A Review of Patients Discharged from a Tuberculosis Hospital

A review of 665 discharges in 1965 from the Tuberculosis Unit of the Toronto Hospital at Weston revealed that 10% did not have tuberculosis; 8% had inactive tuberculosis at the time of last admission; and 82% had active tuberculous disease when admitted (66% were admitted for the first time and 16% were readmissions). Ninety-one per cent of those who did not have tuberculosis were discharged (alive) after a median stay in hospital of 68 days; the remaining 9% died from non-tuberculous diseases after a median stay of five days. Ninety-three per cent of those who were admitted with inactive tuberculosis were discharged (alive) after a median stay of 65 days; the remaining 7% died from non-tuberculous diseases after a median stay of three days. Of the 38 deaths among the 665 discharges, only 13 were due to tuberculosis; 19 had tuberculosis but died from various non-tuberculous diseases; and six had no evidence of tuberculosis.

Suggestions are made for improving diagnostic accuracy before admission, and for facilitating the earlier discharge of certain patients following investigation in a tuberculosis hospital.

     

A prospective study of the process of assessment and care management in the discharge of elderly patients from hospital.

Assessment and care management (ACM) of elderly patients prior to discharge from hospital has been in place since 1993. It involves a complex multi-disciplinary assessment of needs which may delay discharge from hospital. We prospectively studied the process of ACM in a group of patients discharged from hospital over a three month period. The times taken for completion of the necessary reports, and any delays in the process were recorded. The times of each individual step in the process were correlated to overall length of stay and to the length of the care management process. The effect of intercurrent illnesses or other delays was studied. Of the available sample (n = 83), 16 patients died and two required long term hospital care. The median length of stay of the remainder (n = 65) was 36 days (range 5-149 days). The median time from the start of the ACM process to discharge was 22 days (0-89 days). The strongest correlation with total length of stay was the time from admission until ACM commenced (rho = 0.661, p < 0.0001). The time spent in the ACM process was related strongly to the time taken for the Care Manager to process the applications (rho = 0.682, p < 0.0001). Delay was recorded in 17 (24%) cases, resulting in an increased length of stay (p < 0.001). While care management may help in appropriate placement after hospital discharge, these results suggest that it is prone to delays outside the hospital setting. Such delays result in patients waiting in hospital for care packages to be set up in the community. This has implications for acute hospital services.     

Admissions, patterns of utilization and disposition of cases of acute stroke in Brisbane hospitals

In a population of slightly-more than one million persons, all cases of acute admission to hospital for cerebrovascular disease during 1984 were studied. Of the 2676 hospital admissions, 91% were of public-hospital patients. Of the 1908 patients who were aged more than 25 years and whose conditions were assigned the International classification of diseases' (ICD-9) codes (430-437) for cerebrovascular accidents, 1264 (1.8 patients per 1000 population of older than 25 years of age) cases were completed strokes, and 644 (1.0 patients per 1000 population of older than 25 years of age) cases were transient ischaemic attacks. There was no significant difference between the specific aetiological types of stroke that were diagnosed neuroradiologically and those that were diagnosed clinically. Among the cases of completed strokes, 54% of cases were thrombotic, 11% of cases were embolic, and 15% of cases were haemorrhagic, while nearly 20% of cases were unclassified. Twenty-one per cent of patients who were admitted to hospital with completed strokes died within two weeks of their admission, 28% of such patients were discharged home, 8% of such patients were transferred to full-maintenance care, and the remaining 43% of such patients were transferred for inpatient rehabilitation. The median length of stay for patients with completed strokes was 11.8 days compared with 6.2 days for patients with transient ischaemic attacks.     

