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Early, Late Hospital Readmission Factors Differ
September 9, 2015
Clinical question: What are the differences between factors associated with early (zero to seven days after discharge) and late (eight to 30 days after discharge) readmission? Background: Thirty-day readmission rates are a quality metric; however, recent evidence challenges the notion that readmi
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Patient Adherence to Pharmacological Thromboprophylaxis Improves with Interventions
September 9, 2015
Clinical question: How can patient adherence to pharmacological thromboprophylaxis be improved? Background: Prior studies suggest that the hospital-wide prevalence of nonadministration of VTE thromboprophylaxis orders ranges from 5% to 13%, with patient refusal listed as the most common reason fo
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Mortality Risk in Patients Older than 75 Presenting with Non-ST-Elevation Acute Coronary Syndrome
September 9, 2015
Clinical question: Is there a score that will predict the mortality rate in elderly patients presenting with a non-ST-elevation myocardial infarction (NSTEMI)? Background: Although they represent only 9% of patients in clinical trials, patients over the age of 75 make up one third of patients wit
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Clinical Variables Predict Debridement Failure in Septic Arthritis
July 29, 2015
Clinical question: What risk factors predict septic arthritis surgical debridement failure? Background: Standard treatment of septic arthritis is debridement and antibiotics. Unfortunately, 23%-48% of patients fail single debridement.
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Prednisolone or Pentoxifylline Show No Mortality Benefit in Alcoholic Hepatitis
July 29, 2015
Clinical question: Does administration of prednisolone or pentoxifylline reduce mortality in patients hospitalized with severe alcoholic hepatitis? Background: Alcoholic hepatitis is associated with high mortality.
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Corticosteroids Show Benefit in Community-Acquired Pneumonia
July 29, 2015
Joshua LaBrin, MD, SFHM, Kencee Graves, MD, Karli Edholm, MD, Devin Horton, MD, and Katie Lappe, MD; Division of General Internal Medicine, University of Utah School of Medicine, Salt Lake City
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Standard Discharge Communication Process Improves Verbal Handoffs between Hospitalists, PCPs
July 29, 2015
Clinical question: Can a standardized discharge communication process, coupled with an electronic health record (EHR) system, improve the proportion of completed verbal handoffs from in-hospital physicians to PCPs within 24 hours of patient discharge? Background: Discharge from the hospital setti
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Nomogram Predicts Post-Operative Readmission
July 29, 2015
Clinical question: Can a nomogram accurately predict a patient’s risk of post-operative 30-day readmission? Background: Medicare and Medicaid have implemented penalties for hospitals with high readmission rates.
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Antiepileptic Drugs Reduce Risk of Recurrent Unprovoked Seizures
July 29, 2015
Clinical question: What are the updated recommendations for treating first unprovoked seizure in adults? Background: Approximately 150,000 adults present with an unprovoked first seizure in the U.S. annually, and these events are associated with physical and psychological trauma.
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PPI Usage with SBP Prophylaxis Predicts Recurrent Infections in Cirrhosis
July 29, 2015
Clinical question: What are the risk factors for development of a recurrent infection in cirrhotic patients hospitalized with an initial infection? Background: Infections are a major cause of morbidity and mortality in patients with cirrhosis.