Hospital Medicine Alert – December 1, 2016
December 1, 2016
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Outcomes in Patients Treated with Therapeutic Hypothermia After In-hospital Cardiac Arrest
SYNOPSIS: Current guidelines recommend the use of therapeutic hypothermia in patients with in-hospital cardiac arrest, even though its efficacy has been demonstrated only in randomized trials after out-of-hospital cardiac arrest. This non-randomized, observational cohort study based on a large national registry found that the use of therapeutic hypothermia was associated with lower likelihood of survival and less favorable neurological outcome in patients successfully resuscitated after an in-hospital cardiac arrest.
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Reported Beta-lactam Allergy Is Associated with More Adverse Events Among Inpatients
SYNOPSIS: A prospective cohort study from three hospitals determined that patients who did not receive a preferred beta-lactam antibiotic were at greater risk for an adverse event (adjusted odds ratio, 3.1; 95% confidence interval, 1.28-7.89) compared to controls without a beta-lactam allergy.
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What Influences ICU Admission?
SYNOPSIS: There is widespread variability between hospitals in rates of ICU admission. High ICU utilization hospitals were more likely to use invasive procedures and incurred higher costs than low ICU utilization hospitals with no difference in mortality.
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Vasopressin as a Single Vasopressor Agent in Patients with Septic Shock
SYNOPSIS: The use of vasopressin as a vasopressor for septic shock produced similar outcomes as the use of norepinephrine.
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Warning: Reactivation of Hepatitis B Virus Coinfection During Treatment of Chronic Hepatitis C Virus Infection
SYNOPSIS: Prior to initiation of hepatitis C virus treatment with direct-acting antivirals, patients should be screened for hepatitis B virus coinfection. Those who are hepatitis B virus-infected should receive ongoing monitoring for flares and reactivation of hepatitis B.