Abstract:
OBJECTIVES:To determine whether prolonged length of stay (pLOS) in ischemic stroke is related to delays in discharge disposition arrangement. METHODS:We designed a retrospective study to compare patients with acute ischemic stroke who experienced pLOS to those who did not experience pLOS. Patients who have had acute ischemic stroke between July 2008 and December 2010 were included unless they arrived >48 hours after time last seen normal, had an unknown last seen normal, or experienced an in-hospital stroke. pLOS was defined in our prospective stroke registry (before the generation of this research question) as hospitalization extended for ≥ 24 hours more than necessary to determine neurologic stability and next level of care/disposition for a given patient. We characterized the frequency of each cause of pLOS and further investigated the destinations that were more frequently associated with pLOS among patients with delay resulting from arranging discharge disposition. RESULTS:Of the 274 patients included, 106 (31.9%) had pLOS. Reasons for pLOS were discharge disposition (48.1%), non-neurologic medical complications (36.8%), delays in imaging studies (20.8%), awaiting procedure (10.4%), and neurologic complications (9.4%). Among patients with pLOS caused by delayed disposition, more than half were awaiting placement in an inpatient rehabilitation facility. CONCLUSIONS:For the majority of our patients, pLOS was caused by acquired medical complications and delayed disposition, most commonly inpatient rehabilitation. Further efforts are needed to prevent complications and further investigation is necessary to identify the factors that may contribute to delayed discharge to inpatient rehabilitation facilities, which may include delayed planning or heightened scrutiny of insurance companies regarding their beneficiaries.
journal_name
South Med Jjournal_title
Southern medical journalauthors
Siegler JE,Boehme AK,Fowler BD,George AJ,Monlezun DJ,Albright KC,Beasley TM,Martin-Schild Sdoi
10.1097/SMJ.0000000000000036subject
Has Abstractpub_date
2013-12-01 00:00:00pages
693-6issue
12eissn
0038-4348issn
1541-8243pii
00007611-201312000-00011journal_volume
106pub_type
杂志文章abstract::Appendicovesical fistula is an uncommon condition usually occurring in boys and young men and associated with chronic urinary tract infection. Diagnosis is based on cystoscopic findings that may be confirmed by a retrograde study. Treatment by appendectomy is usually successful. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198004000-00037
更新日期:1980-04-01 00:00:00
abstract::We present the case of a 59-year-old woman with an International Federation of Gynecology and Obstetrics stage IIIB serous psammocarcinoma. Only 12 cases of this rare ovarian neoplasm have been reported previously. These tumors act like borderline tumors and, therefore, do not usually require chemotherapy or radiation...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199805000-00015
更新日期:1998-05-01 00:00:00
abstract::The cost of managing chronic ulcers, both venous leg and decubiti (sacral pressure), was reviewed using 36 randomized, controlled studies with a focus on saline, hydrocolloid, and a human skin construct. When one includes the labor intensiveness of dressing changes three to four times per day, the application of hydro...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/01.SMJ.0000082011.70728.8C
更新日期:2004-02-01 00:00:00
abstract::Pressure modes of invasive mechanical ventilation generate a tidal breath by delivering pressure over time. Pressure control ventilation (PC) is the prototypical pressure mode and is patient- or time-triggered, pressure-limited, and time-cycled. Other pressure modes include pressure support ventilation (PSV), pressure...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/SMJ.0b013e31822da7fa
更新日期:2011-10-01 00:00:00
abstract::Between September 1983 and March 1989, 36 loop ileostomies were performed on 34 patients (16 male and 18 female, mean age 36 years, range 11 to 68). Thirty-two patients had ileoanal pouch procedures (30 for ulcerative colitis and two for familial polyposis). One patient had a low anterior resection and another had a c...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199403000-00014
更新日期:1994-03-01 00:00:00
abstract::Computed tomography is widely used to diagnose acute pancreatitis. Iodinated contrast medium lengthens the duration of pancreatitis and may increase the incidence of local or systemic complications. Total parenteral nutrition including IV lipid emulsion plays an important role in the management of patients with pancre...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/01.SMJ.0000047667.00302.CD
更新日期:2003-01-01 00:00:00
