Main Cause Of Hospitalization Research Articles

Profile analysis of patients with HIV/AIDS hospitalized after the introduction of antiretroviral therapy.

Since the introduction of highly active antiretroviral therapy (HAART) in 1996, there have been worldwide shifts in the causes of hospitalization for patients with HIV/AIDS. The aim of this study was to describe the characteristics of HIV/AIDS patient hospitalizations between 1997 and 2012. This cross-sectional study used a hospital database that centralizes records of admissions in 31 hospitals, both public and private, across 26 municipalities in the interior of São Paulo. In order to verify associations between the variables, we used the prevalence ratio (PR) and a 95% confidence interval. Among 9,797 adults and children, 10,696 admissions were registered, which was equal to 1.09 admissions per patient. Most (62%) of the patients were male, and the predominant age group was 21 and 50 years (63.5%). Mortality was higher among male patients from all age groups (PR= 1.42 [95% CI: 1.28-1.57]; p < 0.05). The main cause of hospitalization (54.5% of the total) was infectious disease, whether opportunistic or not. This was true, even in the post-HAART era. Furthermore, gender and age differences were noted in patient mortality rates.

The influence of breastfeeding in the hospitalization of children under two years of age in the State of Pernambuco, Brazil, in 1997 and 2006

The scope of this paper was to evaluate the influence of breastfeeding and other factors on the incidence of hospitalization and the frequency and main causes of hospitalization in children under two years of age in the State of Pernambuco. It is a cross-sectional, descriptive-analytical study using secondary data obtained from the II and III State Health and Nutrition Surveys (PESN) carried out in 1997 and 2006, respectively. A sample of 1503 infants under two years of age was studied. Pearson's Chi-square test was used to analyze bivariate associations and Fisher's exact test for comparison of risk of hospitalization in the two years of observation and Poisson regression for the adjustment of the multivariate model of hospitalizations in the last survey. In the two years analyzed, there was no statistically significant difference in the percentage of hospitalizations of children. The lower risk of hospitalization remained for those who were breastfed exclusively. Regarding to environmental, socioeconomic, demographic characteristics and health assistance, several factors have evolved favorably in the period assessed. In the final model, only the weight/length ratio (low weight category) remained associated with the risk of hospitalization in children under two years of age factors.

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Objective: The chest pain is one of the most common problems in clinical medicine and is a main cause of hospitalization. Its risk factors are smoking, diabetes, uncontrolled hypertension, dyslipidemia, and others that are similar to the infarction. This study has emerged from the question: nursing consultation influence treatment adherence and clinical stabilization in patients with unstable angina?. To develop skills related to nursing care, implementing such care to the patient with Coronary Artery Disease (CAD), focusing on prevention and injury rehabilitation was the objective this study. Design and method: Case study conducted at the medical clinic women in cardiology sector of the a University Hospital in Rio de Janeiro, Brazil. Data collection was conducted by interviews, physical examination and data obtained from medical records. Case: Client 53 years old, obese, diabetic and hypertensive, with stable angina for 6 years. She reports have stopped smoking after chest pain, presents unhealthy eating habits and sedentary lifestyle. The medical records has shown that in 2011 she have had Acute Myocardial Infarction (AMI) and conducted cardiac catheterization, which found bivascular lesion in the right coronary artery and circumflex branch, Introducing occlusion of both branches. Results: After evaluation of this study was possible to understand that angina attack which led the patient to the hospital was caused by cessation of drug therapy because of related side effects. Conclusions: The nurses develops an important role as an educator. We can conclude that the nursing appointments, focused on individual empowerment can be very effective for improving treatment adherence and self-care.

Hospitalizations due to self-inflicted injuries - Brazil, 2002 to 2013.

