Hospital Medicine Virtual Journal Club Minute: Recent Episodes
HMVJC
One article. One minute. 100% evidence based. From the Washington University Hospital Medicine Virtual Journal Club https://journalclub.wustl.edu/
A pair of articles from EMPORER-Preserved examines outcomes in HFpEF patients treated with empagliflozin.
Empagliflozin in Heart Failure with a Preserved Ejection Fraction | Hospital Medicine Virtual Journal Club
Effect of Empagliflozin on Worsening Heart Failure Events in Patients with Heart Failure and a Preserved Ejection Fraction: The EMPEROR-Preserved Trial | Hospital Medicine Virtual Journal Club
An observational study in Frontiers in Cardiovascular Medicine examines the impact of heart rate reduction in patients with heart failure.
In-hospital Heart Rate Reduction With Beta Blockers and Ivabradine Early After Recovery in Patients With Acute Decompensated Heart Failure Reduces Short-Term Mortality and Rehospitalization | Hospital Medicine Virtual Journal Club
A randomized trial from JAMA compares outcomes between a balanced electrolyte solution and normal saline for fluid resuscitation in ICU patients.
Effect of Intravenous Fluid Treatment With a Balanced Solution vs 0.9% Saline Solution on Mortality in Critically Ill Patients: The BaSICS Randomized Clinical Trial | Hospital Medicine Virtual Journal Club
A retrospective cohort study published in Cardiology Research questions the need to transition heart failure patients to oral diuretics before discharge.
Trial of Oral Diuretics Prior to Discharge Is Not Associated With Improved Outcomes in Decompensated Heart Failure | Hospital Medicine Virtual Journal Club
A randomized trial in the New England Journal compares therapeutic anticoagulation to standard prophylaxis in non-ICU patients with COVID-19.
Therapeutic Anticoagulation with Heparin in Noncritically Ill Patients with Covid-19 | Hospital Medicine Virtual Journal Club
A retrospective cohort study in the Journal of Hospital Medicine looks at timeliness of paracentesis performed by a hospitalist procedure service.
Impact of a Hospitalist-Run Procedure Service on Time to Paracentesis and Length of Stay | Hospital Medicine Virtual Journal Club
A database review published in the Journal of Hospital Medicine finds a role for sliding scale insulin monotherapy for some admitted patients with type 2 diabetes.
Inpatient Glycemic Control With Sliding Scale Insulin in Noncritical Patients With Type 2 Diabetes: Who Can Slide?
A meta-analysis from the Journal of Hospital Medicine highlights the challenges in finding a connection between SPS therapy and intestinal necrosis.
Risk of Intestinal Necrosis With Sodium Polystyrene Sulfonate: A Systematic Review and Meta-analysis
A study in Surgical Endoscopy finds some benefits to delaying gallbladder surgery, at the expense of increased readmissions. Delayed cholecystectomy following endoscopic retrograde cholangio-pancreatography is not associated with worse surgical outcomes | Hospital Medicine Virtual Journal Club
A study in the Journal of Patient Experience shows no relationship between physician time at bedside and measures of patient experience.
Relationships Between Time-at-Bedside During Hospital Ward Rounds, Clinician-Patient Agreement, and Patient Experience | Hospital Medicine Virtual Journal Club
A pre-print article in Research in Social and Administrative Pharmacy finds economic and safety benefits when pharmacists perform admission medication reconciliation.
Clinical and economic impact of medication reconciliation by designated ward pharmacists in a hospitalist-managed acute medical unit | Hospital Medicine Virtual Journal Club
A database study in the Journal of Hospital Medicine finds no impact of morning discharges on emergency department throughput.
Morning Discharges and Patient Length of Stay in Inpatient General Internal Medicine | Hospital Medicine Virtual Journal Club
A study in the Western Journal of Emergency Medicine finds a low incidence of clinically significant outcomes in chronic kidney disease patients who undergo emergent contrast CT.
Acute Kidney Injury After CT in Emergency Patients with Chronic Kidney Disease: A Propensity Score-matched Analysis | Hospital Medicine Virtual Journal Club
A meta-analysis in the Journal of Critical Care suggests that thiamine may be useful for the prevention of ICU delirium.
Effect of thiamine supplementation in critically ill patients: A systematic review and meta-analysis | Hospital Medicine Virtual Journal Club
A database review in the American Journal of Infection Control finds a large proportion of low-acuity admissions for complicated urinary tract infection.
