Hospital Stay Research Articles

Routine use of ultrasound-assisted catheter-directed thrombolysis for the management of intermediate-high risk pulmonary embolism: a service evaluation project

Abstract Background Intermediate-high risk Pulmonary Embolism (PE) has considerable morbidity. Conservative management could be sub-optimal. Ultrasound-Assisted Catheter-Directed Thrombolysis (UACDT) is used in our centre for the routine management of this presentation. Purpose We assessed the procedure safety and short-term outcomes by reviewing locally performed procedures. Methods This is an observational retrospective cohort study, with a historic control group. Our centre is a District General Hospital (DGH) in the United Kingdom, and we receive referrals from local acute hospitals. Since the introduction of this service in June 2018 until November 2023, 129 patients (2 patients/month) received routine management with UACDT for intermediate-high risk PE. The controls are 75 acute PE patients of comparable risk classes, managed from January to December 2016. We assessed procedural and in-hospital outcomes including minor, major bleeding/complications and death. We also assessed Length of Stay (LoS) in hospital, recurrent Venous Thrombo-Embolism (VTE) and re-admission rates for recurrent PE at 30 days. Reduction of oxygen requirements and improved estimated systolic Pulmonary Artery Pressure (sPAP) post-procedure were assessed as surrogate measures. Continuous variables were analysed with a Mann-Whitney U test, and categorical variables with a Chi-square Test. Results Baseline demographics are listed in Table 1. Mean duration between CT Pulmonary Angiography (CTPA) and the UACDT procedure was 1.6 (±SD 1.4) days, including inter-hospital transfer. Only 6% (8/129) of UACDT cohort received ≤12 mg standard alteplase dose. In the control group, 4% (3/75) of patients received standard 100mg systemic thrombolysis. There was no significant difference in the rates of minor (p= 0.9), major bleeding/complications (p= 0.8), or death (p= 1.0) between both groups. There was also no significant difference in rates of recurrent VTE (p= 1.0) or re-admission within 30 days for PE (p=0.1) (Table 2). LoS in hospital data were ratified, to exclude inappropriate delays (e.g. physiotherapy requirements, etc). We used the date when the patient was declared medically fit for discharge, and no significant difference was noted (p= 0.2). This was confirmed with a regression analysis of UACDT treatment effect (p= 0.9, CI= -3.5 to 3.1). Nonetheless, there was a 25% reduction of median LoS in hospital from 8 days in the controls to 6 days with UACDT. The proportion of patients requiring O2 was also reduced from 69% (89/129) to 41% (54/129) on day 1 post-procedure. A significant reduction of the estimated sPAP by TTE post-procedure was detected by a mean of 10.4 (±SD 13.9) mmHg (p= <0.01). Conclusion UACDT is generally safe with low complications rate. Compared to the control group, there was a reduction in absolute deaths and median LoS in hospital. This can be secondary to the significant acute reduction of systolic pulmonary artery pressure identified.

Mindfulness Meditation Reduces Stress and Hospital Stay in Gastrointestinal Tumor Patients During Perioperative Period

Mindfulness Meditation Reduces Stress and Hospital Stay in Gastrointestinal Tumor Patients During Perioperative Period

Prolonged Hospital Stays in Continuous Ambulatory Peritoneal Dialysis (CAPD) Patients: The Role of Comorbid Conditions