The scope of this article is to describe hospitalizations resulting from intentionally self-inflicted injuries attended by the Unified Health System (SUS) for the 2002-2013 period. It is an observational, descriptive study of hospital admissions in the SUS arising from intentionally self-inflicted injuries in Brazil between 2002 and 2013. A decreasing trend was observed for the rate of hospitalization in individuals aged 10 and above. Hospitalizations were concentrated between 30 to 49 years of age for men, while for women it was between 20 to 29 years of age. The highest rates of hospitalization and hospital deaths were in the Southeast. The main cause of hospitalization was intentional intoxication with medication and unspecified biological substances. Studies of this type provide input for defining prevention strategies taking into consideration the most vulnerable groups and the complexity of factors associated with suicidal behavior.

Impact of Severity of the Disease on Cost of Illness and Quality of Life of Patients with Chronic Obstructive Pulmonary Disease

Objective: The objective of the study was to assess the cost of illness of COPD and the influence of severity of the disease over cost of illness and the quality of life. Materials and Methods: The study was conducted in 105 patients aged > 40 years and Results: The mean cost spent by the patients with stage II COPD was Rs.3179.62 ± 99.01 per visit to the hospital, stage III was Rs.16414.79 ± 8365.79 and stage IV was Rs.44077.16 ± 15686.21 per visit. As the severity of COPD increased both direct and indirect costs increased and the quality of life of the patient decreased significantly (P=0.000). Out of the total costs, highest was spent on direct medical costs (81.2%). Direct nonmedical costs contributed to 10.6% and indirect costs to 8%. The drivers of the total cost were found to be hospitalizations (36.2%) and length of stay. Conclusion: Since acute exacerbations are the main cause of hospitalization among COPD patients, strategies to prevent severe exacerbations could be very cost effective and may improve the quality of life. Key words: Cost of illness, COPD, Medical costs, Quality of life, Smoking cessation.

Hospitalization Events among Children and Adolescents with Sickle Cell Disease in Basra, Iraq.

Objectives. Despite improvements in the management of sickle cell disease (SCD), many patients still experience disease-related complications requiring hospitalizations. The objectives of this study were to identify causes of hospitalization among these patients and factors associated with the length of hospital stay (LOS) and readmission. Methods. Data from 160 patients (<14 years old) with SCD who were admitted to the Basra Maternity and Children's Hospital from the first of January 2012 through July 2012 were analyzed. Results. The main causes of hospitalization were acute painful crises (73.84%), infections (9.28%), acute chest syndrome (8.02%), and acute splenic sequestration crisis (6.32%). The mean LOS was 4.34 ± 2.85 days. The LOS for patients on hydroxyurea (3.41 ± 2.64 days) was shorter than that for patients who were not (4.59 ± 2.86 days), P < 0.05. The readmission rate (23.1%) was significantly higher among patients with frequent hospitalizations in the previous year (OR 9.352, 95% CI 2.011–43.49), asthma symptoms (OR 4.225, 95% CI 1.125–15.862), and opioid use (OR 6.588, 95% CI 1.104–30.336). Patients on hydroxyurea were less likely to be readmitted (OR 0.082, 95% CI 0.10–0.663). Conclusions. There is a relatively high readmission rate among patients with SCD in Basra. The use of hydroxyurea significantly decreases the LOS and readmission rate.

National trends in main causes of hospitalization: a multi-cohort register study of the finnish working-age population, 1976-2010.

BackgroundThe health transition theory argues that societal changes produce proportional changes in causes of disability and death. The aim of this study was to identify long-term changes in main causes of hospitalization in working-age population within a nation that has experienced considerable societal change.MethodologyNational trends in all-cause hospitalization and hospitalizations for the five main diagnostic categories were investigated in the data obtained from the Finnish Hospital Discharge Register. The seven-cohort sample covered the period from 1976 to 2010 and consisted of 3,769,356 randomly selected Finnish residents, each cohort representing 25% sample of population aged 18 to 64 years.Principal FindingsOver the period of 35 years, the risk of hospitalization for cardiovascular diseases and respiratory diseases decreased. Hospitalization for musculoskeletal diseases increased whereas mental and behavioral hospitalizations slightly decreased. The risk of cancer hospitalization decreased marginally in men, whereas in women an upward trend was observed.Conclusions/SignificanceA considerable health transition related to hospitalizations and a shift in the utilization of health care services of working-age men and women took place in Finland between 1976 and 2010.

