Unit Admission Research Articles

Evolution of hospital clinical pharmacy services in Finland in the period 2017–2022: the third nationwide follow-up survey

Background and objectivesPharmacists’ involvement in patient care became more common in Finnish hospitals during the period of 2011–2016. The first national survey was conducted in 2011 and repeated using the...

Prevalence of and risk factors associated with chronic opioid use after traumatic injury: A historical cohort study using the Korean National Health Insurance Service sample cohort data.

Chronic opioid use (COU) after traumatic injuries is a global health concern. COU after trauma delays recovery and increases the risk of long-term drug dependence. However, the population-prevalence and factors associated with COU after traumatic injury in South Korea remain unclear. We aimed to estimate the prevalence of COU and associated risk factors in patients after trauma in South Korea. A historical cohort study using the population-representative database including 1,103,405 South Korean subjects, patients admitted due to a newly diagnosed trauma (n = 65,444) or nontraumatic etiologies (n = 338,321) from January 1, 2003, to June 30, 2015, were analyzed. COU was defined as the prescription of opioid in the first 3 to 6 months from the index date. Prevalence of COU was summarized. A multivariable logistic regression analysis was conducted to investigate association of COU with traumatic injuries, accounting for a priori sociodemographic and clinical risk factors. A total of 13.5% and 12.6% of patients were found to be chronic opioid users in the trauma and the control group, respectively. The adjusted odds ratio (aOR) (95% CI) of COU in the injured compared to the noninjured was 1.13 (1.01 to 1.16), when controlling for age group, sex, calendar year, area of residence, previous opioid use, comorbidity, surgery during the index admission and intensive care unit care. Risk factors included being aged 65 to 74 years (aOR = 2.87; 95% CI = 2.73 to 3.01), aged ≥ 75 years (aOR = 2.48; 95% CI = 2.35 to 2.62), and history of previous opioid use (aOR = 3.27; 95% CI = 3.21 to 3.34) were the most significant risk factors of COU, independent of injury. COU was prevalent both in the injured and noninjured patients, with slightly increased risk of COU in those sustaining traumatic injury compared to those who were noninjured. Further stud y to address prevalent COU in South Korea is required to avoid opioid-related harms.

Increasing resuscitation status-related goals of care discussions for older adults with severe mental illness in a Canadian mental health setting: a retrospective study

BackgroundOlder adults with severe mental illness, including advanced dementia (AD), within geriatric admission units (GAU) often prioritise comfort care, avoiding life-prolonging procedures including cardiopulmonary resuscitation (CPR). Pre-2019, hospital policy lacked...

지방 국립대 자율전공학부 신임교수의 대학혁신과정에서의 근무경험에 대한 자문화기술지

Objectives This study is about the experience of a professor who started working as a new professor in the Department of Liberal Study at a local national university and was appointed as a new professor in the process of establishing and operating the department according to the university innovation promoted by the Ministry of Education and the university's own innovation process. Methods We explored the process of being selected and appointed as a professor in the newly established Department of Liberal Study at a local national university located in Region J. While working as a new professor in the department, which is directly related to university innovation, I sought to express in-depth my experience in adjusting admissions units, establishing new educational units, consultation processes with university members, and operating new curricula. For this purpose, the autoethnography research method, which is a research method for one's own culture, was applied. Results By conducting this study, the following five research topics were derived. ｢① Universities’ hot potato ‘Department of Liberal Study’｣, ｢② New professors at the Department of Liberal Study who lack even the basics｣, ｢③ Establishment of new educational units facing various obstacles｣, ｢④ Survival and growth, and the life of a professor moving forward with reflection｣, ｢⑤ Department of Liberal Study moving to the forefront of change and innovation｣ Conclusions Based on these research results, we described the difficulties and adaptation problems of new professors in Department of Liberal study in relation to the non-major admission system. And We discussed ways to advance toward growth and reflection in the university innovation process, which is directly related to the sustainability and survival of the department. This study is significant in that it is the first study to reveal the work experience of a new professor in the Department of Liberal Study, and suggested follow-up research in terms of research subjects and research methods.

