News
Antimicrobial Prescribing Common in Inpatient Setting
February 2, 2015
Clinical question: What is the daily prevalence of antimicrobial use in acute-care hospitals? Background: Inappropriate antimicrobial use is associated with adverse events and contributes to the emergence of resistant pathogens. Strategies need to be implemented to reduce inappropriate use.
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Hemoglobin Transfusion Threshold Not Associated with Differences in Morbidity, Mortality Among Patients with Septic Shock
February 2, 2015
Clinical question: Is there a difference in 90-day mortality and other outcomes when a lower versus higher hemoglobin threshold is used for blood transfusions in ICU patients with septic shock? Background: Patients with septic shock frequently receive blood transfusions.
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Early, Goal-Directed Therapy Doesn’t Improve Mortality in Patients with Early Septic Shock
February 2, 2015
Clinical question: Does early goal-directed therapy (EGDT) improve mortality in patients presenting to the ED with early septic shock? Background: EGDT (achieving central venous pressure of 8-12 mmHg, superior vena oxygen saturation (ScvO2) of > 70%, mean arterial pressure ≥ 65mmHg, and urine
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Arterial Catheter Use in ICU Doesn’t Improve Hospital Mortality
February 2, 2015
Clinical question: Does the use of arterial catheters (AC) improve hospital mortality in ICU patients requiring mechanical ventilation? Background: AC are used in 40% of ICU patients, mostly to facilitate diagnostic phlebotomy (including arterial blood gases) and improve hemodynamic monitoring.
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Bedside Attention Tests May Be Useful in Detecting Delirium
February 2, 2015
Clinical question: Are simple bedside attention tests a reliable way to routinely screen for delirium? Background: Early diagnosis of delirium decreases adverse outcomes, but it often goes unrecognized, in part because clinicians do not routinely screen for it.
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What Should Hospitalists Know about Transarterial Liver Tumor Therapies?
February 2, 2015
Case A 51-year-old male with known hepatocellular carcinoma (HCC) recently underwent successful transarterial chemoembolization of a segment VII liver lesion. The patient was admitted to the hospitalist service for overnight observation.
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News
Who Should Be Screened for HIV Infection?
January 7, 2015
Case A 31-year-old male with a history of asthma is admitted with an asthma exacerbation. He has no regular outpatient provider. He denies tobacco use and reports that he is in a monogamous relationship with his girlfriend.
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Ebola Treatment Centers Needed in North America
January 7, 2015
As the hysteria about Ebola spreads, hospitalists who have been running most of the country’s ICUs will find themselves at the forefront of treating these patients when more of them present at our different hospitals.
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Academic Hospitalist Groups Use Observation Status More Frequently
January 7, 2015
Insurers’ use of certain criteria to separate hospital stays into inpatient or observation status remains widespread. Observation status ensures provider reimbursement for hospitalizations deemed necessary by clinical judgment but not qualifying as inpatient care.
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Medical Consultants Provide Benefits for Hospitalized Surgical Patients
January 7, 2015
Clinical question: How are medical consultants used for hospitalized surgical patients, and how does this vary among regions and hospitals in the U.S.? Background: Reimbursement for surgical procedures is moving toward bundled payments, making it increasingly important to understand the use of re