Impact of Polypharmacy on Occurrence of Delirium in Elderly Emergency Patients

ObjectiveTo examine associations between polypharmacy and delirium diagnosed in elderly patients hospitalized in geriatric acute care unit after emergency hospital admission. MethodsStudy design was an observational cohort study in the acute geriatric care unit of a university hospital. We included 410 consecutive patients admitted to the acute geriatric ward during 9 months. Within 72 hours of each patient's hospitalization, a clinically trained geriatrician collected the following data: sociodemographic details (age, sex, type of residence), predisposing factors for delirium, main cause of hospitalization, and current medications. Polypharmacy was defined as 6 or more drugs a day. Delirium was assessed by a geriatrician using the Confusion Assessment Method and was diagnosed on the basis of clinical history with an acute change in usual functional status, behavioral observation, and clinical and cognitive assessment. ResultsNearly 25% of hospitalized patients had delirium. The Confusion Assessment Method was positive in 69% of patients receiving polypharmacy and in 30% of those not receiving polypharmacy, a relative risk of 2.33. The proportion of elderly patients receiving polypharmacy was 58.53%. ConclusionsIn our study, polypharmacy is an independent risk factor for delirium in a population of elderly patients after emergency admission. In the geriatric population, delirium is an underestimated scourge and because of its medicosocial and economic consequences and its impact on morbidity and mortality, we need to give increased attention to the prevention and control of polypharmacy, which is a predisposing factor for delirium.

The Important Role of Specialist Nurse in the Improvement of Patients With Diabetic Foot Ulcer: Letter to the Editor

: Diabetic Foot Ulcer (DFU) is considered as one of the main causes of hospitalization in diabetic patients, which can lead to infection, gangrene, amputation, and even death if the necessary care is not provided. Based on the recent investigations, one of the most effective tactics to manage diabetic foot ulcer is to form a multidisciplinary team including a general practitioner, a nurse, an educator, podiatrists, and some consultants. Although all team members play their own important roles in reduction of DFU and amputation incidence, the role of nurses seems to be more essential. In the developed countries, the diabetes nursing is divided into several categories which one of them is diabetic foot specialist nurse. Totally, these specialists play an effective role in prevention, care, and rehabilitation of the patients with diabetic foot ulcer. Today, the specialist nurses provide effective foot ulcer management and treatment in many countries; however, these specialists, in some developing countries such as Iran, highlight a lack of specialist training as an obstacle to effective healthcare provision. Therefore, the current study aimed to emphasize on the important role of specialist nurses in the improvement of patients with diabetic foot ulcer to encourage the authorities in order to take appropriate strategies.

Sporotrichosis: an emerging neglected opportunistic infection in HIV-infected patients in Rio de Janeiro, Brazil.