Changing paradigm of scrub typhus infection in children: A study from a tertiary care center of Eastern India

Background: Scrub typhus, a zoonotic disease, is transmitted to humans by the bite of larval trombiculid mite. Keeping in view the morbidity and mortality associated with undiagnosed cases (due to both lack of specific diagnostic tests and ignorance about the disease), the disease deserves a special mention. Aims and Objectives: The aims and objectives of the study were to assess complications and atypical manifestations of scrub typhus fever in this subpopulation and to assess the prognosis of patients presenting with atypical manifestations/complications. Materials and Methods: This is a longitudinal observational study on the basis of clinical and laboratory evidence at Department of Pediatrics, Calcutta-National-Medical College and Hospital, Kolkata, West Bengal, from March 2021 to February 2022. Children between >28 days and <12 years with atypical manifestations of scrub typhus who were scrub immunoglobulin (Ig)M positive (Serum and/or cerebrospinal fluid) were included in the study. Results: Of the 120 scrub typhus IgM-positive patients admitted in 1 year, complications present in 35%. These patients developed encephalitis, encephalomyelitis, neurological deficits, myocarditis, disseminated intravascular coagulation, acute kidney injury, atypical pneumonia, acute respiratory distress syndrome, acute encephalitis syndrome (23.8%), myocarditis with/without heart failure (14.3%), and multi-inflammatory syndrome in children with/without severe acute respiratory syndrome coronavirus 2 IgG (14.2%). There is a statistically significant association between the duration of fever at admission and pediatric intensive care unit (PICU) admission, the longer the fever duration at admission, the higher the rate of complications and thus PICU admission. Conclusion: Scrub typhus infection has expanded its various forms, presenting in various atypical manifestations alongside the common clinical features. Multiple cases of multiorgan involvement in the form of multi-inflammatory syndrome and hemophagocytic lymphohistiocytosis have been reported in the background of COVID-19 infection, alongside a significant percentage of scrub typhus infection reported in infancy. Thus, early detection is important to start intervention.

Innovative use of elective admission unit to deliver preoperative intravenous iron infusions

Innovative use of elective admission unit to deliver preoperative intravenous iron infusions

Implementation of routine HIV testing policy in medical admissions in the sultanate of Oman: An experience from the Middle East.

To tackle the issue of late HIV diagnosis in the country, the Ministry of Health (MOH) in Oman introduced a national policy of routine opt-out HIV in medical admission units in September 2022. We hereby report the implementation and outcomes of this policy. All patients aged 16-65years admitted to a medical ward in secondary and local hospitals were offered an HIV test regardless of their symptoms by medical doctors, with training and support from HIV teams. A retrospective review for the period from September 2022 to September 2023 was conducted to determine the HIV testing rate and outcomes of those testing HIV seropositive. Over 12months, there were 23,399 admissions; 6889 had HIV tests. Thirty-two patients (0.46 %) were diagnosed with HIV; all of them were new diagnoses. Two cases were diagnosed during seroconversion. 12 cases had AIDS-defining illnesses. Four contacts were tested HIV positive. Twenty-five out of 28 alive patients are on ART. This is the first national policy of a routine opt-out HIV in medical admission units in the MENA region. Our experience showed that, even in low HIV prevalence and high HIV stigma settings, this policy is feasible, acceptable, and effective.

