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.
News
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.
News
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
News
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.
News
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.
News
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
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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.
News
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.
News
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.