Background: Continuous ambulatory peritoneal dialysis (CAPD) is a widely used treatment for end-stage renal disease (ESRD), but it is associated with frequent hospitalizations that can significantly impact patients' quality of life and increase healthcare costs. This study aimed to investigate the influence of comorbid conditions on the length of hospital stay (LOS) in CAPD patients. Methods: A retrospective cohort study was conducted on CAPD patients admitted to Dr. Kariadi General Hospital Semarang between January 1st, 2023, and December 31st, 2023. Data on demographics, comorbidities, and LOS were extracted from medical records. The Charlson Comorbidity Index (CCI) was used to assess comorbidity burden. Multivariable linear regression analysis was performed to identify predictors of prolonged LOS, defined as exceeding the median LOS. Results: The study included 52 CAPD patients with a median LOS of 18 days (range: 1-72 days). Patients with comorbidities had a significantly longer LOS compared to those without comorbidities (20.25 ± 12.88 days vs. 12.50 ± 3.63 days, p = 0.045). The presence of comorbidities was significantly associated with prolonged LOS (odds ratio [OR] 2.87, 95% confidence interval [CI] 1.15-7.16, p = 0.023), as were older age (OR 1.05, 95% CI 1.01-1.09, p = 0.012) and peritonitis as the primary reason for hospitalization (OR 3.54, 95% CI 1.38-9.08, p = 0.008). Conclusion: Comorbid conditions are significant contributors to prolonged hospital stays in CAPD patients. These findings underscore the importance of effectively managing comorbidities in this population to optimize healthcare resource utilization and improve patient outcomes.

Machine Learning Model for Predicting Risk Factors of Prolonged Length of Hospital Stay in Patients with Aortic Dissection: a Retrospective Clinical Study.

The length of hospital stay (LOS) is crucial for assessing medical service quality. This study aimed to develop machine learning models for predicting risk factors of prolonged LOS in patients with aortic dissection (AD). The data of 516 AD patients were obtained from the hospital's medical system, with 111 patients in the prolonged LOS (> 30days) group based on three quarters of the LOS in the entire cohort. Given the screened variables and prediction models, the XGBoost model demonstrated superior predictive performance in identifying prolonged LOS, due to the highest area under the receiver operating characteristic curve, sensitivity, and F1-score in both subsets. The SHapley Additive exPlanation analysis indicated that high density lipoprotein cholesterol, alanine transaminase, systolic blood pressure, percentage of lymphocyte, and operation time were the top five risk factors associated with prolonged LOS. These findings have a guiding value for the clinical management of patients with AD.

6616 Copeptin Use To Reduce Hospital Stay In A Complicated DI Case

Abstract Disclosure: S.S. Kowsika: None. H. Moran: None. Introduction: While there is literature describing the use of copeptin for the diagnosis of polyuria-polydipsia syndrome, its utilization remains very limited in many hospitals. We present a case where the patient, initially misdiagnosed with central diabetes insipidus (DI), was appropriately diagnosed with partial nephrogenic DI through the use of copeptin. Case: A 48-year old female with a history of cardiac arrest, anoxic brain injury and diabetes insidious (DI) presented to the emergency department with hypernatremia (Na 154 mmol/L). The patient had been initiated on desmopresin (DDAVP) at an outside facility prior to her current admission. Despite receiving high doses of DDAVP, her sodium levels remained elevated, prompting further investigation. DDAVP administration was discontinued. A water deprivation test was subsequently performed, followed by IV administration of 2 mcg of DDAVP, which resulted in an increase in urine osmolality from 191 to 331 mosm/kg, which was less than the expected 50% increase observed in central DI. Additionally, a baseline copeptin level was obtained and noted to be 31 pmol/L, confirming the diagnosis of partial nephrogenic DI. The patient was started on Amiloride, leading to normalization of sodium levels. Discussion: Many patients with polyuria-polydipsia syndrome are frequently misdiagnosed and receive incorrect treatment, potentially worsening their clinical condition. Copeptin (Carboxy-Terminal-Pro-vasopressin) is the C-terminal peptide of pro-vasopressin, co-secreted with arginine vasopressin (AVP). It has been proposed as a direct test for diagnosing polyuria-polydipsia syndrome. Baseline Copeptin testing without stimulation can accurately diagnose nephrogenic DI if elevated (>21.4, pmol/L). To differentiate between central DI and chronic polyuria, prior thirsting with hypertonic saline or glucagon stimulation is necessary, with stimulated copeptin <4.9 pmol/L diagnosing central DI. Despite its diagnostic potential, Copeptin is underutilized in many settings. In this case, using Copeptin to accurately diagnose our patient led to appropriate treatment and the resolution of hypernatremia. Presentation: 6/1/2024

Redefining Surgical Boundaries for Obese Patients? Full Endoscopic Lumbar Discectomy Proves Equally Effective With Shorter Hospital Stay in Obese Patients.