EP181 - The role of abdominal X-rays in the acute abdomen: a retrospective audit

Abstract Introduction Abdominal x-rays (AXR) are commonly performed as part of the diagnostic work up for acute abdomen despite wide availability of CT. Several studies dispute the role of AXR in acute abdomen, due to low accuracy, uncertain role in diagnosis & management and superiority of CT (1). There are calls to replace AXRs with CT altogether where possible, as patients often end up having CT scans, thereby receiving larger doses of radiation (2). The Royal College of Radiologists (RCR) have produced guidelines to reduce the use of AXR in the acute setting (3). The aim of this audit was to clarify if we adhere to the RCR Guidelines at our DGH. Methods 62 consecutive adult surgical patients admitted to our surgical admissions unit as emergency, between September and November 2023 were included in this retrospective audit. Data was collected regarding patient demographics, reason for request, AXR report, whether patient underwent CT, CT report and time between AXR and CT. Results 97% of AXR requests were compliant with RCR guidelines. 30/62 patients also had a CT scan following initial AXR. Of these, 13 had normal AXR and CT. 9 had normal AXR but abnormal CT. 8 had abnormal AXR which was confirmed on subsequent CT. Discussion We identified that our surgical unit has good compliance with RCR guidelines. However, nearly half of our patients also had a CT scan, in addition to AXR. Although the AXR has lower radiation dose, it may be prudent to restrict the addition of AXR, if a CT is required to assess acute abdomen. We now aim to discuss and propose change in our practice for the future.

Postoperative Respiratory Complications After Adenotonsillectomy in Children With High-Risk Obstructive Sleep Apnea.

Identify patient characteristics and polysomnogram (PSG) parameters associated with postoperative respiratory complications after adenotonsillectomy (AT) among children with high-risk obstructive sleep apnea (OSA). Case series with chart review. Tertiary care children's hospital. Pediatric patients (<18 years) with high-risk OSA (any 1 of: apnea-hypopnea index [AHI] >30, O2 nadir <80% and peak CO2 >60 mm Hg) on overnight PSG from 2019 to 2021 were included. Primary outcomes were major respiratory intervention during the postoperative admission, prolonged hospitalization, and intensive care unit (ICU) stay. A total of 307 patients met inclusion criteria. Median age was 6.5 years and 63% were male. Twenty-five (8.1%) required major respiratory intervention and 29 (9.7%) required ICU admission after AT. Major interventions and ICU admissions were significantly associated with neuromuscular disease (P < .01), higher obstructive apnea-hypopnea index (oAHI), higher CO2 peak, and lower O2 nadir. Prolonged admission had similar findings except oAHI was not significantly associated. Younger children were significant more likely to require ICU admission or prolonged admission. Increased oAHI and worsening O2 and CO2 parameters on preoperative PSG were associated with postoperative respiratory complications in children with high-risk OSA. Children with neuromuscular disease and age 0 to 2 had higher risk of ICU stay and prolonged hospitalization. Clinicians should recognize the importance of parameters beyond oAHI when anticipating postoperative monitoring.

Associations Between Readmission and Length of Stay in the Acute Admission Unit for Patients with Alcohol-Related Diagnoses-A Cohort Study.

Patients with alcohol-related diagnosis in emergency departments (ED) are at high risk of readmission. Evidence shows an association between alcohol related admissions and a wide range of diseases and disorders. Understanding the risk factors for readmission and the asso-ciation with length of stay in the ED may help identify those who would benefit from targeted interventions. Thus, the hypothesis of this study is that patients with alcohol-related diagnoses and a short length of stay in the ED have a higher risk for readmission. Therefore, this study aimed to investigate the association between length of stay in the ED and 30-day readmission for patients with alcohol-related acute admissions as well as to uncover possible risk factors for 30-day read-mission. The study used a retrospective cohort design and was carried out from March 1, 2019, to January 31, 2020. The inclusion criteria were ≥ 18 years, admitted to an ED, and having an alcohol-related primary or secondary diagnosis (based on ICD-10 codes). Patients were fol-lowed for 30 days after discharge from initial hospitalization to identify associations between length of stay and 30-day readmission. We included 1,174 patients and found that 17% (95% CI: 15-20) of the patients admitted with an alcohol-related primary or secondary diagnosis were readmitted within 30 days. The hazard ratio (HR) for readmission increased with length of stay when compared to admission ≤ 24 hr; admission > 24-48 hr HR 1.50 (95% CI: 1.08-2.08), admission > 48 hr HR 2.08 (95% CI: 1.23-3.52). The study revealed that patients with alcohol-related diagnoses were at a higher risk of ED readmission the longer they stayed in the ED. Furthermore, the risk of readmis-sion increased if patients had a medical or psychiatric diagnosis prior to admission or lived alone.

