Background: With the recent consolidation of hospital systems and the increasing complexity of inpatient care, receiving inter-hospital transfers (IHT) has become more common for large academic medical centers. Notably, studies have shown IHT to be associated with increased length of hospital stay (1,2), increased cost of care (2,3), as well as delays in care and [...]

Background: Physical restraint use among patients hospitalized with dementia and behavioral disturbances has not been studied on a national level in the United States. We aimed to determine rates of physical restraint use among hospitalized patients with dementia and behavioral disturbances and to characterize associations with mortality and utilization metrics. Methods: National Inpatient Sample database [...]

Background: For most infections, shorter antibiotic durations are similarly effective to longer durations but have lower risk for side effects and antibiotic resistance.1-9 Since 2019, community-acquired pneumonia (CAP) guidelines have recommended hospitalized patients with CAP be treated until clinical “stability and for no less than a total of 5 days.”10 However, randomized clinical trials have [...]

Background: Failure to follow-up on lab tests and radiology results can lead to major patient safety concerns due to missed or delayed diagnoses and can be a cause for litigation for health care practitioners. With increasing patient loads, the volume of follow-up testing and clarifications to documentation needed for billing can be a significant burden [...]

Background: The three most common childhood-onset chronic conditions for which adolescents and young adults (YA) use pediatric hospitals are congenital heart disease (CHD), cystic fibrosis (CF), and sickle cell disease (SCD). Existing studies do not establish clear clinical benefits to continued pediatric hospitalization over hospitalization at adult hospitals. We aimed to determine if if continued [...]

Background: The clinical evaluation of febrile infants less than 28 days has been extensively studied with the aim to improve the sensitivity in identifying those infants at risk for invasive bacterial infections while decreasing the harm of unnecessary invasive diagnostic procedures. Even though bacterial meningitis is associated with high morbidity and mortality, the incidence is [...]

Background: As of March 30, 2022, the Food and Drug Administration now recommends follow up thyroid function testing (TFT) for children less than 4 years of age who have received IV iodinated contrast for imaging or procedures within 3 weeks of receiving contrast dye due to recent studies reporting subsequent thyroid dysfunction and the potential [...]

Background: Pediatricians are mandated by law to report cases of suspected child abuse. The National Association of Children’s Hospitals and Related Institutions 2006 guidelines on the hospital’s role in child maltreatment note that children’s hospitals “are the undisputed leaders in providing medical care to abused and neglected children” and outline that hospitals should ensure that [...]

Background: Febrile infants under 60 days-old undergo extensive evaluation for infection. Recent AAP guidelines recommend evaluation of the procalcitonin (PCT) level in the work-up of febrile infants 8-60 days-old to aid in predicting bacterial infection (BI) due to its high specificity; however, the sensitivity of PCT is relatively low. Recent literature has identified the Procalcitonin-To-Albumin [...]

Background: Adolescent e-cigarette use was declared as an epidemic by the U.S. Surgeon general in 2018 and has severe health consequences, including e-cigarette, or vaping, product use-associated lung injury (EVALI). It is known that e-cigarette use is associated with mental health disorders and psychosocial stressors; however, there is a knowledge gap in characterizing psychosocial stressors [...]