In this large single center analysis of all PCI patient (elective or after acute coronary syndrome), ~10% were readmitted within 30 days after discharge. They found risk factors for readmission included female sex, Medicare, unstable angina, LOS>3 days, low education, and some co-morbid conditions (history of CVA/TIA, COPD, metastatic cancer, peptic ulcer, kidney disease). These […]
In this randomized trial of patients with COPD receiving ventilatory support in the ICU, those randomized to steroids (methylprednisolone versus placebo) had fewer days of ventilation, shorter ICU LOS, and were less likely to fail non-invasive ventilation. Not surprisingly, but now definitively proven, steroids are beneficial for COPD patients in the ICU receiving ventilatory support […]
In this nationally representative sample of US hospitals, elderly patient hospitalized for an adverse drug event were caused by warfarin, anti-platelets, insulin, and hypoglycemic agents in 2/3 of cases. System checks should be built in for these medications at all care transitions (abstract)
The August 2nd citation, Association of Hospitalist Care With Medical Utilization After Discharge: Evidence of Cost Shift From a Cohort Study, generated an enormous amount of attention.The response was significant, and many of the letters published are worth reading (in particular, Dan Brotman’s).
I’ve heard a lot of shocking things since arriving in England five months ago on my sabbatical. But nothing has had me more gobsmacked than when, earlier this month, I was chatting with James Morrow, a Cambridge-area general practitioner. We were talking about physicians’ salaries in the UK and he casually mentioned that he was […]
In this single institutional retrospective analysis, researchers found of inpatient adverse events related to anti-coagulants, almost half were due to medical errors, and 70% were preventable. Despite the Joint Commission National Patient Safety Goal to improve the safety of inpatient anti-coagulants, many medical centers still have a lot of work to do to improve the […]