Quality of stroke care within a hospital: effects of a mobile stroke service

OBJECTIVE: An Australian stroke services study (SCOPES) has developed a framework to compare different forms of acute stroke services, the gold standard being localised stroke units. We aimed to use this framework to assess changes in the quality of stroke care over time as a sequential audit process. DESIGN AND SETTING: A retrospective medical record audit comparing 100 sequential stroke admissions (July 2002 to June 2003) two years after institution of a mobile stroke service (MSS) with 100 historical controls (September 1998 to October 1999) at a 260-bed hospital in Melbourne. The MSS results were also compared with stroke units in SCOPES. MAIN OUTCOME MEASURES: Adherence to quality indicators and standard measures of outcome (complications, length of stay and discharge disability) after implementing the MSS. RESULTS: Significant improvements were seen in prophylaxis for deep-vein thrombosis, incontinence management, premorbid function documentation, frequent neurological observations and early occupational therapy. The MSS demonstrated fewer severe complications (9% versus 24%; P = 0.004), reduced median length of stay (discharged patients: 12.0 days versus 18.5 days; P = 0.003) and more patients were independent at discharge (32% versus 9%; P < 0.001). Comparison with SCOPES stroke units showed our MSS could improve in incontinence management and appropriate use of antiplatelet therapy. CONCLUSION: Institution of the MSS was associated with improvements in the quality of stroke care. This study demonstrates application of an audit procedure for quality improvement in hospital stroke management and the potential to improve stroke services in smaller centres.     

Stroke audit

Medical audit is vital to ensure continuous quality assurance and quality improvements. We did a retrospective study to ascertain the adequacy of clinical documentation and the factors hindering early discharge after an acute stroke in a restructured hospital. The medical records of all patients with acute stroke who died or were discharged from a restructured hospital in Singapore in January and February 1999 were reviewed retrospectively. Demographic data and the presence or absence of clinical documentation were noted. Factors hindering the discharge of patients at Day 5, Day 10 of stroke and at final discharge were noted and classified into: stroke-related, complications of stroke, medical-related and social factors. There were 101 patients in the study cohort, 55 males (54.5%) and 46 females (45.5%). The mean age was 67.9 years (SD 12.3). Documentation in Barthel scores (0%), presence of depression (0%), mental scores (1.0%), visual problems (10.0%), bladder continence (39.6%), admission functional status (37.6%) and dysphagia (52.5%) were deficient. The mean length of stay (LOS) was 13.0 (SD 14.2) days. The main factor hindering discharge at Day 5 (90.4%), Day 10 (95.2%) and at final discharge (82.1%) was stroke-related problems. Poor function (60.3%) and dysphagia (15.8%) were the 2 most common stroke-related problems hindering final discharge. Complications of stroke, medical-related problems and social reasons hindered final discharge in 10.8%, 17.8% and 2.9% of patients respectively. This audit revealed inadequacy in clinical documentation in patients with acute stroke. The main hindrance to final discharge of patients was stroke-related problems. The 2 most important stroke-related problems were poor function and dysphagia.     

The diagnosis of femoral hernia.

The accuracy of diagnosis of femoral hernia in referrals to a district general hospital over a period of 5 years has been studied and related to clinical outcome. A correct diagnosis was made in only 36 of 98 cases (60 urgent, 38 routine) before admission to hospital. A correct pre-operative diagnosis was ultimately made in 85 cases. Four patients, all urgent admissions with incarcerated bowel, died within 30 days of operation. In none of these cases was a correct diagnosis made before admission to hospital. The median length of post-operative stay of urgent admissions was 7 days (range 4-50) when a correct initial diagnosis was made and 10 days (range 4-50) when the initial diagnosis was incorrect (P = 0.07, Mann-Whitney test). When strangulated small bowel was found at operation, 70% of those with an incorrect initial diagnosis (n = 23) required resection, as compared with 20% of those with a correct initial diagnosis (n = 10, P = 0.014, chi 2 with Yates'' correction). Femoral hernias are frequently incorrectly diagnosed before hospital admission and this is associated with worsened outcome in urgent cases.     

Outcome of critically ill patients undergoing interhospital transfer

OBJECTIVE: To quantify the morbidity and mortality associated with acute interhospital transfer of critically ill patients requiring intensive care (ICU) services. DESIGN: Three-year (1 July 1996-30 June 1999) retrospective case-control study based on review of patients' medical records. SETTING: Metropolitan hospitals in Melbourne, Victoria. PARTICIPANTS: 73 (of 75) consecutive, critically ill patients from one metropolitan teaching hospital who were transferred to other hospitals because ICU services were not available. OUTCOME MEASURES: Primary endpoints included inhospital mortality and length of stay in ICU and hospital. Secondary endpoints included time from study entry to ICU admission and the change in predicted mortality risk after resuscitation and transfer to ICU (inter- or intrahospital transfer). RESULTS: The Transfer Group experienced a significant delay in admission to ICU (5.0 [4.0-6.0] v 3.0 [2.0-5.5] hours; P=0.001), and a longer stay in ICU (48 [33-111] v 44 [25-78] hours; P=0.04), and hospital (10 [3-14] v 6 [3-13] days; P=0.02). Hospital mortality in the Transfer Group (24.7%) was not statistically different from that in the Control Group (17.8%; P= 0.41; OR, 1.5; 95% CI, 0.68-3.4). CONCLUSION: Acute interhospital transfer is associated with a delay in ICU admission and a longer stay in ICU and hospital, but no statistically significant difference in mortality. A study of over 300 patient transfers would be required to clarify the morbidity and mortality risk of acute interhospital transfer.     

