Introduction: Endoscopic trans-sphenoidal surgeries are mainly the procedure of choice in pituitary adenomas with favorable results and varied outcomes arise from these techniques. The study aims to report the postoperative complications, and if these complications may have an impact on hospital stay. Methods: This is a retrospective cross-sectional study. 47 patients were involved ages 19 years old and above who had trans-sphenoidal surgery (TSS) from January 2011 to December 2016. Data collected were focused on preoperative diagnosis and post-operative complications (prolonged intubation, post-operative vomiting, CSF leak, post-operative bleeding, adrenal insufficiency, diabetes insipidus, electrolyte imbalance). Chi-square and independent T-tests were used in this study. Results: Most of the cases reported were nonfunctioning pituitary macroadenoma, prolactinoma and acromegaly. The study showed that the average length of stay of a patient who had undergone TSS is about seven days. Mean age of patients was 47 years old and 59% are males. The five most common complications while at hospital stay were headache (46%), throat irritation (38%), electrolyte imbalance (27%), SIRS (25%), and diabetes insipidus (10%). No sufficient evidence was appreciated with these complications comparing to the length of hospital stay. Conclusion Headache is the most common complication of post TSS. Comparing post-operative complications, it did not dictate the length of hospital stay.
Length of Stay

Introduction: Mobility in the Philippines has increasingly become a major issue especially with the growing economy of the country. Collisions on the road cannot be entirely avoided; thus, we focus our efforts to reducing road crashes that result in death and serious injuries. To do this, we analyzed road crash patients brought to the Philippine General Hospital (PGH). Objective: The study aimed to quantify how crash factors affect length of hospital stay (LOS) of patients brought to PGH, as well as to look for associations between the LOS and demographic and clinical variables. Methods: This is a retrospective study using database of patients admitted in PGH from 2008 to 2017. The study focused on LOS, which was used as the dependent variable for Poisson regression and Kruskal-Wallis H tests. The determinants considered in the study are socio-demographic variables such as age, sex, civil status, victim type, vehicle type, patient classification, and region of incidence, as well as clinical variables such as consult type, outcome of the patient, body parts injured, Glasgow coma score (GCS), among others. Results: We analyzed data of 4979 road crash patients from the PGH database. We found that civil status, age, patient classification, vehicle type, and province were associated with LOS. For the clinical variables, consult type, primary service, outcome of patient, body injuries, GCS and systolic blood pressure were found significant. Poisson regression suggests longer hospital stay for patients with injuries sustained in the head and neck (RR = 1.102, p < 0.001), face (RR = 1.218, p < 0.001), and extremity (RR = 1.673, p < 0.001). Conclusion Results show that injury sustained in certain parts of the body such as head and neck, face, and extremity significantly affect LOS. Results also show that subgroups within demographic variables affect LOS. There is a need to address the ever-increasing number of road crash patients and implications to length of hospitalization.
Length of Stay

PURPOSE: We wanted to evaluate the actual work patterns of residents and nurses and the effects of controlling visits by relatives on the mortality of patients and their length of stay and on the workload of the residents and nurses. METHODS: We investigated the actual workload of the residents who worked 12 hours shifts and nurses who worked 8 hours shifts in an emergency center for two weeks. We compared the mortality of the patients, the length of their stay and the work patterns between before we controlled visits by relatives and after we controlled visits by relatives. RESULTS: On the average, residents spent 407.01 minutes (56.5%) taking care of patients for a shift (720 min.) and nurses spent 305.29 minutes (63.6%) taking care of patients for a shift (480 min.). Although we controlled visits by relatives, we're unable to reduce the patient mortality and the length of their stay. Yet we were able to reduce the unnecessary repeated explanation-time, the resting time and the nurses and residents were able to better concentrate to explain to patients or their relatives. We were also able to increase the treatment time and description time, and especially for residents. Nurses spent 71.86 minutes (15.0%) to take a rest a shift, and residents spent 166.40 minutes (23.1%) resting a shift (p=0.01). CONCLUSION: To reduce unnecessary repeated explanation-time and the resting time and to allow nurses and residents to better concentrate when explaining to patients or their relatives, and also to increase the treatment and description time, controlling relatives in an emergency center is necessary.
Emergencies ; Humans ; Length of Stay

