What factors predict length of stay in the intensive care unit? Systematic review and meta-analysis

What factors predict length of stay in the intensive care unit? Systematic review and meta-analysis 
J Crit Care. 2020;60:183-194. doi:10.1016/j.jcrc.2020.08.003

• A systematic review and metaanalysis for six factors from 28 papers and concluded that patients with mechanical ventilation, hypomagnesemia, delirium, and malnutrition tend to have longer ICU stay, and that age and gender were not significant factors. This work suggested a list of risk factors that should be considered in prediction models for ICU LoS, as follows: severity scores, mechanical ventilation, hypomagnesemia, delirium, malnutrition, infection, trauma, red blood cells, and PaO2:FiO2. 

Abstract

Developing criteria-led discharge in an oncology setting

Developing criteria-led discharge in an oncology setting
NHS Improvement 26 June 2018

• The oncology clinical service at Leeds Teaching Hospitals Trust developed and trialled a criteria-led discharge tool to allow senior medical teams to set individual criteria for both elective and non-elective oncology patients.

GIRFT Review of cranial neurosurgery services in England

GIRFT Review of cranial neurosurgery services in England
GIRFT 22 June 2018

• The report focuses on the cranial neurosurgery service pathways and changes that will help avoid bottlenecks and free up hospital beds. It highlights how cranial neurosurgery providers could deliver a better service to patients by treating them more promptly and minimising cancellations and delays and identifies 15 recommendations to support a more productive cranial neurosurgery service.
• The report suggests that there are opportunities to improve patient experience and outcomes, and deliver cost efficiencies of up to £16.4m through smarter procurement, avoiding unnecessary admissions and using critical care only when clinically required.

Trends and determinants of length of stay and hospital reimbursement following knee and hip replacement

Trends and determinants of length of stay and hospital reimbursement following knee and hip replacement: evidence from linked primary care and NHS hospital records from 1997 to 2014.
Burn E et al
BMJ Open. 2018 Jan 27;8(1):e019146. doi: 10.1136/bmjopen-2017-019146

• Analysis of data for length of stay and hospital reimbursement following knee (TKR) and hip (THR) replacement (primary and revisions) from 1997 to 2014. 
• Length of stay (days) for revision TKR (n=505) length of stay fell from 29.8 (17.5 to 50.5) to 11.0 (8.3 to 14.6) and from 18.3 (11.6 to 28.9) to 12.5 (9.3 to 16.8) for revision THR (n=633), but no significant reduction in reimbursement was estimated. 
• Patient profiles have remained broadly stable over time. The observed reductions appear to be mostly explained by improved efficiency.