abstract:OBJECTIVE:To determine vitamin D status in children with spina bifida (SB). METHODS:Charts of all patients with SB at the Shriners Hospital for Children in Houston, Texas, seen between July 2011 and June 2013 were retrospectively reviewed. Daily intake of milk, vitamins, amount of screen time, and time spent outdoors ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000000397
更新日期:2016-01-01 00:00:00
abstract::Allergic rhinitis affects approximately 40% of children and generally presents in children from 10-19 years of age; however, the condition has been seen in children as young as 6 months. Antihistamines are commonly prescribed in infants and children for the relief of allergic symptoms. A 23-month-old male with a histo...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e3181b9ae49
更新日期:2010-05-01 00:00:00
abstract::The majority of abnormalities at the foramen of Monro identified by computed tomography (CT) are colloid cysts, but a number of other diseases in this location may produce a similar CT appearance. In a series of 21 patients the radiologic findings included six colloid cysts, two neoplasms, five vascular lesions, three...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198312000-00016
更新日期:1983-12-01 00:00:00
abstract::Primary small cell undifferentiated carcinomas (SCUCs) are unusual tumors of the colon and rectum. Histologically, these lesions represent a spectrum of neuroendocrine differentiation, with oat cell carcinoma being the most primitive subtype and carcinoid tumors being the most differentiated. This observation is suppo...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199609000-00016
更新日期:1996-09-01 00:00:00
abstract:BACKGROUND:This study was performed to examine the effect of stress on pregnancy outcome in women who underwent assisted reproductive technology (ART) procedures. METHODS:In a controlled clinical study of healthy volunteers in an academic research environment, stress was measured subjectively by administering patient ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/01.SMJ.0000054567.79881.E9
更新日期:2003-06-01 00:00:00
abstract::Cyclosporine is a fungal metabolite increasingly used as an immunosuppressive agent in organ transplantation. It provides immunosuppression primarily through reversible inhibition of T-lymphocytes, without myelotoxicity. Cyclosporine appears to inhibit primary activation of helper cells and to decrease the production ...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/00007611-198602000-00017
更新日期:1986-02-01 00:00:00
abstract:OBJECTIVES:Alloantibody formation secondary to transfusion in patients with sickle cell disease (SCD) is a well-known phenomenon. Pretransfusion testing (eg, "antibody screening") protects patients from receiving incompatible red blood cell transfusions. Because alloantibodies have a tendency to evanesce (ie, become un...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000000528
更新日期:2016-09-01 00:00:00
abstract::We compared a "cardiac profile" test with standard creatine kinase (CK) and lactic dehydrogenase (LD) electrophoresis in 798 cases of possible acute myocardial infarction (MI). The cardiac profile enzyme screen (CK-B, CK, LD) used on 495 patients who came to the emergency department with chest pain suggestive of acute...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:
更新日期:1989-09-01 00:00:00
abstract::Results of treating 238 transverse, longitudinal, and osteochondral fractures of the patella are reviewed. Of these, 89 patients had partial patellectomy and extensor mechanism reconstruction. After an average follow-up of four years, functional results have been excellent; there have been no late patellectomies and t...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197707000-00014
更新日期:1977-07-01 00:00:00
abstract:OBJECTIVES:The objectives of the study were to determine the percentage of osteopathic emergency medicine (EM) residencies that require an original research project to meet the American Osteopathic Association requirement, describe the resources available to the residents and faculty members to complete their projects,...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000000967
更新日期:2019-05-01 00:00:00
abstract::We have described a patient with portal hypertension and retrocardiac paramediastinal density on upright PA chest x-ray film. Splenoportograms showed this density to be paraesophageal collateral veins. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198511000-00030
更新日期:1985-11-01 00:00:00
abstract::We have recently developed a Data Bank for Digestive Disorders, with primary data derived from the performance of upper gastrointestinal endoscopy. By using this system to analyze the clinical characteristics of patients with atypical chest pain, we found information from the patient's history (reflux, dysphagia, abdo...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198301000-00007
更新日期:1983-01-01 00:00:00
