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When Should Harm-Reduction Strategies Be Used for Inpatients with Opioid Misuse?
April 6, 2016
Case A 33-year-old male with a history of opioid overdose and opioid use disorder is admitted with IV heroin use complicated by injection site cellulitis. He is started on antibiotics with improvement in his cellulitis; however, his hospitalization is complicated by acute opioid withdrawal.
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QUIZ: Which Strategy Should Hospitalists Employ to Reduce the Risk of Opioid Misuse?
April 4, 2016
[WpProQuiz 6] [WpProQuiz_toplist 6]
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Ischemic Hepatitis Associated with High Inpatient Mortality
April 4, 2016
Clinical question: What is the incidence and outcome of patients with ischemic hepatitis? Background: Ischemic hepatitis, or shock liver, is often diagnosed in patients with massive increase in aminotransferase levels most often exceeding 1000 IU/L in the setting of hepatic hypoperfusion.
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AIMS65 Score Helps Predict Inpatient Mortality in Acute Upper Gastrointestinal Bleed
April 1, 2016
Clinical question: Does AIMS65 risk stratification score predict inpatient mortality in patients with acute upper gastrointestinal bleed (UGIB)? Background: Acute UGIB is associated with significant morbidity and mortality, which makes it crucial to identify high-risk patients early.
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No Mortality Benefit to Cardiac Catheterization in Patients with Stable Ischemic Heart Disease
March 28, 2016
Clinical question: Can cardiac catheterization prolong survival in patients with stable ischemic heart disease? Background: Previous results from the COURAGE trial found no benefit of percutaneous intervention (PCI) as compared to medical therapy on a composite endpoint of death or nonfatal myoca
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Increase in Broad-Spectrum Antibiotics Disproportionate to Rate of Resistant Organisms
March 28, 2016
Clinical question: Have healthcare-associated pneumonia (HCAP) guidelines improved treatment accuracy? Background: Guidelines released in 2005 call for the use of broad-spectrum antibiotics for patients presenting with pneumonia who have had recent healthcare exposure.
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Discontinuing Inhaled Corticosteroids in COPD Reduces Risk of Pneumonia
March 25, 2016
Clinical question: Is discontinuation of inhaled corticosteroids (ICSs) in patients with COPD associated with a decreased risk of pneumonia? Background: ICSs are used in up to 85% of patients treated for COPD but may be associated with adverse systemic side effects including pneumonia.
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MEDS Score for Sepsis Might Best Predict ED Mortality
March 25, 2016
Clinical question: Which illness severity score best predicts outcomes in emergency department (ED) patients presenting with infection? Background: Several scoring models have been developed to predict illness severity and mortality in patients with infection.
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‘Everything We Say and Do’: Soliciting Goals from Our Patients and Their Families
March 23, 2016
Editor’s note: “Everything We Say and Do” is an informational series developed by SHM’s Patient Experience Committee to provide readers with thoughtful and actionable communication tactics that have great potential to positively impact patients’ experience of care.
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VTEP Guidelines Can Be Systematically Implemented in Pediatric Inpatients
March 21, 2016
Clinical question: Can venous thromboembolism prophylaxis (VTEP) guidelines be systematically implemented in a pediatric inpatient population? Background: VTEP for hospitalized adult medical patients has been characterized in the literature as being safe and efficacious, although mortality benefi
