Background: Self-directed discharge, also known as Against Medical Advice (AMA) discharges, comprise 1–2% of hospital discharges (1). The AMA process poses safety risks to patients and emotional strain on providers, potentially leading to implicit biases in documentation (2). While stigmatizing language in medical records has gained attention (3), its prevalence in AMA documentation remains underexplored. [...]

Background: The decision to reinitiate anticoagulation after a trauma admission is complex. There have been limited studies on post-discharge outcomes of patients who are restarted on therapeutic anticoagulation after traumatic injury versus those who have had anticoagulation discontinued. Methods: All consecutive patients on anticoagulants who were admitted to Saint Marys Hospital in Rochester, Minnesota for [...]

Background: In 2022, healthcare spending in the US accounted for 17.3% of its GDP(1), yet the US ranked near the bottom among high-income nations for key health outcomes. It is unclear if a similar relationship exists between spending and health outcomes across US Hospitals. Centers for Medicare and Medicaid Services (CMS) reports a standardized risk-adjusted [...]

Background: Stroke is a leading cause of long-term disability in the U.S., with many being attributable to lifestyle-related risk factors. Obesity and diabetes, in particular, have been shown to significantly increase the risk of having a stroke. However, the connection between these conditions and the severity of stroke is not as well understood. Some research [...]

Background: Before any gastrointestinal (GI) procedures, it is recommended that patients have no intake of clear liquids (2-4 hours) and solid food (6 hours) prior to induction of sedation to minimize preoperative risks such as regurgitation, pulmonary aspiration, and other risks associated with sedation. These time frames were determined by previous randomized control trials which [...]

Background: Most primates, including humans, belonging to the suborder Haplorrhine lack the innate ability to synthesize ascorbic acid (Vitamin C) and hence exclusively depend on dietary intake (generally plant-based diets) to prevent deficiency. Modern humans’ trend of consuming ultra-processed foods that lack crucial micronutrients places us at risk for developing micronutrient deficiencies. Currently, there is [...]

Background: Acute Decompensated Heart Failure (ADHF) is responsible for over a million hospitalizations per year in the US and Europe. The American Heart Association Guidelines for treatment of patients hospitalized with ADHF recommend intravenous (IV) diuresis with loop diuretics to reduce fluid overload until vascular congestion is relieved. However, the optimal dosing strategy for IV [...]

Background: In Texas, the five-year survival rate for lung cancer is significantly lower compared to the national average with noted disparities in early diagnosis and treatment. The aim of this study is to assess sex, ethnic and racial differences in end-of-life healthcare utilization, advance care planning (ACP) and associated outcomes such as hospice use among [...]

Background: Hypertension and diabetes are common comorbidities frequently managed by primary care physicians. Poorly controlled cases of these conditions can lead to increased healthcare resource utilization. We conducted a prospective pilot study involving high-risk patients with hypertension and diabetes to evaluate whether a multidisciplinary team approach could lead to improved clinical outcomes and reduced healthcare [...]

Background: In 2019, the US Food & Drug Administration issued a warning regarding safety of gabapentin use in patients with respiratory conditions, including chronic obstructive pulmonary disease (COPD). Gabapentin is widely prescribed, often for off-label indications, however limited data exist regarding safety and outcomes among patients with COPD. Methods: We analyzed data from 29 US [...]