This cohort study aims to evaluate the impact of obesity on the outcomes of full endoscopic lumbar discectomy (FELD) in patients with lumbar disc herniation. We conducted a retrospective analysis of 156 adult patients who underwent FELD for lumbar disc herniation from January 2015 to February 2023. Patients were divided into 3 groups: obese endoscopic (n = 71), obese open surgery (n = 31), and nonobese endoscopic (n = 54). Clinical outcomes were assessed using the visual analog scale for leg and back pain, the Oswestry Disability Index, and patient satisfaction rates. Operative time, hospital stay duration, and complication rates were also analyzed. No significant differences were observed in patient-reported outcome measures, operative time, or complication rates between obese and nonobese patients undergoing FELD. The mean operative time was longer in the endoscopic group compared with the open surgery group (70.2 vs 59.8 minutes), but the hospital stay was significantly shorter for endoscopic patients (1.7 vs 2.4 nights, P = 0.0006). Both obese and nonobese groups showed significant improvements in visual analog scale and Oswestry Disability Index scores at the final follow-up, with satisfaction rates of 85.7% in the endoscopic group reporting good to excellent outcomes. FELD is a viable and effective alternative to traditional open surgery for obese patients, offering comparable clinical outcomes and the added benefit of a shorter hospital stay. These findings suggest that obesity does not inherently affect surgical outcomes, underscoring the need for further research with larger sample sizes and longer follow-up periods. FELD offers a viable and effective surgical option for obese patients, with outcomes comparable to traditional surgery but with the added benefit of shorter hospital stays.

Clinical and Nutritional Variables Associated with Hospital Stay Days in Older Adults with CKD

Clinical and Nutritional Variables Associated with Hospital Stay Days in Older Adults with CKD

Development and validation of a risk prediction model for acute care use among patients with advanced cancer on clinical trials.

277 Background: Patients with advanced cancer on clinical trials are at high risk for unplanned Emergency Room visits (ER_visits) and hospital stays (HS). Identifying patients at highest risk could inform personalized intervention strategies. Methods: The data were from the SWOG Cancer Research Network. Medicare claims data were linked to data from advanced cancer clinical trials. The occurrence of any HS or ER visit within 1 year after enrollment was the primary endpoint. Patients must have had 6 months of continuous Medicare claims prior to registration to determine comorbid conditions prior to treatment, and 12 months of claims after registration (or until death) to detect outcomes. We examined 23 sociodemographic (age, sex, race, ethnicity, insurance status), geographic (rural or urban, area-level deprivation), clinical (disease severity, performance status), treatment (line of therapy, therapy type), and individual comorbidity factors to establish a predictive risk model. Model derivation was conducted in a 60% random sample and tested in the remaining 40%. Best subset selection with logistic regression was used with iterative application of 3-, 4-, and 5-fold cross validation repeated 10 times. Results: Among N=1397 total patients from 6 trials (lung, 3; prostate, 2; pancreas, 1), 33.9% were 75+ years, 20.3% were female, and 8.2% were Black. The overall proportion of patients with ≥1 HS/ER visit was 68.8%. In the training set (n=839), a best 5-variable risk was identified with adverse risk factors including cancer type (prostate vs other), performance status (PS; 0 vs. >=1), coronary artery disease (CAD; yes vs. no), hypertension (yes vs. no), and liver disease (yes vs. no). As cancer type was a study-level variable, we derived a risk model using PS, CAD, hypertension, and liver disease and adjusted for cancer type. There were no differences in adverse risk between those in with and without prostate cancer (interaction p-value=.44), justifying combining across cancer types. In the training set, patients with ≥2 risk factors (high risk; n=303, 36.1%) vs. 0/1 risk factor (low risk; n=536, 63.9%) had nearly a 3-fold increased odds of experiencing HS/ER visit (82.2% vs. 59.1%, OR=2.85, 95% CI, 2.01-4.03, p<.001). Results were successfully validated in the test set (OR=1.93, p=.002). In all patients, those in the highest risk quartile (3/4 factors) vs the lowest risk (0 factors) had nearly a fourfold increased odds of HS/ER visits (OR=3.92, 95% CI, 2.25-6.83, p<.001). Conclusions: Rates of HS_ER visits were high within the first year after enrolling on a trial for advanced cancer. We derived and validated a risk model that delineated strong differences in risk. With expansion of eligibility to include patients with more comorbid conditions, personalized interventions aimed at preventing acute care use could decrease the cost and improve the quality of cancer care.

