Tracy Lynn Gulling-Leftwich, DO
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Fluid Resuscitation in Sepsis: A Systematic Review and Network Meta-Analysis
January 28, 2015
Clinical question: Is there any difference between different resuscitative fluids (crystalloids or colloids) on mortality in critically ill sepsis patients? Background: Fluid resuscitation, in addition to antibiotics and source control, is a cornerstone of initial management of sepsis.
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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
News
Fluid Resuscitation in Sepsis: Systematic Review and Network Meta-Analysis
January 7, 2015
Clinical question: Is there any difference between different resuscitative fluids (crystalloids or colloids) on mortality in critically ill sepsis patients? Background: Fluid resuscitation, in addition to antibiotics and source control, is a cornerstone of initial management of sepsis.
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Hip Fracture Adverse Outcomes Among Nursing Home Residents
January 7, 2015
Clinical question: What are the risk factors for mortality and functional decline following hip fracture among nursing home residents? Background: Little is known about the survival and functional outcomes of nursing home residents who sustain hip fracture.
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Post-Operative Pneumonia Reduced by Standardization in Noncritical Surgical Patients
January 7, 2015
Clinical question: What is the long-term effectiveness of a standardized pneumonia prevention program among surgical noncritical inpatients? Background: Few studies have focused on the prevention of post-operative pneumonia in non-mechanically ventilated patients.
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Aspirin vs. Anticoagulation for VTE Prevention in Lower Extremity Orthopedic Surgery
January 7, 2015
Clinical question: What are rates of venous thromboembolism (VTE) and bleeding among adult patients receiving aspirin versus anticoagulants after major lower extremity orthopedic surgery? Background: VTE is common after hip fracture surgery and elective total knee/hip arthroplasty.
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Depletive Fluid Management Strategy During Weaning from Mechanical Ventilation Can Lower VAP Rates
January 7, 2015
Clinical question: What is the benefit associated with a depletive fluid management strategy on ventilator-associated complication (VAC) and ventilator-associated pneumonia (VAP) during weaning from mechanical ventilation? Background: VAP is common in the ICU.
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Limitations of Best Practice Alerts on Curbing Blood Transfusions
January 7, 2015
Clinical question: Why do providers continue to transfuse blood products outside of recommended guidelines, despite best practice alerts (BPAs)? Background: There is evidence that a restrictive approach to blood transfusion versus a liberal approach is beneficial in reducing cost, morbidity, and
News
Peri-Operative Atrial Fibrillation, Long-Term Risk of Ischemic Stroke
January 7, 2015
Clinical question: Is there an association between peri-operative AF and long-term risk of ischemic stroke in patients undergoing any type of surgery? Background: Peri-operative AF is usually viewed as a transient response to physiological stress, and the long-term risk of stroke after peri-opera
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Lower Health Literacy Contributes to Post-Discharge Medication Errors
January 7, 2015
Clinical question: What patient characteristics contribute to post-discharge medication errors? Background: Post-discharge medication errors are common, but the characteristics of patients associated with those errors are not well understood. Study design: Prospective study with patient data c