Background: Community acquired pneumonia (CAP) is commonly treated in hospitals and frequently results in antibiotic overuse. Important areas of overuse for CAP include excess treatment duration and unnecessary fluoroquinolone use. Smaller hospitals, including critical access hospitals (CAHs), often have limited resources for antibiotic stewardship compared to larger institutions which impedes stewardship efforts. After 2 years [...]

Case Presentation: A 54-year-old woman with no significant PMH presented with a macular rash, truncal pain, and progressive bilateral lower extremity weakness. She denied recent illness or travel, but did report frequent mosquito bites, as well as multiple recent sexual partners. She had no outdoor exposure except regular strolls on the Beltline, a popular urban [...]

Background: Hospital admissions among nursing home residents with Alzheimer’s Disease and related dementias (ADRD) are burdensome, expensive, and provide limited clinical benefits. Compared to other patients, those with ADRD are more likely to experience adverse events, such as delirium, urinary infections, pneumonia, and functional decline. Research on nursing home residents has focused on the consequences [...]

Background: Asthma disproportionately affects racial minorities and individuals of lower socioeconomic status (SES). The introduction of biologic therapies in 2015 provided new treatment options for managing severe asthma. This study investigates the impact of biologics on racial and SES disparities in asthma-related emergency care visits before and after 2015. Methods: Data from the National Health [...]

Background: Dichotomous outcomes—such as mortality—rarely capture the range of potential outcomes important to patients and clinicians. To address this limitation, the Desirability of Outcome Ranking (DOOR) score was created to rank potential outcomes from least to most desirable. Currently, there is no standardized method to develop a DOOR score and data are limited on whether [...]

Background: More frequently, clinicians encounter patients with mild-to-moderate COVID-19 (defined as patients whose oxygen saturation remains above 94% on room air)1 in the hospital setting.2 These patients may have acquired COVID-19 in the hospital or have tested positive for COVID-19 while presenting to the hospital for another condition.3 Many of these patients are high risk [...]

Background: In-hospital cardiac arrest (IHCA) remains a leading cause of mortality in the United States, with an estimated 290,000 cases annually and survival to discharge rates ranging from 15% to 40% as of 2024. For those patients who achieve return of spontaneous circulation (ROSC), predicting their neurological outcome and survival in the intensive care unit [...]

Background: Urgency of and time to antibiotic administration has often been highlighted to prevent complications of community acquired pneumonia (CAP). Adult literature is mixed on whether administration of antibiotics within four hours of diagnosis of CAP reduces morbidity and mortality, however this has not been studied in pediatric patients. We evaluated whether time to antibiotics [...]

Background: Patients with opioid use disorder (OUD) are frequently hospitalized, however up to 25% of these encounters end in patient directed discharge (PDD), leading to interruptions in care, increased mortality, and higher hospital readmission rates.1-4 Receipt of medications for opioid use disorder (MOUD) has been shown to decrease odds of PDD.5 However, to date, less [...]

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. [...]