In this large retrospective analysis of an ICU, the amount of blood transfused significantly decreased from 1997 to 2007. The percent of patients transfused decreased from 31% to 18%, the mean hemoglobin level before transfusion decreased from 7.9 to 7.3, and the mean number of transfusions decreased from 4.3 to 3.0. ICU transfusion practices have become more restrictive in accordance with clinical guideline recommendations (abstract)

In this trial of 200 hip fracture patients, they were randomized to IV iron or standard treatment. The iron group had lower rates of blood transfusions (41% vs 33%), which was significantly lower in the subgroup of patients with intra-capsular fractures (46% vs 14%). There were no significant differences in LOS or mortality. IV iron peri-operatively may reduce transfusion need in patients with hip fractures (abstract)

This evaluation of University of Michigan Health System’s liability claims and cost before and after they implemented a program of full disclosure of medical errors (with patient compensation). They found decreases in the rate of liability claims and decreases in the costs (of total liability, patient compensation, and other legal costs). Not only is full medical error disclosure the appropriate thing to do, it may also be financially advantageous (abstract).

In this large retrospective database analysis of healthcare associated invasive MRSA infections, rates decreased 9% per year from 2005-2008. This is a very encouraging report, and likely due to multi-faceted MRSA prevention programs (abstract).

In this before-after study of the use of CPOE to reduce inappropriate medication use in older patients, the use of these alerts (which suggested either alternative medications or dose reductions) reduced inappropriate medication orders by 1.6 orders a day, which was sustained over time. CPOE alerts can be an effective tool for reducing inappropriate medications in hospitalized elderly patients (abstract)

The 11 variable PE severity index (PESI) score accurately predicts the 30 day risk of death, but can be cumbersome to use. This study derived and validated a simpler 6 variable score, based on age, cancer, chronic pulmonary disease, heart rate, blood pressure, and oxygen saturation, which performed just as well as the 11 variable score. This simplified score is easier to use and has the same predictive value as the 11 variable score (abstract)

In this single institutional survey analysis of patient’s and inpatient physician’s communication recall, only 18% of patients could accurately recall the inpatient physician name, but 67% of physicians thought the patients could recall their names. Although 77% of physicians thought that their patients knew their diagnosis, but only 57% of patients actually did. Almost all physicians thought they discussed patients anxiety and fears, but only half of the patients agreed (abstract) This reiterates ongoing concerns around adequate communication between patients and inpatient providers.

Contrary to past randomized trials, this trial of patients with acute osteoporotic vertebral fracture (with persistent pain) found that verebroplasty improved pain control significantly better than the control group, both immediately after the procedure and at 1-year follow up. Vertebroplasty is a reasonable option in patients with persistent pain after acute osteoporotic vertebral fractures (abstract)

This retrospective single institution study of the prevalence of fracture/embolization of Bard vena cava filters found that 25% of first generation and 12% of second generation filters had embolized, resulting in at least 1 case of sudden death. This study cautions careful use of insertion of these filters only in those that absolutely need them, given the risk of fracture and embolization, and the FDA contends it will be scrutinizing these devices more closely (abstract)

In this double dummy trial of 170 patients admitted to the ICU with COPD/respiratory failure (without pneumonia), there were no differences in outcomes (death, need for additional antibiotics, length of stay, or ventilator days) between the 2 groups. This study and others confirms TMP-SMX works just as well as cipro for acute COPD exacerbations (abstract)