Background: Early esophagogastroduodenoscopy (EGD) within 24 hours is recommended for non-variceal upper gastrointestinal bleeding (UGIB). However, the effect of early EGD on resource utilization remains unclear due to selection bias inherent in observational studies. We sought to identify the unbiased effects of early EGD on hospital charges and length of stay (LOS) using a causal [...]

Background: Re-expansion pulmonary edema (RPE) is a potentially life-threatening and feared complication of thoracentesis. While clinicians traditionally focused on avoiding rapid lung expansion by limiting drainage to less than 1.5 liters of pleural fluid, more recent literature suggests that monitoring pleural pressures using pleural manometry (PM) may allow for safe drainage of larger volumes. However, [...]

Background: Hospitalized patients often present with conditions that stimulate antidiuretic hormone (ADH) secretion, increasing the risk of hyponatremia. About one-third of serum sodium measurements fall below 135 mmol/L. Real-world evidence on association between IV fluids and Hyponatremia prevalence is limited. From October to December 2024, Hurricane Helene disrupted IV fluid production, creating a natural experiment [...]

Background: Dysphagia is common among older adults and the physiologic stress of hospitalization can worsen swallowing function. Rehabilitative treatment such as speech language pathology (SLPT), nutrition, and physical therapy (PT) services improve swallowing function, yet little is known about their delivery and impact on dysphagia outcomes after a hospitalization. Here, we describe delivery patterns for [...]

Background: Learning health systems (LHS) integrate evidence generation and implementation into clinical practice to improve healthcare delivery and health outcomes. Pragmatic clinical trials are an important form of LHS research, comparing approaches to clinical care in a real-world setting. The field of hospital medicine is uniquely positioned to advance pragmatic LHS research due to its [...]

Background: Each year, tens of thousands of Americans seek emergency care for rectal bleeding, making hematochezia one of the most common gastrointestinal (GI) bleeding presentations (20–36 cases per 100,000 persons annually)1. In adults aged 18–44, most cases arise from benign anorectal sources, though inflammatory bowel disease (IBD) and diverticular disease remain relevant2. Despite overall low [...]

Background: Ischemic colitis is a rapidly progressive gastrointestinal emergency that causes acute abdominal pain, inflammation, and potentially life-threatening bowel injury. Many mild cases resolve without intervention, but severe disease can quickly advance to necrosis, sepsis, or organ failure1. Ischemic colitis is correctly identified at presentation in only ~9% of patients and occurs at an incidence [...]

Background: Opioid use disorder (OUD) is a major public health challenge. Medications for opioid use disorder (MOUD) are effective and life-saving treatments.(1) Unfortunately, a minority of OUD patients receive MOUD.(2) Over the past decade, there have been several implementation efforts to address this, including inpatient addiction medicine (AM) consult services and removal of the DEA [...]

Background: Adverse events (AEs) following hospital discharge occur in 19–28% of patients and pose significant challenges, particularly among those with multiple chronic conditions (MCCs). Accurate prediction of these events is essential for the growing population of adults with MCCs. Conventional risk models that rely on structured electronic health record (EHR) data often fail to account [...]

Background: It is reported harmful diagnostic errors (DEs) occurred in 7.2% of hospital care setting. DEs are a significant threat to patient safety, and reduction of DEs is a key to achieve diagnostic excellence. Given their central role in patient care, nurses are considered to play significant roles in preventing DEs. Our previous research revealed [...]