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The Major Decrease in Resource Utilization in Recent Decades Seems Guided by Demographic Changes: Fast Tracking—Real Concept or Demographics

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The Major Decrease in Resource Utilization in Recent Decades Seems Guided by Demographic Changes : Fast Tracking—Real Concept or Demographics. / Bhavsar, Rajesh; Jakobsen, Carl-Johan.

In: Journal of Cardiothoracic and Vascular Anesthesia, Vol. 34, No. 6, 06.2020, p. 1476-1484.

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Bhavsar, Rajesh ; Jakobsen, Carl-Johan. / The Major Decrease in Resource Utilization in Recent Decades Seems Guided by Demographic Changes : Fast Tracking—Real Concept or Demographics. In: Journal of Cardiothoracic and Vascular Anesthesia. 2020 ; Vol. 34, No. 6. pp. 1476-1484.

Bibtex

@article{18931127dde94de7908435c412a20734,
title = "The Major Decrease in Resource Utilization in Recent Decades Seems Guided by Demographic Changes: Fast Tracking—Real Concept or Demographics",
abstract = "Objective: To identify dynamics of associations and potential areas for optimization of patient turnover between various patient profile and comorbidity indicators and selected system performance indicators such as ventilation time, length of stay in the intensive care unit, and in-hospital stay. Design: Retrospective study of prospectively registered data (2000-2017). Setting: Three university hospitals. Participants: The study comprised 38,100 adult cardiac surgical patients registered in the Western Denmark Heart Registry. Interventions: Analysis of dynamics in patient indicators and system performance indicators, including effect on the selected performance parameters. Measurements and Main Results: Comorbidity, calculated from EuroSCORE, decreased from 2.5 ± 2.2 to 1.5 ± 2.0 (p < 0.001), whereas the average age of patients increased from 65.1 ± 9.9 years to 67.6 ± 10.8 years (p < 0.001). Median ventilation time decreased from 380 to 275 minutes (p < 0.0001). The mean length of stay in the intensive care unit demonstrated a statistically significant decrease from 35.1 hours between 2000 to 2002 to 31.8 hours between 2015 to 2017 (p = 0.004), and the median time was unchanged at 22.0 hours throughout the observation period. The median in-hospital stay decreased from 6.5 to 5.1 days (p < 0.001) and the mean in-hospital stay from 8.7 days (2003-2005) to 7.0 days (2015-2017; p < 0.001). Logistic regression analysis of performance factors showed a statistically significant negative independent effect on most comorbidity and surgical factors. Conclusion: The increase in performance parameters appears to be highly associated with decreased comorbidities and fast-tracking protocols and may only offer limited effect in additional patient turnover.",
keywords = "comorbidity, hospital stay, intensive care unit, length of stay, ventilation time",
author = "Rajesh Bhavsar and Carl-Johan Jakobsen",
year = "2020",
month = jun,
doi = "10.1053/j.jvca.2019.09.034",
language = "English",
volume = "34",
pages = "1476--1484",
journal = "Journal of Cardiothoracic and Vascular Anesthesia",
issn = "1053-0770",
publisher = "W.B. Saunders Co.",
number = "6",

}

RIS

TY - JOUR

T1 - The Major Decrease in Resource Utilization in Recent Decades Seems Guided by Demographic Changes

T2 - Fast Tracking—Real Concept or Demographics

AU - Bhavsar, Rajesh

AU - Jakobsen, Carl-Johan

PY - 2020/6

Y1 - 2020/6

N2 - Objective: To identify dynamics of associations and potential areas for optimization of patient turnover between various patient profile and comorbidity indicators and selected system performance indicators such as ventilation time, length of stay in the intensive care unit, and in-hospital stay. Design: Retrospective study of prospectively registered data (2000-2017). Setting: Three university hospitals. Participants: The study comprised 38,100 adult cardiac surgical patients registered in the Western Denmark Heart Registry. Interventions: Analysis of dynamics in patient indicators and system performance indicators, including effect on the selected performance parameters. Measurements and Main Results: Comorbidity, calculated from EuroSCORE, decreased from 2.5 ± 2.2 to 1.5 ± 2.0 (p < 0.001), whereas the average age of patients increased from 65.1 ± 9.9 years to 67.6 ± 10.8 years (p < 0.001). Median ventilation time decreased from 380 to 275 minutes (p < 0.0001). The mean length of stay in the intensive care unit demonstrated a statistically significant decrease from 35.1 hours between 2000 to 2002 to 31.8 hours between 2015 to 2017 (p = 0.004), and the median time was unchanged at 22.0 hours throughout the observation period. The median in-hospital stay decreased from 6.5 to 5.1 days (p < 0.001) and the mean in-hospital stay from 8.7 days (2003-2005) to 7.0 days (2015-2017; p < 0.001). Logistic regression analysis of performance factors showed a statistically significant negative independent effect on most comorbidity and surgical factors. Conclusion: The increase in performance parameters appears to be highly associated with decreased comorbidities and fast-tracking protocols and may only offer limited effect in additional patient turnover.

AB - Objective: To identify dynamics of associations and potential areas for optimization of patient turnover between various patient profile and comorbidity indicators and selected system performance indicators such as ventilation time, length of stay in the intensive care unit, and in-hospital stay. Design: Retrospective study of prospectively registered data (2000-2017). Setting: Three university hospitals. Participants: The study comprised 38,100 adult cardiac surgical patients registered in the Western Denmark Heart Registry. Interventions: Analysis of dynamics in patient indicators and system performance indicators, including effect on the selected performance parameters. Measurements and Main Results: Comorbidity, calculated from EuroSCORE, decreased from 2.5 ± 2.2 to 1.5 ± 2.0 (p < 0.001), whereas the average age of patients increased from 65.1 ± 9.9 years to 67.6 ± 10.8 years (p < 0.001). Median ventilation time decreased from 380 to 275 minutes (p < 0.0001). The mean length of stay in the intensive care unit demonstrated a statistically significant decrease from 35.1 hours between 2000 to 2002 to 31.8 hours between 2015 to 2017 (p = 0.004), and the median time was unchanged at 22.0 hours throughout the observation period. The median in-hospital stay decreased from 6.5 to 5.1 days (p < 0.001) and the mean in-hospital stay from 8.7 days (2003-2005) to 7.0 days (2015-2017; p < 0.001). Logistic regression analysis of performance factors showed a statistically significant negative independent effect on most comorbidity and surgical factors. Conclusion: The increase in performance parameters appears to be highly associated with decreased comorbidities and fast-tracking protocols and may only offer limited effect in additional patient turnover.

KW - comorbidity

KW - hospital stay

KW - intensive care unit

KW - length of stay

KW - ventilation time

UR - http://www.scopus.com/inward/record.url?scp=85074400793&partnerID=8YFLogxK

U2 - 10.1053/j.jvca.2019.09.034

DO - 10.1053/j.jvca.2019.09.034

M3 - Journal article

C2 - 31679999

AN - SCOPUS:85074400793

VL - 34

SP - 1476

EP - 1484

JO - Journal of Cardiothoracic and Vascular Anesthesia

JF - Journal of Cardiothoracic and Vascular Anesthesia

SN - 1053-0770

IS - 6

ER -