Effectiveness of nirsevimab immunoprophylaxis against respiratory syncytial virus-related outcomes in hospital and primary care settings: a retrospective cohort study in infants in Catalonia (Spain)

BackgroundIn Catalonia, infants under 6 months old were eligible to receive nirsevimab, a novel monoclonal antibody against respiratory syncytial virus (RSV). We aimed to analyse nirsevimab’s effectiveness across primary and...

2297 Impact of creation and subsequent expansion of the acute frailty team at Queen Elizabeth Hospital, Gateshead on patient outcomes

Abstract Introduction An Acute Frailty Team pilot was launched in December 2022 at the QEH. The aim was to reduce unnecessary hospital admissions and length of stay (LOS) by providing interventions in the Emergency Admissions Unit (EAU), through comprehensive geriatric assessment. Following the pilot’s success additional recruitment was made to the multi-disciplinary team (MDT) and the service revaluated. The MDT consists of a Consultant Geriatrician, Specialist Frailty Practitioner, Frailty Fellow, Physiotherapist, Technical Instructor, Occupational Therapist, and Pharmacist. Method To allow comparisons a pre-pilot control group audit of 100 patients ≥65 with a clinical frailty score &amp;gt; 5 was undertaken. This data has subsequently then been compared to a phase-1 (Consultant Geriatrician, Specialist Frailty Practitioner team) audit of 121 patients and a phase-2 (full MDT) audit of 133 patients with the same parameters. Results The creation and expansion of the acute frailty team has reduced the average length of stay from 13.8 days, pre-pilot, to 9.4 days in phase-1 and subsequently been maintained at 9.56 days during phase-2. More frail patients are now being discharged from the emergency admission unit (EAU). Pre-pilot 7% of patients were discharged from EAU, increasing to 13% during phase-1 and 18.75% phase-2. 16% of patients were originally discharged within 72 hours of admission, this increased to 20% during phase-1 and 24.81% phase-2. This is also reflected in 7-day discharge data (37%, to 39% to 44.36%). Conclusion(s) MDT expansion of the acute frailty team at the QEH has resulted in improved recognition and holistic assessment of frail patients’ needs and reduced their length of stay.

Clinical and Genomic Characteristics of Candida auris in Central Ohio: An Insight into Epidemiological Surveillance

Background: Candida auris is an emerging threat to hospitalized patients and invasive disease is associated with high mortality. This study describes clinical and microbiological characteristics of nine patients identified with C. auris at Ohio State Wexner Medical Center discovered through active surveillance or clinical investigation and uses whole genome sequencing (WGS) to compare isolates. Methods: In November 2022, an active C. auris surveillance program was implemented to screen patients admitted to high-risk units (intensive care units and progressive care units). Bilateral axilla and groin swabs were obtained upon unit admission and, if positive, were submitted for C. auris polymerase chain reaction (PCR) with culture and sensitivity testing. Patients with a positive screening or clinical isolate from November 2022 to November 2023 underwent chart review for clinical characteristics, microbiologic data, and index admission information. For each isolate, DNA was extracted and WGS was performed. Core single nucleotide polymorphism (SNP) variation identified from the sequence data was used to infer genetic relationships among the isolates. Results: Nine patients were identified between November 2022 and November 2023. The clinical and microbiologic characteristics are summarized in Table 1. All patients were hospitalized at various acute care facilities across the state at least once in the preceding 12 months. C. auris was determined to be present on admission for 6 patients. For 5 of these patients, it was their first interaction with our healthcare system. Three patients were not in contact isolation for &gt;3 days before C. auris was identified. Unit wide point-prevalence screening was completed in these cases and no evidence of transmission was found. WGS showed eight of the nine isolates were related with 28 or less core SNP differences between isolates (Figure 1). One isolate (8) was genetically distinct with &gt;45000 core SNP differences. Five isolates were highly related with a range of 4-15 SNP differences. No temporal or spatial overlap at our institution was identified among these five patients. Conclusions: The active surveillance program identified several patients colonized with C. auris in addition to those found through clinical testing. Multiple risk factors for C. auris were identified with high patient mortality (67%). Majority of the isolates were closely related without association with a known outbreak or epidemiologic link, suggesting a possible diffuse common reservoir. Next steps with surveillance in acute care and long-term care facilities will be critical for early detection to halt transmission of this organism.

