March 29, 2023
Putting discharge first
Asking hospitalists to prioritize discharging patients first didn't speed throughput and caused other issues, a study found. The authors discussed what their findings mean for clinicians, administrators, and researchers.
Rapidly progressive cerebral edema in cryptococcal meningitis
A patient previously diagnosed with an upper respiratory infection presented with fever, headache, and confusion.
Early hydrocortisone therapy reduced 28-day mortality in ICU patients with severe CAP
A phase 3 double-blind trial in France randomly assigned adults who had been admitted to the ICU with community-acquired pneumonia (CAP) to receive IV hydrocortisone or placebo for eight to 14 days.
Higher-dose prophylactic anticoagulation required to prevent thrombosis in hypoxemic COVID-19
Mortality and time to improvement didn't differ with twice the standard dose of heparin versus a standard or therapeutic dose, but there was a lower rate of new thromboembolic events with no increase in major bleeding, a French trial found.
Hospital rankings change when Medicare Advantage patients included
When researchers included both Medicare fee-for-service and Medicare Advantage beneficiaries in calculations of CMS performance measures, between 21.6% and 30.2% of hospitals in the top-performing group for readmissions and mortality fell to a lower-performing group.
Inpatient oral penicillin challenge more likely in certain low-risk patients
An inpatient penicillin allergy program showed that patients were more likely to proceed from assessment to oral challenge if they had a low-risk phenotype, had an indication for beta-lactam antibiotic therapy, and were medically stable.