Clinical

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Evidence is uncertain for benefit of short-stay unit hospitalization

A Cochrane review of 14 randomized trials evaluating short-stay unit hospitalization for internal medicine conditions was unable to ascertain any definite benefit or harm, compared with usual care, with concerns for heterogeneity, bias, and random error in the studies. The authors recommended conducting more trials with low risk of bias and low risk of random errors.

Citation: Strøm C et al. Hospitalisation in short-stay units for adults with internal medicine diseases and conditions. Cochrane Database Syst Rev. 2018;8. CD012370. doi: 10.1002/14651858.CD012370.pub2.

Hospice use among Medicare patients with heart failure

Of the 4% percent of Medicare patients discharged to hospice from a hospitalization for heart failure, 25% died within 72 hours of discharge, leading the authors to conclude that hospice is underutilized and initiated too late in the setting of heart failure.

Citation: Warraich HJ et al. Trends in hospice discharge and relative outcomes among Medicare patients in the Get With The Guidelines–Heart Failure Registry. JAMA Cardiol. 2018 Oct 1;3(10):917-26.

Culprit lesion PCI has similar 1-year mortality to immediate multivessel PCI

This is the follow-up study to CULPRIT-SHOCK trial , which examined percutaneous coronary intervention in culprit lesion only vs. multivessel PCI in the setting of cardiogenic shock. The initial trial showed improved 30-day mortality outcomes with culprit lesion PCI only and the follow-up demonstrated no significant difference in 1-year mortality between the two groups.

Citation: Thiele H et al. One-year outcomes after PCI strategies in cardiogenic shock. N Engl J Med. 2018 Nov 1;379(18):1699-710 .

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