Clinical

Patient care

Early Warning System Boosts Sepsis Detection, Care

An alert system that monitors inpatients at risk of developing sepsis can prompt early sepsis care, can speed patient transfers to the ICU, and may even reduce mortality risk from sepsis. A recent study published in the Journal of Hospital Medicine reports on an early warning and response system (EWRS) for sepsis used in all… [Read More]

New-Onset Perioperative Atrial Fibrillation Associated With Increased Risk of Ischemic Stroke

Clinical question For patients undergoing any inpatient surgery, is the presence of new-onset perioperative atrial fibrillation associated with a greater long-term risk of ischemic stroke? Bottom line Perioperative atrial fibrillation (AF) is associated with an increased risk of ischemic stroke for patients who are hospitalized for surgery. (LOE = 2b) Reference Gialdini G, Nearing K,… [Read More]

Colchicine Prevents Postpericardiotomy Syndrome Following Cardiac Surgery

Clinical question Does perioperative colchicine reduce postpericardiotomy syndrome following cardiac surgery? Bottom line The use of colchicine in the perioperative period decreases the incidence of postpericardiotomy syndrome after cardiac surgery with a number needed to treat (NNT) of 10. However, colchicine leads to adverse effects—specifically, gastrointestinal intolerance—and may not be tolerated during the vulnerable postoperative… [Read More]

LISTEN NOW: Kristen Kulasa, MD, Explains How Hospitalists Can Work with Nutritionists and Dieticians

Kristen Kulasa, MD, assistant clinical professor of medicine and director of Inpatient Glycemic Control, Division of Endocrinology, Diabetes, and Metabolism at the University of California in San Diego, provides tips on how hospitalists can work with nutritionists and dieticians for the betterment of diabetic patients. As a mentor for SHM’s care coordination program on inpatient diabetes,… [Read More]

Insulin Rules in the Hospital

Although new medications to manage and treat hyperglycemia and diabetes continuously appear on the market, national guidelines and position statements consistently refer to insulin as the treatment of choice in the inpatient hospital setting. “When patients are admitted to the hospital, our standard is to switch from the outpatient regimen [wide variety of medications] to… [Read More]