The 2 Minute Update

Does pulmonary rehab decrease mortality?

May 23, 2020 • COPD exacerbation • hospital guidelines • Hospital medicine • journal review • journal study • mortality outcome • pulmonary rehab

Mortality is greatly decreased if pulmonary rehab is started within 90 days of a COPD-related hospital admission. But only 1.5% of Medicare patients start pulmonary rehab shortly after being admitted for COPD.

Does paracentesis timing matter?

April 15, 2020 • hospital guidelines • Hospital medicine • journal review • journal study • mortality outcome • paracentesis

Paracentesis is recommended in patients with cirrhosis and ascites, but timing is not addressed. This study shows that early paracentesis - in the first 24 hours of admission - saves lives and prevents readmissions, especially in patients with encephalopathy of AKI.

Low-dose colchicine after MI?

February 18, 2020 • Colchicine • hospital guidelines • Hospital medicine • journal review • journal study • MI • mortality outcome

Low-dose colchicine reduces further cardiovascular events after myocardial infarction. The rates of stroke, after an initial MI, were dramatically lower.

Hospitalized at home?

January 31, 2020 • hospital care at home • hospital guidelines • Hospital medicine • hospitalized at home • journal review • journal study

A randomized trial evaluated treating inpatients inside their home instead of inside a hospital, with doctor and nurse visits, IV med, oxygen, etc. There were fewer readmissions, and costs were lower.

Oral vancomycin to prevent C diff?

January 17, 2020 • C. diff prevention • hospital guidelines • Hospital medicine • journal review • journal study • mortality outcome • vancomycin

Should we use oral vancomycin as prophylaxis against C. difficile infections? A recent prospective study randomized high risk patients to 125 mg oral vanc once a day, or no intervention.