Hospital Admission Patterns of Adult Patients with Complicated Urinary Tract Infections Who Present to the Hospital by Disease Acuity and Comorbid Conditions: How Many Admissions are Potentially Avoidable? | Hospital Medicine Virtual Journal Club | Washington University in St. Louis (wustl.edu)
A Cochrane review finds limited evidence to support various medication classes in heart failure with preserved ejection fraction.
Beta-blockers and inhibitors of the renin-angiotensin aldosterone system for chronic heart failure with preserved ejection fraction
A study in PLOS One finds a 2-day course of antibiotics non-inferior to a longer course in patients with COPD exacerbation.
https://journalclub.wustl.edu/2021/05/20/2-day-versus-c-reactive-protein-guided-antibiotherapy-with-levofloxacin-in-acute-copd-exacerbation-a-randomized-controlled-trial/
The RECOVERY trial published in Lancet finds no benefit to convalescent plasma in hospitalized patients with COVID-19.
Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial | Hospital Medicine Virtual Journal Club
A study in JGIM finds similar outcomes for chest pain patients whether they were admitted or discharged from the emergency department.
Does Hospital Admission/Observation for Chest Pain Improve Patient Outcomes after Emergency Department Evaluation for Suspected Acute Coronary Syndrome?
A database review in BMJ finds improved outcomes in patients who underwent a rhythm control strategy within the first year of diagnosis.
Treatment timing and the effects of rhythm control strategy in patients with atrial fibrillation: nationwide cohort study
An article in JAMA describes the first 12 cases of CVST and thrombocytopenia after receiving the Johnson and Johnson COVID vaccine. US Case Reports of Cerebral Venous Sinus Thrombosis With Thrombocytopenia After Ad26.COV2.S Vaccination, March 2 to April 21, 2021
A study from Critical Care Medicine suggests that haloperidol may reduce mortality in patients who develop delirium in ICU.
Association Between Incident Delirium Treatment With Haloperidol and Mortality in Critically Ill Adults
A retrospective review finds lower rates of distal DVT extension and recurrence in patients who undergo anticoagulation.
Calf Vein Thrombosis Outcomes Comparing Anticoagulation and Serial Ultrasound Imaging Management Strategies
Deaf non-speaking patients in the Nationwide Inpatient Sample had a longer length of stay and increased mortality relative to hearing patients.
A Nationwide Study Examining Deafness Among Hospitalized Adults
Adding tofacitinib to standard care in patients with COVID-19 pneumonia was associated with lower mortality in this pre-proof retrospective observational study.
Anti-Inflammatory treatment of COVID-19 pneumonia with tofacitinib alone or in combination with dexamethasone
An Annals study uses a database to compare warfarin and DOACs in patients with valvular atrial fibrillation.
Effectiveness and Safety of Direct Oral Anticoagulants Versus Warfarin in Patients With Valvular Atrial Fibrillation : A Population-Based Cohort Study
A study published in Lancet looks at whether a shorter course of antibiotics is non-inferior for patients with moderate severity community acquired pneumonia.
Discontinuing β-lactam treatment after 3 days for patients with community-acquired pneumonia in non-critical care wards (PTC)
Review of a Medicare database shows no mortality difference in patients admitted toward the end of a hospitalist's block of days versus toward the beginning except for among the sickest patients.
Assessment of Care Handoffs Among Hospitalist Physicians and 30-Day Mortality in Hospitalized Medicare Beneficiaries
From the journal Circulation: a pathway for early MI rule out using high-sensitivity troponin leads to fewer admissions, but does not meet non-inferiority criteria.
High-Sensitivity Cardiac Troponin on Presentation to Rule Out Myocardial Infarction
Albumin infusion had no benefit when given empirically to patients with cirrhosis.
A Randomized Trial of Albumin Infusions in Hospitalized Patients with Cirrhosis
A new antibiotic may allow outpatient treatment for higher-risk patients with pneumonia.
Oral 5-Day Lefamulin for Outpatient Management of Community-Acquired Bacterial Pneumonia: Post-hoc Analysis of the Lefamulin Evaluation Against Pneumonia (LEAP) 2 Trial
Alternative treatment for alcohol withdrawal syndrome may reduce length of stay:
Phenobarbital Versus Lorazepam for Management of Alcohol Withdrawal Syndrome: A Retrospective Cohort Study
A trial finds one of the major COVID vaccines ineffective against a circulating strain.
Efficacy of the ChAdOx1 nCoV-19 Covid-19 Vaccine against the B.1.351 Variant