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|
|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.
For DRGs 870, 871, and 872, from 2013-2016 at for below hospitals: