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Can I use DOAC in a patient with renal disease?
Case A 76-year-old man is diagnosed with non-valvular atrial fibrillation. His comorbid conditions are hypertension, diabetes complicated by neuropathy, and chronic kidney disease stage 3. His current medications include metformin, lisinopril, gabapentin, and aspirin. His most recent laboratories showed a creatinine 1.8, creatinine clearance (CrCl) 35 mL/min, hemoglobin 11g/dL, and international normalized ratio 1.0. His congestive heart failure, hypertension, age, diabetes, stroke, vascular disease, and sex (CHADSVASc) score is 4. Which medication should we use to prevent stroke in this patient?  Brief overview of the is...
Source: The Hospitalist - February 3, 2022 Category: Hospital Management Authors: Ronda Whitaker Tags: Renal & Genitourinary Source Type: research

There is a Decreased Risk of Hospitalization from Heart Failure in Type II Diabetics Initiated on a SGLT2 Inhibitor When Compared to a GLP-1 Receptor Agonist
Dr. Huang Clinical question: Determine the cardiovascular risk outcome in type II diabetic patients initiated on an sodium-glucose cotransporter-2 (SGLT2)  inhibitor versus a glucagon-like peptide-1 (GLP-1) receptor agonist. Background: Various studies have suggested that several SGLT2 inhibitors and GLP-1 receptor agonists may improve cardiac outcomes—myocardial infarction, stroke, hospitalization for heart failure, and cardiovascular death. Current guidelines recommend using either an SGLT2 inhibitor or GLP-1 receptor agonist for patients with type II diabetes and cardiovascular disease. However, there has been no st...
Source: The Hospitalist - September 1, 2022 Category: Hospital Management Authors: Ronda Whitaker Tags: Diabetes Heart Failure In the Literature Source Type: research

Updates in perioperative medicine
CONCLUSIONSThe body of literature reviewed provides important information for clinicians caring for surgical patients across multiple fronts, including preoperative risk assessment, medication management, and postoperative medical care. Journal of Hospital Medicine 2015. © 2015 Society of Hospital Medicine
Source: Journal of Hospital Medicine - September 18, 2015 Category: Hospital Management Authors: Suparna Dutta, Steven L. Cohn, Kurt J. Pfeifer, Barbara A. Slawski, Gerald W. Smetana, Amir K. Jaffer Tags: Reviews Source Type: research

Readmissions following hospitalisations for cardiovascular disease: a scoping review of the Australian literature.
ConclusionsHigh rates of readmissions are reported for cardiovascular conditions, although substantial methodological heterogeneity exists among studies. Nationally standardised definitions are required to accurately measure readmissions and further studies are needed to address knowledge gaps and test interventions to lower readmissions in Australia.What is known about the topic?International studies suggest readmissions are common following cardiovascular hospitalisations and are costly to the health system, yet little is known about the burden of readmission in the Australian setting or the effectiveness of intervention...
Source: Australian Health Review - February 20, 2019 Category: Hospital Management Authors: Labrosciano C, Air T, Tavella R, Beltrame JF, Ranasinghe I Tags: Aust Health Rev Source Type: research

Risk of hospital admission or emergency department presentation due to diabetes complications: a retrospective cohort study in Tasmania, Australia
ConclusionsOur results demonstrated the high demand on hospital services due to diabetes complications (especially macrovascular complications) and highlighted the importance of preventing and properly managing microvascular complications. These findings will support future resource allocation to reduce the increasing burden of diabetes in Australia.PMID:37137728 | DOI:10.1071/AH22271
Source: Australian Health Review - May 3, 2023 Category: Hospital Management Authors: Ngan T T Dinh Barbara de Graaff Julie A Campbell Matthew D Jose John Burgess Timothy Saunder Alex Kitsos Petr Otahal Andrew J Palmer Source Type: research

Choosing wisely in adult hospital medicine: Five opportunities for improved healthcare value
CONCLUSIONSHospitalists have many opportunities to impact overutilization of care. The adult hospital medicine Choosing Wisely recommendations offer an explicit starting point for eliminating waste in the hospital. Journal of Hospital Medicine 2013. © 2013 Society of Hospital Medicine
Source: Journal of Hospital Medicine - August 19, 2013 Category: Hospital Management Authors: John Bulger, Wendy Nickel, Jordan Messler, Jenna Goldstein, James O'Callaghan, Moises Auron, Mangla Gulati Tags: Review Source Type: research

Disproportionate effects of dementia on hospital discharge disposition in common hospitalization categories
CONCLUSIONSDementia proportions in many hospitalization categories have increased. The variable effect of dementia on home discharge suggests that dementia has a differential influence on hospital discharge disposition depending on the DRG. These findings have implications for healthcare allocation and long‐term care planning. Journal of Hospital Medicine 2015. © 2015 Society of Hospital Medicine
Source: Journal of Hospital Medicine - June 7, 2015 Category: Hospital Management Authors: Robert Y. Lin, Brian C. Scanlan, William Liao, Truc Phuong Thanh Nguyen Tags: Original Research Source Type: research

New Cardiac Pump Device Improves Long-Term Outcomes for Heart Failure Patients
MOMENTUM 3 clinical trial finds that advanced heart-failure patients who had a centrifugal-flow circulatory pump implanted had lower rates of pump-related blood clots and stroke.
Source: BWH News - March 11, 2018 Category: Hospital Management Source Type: news

Sodium-containing Acetaminophen Intake Increases the Risk of CVD and All-cause Mortality
Dr. Hoque Clinical question: Does the use of sodium-containing acetaminophen increase the risk of cardiovascular disease (CVD) and all-cause mortality in patients with and without a history of hypertension when compared to non-sodium-containing acetaminophen? Background: There is a common misconception that excess sodium intake comes primarily from dietary sources. The excipients of common over-the-counter medications such as some formulations of acetaminophen may contain significant amounts of sodium. For example, a 500-mg dose of soluble acetaminophen contains 390 mg of sodium, and a 500-mg dose of effervescent acetamin...
Source: The Hospitalist - October 3, 2022 Category: Hospital Management Authors: Ronda Whitaker Tags: In the Literature Source Type: research

Costs of major complications in people with and without diabetes in Tasmania, Australia
ConclusionsDiabetes complications are costly, and the costs are higher in people with diabetes than without diabetes. Our results can be used to populate diabetes simulation models and will support policy analyses to reduce the burden of diabetes.PMID:36375176 | DOI:10.1071/AH22180
Source: Australian Health Review - November 14, 2022 Category: Hospital Management Authors: Ngan T T Dinh Barbara de Graaff Julie A Campbell Matthew D Jose Burgess John Timothy Saunder Alex Kitsos Nadine Wiggins Andrew J Palmer Source Type: research

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