abstract::Nitrogen, derived from breakdown of dietary amino acids as ammonia, is normally converted to urea and excreted. Impairment in the conversion process (called the urea cycle) can occur, either as a consequence of primary genetic defects or through secondary suppression of enzyme activity. Either process results in hyper...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199307000-00004
更新日期:1993-07-01 00:00:00
abstract::Blastomycosis is an endemic systemic fungal infection that usually involves the lungs and superficial skin. Although head and neck involvement has been reported in the literature, no previous cases of neck mass resulting from direct extension of a pulmonary lesion have been published. We encountered an immunocompetent...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199810000-00009
更新日期:1998-10-01 00:00:00
abstract::To assess the reliability and accuracy of the Papanicolaou smear for the detection of cervical Chlamydia trachomatis infections, we obtained chlamydial cultures and cervical smears from 252 patients attending a gynecologic service during an eight-month time period. In 12 of these patients (4.8%), the cervical culture ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:1985-11-01 00:00:00
abstract::We have presented an unusually swift progression of progressive systemic sclerosis (PSS), with death from cardiogenic shock in a 22-year-old woman who had severe hypertension and acute renal insufficiency. She arrived at our hospital with pericardial tamponade and shock. Despite initial improvement after pericardiocen...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199207000-00026
更新日期:1992-07-01 00:00:00
abstract:OBJECTIVES:Age-related macular degeneration (AMD) is the leading cause of blindness in the United States. Although AMD shares multiple risk factors with coronary artery disease (CAD), the association between AMD and CAD has not been established. The objective of our study was to demonstrate an association between the d...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000000329
更新日期:2015-08-01 00:00:00
abstract::A total of 37 physicians and other health care professionals have been accepted into a monitoring and advocacy program for an average of 24 months. Thirty-five are working in their profession, one is in treatment, and one has repeatedly relapsed and is no longer practicing medicine (an overall improvement rate of 97%)...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199409000-00003
更新日期:1994-09-01 00:00:00
abstract::Twenty-eight women were tested with a standard three-hour oral glucose tolerance test before and after three years of using a combination-type oral contraceptive containing mestranol and ethynodiol diacetate (Ovulen). At the three-year test time there was a significant elevation of the patients' weights and their 1-, ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197710000-00010
更新日期:1977-10-01 00:00:00
abstract::Any terrorist attack using weapons of mass destruction will result in substantial psychological trauma and stress. Primary care and emergency clinics will likely see patients who have stress-related emotional or physical symptoms, or exacerbations of preexisting health concerns. Significant psychological and behaviora...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/01.SMJ.0000054783.69453.79
更新日期:2003-04-01 00:00:00
abstract::A 12-year-old female patient with atypical orbital and periorbital cellulitis was found to have an occult lymphangioma of the orbit. Recognition of this entity provided an explanation for the atypical features of the case and guided appropriate medical management. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:2001-05-01 00:00:00
abstract::Appropriate use of antibiotics is enhanced by the effective application of data on antimicrobial susceptibility. A number of methods are currently available for routine determination of susceptibilities, including agar dilution, broth dilution, agar diffusion, and several semiautomated methods. If susceptibility testi...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:1977-10-01 00:00:00
abstract::Studies at "the Farm," a community of spiritually gathered young people in Summertown, Tenn, have shown that it is possible to sustain a normal pregnancy on a vegan diet. The source of dietary protein (ie, animal or vegetable) does not seem to affect birth weight, as long as vegans are health conscious, receive contin...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198706000-00007
更新日期:1987-06-01 00:00:00
abstract::An 86-year-old diabetic man had a late, gas-forming infection about Knowles pins. Although blood cultures were negative, a urinary tract infection followed by infection with the same organism in bone, muscle, and lung strongly supports hematogenous spread of E coli from the genitourinary system in this patient. The ge...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:1983-02-01 00:00:00