Neurology

Survival after discharge after in-hospital cardiac arrest

This large cohort of patients age>65 who survived in-hospital cardiac arrest found that 1 year after discharge, 59% were still alive, and 34% had not been readmitted to the hospital. Both mortality and readmission rates were substantially affected by the neurologic status of the patient at the time of discharge from the index hospitalization (abstract).

Head CT not helpful for acute dizziness

This single center retrospective cohort of patients presenting to an ED with acute dizziness found head CT imaging to be diagnostic in only 2% of patients; MRI yielded a diagnosis in 16% of patients. This study supports the recommendations of the American College of Radiology, which recommends MRI for patients with a suspected intracranial source of dizziness (abstract).

Quetiapine effective and relatively safe for delirium

This systematic review found quetiapine was more effective than placebo and as effective as haloperidol in reducing the duration of delirium, and is associated with fewer extrapyramidal side effects than the first generation antipsychotics. Quetiapine is a reasonable first line choice for reducing the duration of hospital acquired delirium (abstract).

Effect of delirium in critically ill

This meta-analysis of critically ill patients found significantly worse outcomes in those that experience delirium compared to those that do not, including higher mortality, more complications, longer vent duration, and longer ICU and hospital LOS (abstract). Continued efforts for prevention and early treatment of delirium is needed.
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