By  | January 31, 2009 |  7
A study in this week’s Archives of Internal Medicine by Vinny Arora and colleagues found that vanishingly few hospitalized patients could name any of their hospital doctors. Should we care? I think we should. Vinny is one of the nation’s up-and-coming researchers in the field of hospital medicine, and a good friend. In this clever […]
By  | January 29, 2009 |  0
In 2005, the IDSA and ATS issued guidelines on the treatment of pneumonia in hospitalized patients, and included a new categorization of healthcare-associated pneumonia (HCAP) for patients with recent interface with medical facilities (guidelines). In this prospective cohort, researchers identified 362 patients with CAP, HAP, or HCAP, and determined rates of guideline-appropriate treatment and mortality. Patients with HCAP […]
By  | January 28, 2009 |  0
In this small study of 37 patients with suspected endocarditis, researchers examined the diagnostic accuracy of CT (compared to TEE or surgery), in detecting endocarditis. CT (on per valve evaluation) compared favorably to TEE (PPV 93% and NPV 98%) and surgery (PPV 96% and NPV 97%) in detecting valve abnormalities (vegetations, abscesses, perforations, fistulas, or valve dehiscence) […]
By  | January 28, 2009 |  0
In this multicenter trial of 500 patients >age 60, patients were randomized to CHF medical titration based on symptoms alone (goal NYHA class <2), or symptoms + BNP (goal of <2 times upper limit of normal). There was no difference in 18 month quality of life, overall survival, or survival free hospitalizations, but the BNP-guided group […]
By  | January 27, 2009 |  0
In this multi-institutional cross-sectional analysis, researchers measured physician’s use of IT (CPOE, decision support, and automated notes). They found automated notes decreased in-hospital mortality (15% for every 10 point increase in use), CPOE decreased MI death by 9% and CABG death by 55%, and decision support decreased in-hospital complications by 16%. They all reduced cost. […]
By  | January 27, 2009 |  0
In this single-institution point-prevalence culture survey, researchers found contamination with Cdiff in 16% on non-isolation rooms, 31% of physician work areas, 10% of nurses work areas, and 21% of portable pieces of equipment. Although this was in the setting of a Cdiff outbreak, it reminds us that Cdiff spores are environmentally hearty, and that handwashing […]