Inpatient Specialty Program
News
SIRS Criteria Could Identify More Patients with Severe Sepsis
June 8, 2015
Clinical question: Does inclusion of two or more SIRS criteria in the definition of severe sepsis accurately identify patients with higher mortality risk, as compared with patients with infection and organ failure but with fewer than two SIRS criteria? Background: SIRS describes dysregulation of
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Trimethoprim-Sulfamethoxazole Use in Older Patients Taking Spironolactone
June 8, 2015
Clinical question: Does trimethoprim-sulfamethoxazole (TMP-SMX) increase the risk of sudden death in older patients taking spironolactone? Background: TMP-SMX increases the risk of hyperkalemia when used with spironolactone; however, previous studies have not examined whether the drug interaction
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Medicare Nonpayment for Hospital-Acquired Conditions May Have Reduced Infection Rates
June 8, 2015
Clinical question: What was the effect of the Centers for Medicare and Medicaid Services’ (CMS) nonpayment for hospital-acquired conditions? Background: In 2008, CMS implemented the Hospital-Acquired Conditions (HAC) initiative, denying incremental payment to hospitals for complications of hospit
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Peri-Operative Phlebotomy Might Cause Significant Blood Loss in Cardiac Surgery Patients
June 8, 2015
Clinical question: What are the frequency of laboratory testing, the average total blood volume drawn per patient, and the resulting transfusion utilization in patients undergoing cardiac surgery? Background: Healthcare providers seldom recognize the amount of phlebotomy, and, therefore, its cons
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Clostridium Difficile Infection Rates in the U.S. in 2011
June 8, 2015
Clinical question: What are the incidence, recurrence rate, and mortality rate of Clostridium difficile infection (CDI) in the U.S.
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CT Angiography Effect on Outcome for Patients with Symptomatic Chest Pain
June 8, 2015
Clinical question: Does CT angiography (CTA) improve clinical outcomes in patients with new-onset stable chest pain more than functional testing? Background: Chest pain is a common clinical problem, and multiple noninvasive tests are available to detect coronary artery disease (CAD).
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Early Goal-Directed Therapy for Sepsis Offers No Benefit Over Usual Care
June 8, 2015
Background: Recent trials (ARISE, ProCESS) showed EGDT provided no mortality benefit over usual care. Questions remain about the effectiveness of intensive monitoring protocols, as well as the evolution of what constitutes usual care.
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NSAID Use by Patients on Antithrombotic Therapy Has Bleeding, Cardiovascular Risks
June 8, 2015
Clinical question: Is there increased risk of bleeding or cardiovascular events when using NSAIDs while on antithrombotic therapy for secondary cardiovascular prevention? Background: NSAIDs are among the most commonly used medications, despite the fact that individual NSAIDs have been associated
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Treatment of Patients with Atrial Fibrillation, Low CHA2DS2-VASc Scores
June 8, 2015
Clinical question: Is anticoagulation beneficial for patients with atrial fibrillation (Afib) and low CHA2DS2-VASc score (0 for men, 1 for women) or for those with one additional stroke risk factor? Background: Guidelines nearly universally recommend anticoagulation for patients with a CHA2DS2-VA
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Research Review: Ticagrelor for Post-Myocardial Infarction
June 8, 2015
Clinical question: Is ticagrelor for secondary prevention indicated for more than one year after myocardial infarction (MI)? Background: The efficacy and safety of ticagrelor combined with low-dose aspirin more than one year after MI for secondary prevention has not previously been established.