Sporotrichosis associated with zoonotic transmission remains a relevant public health problem in Rio de Janeiro, Brazil, affecting a large at-risk population, which includes HIV-infected individuals. We assessed patients co-infected by Sporothrix spp. and HIV over time in the context of an unabated sporotrichosis epidemic.A retrospective cohort retrieved information from a National reference institute for infectious diseases regarding 48 patients with sporotrichosis-HIV co-infection (group 1) as well as 3,570 patients with sporotrichosis (group 2), from 1987 through March 2013. Most patients from group 1 were male (68.8%), whereas women were predominant in group 2 (69.1%; p<0.0001). Patients from group 1 were younger than those from group 2 (μ = 38.38±10.17 vs. 46.34±15.85; p<0.001) and differed from group 2 in terms of their race/ethnic background, with 70.8% non-white patients in group 1 vs. 38.6% from group 2 (p<0.0001). Close to half (∼44%) of the patients from group 1 were hospitalized due to sporotrichosis over time, whereas hospitalization was very unlikely in group 2, among whom approximately 1% were hospitalized over time. Dissemination of sporotrichosis was the main cause of hospitalization in both groups, although it was more common among hospitalized patients from group 1 (19/21 [90.5%] vs. 16/37 [43.2%]; p<0.001). Over the period under analysis, eight patients died due to sporotrichosis (3/48 vs. 5/3,570). The diagnosis of sporotrichosis elicited HIV testing and subsequent diagnosis in 19/48 patients, whereas 23/48 patients were simultaneously diagnosed with the two infections.HIV infection aggravates sporotrichosis, with a higher incidence of severe disseminated cases and a higher number of hospitalizations and deaths. Underserved populations, among whom sporotrichosis has been propagated, have been affected by different transmissible (e.g., HIV) and non-transmissible diseases. These populations should be targeted by community development programs and entitled to integrated management and care of their superimposed burdens.

Hospitalización en lupus eritematoso sistémico: causas, evolución, complicaciones y mortalidad

BackgroundSome studies have found that the main reasons for hospital admission in systemic lupus erythematosus are either disease activity or infection. However, in our environment, and to our knowledge, the causes of hospitalization have not been studied. The aim of this study was to describe the causes of hospitalization and hospital course of patients with this disease. MethodsA descriptive, retrospective study was conducted. Hospital admissions were evaluated (January, 2006 – August, 2012) of patients with systemic lupus erythematosus over 18 years old. ResultsA total of 208 hospital admissions were evaluated. The main cause of hospitalization was disease activity (57%), followed by infection (15%). Nephritis was the leading cause of hospitalization for activity (74%), and 18% of patients experienced, at least, one nosocomial complication, with infection being the most common (64%). Thirteen of the 130 patients (10%) died during hospitalization. ConclusionsLupus activity was the leading cause of hospitalization. Infections were the main cause of nosocomial complication.

Mental health and psychiatric care in Bolivia: what do we know?

BackgroundRecently Bolivia has implemented a universal health system, but their mental health policy is still emerging.ObjectivesTo investigate the current state of the mental health care system in Bolivia and discuss challenges for structuring a coordinated network of services that can effectively meet the needs of the Bolivian population.MethodsThis review was conducted by searching for scholarly articles through the databases Lilacs, Medline OPS, HISA and IBECS REPIDISCA via the search portal in the Virtual Health Library - NLM (http://www.bireme.br).ResultsBolivia has a National Mental Health Plan that is intended to guide mental health promotion, prevention, treatment and rehabilitation of mental illness, but the resources for this area of health are limited. There are 1.06 psychiatrists and 0.46 psychologists per 100, 000 inhabitants. Information on psychiatric morbidity in Bolivia and the impact of mental disorders on the global burden of disease is scarce. Admission statistics reported by psychiatric hospitals in the country show that the main cause of hospitalization is substance abuse (30%). Alcohol consumption is responsible for 90% of these admissions, in addition to being a major cause of deaths in traffic and one of the main risk factors for domestic violence. Almost one in two women in Bolivia (47%) experienced some form of violence from their partner in the last year. Nineteen percent of women living with a partner reported being physically abused, while 7% were sexually abused by their partners. Isolated studies report that suicide rates are disproportionately high in Bolivia.ConclusionsAlthough there is a shortage of epidemiological data in Bolivia, it is clear the impact of alcohol addiction in psychiatric admissions, domestic violence and traffic accidents. Violence against women and suicides are important issues to be tackled. Among the proposed strategies to afford human resources for mental health in Bolivia, “task shifting”, the delegation of tasks to non-specialists should be extensively adopted in the country to improve mental health care.

