Fluid Imbalance Increases Sepsis LOS by One Standard Deviation at Large Mississippi Hospitals
In Fluid Imbalance
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By: James Pitt Jun. 12, 2018
Following Dexur’s analysis of length of stay (LOS) in sepsis patients in Mississippi, analysts examined the effects of fluid imbalance on LOS.
On average, patients with DRG 870 and fluid imbalance stay in hospital 3.06 days longer than patients with DRG 870 without fluid imbalance. This average difference is 1.5 days for DRG 871, and 0.86 days for DRG 872.
Average LOS difference had much more variance in DRG 870 than in DRGs 871 and 872. DRG 870 patients at Merit Health - River Region had an average length of stay 11.39 days longer with fluid imbalance than without. Patients at Baptist Memorial Hospital-Golden Triangle (Columbus, MO) had an average length of stay only 0.44 days longer with fluid imbalance than without.
Fluid imbalance increased LOS by about one standard deviation for sepsis patients in DRG 870 and DRG 872. The effect was even greater for patients in DRG 871. Average LOS difference has the greater variance for DRG 870 than for DRGs 871 and 872, but the effect of fluid imbalance on the length of stay appears large regardless of DRG.
| Effect of fluid imbalance on sepsis LOS | DRG 870 | DRG 871 | DRG 872 |
|---|---|---|---|
| Mean difference | 3.06 | 1.5 | 0.86 |
| Standard deviation of difference | 2.81 | 0.65 | 0.82 |
| Effect size (Cohen’s d) of fluid imbalance | 0.96 | 1.43 | 0.7 |
The percent of sepsis discharges who had fluid imbalance explains about 70% of the variance in a hospital’s average length of stay for patients in a particular DRG. Each point represents patients in a particular DRG at a particular hospital.
The correlation is strongest at lower average lengths of stay, due to the high variance of the average length of stay in patients on mechanical ventilation.
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- Average LOS (in days) at DRG
- Average LOS without Fluid Imbalance at DRG
- Average LOS with Fluid Imbalance at DRG
- Average Difference in LOS with & without Fluid Imbalance
- State-level Average Difference in LOS with & without Fluid Imbalance
- National-level Average Difference in LOS with & without Fluid Imbalance
For DRGs 870, 871, and 872, from 2013-2016 at for below hospitals:
- Anderson Regional Medical Center (Meridian, MS)
- Baptist Memorial Hospital - Desoto (Southaven, MS)
- Baptist Memorial Hospital-Golden Triangle (Columbus, MS)
- Baptist Memorial Hospital-North Mississippi (Oxford, MS)
- Delta Regional Medical Center (Greenville, MS)
- Forrest General Hospital (Hattiesburg, MS)
- Greenwood Leflore Hospital (Greenwood, MS)
- Magnolia Regional Health Center (Corinth, MS)
- Memorial Hospital at Gulfport (Gulfport, MS)
- Merit Health - Biloxi (Biloxi, MS)
- Merit Health - Central (Jackson, MS)
- Merit Health - River Region (Vicksburg, MS)
- Merit Health - Wesley (Hattiesburg, MS)
- North Mississippi Medical Center-Tupelo (Tupelo, MS)
- Rush Foundation Hospital (Meridian, MS)
- Singing River Hospital (Pascagoula, MS)
- South Central Regional Medical Center (Laurel, MS)
- Southwest Mississippi Regional Medical Center (McComb, MS)
- St Dominic-Jackson Memorial Hospital (Jackson, MS)
- University Of Mississippi Medical Center (Jackson, MS)
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