Clinical

Increased Mortality With Perioperative Beta-Blockade in Low-Risk Patients Undergoing Noncardiac Surgery

Clinical question: Does the use of perioperative beta-blockers affect the outcomes in patients undergoing noncardiac surgery? Bottom line: Determining the presence or absence of cardiac risk factors is important when deciding whether to use beta-blockers during the perioperative period for patients undergoing noncardiac surgery. This study shows that although perioperative beta-blockade may benefit patients with… [Read More]

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Corticosteroids Show Benefit in Community-Acquired Pneumonia

Clinical question: Does corticosteroid treatment shorten systemic illness in patients admitted to the hospital for community-acquired pneumonia (CAP)? Background: Pneumonia is the third-leading cause of death worldwide. Studies have yielded conflicting data about the benefit of adding systemic corticosteroids for treatment of CAP. Study design: Double-blind, multicenter, randomized, placebo-controlled trial. Setting: Seven tertiary-care hospitals in… [Read More]

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Infection, Acute Kidney Injury Raise 30-Day Readmission Risk for Sepsis Survivors

Nearly one-third of hospitalized patients who survive severe sepsis or septic shock require readmission within 30 days, according to a new report in the Journal of Hospital Medicine. Between 660,000 and 750,000 sepsis hospitalizations occur annually, with the direct costs surpassing $24 billion, the paper notes. The study, which examined 1697 sepsis survivors from 2008… [Read More]

Medicare Rule May Needlessly Extend Hospital Stay

(Reuters Health) – A decades old Medicare rule requiring a three-day hospital stay before patients can transfer to skilled nursing facilities may needlessly prolong hospitalizations, a study suggests. Researchers compared the average time patients were hospitalized between 2006 and 2010 in privately administered Medicare Advantage health plans that either stuck to this rule or allowed… [Read More]

Better Catheter-Directed Thrombolysis Outcomes at Higher-Volume Institutions

NEW YORK (Reuters Health) – In-hospital mortality and bleeding rates after catheter-directed thrombolysis (CDT) of lower extremity proximal deep vein thrombosis are lower in institutions that perform more procedures than in those with fewer procedures, according to a new study. “As utilization of CDT continues to increase, we propose that institutions follow a standardized CDT… [Read More]

Inflammation Contributes to Effect of Diabetes on Brain

NEW YORK (Reuters Health) – Inflammation may contribute to impaired cerebral vasoregulation in type 2 diabetes, research suggests. In a two-year study, participants with type 2 diabetes experienced diminished regional and global vasoreactivity in the brain, as well as a decline in cognitive function and the ability to perform daily tasks. Higher blood levels of… [Read More]

Similar Early Outcomes in nvAF Regardless of Anticoagulant Type

NEW YORK (Reuters Health) – In the early months of anticoagulant treatment, patients with nonvalvular atrial fibrillation (nvAF) have similar rates of bleeding and arterial clots with dabigatran, rivaroxaban and vitamin K antagonists (VKA) like warfarin, researchers from France report. Large randomized trials have shown the newer non-VKA oral anticoagulants (NOAC) to have superior safety… [Read More]

Many Older Acute MI Patients Don’t Complete Rehab

(Reuters Health) – Most older adults who are hospitalized for acute myocardial infarction do not attend even one of the recommended cardiac rehabilitation sessions, according to a new study. Cardiac rehab increases physical and cardiovascular fitness through structured exercise and education sessions, said lead author Dr. Jacob A. Doll, of Duke Clinical Research Institute in… [Read More]