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Will SHEA Drop Flu Shot Mandate of HCWs?
“Given the assault on science that we are likely to see over the next four years in the U.S., SHEA must lead by ensuring that all of its recommendations are solidly based in evidence and that expectations for compliance with interventions correlate with the strength of the evidence,” notes Michael Edmond, MD, clinical professor of internal medicine and infectious diseases at the University of Iowa in Iowa City. “Just as we must defend vaccines from false claims of adverse effects, we must also truthfully acknowledge their limitations and shape our policy on science not opinion.”
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Study: Flu Shot Mandates Unsupported by Science
The four trials were conducted in long-term care facilities, but have generally been extrapolated to support flu immunization requirements in acute care and other settings. Among other benefits, the studies generally link reductions in resident mortality to higher staff flu vaccination rates. With healthcare worker vaccination rates lagging in most hospitals, several facilities began mandating immunization several years ago in what has since become a national trend.
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Troponin Highly Prognostic in Decompensated Heart Failure with Preserved Ejection Fraction
SYNOPSIS: Among patients with acute decompensated heart failure and preserved ejection fraction, elevated troponin is associated with worse in-hospital outcomes and long-term survival, independent of other predictors.
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NOACs in Patients Requiring Anticoagulation Post-PCI
SYNOPSIS: The PIONEER study of atrial fibrillation patients post-percutaneous coronary intervention showed that regimens of clopidogrel plus reduced-dose regimens of rivaroxaban demonstrated lower bleeding and similar rates of stroke and adverse cardiac events compared with traditional warfarin triple therapy.
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A New Risk Score for Stroke in Atrial Fibrillation
SYNOPSIS: A new, simpler score for stroke risk prediction in atrial fibrillation patients uses biomarkers to supplant many clinical variables and outperforms the CHA2DS2-VASc score in two large cohorts.
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Antibiotic Treatment in Community-acquired Pneumonia
SYNOPSIS: In patients with newly diagnosed community-acquired pneumonia, basing the duration of antibiotic treatment on clinical stability criteria led to a significant reduction in duration of antibiotic treatment without an increased risk of adverse outcomes.
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Discharge Antibiotic Prescriptions Often Are Inappropriate with Regard to Choice, Dose, Duration
SYNOPSIS: Seventy percent of discharge antibiotic prescriptions are inappropriate.
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High-sensitivity Cardiac Troponin
In a recent trial, the use of high-sensitivity troponin T did not increase the use of coronary angiography or stress testing, but did reduce ED length of stay and costs.
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Hemoconcentration Associated with Lower Mortality in Acute Heart Failure
Among patients hospitalized for acute heart failure, hemoconcentration was associated with reduced 90-day mortality and may be a useful marker for guiding therapy.
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Mechanical Circulatory Support in Cardiogenic Shock: Can Any Device Move the Mortality Needle?
In a small randomized trial of patients with cardiogenic shock secondary to acute myocardial infarction, the Impella heart pump failed to improve mortality compared with intra-aortic balloon counterpulsation.