Protocol for the Development and Analysis of the Oxford and Reading Cognitive Comorbidity, Frailty and Ageing Research Database-Electronic Patient Records (ORCHARD-EPR)

BackgroundHospital electronic patient records (EPRs) offer the opportunity to exploit large-scale routinely acquired data at relatively low cost and without selection. EPRs provide considerably richer data, and in real-time, than...

#3054 The hospital frailty risk score lacks service planning and decision-making utility in end stage kidney disease

Abstract Background and Aims Survival time for patients commencing dialysis is poor (median 2.0 years in our data) and treatment is invasive. While the age of patients commencing dialysis has increased significantly, the survival advantage diminishes with increasing comorbidity and frailty. The Hospital Frailty Risk Score (HFRS) is a recently-described score derived from ICD-10 codes which has been shown to correlate with outcomes in patients aged &amp;gt;75 years admitted to acute hospital settings. As part of a wider initiative to improve service planning and patient decision-making in the renal setting, we investigated the utility of the HFRS in modelling the survival time of dialysis patients with chronic kidney disease (CKD) both prior to reaching end-stage kidney disease (ESKD), and at dialysis start date. Method A secondary care dataset was obtained of all patients who attended pre-dialysis clinic at a single renal unit in the north of England between 2006–2019 (n = 2,573). Patients choosing dialysis and conservative management were included in the cohort; 1,081 eventually underwent dialysis including 329 patients who were aged ≥70 years when they commenced dialysis. 62.9% were male. Retrospective survival analysis was conducted using the HFRS prior to, and at, dialysis start date and estimates compared using the log-rank test. Results HFRS on dialysis start date was associated with survival time in patients aged ≥70 years (Low frailty Median = 2.5 years; CI = [2.1–3.0 years] vs. Intermediate frailty Median = 1.5 years; CI = [1.0–2.0 years] vs. High frailty Median = 1.3 years; CI = [0.2–2.2 years]; p = 0.005). No association was found between HFRS and survival in the same patients (aged ≥70 on dialysis start date), at any of 3 timepoints prior to dialysis: eGFR level of 20, 15, or 12 (p = 0.18, p = 0.63, p = 0.38 respectively). However, only 150/329 patients (46%) had HFRS recorded prior to eGFR level so sample size was limited. 60 patients’ HFRS had also worsened by dialysis start date (8 had improved). Additional analyses including all age groups found a weaker association between HFRS on dialysis start date and survival (Low frailty Median = 2.1 years; CI = [1.9–2.3 years] vs. Intermediate frailty Median = 1.7 years; CI = [1.5–2.0 years] vs. High frailty Median = 2.1 years; CI = [1.3–2.4 years]; p = 0.04). HFRS and survival were associated at eGFR 15 for all ages (p = 0.02) but not eGFR 20 or 12. Conclusion We identified issues with the HFRS and its implementation that present challenges to its utility for treatment decision-making or service planning in a renal setting. While the HFRS has previously been shown to be predictive of 30-day outcomes in an acute admissions unit, it performed poorly in our cohort of patients with CKD, a long-term condition where HFRS may worsen or improve between treatment choice and dialysis start. Although HFRS did predict outcome from dialysis start in patients aged ≥70 years, this is of limited use given the abundance of validated tools that predict outcome at ESKD. More work is needed to refine the HFRS for pre-ESKD decision-making in a renal setting.