影响呼吸重症监护病房慢性阻塞性肺病患者机械通气时间的因素

目的:探讨呼吸重症监护病房的慢性阻塞性肺病(COPD)患者机械通气时间分别大于7,14,21 d的潜在危险因素.方法:前瞻性记录和回顾性分析患者在疾病稳定期,入住呼吸重症监护病房时及在呼吸重症监护病房期间的特征.以t检验,X2检验和逻辑回归分析作为统计学方法.结果:63例COPD需要机械通气患者入选.其中26例患者机械...     

Who needs a hospice?

OBJECTIVE: Rapid evolution of palliative care programs in Australia over recent years has brought the role of traditional inpatient hospices under review. This study attempts to define the clinical characteristics of patients referred for inpatient palliative care. DESIGN: A retrospective chart survey was performed of 432 consecutively referred patients. SETTING: The study was undertaken in a 60-bed hospice providing intensive nursing and medical care to patients with terminal illness. OUTCOME MEASURES: Demographic characteristics, diagnosis, length of stay, outcome and use of analgesics are presented. Patients not using regular analgesia at admission were studied to determine their major symptom complexes and their use of medication. RESULTS: Public hospitals referred 67.6% of patients and 25% came from home. While 83.8% of patients died in hospice care, 16.2% were discharged, usually to home or a nursing home. At admission, 16.9% of patients could walk unassisted, 20.6% were chair-bound and 62.5% were bed-bound. The median length of stay in the hospice was 16 days. Ambulant status, female sex, non-use of opioids and a diagnosis of brain or breast cancer were all associated with longer stay. At admission, 39.1% of patients were taking potent opioids regularly, 22.9% were taking mild analgesics and 38.0% were taking no regular analgesia. Of those taking no analgesia, cachexia (55.9%), confusion (35.4%), impaired conscious state (19.9%) and impaired motor neurological function (21.7%) were the major clinical problems. CONCLUSIONS: The data show that patients selected for hospice care were highly dependent, with major functional impairments and short life expectancy. The medical, social and economic implications of these findings are discussed.     

超早期康复护理对缺血性卒中患者运动功能恢复影响的分析

目的 分析超早期康复护理对缺血性卒中患者运动功能恢复及护理依从性影响。 方法 选取杭州师范大学附属医院神经内科收治确诊的病情稳定脑卒中患者162例，随机分为观察组(超早期护理)与对照组(普通神经内科护理)，观察入院时及出院前Barthel指数及Fegl-Mevyer评分情况，并对比2组患者护理依从性。 结果 入院时，2组患者Barthel指数在小于40分(χ2=0.15，P＝0.70)、40～60分(χ2=0.04，P＝0.83)及大于60分(χ2=0.15，P＝0.70)组间数据差异均无统计学意义，具有可比性；出院前观察组患者大于60分的患者多于对照组(χ2=19.56，P<0.01)。入院时，2组患者Fegl-Mevyer评分在小于50分(χ2=0.10，P＝0.75)、50～84分(χ2=0.65，P＝0.42)、85～95分(χ2=0.15，P＝0.70)及96～99分组间数据差异均无统计学意义，具有可比性；出院前观察组患者小于50分的患者少于对照组(χ2=4.84，P＝0.03)。2组患者在服药方面，依从性差异不具有统计学意义(χ2=1.22，P＝0.27)，但在康复运动方面，观察组患者依从性高于对照组，差异具有统计学意义(χ2=10.06，P＝0.02)。 结论 对卒中患者采用超早期护理干预能够促进患者运动功能及生活能力的恢复，且能够提高患者康复治疗的依从性，对患者的康复具有积极意义。      

