Hospital quality reporting that does not account for case volume is misleading to hospitals and consumers. In this study, larger-volume hospitals appeared to perform better in process measures, but were less likely to receive “top hospital” rating.
Bottom line: Hospitals with large and small case volumes can easily be compared to one another for process measures in AMI.
Citation: O’Brien SM, DeLong ER, Peterson ED. Impact of case volume on hospital performance assessment. Arch Intern Med. 2008;168(12):1277-1284.
By Jill Goldenberg, MD, Imuetinyan Asuen, MD, Ramiro Jervis, MD, Brian Markoff, MD, and Andrew Dunn, MD, FACP
Coffee consumption not associated with increased mortality
A prospective cohort study showed mortality rates didn’t change with coffee consumption in both men and women. A modest benefit on all-cause cardiovascular disease mortality needs further evaluation.
Citation: Lopez-Garcia E, van Dam RM, Li TY, Rodriguez-Artalejo F, Hu FB. The relationship of coffee consumption with mortality. Ann Intern Med. 2008;148:904-914.
Hospitalized patients want and have ample time for educational activities during hospital stay
Of 316 patient hours observed (13 hours of time-motion data, 138 surveys, and 15 interviews), more than 80% of patients were interested in and willing to receive education.
Citation: Chu ES, Hakkarinen D, Evig C, Page S, Keniston A, Dickenson M, Albert RK. Underutilized time for health education of hospitalized patients. J Hosp Med. 2008;3:238-246.
Specialized Orthopedic Surgery (SOS) units decrease length of stay (LOS) and hospital costs after elective total knee arthroplasty
A retrospective review at a single academic center found adjusted LOS and costs decreased by 0.234 days and $600, respectively, for patients admitted to SOS units compared to non-orthopedic units.
Citation: Batsis JA, Naessens JM, Keegan MT, Huddleston PM, Wagie, AE, Huddleston JM. Resource utilization of total knee arthroplasty patients cared for on specialty orthopedic surgery units. J Hosp Med. 2008;3:218-227.
RFID induces potentially hazardous electromagnetic interference (EMI) in critical care medical equipment
In 123 EMI tests conducted on 41 medical devices, radio frequency identification (RFID) induced 34 incidents—24 of which were classified as potentially hazardous or significant—at an average distance of 30 centimeters.
Citation: Van der Togt R, van Lieshout EJ, Hensbroek R, Beinaut E, Binnekade JM, Bakker PJM. Electromagnetic interference from radio frequency identification inducing potentially hazardous incidents in critical care medical equipment. JAMA. 2008;299(24): 2884-2890.
Incidence of pulmonary embolism increasing
A retrospective database review shows from 1997 to 2001, PE incidence increased from 0.47 to 0.63 per 1000 patients, and CT angiography in PE evaluation increased from 23.2% to 45.2% (p<.001).
Citation: DeMonaco NA, Dang Q, Kapoor WN, Ragni MV. Pulmonary embolism incidence is increasing with use of spiral computed tomography. Am J Med. 2008;121:611-617.
Neurologists, generalists may have similar stroke outcomes
A retrospective U.S. academic medical center database review shows stroke patients treated by neurologists have better outcomes than generalists using standard analyses, but similar outcomes after controlling for selection bias.
Citation: Gillum LA, Johnston SC. Influence of physician specialty on outcomes after acute ischemic stroke. J Hosp Med. 2008;3:184-92.
Sequential therapy may be superior to standard therapy for H. pylori
Meta-analysis of 10 trials involving 2,747 patients shows evidence for superior Helicobactor pylori eradication rates with sequential therapy (93.4%) versus usual triple therapy (76.9%).
Citation: Jafri N, Hornung C, Howden C. Meta-analysis: Sequential therapy appears superior to standard therapy for Helicobacter pylori infection in patients naïve to treatment. Ann Intern Med. 2008;148:923-31.
COX-2 selective and nonselective NSAIDS increase stroke risk
A prospective, population-based study with 70,063 person-years of follow-up shows increased stroke risk among current users of nonselective and COX-2 selective, but not COX-1 selective NSAIDS.
Citation: Haag M, Bos M, Hofman A, Koudstaal P, Breteler M, Strickler B. Cyclooxygenase selectivity of nonsteroidal anti-inflammatory drugs and the risk of stroke. Arch Intern Med. 2008;168:1219-24.
Decision to withhold life support may increase mortality in critically ill patients
A retrospective cohort study from a single medical ICU suggests the decision to withhold life support, while providing all other indicated care, may reduce survival in critically ill patients.
Citation: Chen Y, Connors, AF, Garland A. Effect of decisions to withhold life support on prolonged survival. Chest. 2008;133:1312-1318.
Post night-shift nurses working in ICU have pathologic degree of sleepiness
A single-institution prospective pilot study examining 10 ICU nurses and 10 floor nurses found ICU nurses working 12-hour night shifts have a pathologic level of sleepiness using subjective and objective measurements.
Citation: Surani S, Subramanian S, Babbar H, Murphy J, Aguillar R. Sleepiness in critical care nurses: Results of a pilot study. J Hosp Med. 2008;3(3):200-205.