Hypogonadism in aged hospitalized male patients: prevalence and clinical outcome

Objective Male hypogonadism is common in the elderly and has been associated with increased risk of mortality. Our objective has been to assess the prevalence of primary and central hypogonadism in elderly male patients admitted to the hospital because of acute illness. We also evaluated the relationships between gonadal dysfunction and in-hospital mortality. Patients and methods 150 patients, aged C65 years, admitted during 2010 and 2011 in our geriatric unit, were studied. Serum concentrations total, bioavailable and free testosterone, as well as of follicle-stimulating hormone and luteinizing hormone were quantified in every patient. Hypogonadism was defined by the presence of serum testosterone levels lower than 200 ng/dl. Results Hypogonadism was found in 80 patients (53.3 %). Serum gonadotropin concentrations were elevated in 43.7 % of these patients, whereas 41.3 % of hypogonadic patients showed normal and 15 % low gonadotropin concentrations. Respiratory tract infection and congestive heart failure were the main causes of hospitalization in hypogonadal men, whereas acute cerebrovascular disease was the main reason for admission in eugonadal patients. Of the 13 patients who died during hospitalization, 12 were hypogonadic. Patients who died showed significantly lower serum levels of total, free and bioavailable testosterone than those found in patients who survived. Conclusion Our results show that about half of patients admitted for acute illness have hypogonadism, mainly of non-hypergonadotropic type. Gonadal hypofunction is significantly related with in-hospital mortality. A low value of serum testosterone may be a predictor for mortality in elderly male patients.

Nosocomial Infections and Antibiotic Administration in Pediatric Department, Imam Reza Hospital, Mashhad-Iran

Introduction: Nosocomial Infections (NI) are a frequent and relevant problem, in other hands; those are responsible of mortality especially in pediatric ICU( Intensive Care Unit) and NICUs (Neonatal Intensive Care Unit). Healthcare-associated infections are important in wide-ranging concern in the medical field. The most cause of Nosocomial infection include: bloodstream infection, urinary tract infection, pneumonia, and wound infection. The purpose of this study was to determine the epidemiology of the three most common NI in the Pediatric department. Materials and Methods: We performed a prospective study in a single Pediatric department during 12 months. Children were assessed for 3 NI: wound infections, pneumonia and urinary tract infections (UTI), as the same method as Center of Disease Control criteria. All patients were followed up and individuals who had have NI and their treatment was entered in this study. Results: In this study 811 patients were hospitalized that 60% of them were male and were older than 60 months. The main causes of hospitalization include: toxicity, seizure, respiratory infection and fever. Among them 15 cases had NI (1.87%). The most NI occurred in pediatric intensive care unit (PICU) and it was followed in aspect of intubation. The most cultured organism was pseudomonas that they suspected to ceftazidime and isolate from blood and endotracheal tube. Conclusion: NI presence was associated with increased mortality and length of stay in hospital. This study highlights the importance of NIs in children admitted to a pediatric department especially PICU in a developing country. Clinical monitoring of NIs and bacterial resistance profiles are required in all pediatric units.

Dialyse- und Ultrafiltrationsverfahren bei kardio-renalem Syndrom. Empfehlung der Arbeitsgemeinschaft „Herz – Niere“ der Deutschen Gesellschaft für Kardiologie – Herz- und Kreislaufforschung e.V. und der Deutschen Gesellschaft für Nephrologie e.V.

Renal failure is common in patients with severe heart failure. This complex pathophysiological interaction has been classified as cardio-renal syndrome. In these patients hydropic decompensation is the main cause of hospitalization. In patients with refractory heart failure, characterized by diuretic resistance and congestion due to volume overload, ultrafiltration has to be considered. In acute decompensated heart failure with worsening of renal function, extracorporeal ultrafiltration is the preferred treatment modality. On the other hand, patients suffering from chronic decompensated heart failure, particularly patients with ascites, will profit from the treatment specific advantages of peritoneal ultrafiltration. Prerequisite for an optimized care of patients with cardio-renal syndrome is the close collaboration among intensive care doctors, cardiologists and nephrologists.