云南地区动脉瘤性蛛网膜下腔出血手术患者的长期结局分析

目的 为云南地区动脉瘤性蛛网膜下腔出血（aSAH）手术患者的长期临床结局提供真实数据支撑。方法 回顾性分析85例aSAH手术患者,记录他们的人口学特征、血管危险因素、入院时的病情严重程度和动脉瘤的位置。采用改良Rankin量表（mRS）和ADL量表评价两种手术方式后患者的临床结局和生活能力。结果 34例（40.0%）行开颅夹闭,51例（60.0%）行血管内栓塞治疗。经过中位数66.23个月（IOR为12.03个月）的随访,84.7%的患者mRS评分较低,78.8%的患者能独立生活。入院时患者的WFNS分级,分别与随访时mRS评分（95% CI=1.48-19.09,P=0.011）和ADL评分（95% CI=2.55-28.77,P<0.001）显著相关。多变量分析显示,年龄（95% CI=1.02-1.23,P=0.017;95% CI=1.00-1.15,P=0.038）和入院时高WFNS分级（95%CI=2.19-141.48,P=0.007;95% CI=2.84-82.61,P=0.002）是随访时mRS评分和ADL评分的独立预测因子。两种手术方式的长期结果和住院时间无显著差异（P>0.05）,但住院费用血管内栓塞组明显高于开颅夹闭组（P<0.001）。结论 在云南地区的这组患者中,老龄和入院时高WFNS分级都容易导致临床结局不良;开颅夹闭或血管内栓塞在长期治疗效果方面没有优劣;从卫生经济学的角度,高WFNS分级的患者更适合开颅夹闭。     

A review of burns patients admitted to the Burns Unit of Hospital Universiti Kebangsaan Malaysia

This is a retrospective review of 110 patients admitted to the Burns Units between October 1999 and November 2001. The aim was to determine the burns pattern of patients admitted to hospital UKM. There was an increasing trend for patients admitted. Female to male ratio was 1:2. Children consisted 34% of the total admission. Children had significant higher number of scald burns as compare to adult (p < 0.01). Domestic burns were consist of 75% overall admission. Mean percentage of TBSA (total body surface area) burns was 19%. Thirty percent of patients sustained more than 20% of TBSA. Sixty percent of patients had scald burns. Ninety percents of patients with second degree burns that were treated with biologic membrane dressing or split skin graft. Mean duration of hospital stay was 10 days. Over 70% of patients were discharged within 15 days. Overall mortality rate was 6.3%. The patients who died had significantly larger area of burns of more than 20% TBSA (p < 0.05) and a higher incidence of inhalation injury (p < 0.02). Hence, this study suggests a need for better preventive measures by the authority to prevent burns related accident and the expansion of the service provided by the Burns Unit.     

Meta-analysis of defibrase in treatment of acute cerebral infarction

Background Fibrinogen-depleting agents are promising in the treatment of cerebral ischemic disease. They were studied by many trials, and the outcomes were different because of different regimens and different doses. In this study, we assessed the efficacy and safety of defibrase on acute cerebral infarction in China. Methods A search using Chinese hospital knowledge database （CHKD） and MEDLINE database for randomized controlled trials was carded out. A CHKD （1994 June 2005） search was performed with the keyword ＂defibrase＂, then a second search for the keyword ＂acute cerebral infarction＂; a MEDLINE search （1950 June 2005） was performed with the following keywords： [（cerebral ischemia）, OR （acute cerebral infarction）, OR （stroke）], AND [defibrase]. Meta-analysis was performed with RevMan software 4.2. Results Included were 14 studies comparing the efficiency and safety of defibrase with other drugs in the treatment of acute cerebral infarction. Patients＇ records were pooled （total 646 patients; defibrase, n=328, no defibrase n=318）. Neurological deficit score （NDS） before treatment showed weighted mean differences （WMD）=0.95, 95% confidence interval （CI）= （-0.60, 2.50）, P=0.23; NDS after treatment showed WMD=- 2.20, 95% CI= （-4.21, -0.18）, P=0.03; Barthel index at 3 months showed WMD=4.45, 95% CI= （-0.13, 9.03）, P=0.06; the plasma fibrinogen level before treatment showed WMD=0.02, 95% CI= （-0.16, 0.19）, P=0.86; plasma fibrinogen level after treatment showed WMD=- 1.51, 95% CI= （- 1.88, - 1.15）, P〈0.00 001. Conclusions With the given dose and regimen of defibrase in China, defibrase may play a role of anticoagulation. It might inhibit the progression of stroke and prevent the recurrence of stroke.     

