Length of hospital stay and postdischarge mortality in patients with pulmonary embolism: a statewide perspective

Details

Serval ID
serval:BIB_1DF0A7C4A0EB
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Length of hospital stay and postdischarge mortality in patients with pulmonary embolism: a statewide perspective
Journal
Archives of Internal Medicine
Author(s)
Aujesky D., Stone R. A., Kim S., Crick E. J., Fine M. J.
ISSN
0003-9926
Publication state
Published
Issued date
2008
Peer-reviewed
Oui
Volume
168
Number
7
Pages
706-712
Language
english
Abstract
BACKGROUND: The optimal length of stay (LOS) for patients with pulmonary embolism (PE) is unknown. Although reducing LOS is likely to save costs, the effects on patient safety are unclear. We sought to identify patient and hospital factors associated with LOS and assess whether LOS was associated with postdischarge mortality. METHODS: We evaluated patients discharged with a primary diagnosis of PE from 186 acute care hospitals in Pennsylvania (January 2000 through November 2002). We used discrete survival models to examine the association between (1) patient and hospital factors and the time to discharge and (2) LOS and postdischarge mortality within 30 days of presentation, adjusting for patient and hospital factors. RESULTS: Among 15 531 patient discharges with PE, the median LOS was 6 days, and postdischarge mortality rate was 3.3%. In multivariate analysis, patients from Philadelphia were less likely to be discharged on a given day (odds ratio [OR], 0.82; 95% confidence interval [CI], 0.73-0.93), as were black patients (OR, 0.88; 95% CI, 0.82-0.94).The odds of discharge decreased notably with greater patient severity of illness and in patients without private health insurance. Adjusted postdischarge mortality was significantly higher for patients with an LOS of 4 days or less (OR, 1.55; 95% CI, 1.21-2.00) relative to those with an LOS of 5 to 6 days. CONCLUSIONS: Several hospital and patient factors were independently associated with LOS. Patients with a very short LOS had greater postdischarge mortality relative to patients with a typical LOS, suggesting that physicians may inappropriately select patients with PE for early discharge who are at increased risk of complications
Keywords
Aged , analysis , complications , diagnosis , Female , Humans , Length of Stay , Male , methods , mortality , Multivariate Analysis , Odds Ratio , Patient Discharge , Patients , Physicians , Pulmonary Embolism , Risk , standards , statistics & numerical data , Survival , Switzerland
Pubmed
Web of science
Open Access
Yes
Create date
29/01/2009 22:13
Last modification date
20/08/2019 12:54
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