Effects of preoperative respiratory muscle training for improvement of postoperative health related quality of life in mitral valve replacement patients.

A patient's defective mitral valve is replaced as part of a treatment called mitral valve replacement (MVR) with a mechanical or biological (bioprosthetic) valve. To evaluate the effects of preoperative respiratory muscle training (RMT) on the improvement of postoperative Health related quality of life in MVR patients. A quasi-experimental study was conducted at Faisalabad Institute of Cardiology. A Sample of 40 adult patients aged 25-50years of both genders who underwent MVR was selected and divided into two groups Group 1 (Respiratory Muscle Training Group) was received RMT consisting of 10-15 repetitions a day for 5days; for 3weeks. Whereas Group 2 (Conventional Group) was receive breathing exercise consisting of 10-12 repetitions a day for 5days; for 3weeks. Modified Healthy Heart Questionnaire (HHQ-GP-1) was used as screening tool. In outcome measuring tools Health Related Quality of life Questionnaire (EuroQol), New York Heart Association, was used at baseline, 3rd week and postoperatively. Duration of Postoperative Mechanical Ventilation (hours) and Hospital Stay was also noted as outcome measures of this study. Results obtained indicate that level of Self-Care in EuroQol-5-D-5L has improved in group 1 3.35±1.03 to 1.35±0.48 showing significant improvement similarly in case of Hospital Length of Stay, Mechanical ventilation 4.05±0.68 to 5.05±0.51 and Pain 65.25±8.34 to 71.50±6.70 has improved. It was concluded that Respiratory Muscle Training and Conventional Muscle Training both are effective in MVR patients. But RMT is more effective in improving self-care, reducing pain, Hospital Length of Stay and Mechanical Ventilation in postoperative period as compared to Conventional Muscle Treatment.

Road traffic injury among elderly people and its determinant factors: a cross-sectional study.

Injuries from Road Traffic Accidents (RTAs), particularly among vulnerable groups such as the elderly, are considered a significant public health concern. The aim of this study was to show epidemiology of RTIs among the elderly people in the Eastern Azerbaijan province of Iran. This cross-sectional study included all patients over 60 years old who admitted to the Shohada Hospital from 2006 to 2016. Data were extracted from the Hospital Information System. Injuries types were classified based on the International Classification of Diseases (ICD-10). Descriptive statistics (Mean, median and frequency) and inferential statistics (The Pearson Chi-square test) were used for data analysis through SPSS-24 software. A total of 3509 RTAs involving patients over 60 years old from 2006 to 2016. These traffic-related injuries comprised 15% of all recorded injuries (23,321 cases). The mean age of the patients was 69.91 ± 7.61 years, with a predominant male representation (2324 patients, 64.74%). The median Length of Stay (LOS) in hospital was 3 days. Injuries most commonly affected the knee and lower leg regions (27.5%). The most frequent types of accidents were those involving car passengers (40.47%) and pedestrians (36.33%). The majority of RTAs occurred during the summer season. There was a significant difference in the rate of RTAs based on variables such as sex, age, season, and LOS (p < 0.001). The study highlights traffic-related injuries among the elderly, mostly affecting the knee and lower leg regions, especially during the summer season. The efforts should include enhancing safety measures for car passengers and pedestrians, particularly during the high-risk summer months. Also, it emphasizes the need for public transportation to improve safety for older people due to lower accident rates and senior-friendly features.

