By  | March 30, 2012 |  8
It’s been said that losing weight is much harder than kicking cigarettes or alcohol. After all, because one doesn’t need to smoke or drink, the offending substances can simply be kept out of sight (if not out of mind). Dieting, on the other hands, involves changing the way a person does something we all must […]
By  | March 28, 2012 |  0
The AABB has issued updated guidelines on transfusion thresholds, which include a Hb<7 for most ICU patients, and a Hb<8 for most post-surgical patients, with higher thresholds for those with symptoms (such as chest pain or decompensated CHF). The full guidelines are available at (guidelines)
By  | March 28, 2012 |  0
In this large of hospitalized patients at 14 patients with a comprehensive EMR, a host of predictors automatically pooled from the EMR accurately predicted a patient’s risk of ICU transfer or death with a validation c-statistic of 0.77. Automated EMR-based scores such as this can quickly identify patients at risk for clinical deterioration (abstract)
By  | March 28, 2012 |  2
Of note, a very nice commentary in today’s NEJM regarding our inability to control 30-day readmissions, and the justifications (or lack thereof) for its continued use as a metric in judging inpatient quality.  I suggest everyone who works on the front lines read it: […]Although a focus on readmissions may have good face validity, we believe […]
By  | March 26, 2012 |  0
In patients with low risk chest pain (TIMI score 0-2), this large trial randomized patients to usual care, or to CTA imaging. Of those with a negative CTA, none experienced death or MI within 30 days. Those in the CTA group had higher rates of ED discharge (50% vs 23%) and shorter total LOS (18 […]
By  | March 26, 2012 |  0
In this large trial of 4832 patients with PE, they were randomized to rivaroxaban (15mg bid for 3 weeks, then 20mg qday) or enoxaparin-warfarin. Recurrent VTE occurred at about the same rate in both groups (2.1% of rivaroxaban group and 1.8% of enoxaparin-warfarin group), but major bleeding was less common with rivaroxaban (1.1% vs 2.2%). […]