PURPOSE: The aim of this study was to improve overcrowding in an emergency department with the six sigma process. The authors evaluated possible factors that might delay patients' length of stay and suggest possible means for improvement. METHODS: We measured time spent in each step of emergency clinic care and investigated possible reasons for delay. The time spent in each step was measured again after change were made to address possible causes of delay. The difference in time between before and after the change were analyzed. RESULTS: According to the steps of 'measure' and 'analyze' in six sigma, greatest delays occurred in obtaining laboratory test results and explaining overall status to patients. After practicing an improvement plan, total time spent in the emergency department decreased from 467 minutes to 364 minutes (p=0.000), and the six sigma level increased from 1.145 to 1.450. Defects per million opportunities (DPMO) decreased from 638,554 to 520,095. CONCLUSION: Through six sigma improvement, the length of stay in an emergency department can be reduced. This can not only bring more satisfaction to patients, but it can also improve overcrowding of emergency department clinics through increased hospital bed turnover.
Emergencies ; Humans ; Length of Stay

Objective: Prolonged nasopharyngeal carriage of SARS-CoV-2 has been linked to prolonged hospital stay and delayed radiologic recovery. To determine if clinical risk factors are associated with prolonged nasopharyngeal carriage or longer hospital stay, we performed a descriptive analysis of 169 moderate to severe COVID-19 patients admitted at the Philippine General Hospital from March to June 2020. Methods: Length of nasopharyngeal RT-PCR positivity and clinical demographic data were extracted from existing patient records. Chi-square test, Mann-Whitney U test, and regression analysis were performed to describe the association of clinical risk factors with prolonged nasopharyngeal carriage and length of hospital stay. Results: The median duration of carriage was 19 days (IQR 12.0-30.0 days). No comorbidities or inflammatory markers had a statistically significant association with prolonged nasopharyngeal carriage defined as >24 days of nasopharyngeal RT-PCR positivity. Characteristics associated with a statistically significant longer hospital stay included chronic kidney disease stages 3-5, severe disease, and use of empiric antibiotics on admission. Prolonged carriage >24 days, hsCRP, and D-dimer at admission, also had a statistically significant but weak correlation with length of stay. Conclusion Among patients with moderate disease, comorbidities and inflammatory markers were not associated with prolonged COVID-19 nasopharyngeal carriage. Prolonged nasopharyngeal carriage >24 days was associated with longer hospital stay, while D-dimer and hsCRP levels at admission, also had statistically significant but small effects on increasing the hospital length of stay
COVID-19 ; Length of Stay

Objectives: This study aimed to examine schizophrenic patient related factors- demographic, psychopathology, social function & premorbid social functioning - that would predict length of hospital stay and determine their relationship. Methodology: One hundred eighty four charts of schizophrenic patients admitted to Ward 7 of UP PGH from 2001- 2004 were reviewed. Data collected were the patient's demographic characteristics, psychopathology, premorbid social functioning and economic support system. Univariate and multivariate analyses were made to identify factors associated with length of hospital stay. Results: Of the 184 charts reviewed, 42 (23%) had a short hospital stay of 1- 14 hospital days while 142 ( 77%) were considered as having a long hospital stay i.e. more than 14 hospital days. Univariate analysis with p< 0.05 revealed that the number of IM medications and number of psychopharmacologic medications had a significant relationship with length of hospital stay. At a p value < 0.20, two additional predictors were identified: absence of heterosexual relationship and age of onset of illness. Multivariate analysis of these four factors revealed that age of onset of illness and number of psychopharmacologic interventions were patient related factors that predicted length of hospital stay. Conclusion Knowledge concerning patient related factors such as number of medications and age of onset were significant in predicting length of hospitalization for schizophrenic patients, which would be of help in formulating admissions and in patient policies for the hospital.
Length of Stay ; Demography