Comparison of Hospital Stay After Open Abdominal Aortic Aneurysm Repair With or Without Enhanced Recovery Protocol

ObjectiveEnhanced recovery after surgery (ERAS) is a protocol of evidence based practices applied in major surgery. Open aortic aneurysm repair is major surgery in terms of complications and mortality. This study aimed to compare early outcomes of ERAS with a traditional post-operative protocol in patients undergoing elective open aortic surgery. MethodsThis retrospective cohort study was conducted between 2018 – 2022 in two tertiary vascular surgery centres. The ERAS program was routinely implemented in one centre, while the other one used a standard peri-operative protocol. The primary outcome was post-operative length of stay (pLOS). Secondary outcomes were 30 day mortality, complications, re-interventions, and rehospitalisations. Propensity score weighting was used to balance the two groups by comorbidities. Inverse probability of treatment weight (IPTW) was used to estimate the average treatment effect on the treated patients. ResultsA total of 198 patients were enrolled: 128 in the ERAS group (EG) and 70 in the standard group (SG). Mean age was 70.8 ± 6.7 years in EG and 71.1 ± 6.7 in SG (p = .34). No significant differences were observed in pre-operative cardiovascular risk factors. Median pLOS was 5 days (IQR 3, 6) in the EG group and 8 days (IQR 6, 11) in the SG group (p < .001). No differences in terms of mortality, re-operations, and rehospitalisations were observed. The IPTW analyses showed a 40% reduction in pLOS and a significant reduction in major complications in EG (OR 0.41, 95% CI 0.26 – 0.66; p < .001). A 45% increase in pLOS in patients with chronic obstructive pulmonary disease was found in both groups. ConclusionEnhanced recovery after surgery is safe and feasible for elective open aortic surgery, and associated with earlier hospital discharge without differences in terms of mortality and lower complication rates compared with a standard protocol. Chronic obstructive pulmonary disease is a major risk factor for an increase in pLOS. The ERAS protocol is promising in terms of resource utilisation.

TCT-285 Comparative Efficacy of Hybrid vs Traditional Cardiac Surgery: A Meta-Analysis of Survival Rates, Postoperative Complications, and Length of Hospital Stay

TCT-285 Comparative Efficacy of Hybrid vs Traditional Cardiac Surgery: A Meta-Analysis of Survival Rates, Postoperative Complications, and Length of Hospital Stay

TCT-972 Short-Term Outcomes of Transcatheter Tricuspid Valve Interventions on Post-Procedural Length of Hospital Stay, Readmission for Heart Failure, and Procedure Success If an Intracardiac Device Is Present: A Systematic Review and Meta-Analysis in a New Era of Tricuspid Interventions

TCT-972 Short-Term Outcomes of Transcatheter Tricuspid Valve Interventions on Post-Procedural Length of Hospital Stay, Readmission for Heart Failure, and Procedure Success If an Intracardiac Device Is Present: A Systematic Review and Meta-Analysis in a New Era of Tricuspid Interventions

EP.07A.14 The Postoperative Chest Tube Drainage Strategy of "Lesstube" Can Reduce Patient Pain and Shorten Hospital Stay

EP.07A.14 The Postoperative Chest Tube Drainage Strategy of "Lesstube" Can Reduce Patient Pain and Shorten Hospital Stay