经皮内窥镜引导下胃造口术在脑卒中和脑外伤后患者家庭喂养中的应用价值

目的评估经皮内窥镜引导下胃造口术(PEG)在脑卒中和脑外伤后患者家庭喂养中的应用价值。方法回顾性分析了16例无法经口进食、在我院实施PEG的脑卒中或脑外伤后患者的临床资料,其中脑梗塞9例,脑出血5例,蛛网膜下腔出血1例,脑外伤1例。结果出院后第30、60和120天,患者的体重、肱三头肌皮褶厚度、上臂肌围、血清白蛋白、血红蛋白和淋巴细胞计数等指标均明显高于出院时(P<0.05或P<0.01)。出院后第30、60和120天的NHISS评分分别为14.0±1.3、14.0±1.1和3.0±1.2,均明显低于出院时的16.0±1.2(P均<0.05)。1例患者发生胃内容物潴留,1例发生反流,1例发生吸入性肺炎,1例发生内垫综合征。结论PEG人工家庭肠内营养对脑卒中或脑外伤后吞咽困难、长期昏迷和营养不良患者有显著治疗作用,可避免患者营养状况进一步恶化,提高患者生活质量。     

Postoperative serious adverse events in a teaching hospital: a prospective study

OBJECTIVE: To assess the incidence and nature of postoperative serious adverse events (SAEs) among inpatients having surgery in a tertiary hospital, and to determine which subgroups of patients might be at greatest risk. DESIGN: Prospective observational study from 1 December 1998 - 31 March 1999. SETTING: Tertiary teaching hospital in Melbourne, Victoria. SUBJECTS: 1,125 subjects having inpatient surgery during the study period. MAIN OUTCOME MEASURES: Inhospital mortality, length of hospital stay, and SAEs (myocardial infarction, pulmonary embolism, acute pulmonary oedema, unscheduled tracheostomy, respiratory failure, cardiac arrest, stroke, severe sepsis, acute renal failure, and emergency admission to intensive care unit [ICU]). RESULTS: There were 414 SAEs in 190 of the 1,125 patients (16.9%); 80 patients died (7.1%). The most common adverse events were emergency admission to ICU (95), respiratory failure (52) and readmission to ICU (37). In patients without SAEs, mean duration of hospital stay was 18.4 days (95% Cl, 15.4-21.4), while in those with SAEs it was 38.5 days (95% CI, 35.3-41.7) (P < 0.0001). SAEs, including deaths, were more common after unscheduled surgery and in patients over 75 years of age. The combination of these two factors carried a 20% mortality. There were no differences in the incidence of SAEs among the major surgical specialties. CONCLUSIONS: SAEs are common and result in high mortality, especially in older surgical inpatients and those having unscheduled surgery. These findings raise important issues of optimal perioperative management in tertiary hospitals.     

Infantile hypertrophic pyloric stenosis: Long-term audit from a general surgical unit

This article describes a 22 year experience of a general surgical unit in the treatment of infantile hypertrophic pyloric stenosis (I HPS). The hospital course of 229 IHPS patients is reviewed. The male:female ratio was 3.6:1, median age 6 weeks (range 2-26 weeks) with a positive family history in 8.3%. The diagnosis of IHPS was established clinically by palpation of a “pyloric tumour” during a pre operative test meal/clinical examination in 92.6%; in the remainder, the diagnosis was made radiologically. Ramstedt’s pyloromyotomy was performed within 5 days of admission in 74% of patients and within 10 days of admission in 89%. The median post-operative hospital stay was 10 days (range 3-60 days). Wound morbidity occurred in 10.0% — wound infection (7.3%) and wound dehiscence (2.6%). However, wound morbidity was reduced in the second half of the series, partly by greater utililisation of non-absorbable suture in place of chromic catgut for wound closure. Mucosal penetration was suspected in 14.8% of cases. Repeat pyloromyotomy was necessary in 1.3%. One baby died (0.4%) — this was in the early part of the series and was directly attributable to fluid and electrolyte disorder. We conclude that Ramstedt’s pyloromyotomy for infantile hypertrophic pyloric stenosis can be performed with acceptable morbidity and minimal mortality in a general surgical unit.     