Hypogonadism in aged hospitalized male patients: prevalence and clinical outcome

Male hypogonadism is common in the elderly and has been associated with increased risk of mortality. Our objective has been to assess the prevalence of primary and central hypogonadism in elderly male patients admitted to the hospital because of acute illness. We also evaluated the relationships between gonadal dysfunction and in-hospital mortality. 150 patients, aged ≥65years, admitted during 2010 and 2011 in our geriatric unit, were studied. Serum concentrations total, bioavailable and free testosterone, as well as of follicle-stimulating hormone and luteinizing hormone were quantified in every patient. Hypogonadism was defined by the presence of serum testosterone levels lower than 200ng/dl. Hypogonadism was found in 80 patients (53.3%). Serum gonadotropin concentrations were elevated in 43.7% of these patients, whereas 41.3% of hypogonadic patients showed normal and 15% low gonadotropin concentrations. Respiratory tract infection and congestive heart failure were the main causes of hospitalization in hypogonadal men, whereas acute cerebrovascular disease was the main reason for admission in eugonadal patients. Of the 13 patients who died during hospitalization, 12 were hypogonadic. Patients who died showed significantly lower serum levels of total, free and bioavailable testosterone than those found in patients who survived. Our results show that about half of patients admitted for acute illness have hypogonadism, mainly of non-hypergonadotropic type. Gonadal hypofunction is significantly related with in-hospital mortality. A low value of serum testosterone may be a predictor for mortality in elderly male patients.

Epidemiologic profile of psychiatric hospitalizations in the public health system in Brazil in the period 2010-2012

Background This study aims to analyze the profile of psychiatric hospitalizations within the public health service in Brazil between the years 2010 and 2012, analyzing the main causes of hospitalization, according to the International Classification of Diseases (WHO CID.10), the profile of patient and place of residence in Brazil. This analysis is essential in order to support the planning and actions of policies public mental health. Methods Is a descriptive study on the profile of psychiatric hospitalizations within the public system …

FRI0305 Hospitalizations among danish sle patients: a prospective study on incidence, causes of admission and outcome in a population-based cohort.

BackgroundAll patients with SLE residing in the county of Funen are offered specialized care in a dedicated lupus outpatient clinic at 1-4 months intervals as needed. The pattern and frequency...

Efficacité des emplâtres de lidocaïne 5 % sur les douleurs des crises vaso-occlusives chez l’enfant drépanocytaire

Pain associated with vaso-occlusive crisis is the main cause of hospitalization in children with sickle cell disease. Recent studies have suggested that pain might have a neuropathic component. Lidocaine patches are commonly prescribed as a topical analgesic in adult neuropathic pain. This study reports the efficacy and safety of such treatment in 6 patients with sickle cell disease, aged 6-18 years, who had been hospitalized for vaso-occlusive crisis after failure of the standard analgesic treatment. These data have led to setting up a confirmatory phase II trial, which is currently underway.

Heart failure in South America.

Continued assessment of temporal trends in mortality and epidemiology of specific heart failure in South America is needed to provide a scientific basis for rational allocation of the limited health care resources, and strategies to reduce risk and predict the future burden of heart failure. The epidemiology of heart failure in South America was reviewed. Heart failure is the main cause of hospitalization based on available data from approximately 50% of the South American population. The main etiologies of heart failure are ischemic, idiopathic dilated cardiomyopathy, valvular, hypertensive and chagasic etiologies. In endemic areas, Chagas heart disease may be responsible by 41% of the HF cases. Also, heart failure presents high mortality especially in patients with Chagas etiology. Heart failure and etiologies associated with heart failure may be responsible for 6.3% of causes of deaths. Rheumatic fever is the leading cause of valvular heart disease. However, a tendency to reduction of HF mortality due to Chagas heart disease from 1985 to 2006, and reduction in mortality due to HF from 1999 to 2005 were observed in selected states in Brazil. The findings have important public health implications because the allocation of health care resources, and strategies to reduce risk of heart failure should also consider the control of neglected Chagas disease and rheumatic fever in South American countries.