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Hirani R, Podder D, Stala O, Mohebpour R, Tiwari RK, Etienne M. Strategies to Reduce Hospital Length of Stay: Evidence and Challenges. MEDICINA (KAUNAS, LITHUANIA) 2025; 61:922. [PMID: 40428880 PMCID: PMC12112870 DOI: 10.3390/medicina61050922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/03/2025] [Revised: 05/16/2025] [Accepted: 05/19/2025] [Indexed: 05/29/2025]
Abstract
Hospital length of stay (HLOS) is a critical healthcare metric influencing patient outcomes, resource utilization, and healthcare costs. While reducing HLOS can improve hospital efficiency and patient throughput, it also poses risks such as premature discharge, increased readmission rates, and potential compromise of patient safety. This literature review synthesizes current evidence on the determinants of HLOS, including patient-specific factors such as demographics, comorbidities, and socioeconomic status, as well as hospital-related factors like admission route, resource allocation, and institutional policies. We also examine the relationship between HLOS and key clinical outcomes, including mortality, readmission rates, and healthcare-associated infections. Additionally, we evaluate predictive modeling approaches, including artificial intelligence and machine learning, for forecasting HLOS and guiding early intervention strategies. While interventions such as enhanced recovery after surgery (ERAS) protocols, multidisciplinary care teams, and structured discharge planning have demonstrated efficacy in reducing HLOS, their success varies based on healthcare setting, patient complexity, and resource availability. Predictive analytics, incorporating clinical and non-clinical variables, offer promising avenues for improving hospital efficiency, yet may carry risks related to data quality and model bias. Given the impact of HLOS on clinical and economic outcomes, targeted interventions and predictive models should be applied cautiously, with future research focusing on refining personalized discharge strategies and addressing disparities across diverse patient populations.
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Affiliation(s)
- Rahim Hirani
- School of Medicine, New York Medical College, Valhalla, NY 10595, USA
- Graduate School of Biomedical Sciences, New York Medical College, Valhalla, NY 10595, USA
| | - Dhruba Podder
- School of Medicine, New York Medical College, Valhalla, NY 10595, USA
| | - Olivia Stala
- School of Medicine, New York Medical College, Valhalla, NY 10595, USA
| | - Ryan Mohebpour
- School of Medicine, New York Medical College, Valhalla, NY 10595, USA
| | - Raj K. Tiwari
- School of Medicine, New York Medical College, Valhalla, NY 10595, USA
- Graduate School of Biomedical Sciences, New York Medical College, Valhalla, NY 10595, USA
| | - Mill Etienne
- School of Medicine, New York Medical College, Valhalla, NY 10595, USA
- Department of Neurology, New York Medical College, Valhalla, NY 10595, USA
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El-Saadony MT, Saad AM, Mohammed DM, Korma SA, Alshahrani MY, Ahmed AE, Ibrahim EH, Salem HM, Alkafaas SS, Saif AM, Elkafas SS, Fahmy MA, Abd El-Mageed TA, Abady MM, Assal HY, El-Tarabily MK, Mathew BT, AbuQamar SF, El-Tarabily KA, Ibrahim SA. Medicinal plants: bioactive compounds, biological activities, combating multidrug-resistant microorganisms, and human health benefits - a comprehensive review. Front Immunol 2025; 16:1491777. [PMID: 40375989 PMCID: PMC12079674 DOI: 10.3389/fimmu.2025.1491777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2024] [Accepted: 03/13/2025] [Indexed: 05/18/2025] Open
Abstract
In recent years, medicinal plants have gained significant attention in modern medicine due to their accessibility, affordability, widespread acceptance, and safety, making herbal remedies highly valued globally. Consequently, ensuring medicinal plants' quality, efficacy, and safety has become a critical concern for developed and developing nations. The emergence of multidrug-resistant microorganisms poses a serious global health threat, particularly in low-income regions, despite significant advancements in antimicrobial drugs and medical research over the past century. The rapid spread of these multidrug-resistant infections is primarily attributed to improper prescriptions, overuse, and unregulated access to antibiotics. Addressing these challenges, the standardization of plant-derived pharmaceuticals could pave the way for a transformative era in healthcare. Preserving and leveraging the historical knowledge of medicinal plants is essential before such valuable information is lost. Recently, there has been growing interest among natural and pharmaceutical scientists in exploring medicinal plants as potential sources of antimicrobial agents. This current review aims to identify the most common pathogens threatening human health, analyze the factors contributing to the rise of drug-resistant microorganisms, and evaluate the widespread use of medicinal plants across various countries as alternative antibiotics, highlighting their unique mechanisms of antimicrobial resistance.
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Affiliation(s)
- Mohamed T. El-Saadony
- Department of Agricultural Microbiology, Faculty of Agriculture, Zagazig University, Zagazig, Egypt
| | - Ahmed M. Saad
- Biochemistry Department, Faculty of Agriculture, Zagazig University, Zagazig, Egypt
| | | | - Sameh A. Korma
- Department of Food Science, Faculty of Agriculture, Zagazig University, Zagazig, Egypt
| | - Mohammad Y. Alshahrani
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
| | - Ahmed Ezzat Ahmed
- Biology Department, College of Science, King Khalid University, Abha, Saudi Arabia
| | - Essam H. Ibrahim
- Biology Department, College of Science, King Khalid University, Abha, Saudi Arabia
- Blood Products Quality Control and Research Department, National Organization for Research and Control of Biologicals, Cairo, Egypt
| | - Heba M. Salem
- Department of Poultry Diseases, Faculty of Veterinary Medicine, Cairo University, Giza, Egypt
- Department of Diseases of Birds, Rabbits, Fish & their Care & Wildlife, School of Veterinary Medicine, Badr University in Cairo (BUC), Cairo, Egypt
| | - Samar Sami Alkafaas
- Molecular Cell Biology Unit, Division of Biochemistry, Department of Chemistry, Faculty of Science, Tanta University, Tanta, Egypt
| | - Abdullah M. Saif
- Division of Biochemistry, Department of Chemistry, Tanta University, Faculty of Science, Tanta, Egypt
| | - Sara Samy Elkafas
- Faculty of Control System and Robotics, Information Technologies, Mechanics and Optics University, Saint-Petersburg, Russia
- Production Engineering and Mechanical Design Department, Faculty of Engineering, Menofia University, Menofia, Egypt
| | - Mohamed A. Fahmy
- Department of Agricultural Microbiology, Faculty of Agriculture, Zagazig University, Zagazig, Egypt
| | - Taia A. Abd El-Mageed
- Soils and Water Science Department, Faculty of Agriculture, Fayoum University, Fayoum, Egypt
| | - Mariam M. Abady
- Nutrition and Food Sciences Department, National Research Centre, Giza, Egypt
- Department of Bio-Analytical Science, University of Science and Technology, Daejeon, Republic of Korea
| | - Hanya Y. Assal
- Faculty of Biotechnology, October University for Modern Sciences and Arts, 6 October City, Egypt
| | | | - Betty T. Mathew
- Department of Biology, College of Science, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Synan F. AbuQamar
- Department of Biology, College of Science, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Khaled A. El-Tarabily
- Department of Biology, College of Science, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Salam A. Ibrahim
- Food Microbiology and Biotechnology Laboratory, Food and Nutritional Science Program, North Carolina A&T State University, Greensboro, NC, United States
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