Impact of Statins on Mortality and Length of Hospital Stay among Patients with AKI: A Systematic Review and Meta-Analysis

Impact of Statins on Mortality and Length of Hospital Stay among Patients with AKI: A Systematic Review and Meta-Analysis

The Five Times Sit to Stand Test as a Tool to Assess Disability and Physical Capacity after Hospitalization for COVID-19

Background: Assessment of exercise tolerance should be an integral part of the follow- up of COVID-19 survivors. Objective: We aimed in this study to investigate the correlation between the 5 Times Sit to Stand Test (5STST) and the 6-Minute Walk Test (6MWT) and to determine their place in assessing exercise tolerance and disability in COVID-19 survivors. Methods: This was a cross-sectional study that included 201 survivors of COVID-19. All patients underwent a detailed medical questionnaire, assessment of disability by the Lawton scale, and sub- -maximal exercise tolerance by 6MWT and 5STST. Our study population was divided into two groups based on the Length of Hospital Stay (LHS) (&lt;10 or ≥10 days). Results: Compared with the group with a LHS &lt; 10 days, the group with prolonged LHS (≥10 days) had a significantly greater mean value of 5STST. In contrast, the mean values of 6-minute Walk Distance (6MWD) and Minimal Oxygen Saturation (MOS) were significantly lower. A significant correlation of 5STST with Lawton score (r = -0.373; p &lt; 0.0001) and 6MWD (r = -0.563; p &lt; 0.0001) was also found. Conclusion: Our results showed that the 5STST was correlated with the 6MWD and Lawton score. Hence, it could be proposed to assess physical capacity and disability, especially in patients who had a prolonged LHS for COVID-19.

Is there a Solution to Lengthy Hospital Stays for Nursing Home Residents? Our Nursing Home Liaison Team Are Virtually There

Abstract Background Research indicates that Nursing Home residents frequently undergo transfers to acute care, leading to adverse events and functional decline (Brucksch et al., 2018). Local data from highlights the significance of this issue, with 447 admissions averaging 11.1 days in 2022 (HIPE, 2023). Hospital at Home is recognised as a cost-effective alternative for older patients (Singh et al., 2022). The proposed solution involves implementing Virtual Wards, remote telemetry, and a Nursing Home Liaison team led by a Consultant Geriatrician. This initiative targets Early Supported Discharge to reduce the hospital length of stay for Nursing Home patients. The study aimed to investigate the feasibility of using the Virtual Ward platform in this service. Methods The study aimed to investigate the feasibility of using the Virtual Ward platform, primarily utilising the Telehealth Usability Questionnaire (TUQ) (Parmanto et al., 2016). A Simulation Lab was also used to test the digital solution before its clinical implementation. Additionally, debriefing sessions were conducted to assess clinicians' perceptions of the technology and identify any potential issues. Results The TUQ scores for clinicians using a Virtual Ward for Nursing Home patients show a notably positive outcome. With an average score of 120.5 out of 147, the system received significant approval. The range of scores, from 111 to 139, demonstrates a consistent positive perception among respondents. After simulation-based training in the Simulation Lab, participants reflected on their experiences with Virtual Ward technology. They found it useful, easy to navigate and committed to future use. However, they also identified areas, such as information retrieval, needing refinement. Increased training was suggested to address these concerns. Conclusion The Virtual Ward system demonstrates significant approval. In light of these promising results, we are proceeding with the plan to launch the Virtual Wards in May 2024 to complement the existing team.

Comparative Analysis of Mean Hospital Stay in Patients Undergoing Percutaneous Nephrolithotomy (PCNL) With Versus Without Nephrostomy Tube

Background: Percutaneous nephrolithotomy (PCNL) is a minimally invasive surgical procedure for the removal of large renal calculi. The use of nephrostomy tubes postoperatively is common; however, they may increase hospital stay and patient discomfort. Tubeless PCNL has emerged as a potential alternative.Objective: To compare the mean hospital stay in patients undergoing PCNL with and without a nephrostomy tube.Methods: A prospective cohort study was conducted on 60 patients undergoing PCNL at the Armed Forces Institute of Urology, Rawalpindi, from June to December 2020. Patients were divided into two groups: Group A (PCNL with nephrostomy tube) and Group B (tubeless PCNL). Both groups were assessed for mean hospital stay, postoperative complications, and stone size using SPSS version 25. Inclusion criteria were age ≥18 years, stone size of 2-3 cm, and ASA I-II. Exclusion criteria included prior renal surgeries and comorbidities.Results: The mean hospital stay was significantly shorter in Group B (1.90 ± 0.80 days) compared to Group A (2.46 ± 0.81 days, p=0.0001).Conclusion: Tubeless PCNL significantly reduces hospital stay compared to standard PCNL.

Comparison of One-Year Post-Operative Evolution of Children Born of COVID-19-Positive Mothers vs. COVID-19-Negative Pregnancies Having Congenital Gastrointestinal Malformation and Having Received Proper Parenteral Nutrition during Their Hospital Stay.

Background: The long-term effects on neonates born of COVID-19-positive pregnancies are still unclear. Congenital gastrointestinal malformations (CGIMs) often require urgent surgical intervention and antibiotic coverage. We aim to compare the health status at one-year post-surgical follow-up of cases of CGIM born of COVID-19-positive pregnancies to those of non-COVID-19 pregnancies. Methods: We conducted a comparative, observational study of 41 patients who underwent surgery at our hospital for congenital gastrointestinal malformations in 2022. They were initially treated with antibiotics and parenteral nutrition, which was later replaced with enteral nutrition gradually after the surgery. We then analyzed the data related to their growth and development during their 12-month follow-up visit at our outpatient clinic. We classified the children born of COVID-19-positive mothers as Group 1 (n = 14) and those born of mothers without COVID-19 symptoms or with unconfirmed status as Group 2 (n = 33). Results: Forty-one patients showed up for a one-year follow-up (between 11 and 13 months of life). Hence, the final Group 1 comprised 12 and Group 2 comprised 29 children. The patients were categorized based on their anatomical location. Of the cohort, 56.09% were preemies, and 43.91% were full-term newborns. We used seven parameters to evaluate both groups based on growth and developmental milestones: verbal skills, cognitive development, weight gain, height achieved, fine motor movements, gross motor movements, and social/emotional behavior. Group 1 children showed a significant decrease in height and weight compared to Group 2 children. In Group 1, 83.33% of patients were prescribed antibiotics, while only 10.34% in Group 2 were in the same situation. There were no cases of malabsorption syndrome in Group 2, but 16.66% of patients in Group 1 had it, with patients being operated on for duodenal malformations. None of the infants had necrotizing enterocolitis, post-surgical complications, or sepsis. All the children received antibiotics to prevent infection before and after surgery. No mortality was noted. Conclusions: In our one-year follow-up study, it was seen that even after surgical correction of congenital gastrointestinal malformations, children born of COVID-19-positive pregnancies can suffer serious growth and developmental delays, and gastrointestinal health issues might be more common. Since the long-term effects of COVID-19-positive pregnancies are not yet clear, larger cohort-based studies are required in this domain. Antibiotics destroy gut microbiota, especially in cases of gastrointestinal malformations and surgical resections. Growth and developmental milestones can not only be affected by CGIMs but also be further delayed by COVID-19 infections.

Charlson Comorbidity Index can be a Predictor of Post-Operative Complications and Hospital Stay by Using Clavien-Dindo Classification of Patients Undergoing Per-Cutaneous Nephrolithotomy

Charlson Comorbidity Index can be a Predictor of Post-Operative Complications and Hospital Stay by Using Clavien-Dindo Classification of Patients Undergoing Per-Cutaneous Nephrolithotomy