Effects of a medical admission unit on in-hospital patient flow and clinical outcomes

Backgroundthe burden of acute complex patients, increasingly older and poli-pathological, accessing to Emergency Departments (ED) leads up hospital overcrowding and the outlying phenomenon. These issues highlight the need for new adequate patients’ management strategies.The aim of this study is to analyse the effects on in-hospital patient flow and clinical outcomes of a high-technology and time-limited Medical Admission Unit (MAU) run by internists. Methodsall consecutive patients admitted to MAU from Dec-2017 to Nov-2019 were included in the study. The admissions number from ED and hospitalization rate, the overall in-hospital mortality rate in medical department, the total days of hospitalization and the overall outliers bed days were compared to those from the previous two years. Results2162 patients were admitted in MAU, 2085(95.6%) from ED, 476(22.0%) were directly discharged, 88(4.1%) died and 1598(73.9%) were transferred to other wards, with a median in-MAU time of stay of 64.5 [0.2–344.2] hours. Comparing the 24 months before, despite the increase in admissions/year from ED in medical department (3842 ± 106 in Dec2015–Nov2017 vs 4062 ± 100 in Dec2017-Nov2019, p<0.001), the number of the outlier bed days has been reduced, especially in surgical department (11.46 ± 6.25% in Dec2015–Nov2017 vs 6.39 ± 3.08% in Dec2017-Nov2019, p=0.001), and mortality in medical area has dropped from 8.74 ± 0.37% to 7.29 ± 0.57%, p<0.001. Conclusionsover two years, a patient-centred and problem-oriented approach in a medical admission buffer unit run by internists has ensured a constant flow of acute patients with positive effects on clinical risk and quality of care reducing medical outliers and in-hospital mortality.

The Diagnostic Evaluation of the SINEH Cardiopulmonary Triage Scale and the Emergency Severity Index in the Emergency Department: A Comparative Study.

The diagnostic evaluation of the emergency severity index (ESI) in the triage of patients with cardiopulmonary complaints has a high sensitivity but a low specificity in the emergency department (ED). Therefore, triage scales with more accurate diagnostic evaluation are required. As a result, accuracy of the SINEH triage scale (SinTS) and the ESI was compared to compare mistriage of critically ill patients with cardiopulmonary complaints. This descriptive, analytical and cross-sectional study was conducted between December 2022 and April 2023. In this study, two nurses independently examined each patient using two triage scales. The admission unit and length of hospital stay were also recorded. The outcome was classified as high-risk admission (cardiac care unit and intensive care unit) and low-risk admission (internal unit or discharge from the ED). Undertriage and overtiage were defined as high-risk admission with triage level 3 and 4 and low-risk admission with triage level 1 or 2, respectively. A panel of experts evaluated content validity of SinTS and kappa designating agreement on relevance reported. The inter-rater reliability of two scales was also reported. Finally, the study included 145 patients. The average age of the patients studied was 61.35 years. SinTS has a total mistriage of 29.63%, with 4.13% being undertriage and 25.5% being overtriage. In ESI, the total mistriage is 66.8%, with 1.3% being undertriage and 65.5% being overtriage. The undertriage of the two scales did not differ significantly by admission unit (p=0.26), but the overtriage of the two methods did (p=0.001). The sensitivity, specificity, and accuracy of SinTS were 86.3%, 63.37%, and 72.27%, respectively, while those of ESI were 95.4%, 5.94%, and 32.79%, respectively. SINEH triage scale has achieved the optimal accuracy in recognizing the acuity of the patients with chest pain and dyspnea by using SpO2, pressure of end-tidal carbon dioxide, troponin I, and peak expiratory flow. When triaging patients with chest pain and dyspnea, SinTS may exhibit a higher level of accuracy compared to ESI. More research is needed to improve accuracy of triage scales in patient with cardiopulmonary complaints.

