Recent emphasis on cutting the costs of psychiatric care and the possibility that reimbursement for psychiatric services will one day be based on diagnosis-related groups has stimulated debate about the proper length of psychiatric hospitalization. The authors review the literature on length of stay, focusing primarily on studies of the relationship between various patient and environmental variables and length of stay and studies comparing the outcomes of long and short hospitalizations. They conclude that diagnosis alone is not an accurate predictor of length of stay but may have predictive ability when combined with other data. Most studies found no differences in the outcomes of short and long hospitalizations. The authors identify numerous avenues for further research and are optimistic that a policy governing length of stay is within reach.
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http://dx.doi.org/10.1176/ps.38.8.858 | DOI Listing |
J Intensive Med
January 2025
Department of Critical Care Medicine, The First Hospital of Jilin University, Changchun, Jilin, China.
Background: The effect of the modality of hydrocortisone administration on clinical outcomes in patients with septic shock remains uncertain. This systematic review and meta-analysis evaluate the impact of intermittent bolus and continuous infusion of hydrocortisone on these outcomes.
Methods: We searched the PubMed, Embase databases, and Cochrane Library for randomized controlled trials (RCTs) and cohort studies published from inception to January 1, 2023.
World J Gastrointest Surg
January 2025
Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Fujian Medical University, Quanzhou 362000, Fujian Province, China.
Early recurrence (ER) following surgery for rectal cancer is a significant factor impacting patient survival rates. Tsai identified age, preoperative neoadjuvant therapy, length of hospital stay, tumour location, and pathological stage as factors influencing the risk of ER. Postoperative monitoring for ER should encompass a thorough medical history review, physical examination, tumour marker testing, and imaging studies.
View Article and Find Full Text PDFWorld J Gastrointest Surg
January 2025
Department of Hepatobiliary Surgery, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha 410005, Hunan Province, China.
Background: Pancreatic cancer involving the pancreas neck and body often invades the retroperitoneal vessels, making its radical resection challenging. Multimodal treatment strategies, including neoadjuvant therapy, surgery, and postoperative adjuvant therapy, are contributing to a paradigm shift in the treatment of pancreatic cancer. This strategy is also promising in the treatment of pancreatic neck-body cancer.
View Article and Find Full Text PDFCureus
December 2024
Internal Medicine, Kütahya University of Health Sciences, Kütahya, TUR.
Objective: The mortality risk for critically ill patients in the intensive care unit (ICU) can be predicted through clinical assessments and laboratory test results. The accurate utilization of these parameters is essential for timely intervention and the initiation of appropriate therapeutic strategies. This study aims to retrospectively examine the relationship between patients' clinical status at ICU admission, prognostic risk scoring systems, biochemical and hematological parameters, and mortality outcomes.
View Article and Find Full Text PDFCureus
December 2024
Emergency Medicine, Christiana Care Health System, Newark, USA.
Introduction: Sepsis remains a prevalent critical illness encountered in emergency departments and intensive care units (ICU), with culture-negative sepsis constituting 30-60% of cases. The effect of culture type on treatment and outcomes remains unclear, and conflicting evidence exists regarding disparities between Gram-positive and Gram-negative infections.
Objective: To further describe and compare characteristics and outcomes of culture-positive versus culture-negative sepsis.
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