.876) and arrhythmia (OR=2.944, 95%CI 1.380 to 6.284) were independent risk factors of PLOS (all P<0.05). Conclusion LOS is influenced by age, surgical type, FVC%, numbers of lymph node dissection, arrhythmia and operation duration. Careful assessment and appropriate management of risk factors are helpful to improve postoperative recovery after lobectomy for lung cancer patients.
ObjectiveTo investigate the effects of antimicrobial management program on inpatients outcomes and antimicrobial resistance among clinical isolates in a large-scaled university hospital.MethodsThe antibiotics use density (AUD) and antimicrobial resistance rate of multi-drug resistant bacteria before (from January 2009 to December 2010) and after (from January 2012 to December 2016) the intervention of antimicrobial management program in a large-scaled university hospital (4 300 beds) were calculated and compared, and the correlations of AUD with average length of hospital stay and mortality rate were analyzed.ResultsThe AUD was significantly decreased after intervention (P<0.001). The resistance rate of Staphylococcus aureus to oxacillin decreased (P<0.001). Among Gram-negative bacteria, the resistance rates to carbapenems in Acinetobacter baumannii (P<0.001) and Klebsiella pneumoniae increased (P=0.011). AUD was not correlated with the average length of hospital stay (P=0.644), while positively correlated with the in-hospital mortality rate (r=0.932, P=0.001).ConclusionsThe implementation of antimicrobial management program can significantly reduce the antimicrobial use and do not worsen patient outcomes in the hospital. The impact of the program on resistance varies significantly depending on both the bacterium and the agent, and carbapenem-non-susceptible Gram-negative bacilli emerges as a major threat. It is still necessary to combine other infection control measures.
ObjectiveTo explain in detail hospitalization process management of colorectal cancer as well as its tag and structure of Database from Colorectal Cancer (DACCA) in the West China Hospital.MethodThe article was described in the words.ResultsThe definition and setting of 8 classification items involved in the hospitalization process management from DACCA in the West China Hospital were set. The items were included the date of first out-patient meeting, admitted date, operative date, discharged date, waiting time before the admission, preoperative staying days, total hospital staying days, and manage protocol. The relevant data tag of each item and the structured way needed at the big data application stage were elaborated and the corrective precautions of classification items were described.ConclusionsBased on description about hospitalization process management from DACCA in West China Hospital, it is provided a clinical standard and guidance for analyzing of DACCA in West China Hospital in future. It also could provide enough experiences for construction of colorectal cancer database by staff from same occupation.