The Evaluation of In-Hospital Transportation of Emergency Room Critically Ill Patients

Backround/Aims:The overcrowding of emergency departments, insufficient bed capacity in these units, lack of integrated radiology units, and the distance of other departments and intensive care units from the emergency department make it inevitable to transport patients within the hospital for either short-term or long-term purposes. Patients can be transported at least once for diagnostic and treatment procedures to radiology units, operating rooms, or intensive care units for admission. However, even during short-term patient transport in critical situations, complications may arise. Methods:This study evaluates the data obtained prospectively by examining the transport information of 588 patients who met the study criteria in an eight-month period in the emergency department of a university hospital in 2020. The study is designed to assess survival, disability, and the safe transport process of critically ill patients transported from the emergency department to hospital imaging, interventional procedures, surgery, and admission units. For statistical analysis of the data, independent sample t-test was used for normally distributed variables, Mann-Whitney U test when the normality assumption was not met, chi-square, ANOVA tests for the comparison of categorical variables. The significance level for all hypothesis tests was set at 0.05. Results:Of the 588 patients included in the study, 36.9% were female and 63.1% were male, with an average age of 61.9 years. The average transport time for patients transferred for examination, admission, or interventional procedures was 18.5 minutes. 63.3% of the transferred patients sought medical attention during the night shift. During transport, 51.7% of patients experienced problems. Among the issues encountered during transport, 48.3% were related to the system, 27% were related to equipment, and 24.7% were related to human factors. The most common problem, accounting for 23.0%, was waiting in radiology units or corridors for radiology examinations and interventional procedures. Conclusion:In critically ill patients in the emergency department, the most common transport problems occur when planned examinations take place outside the emergency department. Therefore, the necessity of these requests should be carefully evaluated to reduce complications that may occur during transfer. The physical organization of emergency departments should be designed to facilitate the transfer of critical patients as quickly as possible to prevent problems that arise due to prolonged transfer times.

Design Of A Decision Support System For The Graduation Of New Student Candidates Based On MVC

The selection process for new students in the field of education is crucial and warrants careful consideration. IT Telkom Purwokerto has a dedicated division, the Admission Unit, responsible for the selection of new students. However, this process often encounters errors, such as miscalculations in the average scores of three subjects, discrepancies between new student data and graduation guideline data, and prolonged simulation processes for graduation. This study proposes a solution to these issues through the implementation of an MVC-based Decision Support System (DSS) for determining the eligibility of new student admissions. The Prototype methodology was chosen to develop an MVC-based system as a resolution to these issues. The criteria used in this research to determine new student admissions involve various factors, including the chosen high school major, interest in the offered majors, average mathematics scores, and the average scores of three main subjects: mathematics, Bahasa Indonesia, and English. The outcomes of this research include the development of an MVC-based decision support system that aims to determine the admission status of new students. It is anticipated that the implementation of this decision support system based MVC will not only aid relevant personnel in the admission decision process but also mitigate potential issues that may arise. The research contributes to the enhancement of the efficiency and accuracy of the new student selection process at IT Telkom Purwokerto.

Statin use and clinical outcomes in hospitalized COVID-19 patients: A retrospective analysis in Riyadh, Saudi Arabia.

To investigate the relationship between statin use and coronavirus disease-19 (COVID-19) severity. This was a retrospective study of adult patients with confirmed COVID-19 who were hospitalized at Prince Mohammed Bin Abdulaziz Hospital, Riyadh, Saudi Arabia. The study was carried out from July - September 2020. Antecedent statin use was evaluated using medication information available in the electronic medical records. In this retrospective study, we collected data from 689 patients hospitalized with COVID-19. Among the patients, 56.2% of them were non-Saudi and 67.3% were males. The mean age of the patients was 53.7 years. The most common comorbidities among patients with COVID-19 at admission were hypertension (65.2%) and diabetes mellitus (65%). Among these patients, 155 (22.5%) patients received statins during hospitalization and 79.7% of them received corticosteroids. Receiving statins significantly increased the risk of intensive care unit's admission by 1.64 times, intubation by 1.76 times, developing complications by 2.48 times, and mortality by 3.16 times. Statins are associated with a higher risk of mortality and morbidity among patients hospitalized for COVID-19.