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Category Archives: Other
“Basal plus” option for inpatient diabetic control
This multi-center trial randomized hospitalized diabetics to (1) Basal + standing mealtime + corrective mealtime (2) Basal + corrective mealtime (3) Sliding Scale. Rates of glucose control and severe hypoglycemia were similar between the 1st and 2nd groups. Basal + … Continue reading
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Capnography to rule out DKA
This single center trial of ~180 adults with a blood sugar>250 and suspected DKA were evaluated by serum pH, serum Hco3, urine ketones, and capnography. Those with an end tidal Co2 of >24.5 mmHg had a sensitivity and specificity for … Continue reading
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PICC lines higher DVT risk than central venous catheters
PICC lines are increasingly being used for central venous access in hospitalized patients. This large meta analysis found the risk of DVT was 2.5 times higher with PICC lines compared to CVCs, although there were no PEs. The DVT risk … Continue reading
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Patient participation in medical decision making
This large single center study found 29% of patients wanted to participate in medical decision making, which was more likely in those highly educated and with private insurance. This preference was associated with a longer LOS (0.26 days) and higher … Continue reading
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Medicaid benefits?
This study in Oregon compared 2 year results of those that were enrolled in Medicaid or not, based on a random lottery system. There were no difference between the groups in outcomes of chronic conditions, such as high cholesterol or … Continue reading
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Elderly inpatient services improve outcomes
This single center trial randomized elderly (age >75) inpatients to usual care, or to a team which specialized in the care of the elderly; those in the latter group were less likely to experience adverse events (10% vs 17%) and had … Continue reading
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Litigation from diagnostic errors
This large analysis of closed malpractice claims from 1986 to 2010 found 29% were due to diagnostic errors, which accounted for 35% of total payments. Diagnostic errors resulted in death 41% of the time, as opposed to only 24% with … Continue reading
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Revealing lab costs reduces utilization
This controlled trial found that displaying the cost of lab tests reduced utilization only modestly by 9%; this benign intervention can modestly reduce lab test utilization (abstract).
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Patient centered decisions result in better outcomes
This study of audio recorded physician encounters found that when physicians addressed contextual “red flags” in clinical decision making, clinical outcomes were improved in 71% of the patients, compared to 46% of those whose physicians did not address the contextual … Continue reading
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WE ARE MOVING!
The Hospital Medicine Quick Hits is moving to www.hospitalmedicine.org/blog. Migration will take place between April 18-29th, we apologize for any inconvenience or disruption.
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