In this small single institution study of 159 bacteremic patients, all of which had troponin I sent, 43% were elevated (abstract). Most were minor elevations (96% < 1mcg/L). Not surprisingly, independent risk factors for troponin elevations included renal insufficiency, higher WBC, and septic shock. Troponin elevations were not significantly associated with EKG changes (although not performed in all patients), and did not independently predict mortality. For bacteremic patients, if you check troponin, there is about a coin-toss chance it will be elevated, but given the lack of association with EKG changes or mortality, there is no clear benefit of routinely checking it in the first place.
Fill in the Blanks: Q: “The diagnosis of type 2 MI is associated with a _____ prognosis. ___% of patients will live five years after their diagnosis.” The answer is a) POOR and b) a staggering 40%. I did not know that. However, what I am aware of is the ambiguity around Type 2 MIs and […]
What comes to mind when you think of getting CME? I bet most of you would say sitting in an auditorium, whether that be during your local grand rounds or at our professional society meeting, like Hospital Medicine 16 in sunny San Diego this past March. Hanging out in the Twitterverse? Probably not so much… […]
As a nurse practitioner in hospital medicine I have multiple opportunities to interact with all sorts of physician hospitalist colleagues, hospital medicine group leaders, quality officers etc. Often their interactions with me take on a certain wary curiosity, like I am some exotic monkey or another creature that is unfamiliar to them. If I am […]