Hospital Medicine Alert – June 1, 2017
June 1, 2017
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Risk Factors for Hospital Readmissions Ending in Death or Transition to Hospice
In this retrospective cohort study, multiple factors were identified during initial hospitalization, including sepsis and shock, that were associated with a hospital readmission within 30 days resulting in death or transition to hospice. Infection was a frequent cause for readmissions that ended in death.
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Restricting Fluoroquinolone Use Reduces CDI More Than Infection Control Methods
An observational study from England showed that restricting fluoroquinolone use reduced incidence of Clostridium difficile infection more than would be predicted by improved infection control methods alone.
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Tolvaptan Fails to Improve Dyspnea in Acute Heart Failure
In patients hospitalized for acute heart failure, adding tolvaptan to furosemide lead to increased weight and fluid loss, but did not improve dyspnea at 24 hours.
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Predicting Electrical Cardioversion Failure
A study of the 30-day success rate of electrical cardioversion of acute atrial fibrillation revealed five clinical predictors of recurrence. These were combined into a risk score that could be useful to avoid unnecessary cardioversions in the acute setting.
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Is Exposure to Arterial Hyperoxia During Critical Illness Dangerous?
Exposure to severe hyperoxia during critical illness is associated positively with increased ICU and hospital mortality and associated negatively with ventilator-free days.