Outcomes for dialysis patients with end-stage renal failure admitted to an intensive care unit or high dependency unit

OBJECTIVE: To assess the outcomes for chronic dialysis patients requiring admission to an intensive care unit (ICU) or high dependency unit (HDU). DESIGN: Retrospective audit of prospectively collected data from local and national databases. SETTING: The ICU and HDU at a tertiary referral hospital. PARTICIPANTS: 70 chronic dialysis patients admitted between 2001 and 2006. MAIN OUTCOME MEASURES: Unit and hospital mortality, recurrent admission patterns and median survival after discharge from hospital. RESULTS: For patients' last admissions, mortality in the ICU or HDU was 17% and in hospital was 29%. The 12 deaths in the ICU or HDU occurred a median of 18 hours (range, 3-203 hours) after admission, reflecting the severity of their underlying illness. The independent predictors of death in hospital were age and the number of non-renal organ systems failing. Patients with pulmonary oedema had a lower risk of death than patients admitted for other reasons. Although 21 patients accounted for 55 of 104 admissions (53%), recurrent admissions to the ICU or HDU generally occurred during different hospital admissions. They were not associated with a higher risk of death in hospital. Patients discharged home had a median survival of 2.25 years, and a median survival of 3.5 years from starting dialysis. The median survival for patients on dialysis in Australia in general is 4.5 years (Australia and New Zealand Dialysis and Transplant Registry). CONCLUSION: Dialysis patients discharged home after an ICU or HDU admission have survival similar to that of Australian dialysis patients generally.     

前后循环急性缺血性卒中患者血尿酸的变化及预后分析

目的: 检测前后循环急性缺血性卒中（acute ischemic stroke, AIS）患者血尿酸的变化,并探讨其预后意义。方法: 收集141例AIS患者的临床资料,根据损伤部位将其分为前循环组和后循环组,测患者血尿酸水平、Barthel指数、神经功能缺损（neurologic impairment score,NIS）评分,并采用Pearson相关分析血尿酸水平与Barthel指数、NIS评分的相关性;根据随访情况分为预后良好组和预后不良组,采用多因素Logistic回归分析影响前后循环AIS患者预后不良的危险因素。结果： 经Pearson相关性分析,前后循环组血尿酸水平与Barthel指数均呈显著负相关（r=-0.832、-0.801,P=0.002、0.005）,与NIS评分均呈显著正相关（r=0.874、0.885,P=0.000、0.000）;前后循环预后不良组年龄、发病至溶栓时间>4.5 h、入院高血尿酸症、Barthel指数<60分、NIS>12分患者构成比均高于预后良好组,且差异均有统计学意义（P<0.05）;经Logistic回归分析,年龄≥60岁、发病至溶栓时间>4.5 h、入院高血尿酸血症、Barthel指数<60分、NIS评分>12分均是影响前后循环AIS患者预后不良的独立危险因素（P<0.05）。结论： 前后循环AIS患者中血尿酸的变化与患者自理能力、神经功能缺损程度关系密切,可作为判断预后的参考指标。     

Predicting improvement in stroke patients referred for inpatient rehabilitation.

An historical prospective study of prediction of improvement and final disposition of 105 patients with a stroke was carried out over a 2-year period in the rehabilitation service of a hospital providing long-term care. Patients were referred a mean of 37.8 days after the stroke, and were evaluated for total function and for mental status, perception, communication and motor ability at the time of admission and every 2 to 3 weeks thereafter. At the time of admission 26% of the patients were able to care for themselves; at the time of discharge 59% were able to do so, but 44% of these could not return home, primarily because of unfavourable social and environmental circumstances. In contrast, 35% of the patients unable to care for themselves went home because their families were willing to provide extra care. Neither the total function score nor the neurologic subtest scores at the time of admission predicted improvement. The presence of sphincter control and a lower age were the only significant predictors of improvement.     

入院特征预测急性左心功能不全老年患者住院时间长短的初步研究

目的探讨急性左心功能不全老年患者住院时间与入院特征的关系。方法回顾性分析244例急性左心功能不全的老年患者（≥60岁）的临床资料,观察其人口学、病史、临床表现及辅助检查等入院特征与住院时间的关系。结果男性147例,占60.2%,女性97例,占39.8%,平均年龄（68.6±7.2）岁,平均住院时间（10.1±10.3）d。统计分析结果显示,性别（P=0.004）、入院时心功能水平（P=0.02）及入院前症状恶化持续时间（P=0.013）与住院时间有相关性。结论急性左心衰老年患者性别、入院时心功能水平及院前症状恶化持续时间对住院时间有预示作用。