Factors affecting emergency department length of stay of patients admitted to telemetry and critical care units

The purpose of this study was to determine the emergency department (ED) length of stay (LOS) of patients admitted to inpatient telemetry and critical care units and to identify the factors that contribute to a prolonged ED LOS. It also examined whether there was a difference in ED LOS between clients evaluated by an ED physician, an Advanced Registered Nurse Practitioner (ARNP) or a Physician's Assistant (PA).^ A data collection tool was devised and used to record data obtained by retrospectively reviewing 110 charts of patients from this sample. The mean ED LOS was 286.75 minutes. Multiple factors were recorded as affecting the ED LOS of this sample, including: age, diagnosis, consultations, multiple radiographs, pending admission orders, nurse unable to call report/busy, relatives at bedside, observation or stabilization necessary, bed not ready and infusion in progress. No significant difference in ED LOS was noted between subjects initially evaluated by a physician, an ARNP or a PA. ^

Elder malnutrition: A meta analysis of studies using the nutrition screening initiative determine checklist

To demonstrate the extent of elder malnutrition risk in this country, a meta analysis of 30 studies that used the Nutrition Screening Initiative's "DETERMINE Your Nutritional Health Checklist" was conducted. The studies were divided into three categories: Elder Populations in Healthcare Related Systems (HS), Elder Meal Program Participants (MP), and General Community Residing Elder Population (GC). HS was sub-divided into Hospital Inpatient/Clinic Outpatient and Long Term Care/Home Care. The MP population were identified as Congregate or Home Delivered meal participants. Overall, results indicate that 63% of elders are at moderate (32%) or high (31 %) risk of malnutrition. Home Delivered Meal Participants and Hospital Inpatient/Clinic Outpatients are most likely to be at high risk of malnutrition (49.5% and 49.1%, respectively). Individuals least likely to be at high malnutrition risk are the General Community Residing Elder Population (17.5%) and Congregate Meal Participants (22.5%).

Does Obesity Affect Outcomes in Children Admitted from Trauma Centers?

Introduction and Research Objectives: Pediatric obesity has reached epidemic proportions in the United States. In the critical care setting, obesity has yet to be fully studied. We sought to evaluate the effects of obesity in children who are admitted to a hospital from trauma centers using Kid's Inpatient Database (KID) during 2009. Methods: The study examined inpatient admissions from pediatric trauma patients in 2009 using the Kids´ Inpatient Database (KID). Patients (n=27599) were selected from the KID based on Age (AGE>1) and Admission Type (ATYPE=5) and assessed on Race, Sex, Length of Stay (LOS), Number of Diagnoses and Procedures, Severity of Illness (SOI), Risk of Mortality (ROM), Co-morbidities, and Intubation by comparing obese and non-obese cohorts. Chi-square test and student t-test were used to analyze the data. All variables were weighted to get national estimates. Results: The overall prevalence of obesity (those coded as having obesity as co-morbidity) was 1.6% with significantly higher prevalence among Blacks (1.8%), Hispanics (2.3%), and Native Americans (4.1%; p<0.001). Obesity was more prevalent among females (2.4% vs 1.2%; p<.001). Overall mortality in the cohort was 4.8%. Obesity was significantly lower among children who died during hospitalization (0.5% vs 1.6%; p<0.002). However, obese children had significantly longer LOS, greater number of diagnoses, more procedures and greater than expected loss of function due to SOI when compared with nonobese cohort (p<.001). Deficiency anemia, diabetes, hypertension, liver disease, and fluid and electrolyte disorders are all strongly associated with the presence of obesity (p<.005). The rate of intubation is similar between obese and non-obese cohorts. Conclusion: Our study using KID national database found that obese children who are admitted from trauma centers have a higher morbidity and LOS but lower mortality. Racial and gender inequalities of obesity prevalence is consistent with previous reports.

Does Obesity Affect Outcomes In Children Admitted From Trauma Centers?

Introduction and Research Objectives: Pediatric obesity has reached epidemic proportions in the United States. In the critical care setting, obesity has yet to be fully studied. We sought to evaluate the effects of obesity in children who are admitted to a hospital from trauma centers using Kid's Inpatient Database (KID) during 2009. Methods: The study examined inpatient admissions from pediatric trauma patients in 2009 using the Kids´ Inpatient Database (KID). Patients (n=27599) were selected from the KID based on Age (AGE>1) and Admission Type (ATYPE=5) and assessed on Race, Sex, Length of Stay (LOS), Number of Diagnoses and Procedures, Severity of Illness (SOI), Risk of Mortality (ROM), Co-morbidities, and Intubation by comparing obese and non-obese cohorts. Chi-square test and student t-test were used to analyze the data. All variables were weighted to get national estimates. Results:The overall prevalence of obesity (those coded as having obesity as co-morbidity) was 1.6% with significantly higher prevalence among Blacks (1.8%), Hispanics (2.3%), and Native Americans (4.1%; p Conclusion: Our study using KID national database found that obese children who are admitted from trauma centers have a higher morbidity and LOS but lower mortality. Racial and gender inequalities of obesity prevalence is consistent with previous reports.