Objective: Prolonged nasopharyngeal carriage of SARS-CoV-2 has been linked to prolonged hospital stay and delayed radiologic recovery. To determine if clinical risk factors are associated with prolonged nasopharyngeal carriage or longer hospital stay, we performed a descriptive analysis of 169 moderate to severe COVID-19 patients admitted at the Philippine General Hospital from March to June 2020. Methods: Length of nasopharyngeal RT-PCR positivity and clinical demographic data were extracted from existing patient records. Chi-square test, Mann-Whitney U test, and regression analysis were performed to describe the association of clinical risk factors with prolonged nasopharyngeal carriage and length of hospital stay. Results: The median duration of carriage was 19 days (IQR 12.0-30.0 days). No comorbidities or inflammatory markers had a statistically significant association with prolonged nasopharyngeal carriage defined as >24 days of nasopharyngeal RT-PCR positivity. Characteristics associated with a statistically significant longer hospital stay included chronic kidney disease stages 3-5, severe disease, and use of empiric antibiotics on admission. Prolonged carriage >24 days, hsCRP, and D-dimer at admission, also had a statistically significant but weak correlation with length of stay. Conclusion Among patients with moderate disease, comorbidities and inflammatory markers were not associated with prolonged COVID-19 nasopharyngeal carriage. Prolonged nasopharyngeal carriage >24 days was associated with longer hospital stay, while D-dimer and hsCRP levels at admission, also had statistically significant but small effects on increasing the hospital length of stay.
COVID-19 ; Length of Stay

The objective of this article was to review the published scientific literature pertaining to robotic surgery and its applications in gynecologic malignancies and to summarize the impact of robotic surgery on the field of gynecologic oncology. Summarizing data from different gynecologic disease-sites, robotic-assisted surgery is safe, feasible, and demonstrates equivalent histopathologic and oncologic outcomes. In general, benefits to robotic surgery include decreased blood loss, fewer perioperative complications and decreased length of hospital stay. Disadvantages include accessibility to robot surgical systems, decreased haptic sensation and fixed cost as well as cost of disposable equipment. As robotic surgery becomes readily available it will be imperative to develop standardized training modalities. Further research is needed to validate the role of robotic surgery in the treatment of gynecologic malignancies.
Disposable Equipment ; Length of Stay ; Sensation

BACKGROUND: Increasing demand and complex procedures may associate with the length of stay (LOS) in the Emergency Department (ED). Prolonged LOS may decrease the quality of ED care and increase patient harm. Therefore, it is pivotal to analyze factors that may contribute to ED LOS. OBJECTIVE: This review aimed to identify and discuss factors that contribute to the Emergency Department length of stay (ED LOS) to improve the quality of care. METHODS: Relevant healthcare databases including PubMed and CINAHL were searched using the combinations of search terms: length of stay, length of visit, emergency department, emergency room, and patient flow. Inclusion criteria included publications between 2007-2017. RESULTS: A total of 24 relevant papers was selected. The literature indicates that three main factors are associated with ED LOS: input (older patients and acuity level), throughput (diagnostic tests and or radiology, specialist consultation), and output (need for admission and boarding time). CONCLUSION: Input, throughput, and output factors are contributed to ED LOS. Further review is necessary to determine organizational factors that may contribute ED LOS including the number of health staff, staff workload, flow studies, and health system.
Length of Stay ; Emergency Service, Hospital

There are a lot of advantages to laparoscopic surgery, including early recovery, less postoperative pain, better cosmesis, shorter hospital stay and an early return to normal activities because of its minimal invasiveness. So, most surgeons have agreed on these points and have accepted the various indications for laparoscopic surgery. Despite these advantages and the recent advances in laparoscopic surgery, there are few cases using the laparoscopic approach for treating retroperitoneal schwannomas. Laparoscopic resection of a large retroperitoneal schwannoma has some difficulties for tumor retraction, dissecting around the large vessels, and removal of the resected tumor. Sometimes these difficulties may cause complications and a lengthened hospital stay. However, if appropriate methods are used, long hospital stay and complication can be prevented while maintaining the advantages of laparoscopic surgery.
Laparoscopy ; Length of Stay ; Neurilemmoma ; Pain, Postoperative