Background: Limited hospital capacity continues to be one of the major challenges to health care in hospitals in the US and the developed word. This problem manifests in a variety of ways in multiple settings starting with prolonged emergency room wait times and left without being seen rates, prolonged ED boarding time, and elective surgery [...]

Background: Chronic Obstructive Pulmonary Disease (COPD) is a lung disease characterized by chronic, irreversible airway obstruction that can precipitate into acute exacerbations (AECOPD) of cough, dyspnea and sputum production, often requiring hospitalization. Hospital systems aiming to improve outcomes for patients with AECOPD are testing innovative approaches to care in the acute care setting. To enroll [...]

Background: Sepsis research is limited by heterogeneity and inaccuracy of patient identification. An ideal identification algorithm would broadly define a population with suspected infection to optimize discrimination and provide real-time identification of high-risk populations for potential interventions. We combined clinical and administrative to identify a population of adults hospitalized with suspected infection and examined characteristics [...]

Background: The US healthcare system is under increasing pressure to improve value and affordability. Acute care is responsible for a large proportion of overall health costs, but the complexities and pace in this environment have left an evidence gap in value-based care transformation. Novel improvement and evaluation strategies are thus needed more than ever to [...]

Background: The subset of admitted Major Depressive Disorder (MDD) patients with treatment-resistant depression (TRD) may be associated with incremental economic burden compared with other MDD patients. This study aimed to characterize and evaluate healthcare resource use, admission measures, and costs in these two groups. Methods: Patients aged ≥18 years with a diagnosis of MDD admitted [...]

Background: The treatment of acute decompensated heart failure (ADHF) and comorbid acute kidney injury (AKI) can be quite challenging. Many times the etiology of AKI in this setting is multifactorial and may involve cardiorenal syndrome (CRS). Arterial underfilling, sympathetic nervous system upregulation, and systemic venous congestion contribute to impaired glomerular filtration rate in ADHF patients. [...]

Background: Warfarin and other anticoagulants increase the risk of hemorrhagic complications, including upper gastrointestinal hemorrhages (UGIB). Warfarin is commonly used in the management of atrial fibrillation to reduce the risk of ischemic stroke, and frequently resumed following UGIB. However, optimal timing of reinitiation remains unclear. Theory suggests that resuming warfarin immediately after UGIB would lead [...]

Background: Venous thromboembolism (VTE) in hospitalized medically ill patients is a leading preventable cause of morbidity and mortality in the United States. About half of VTE events occur following discontinuation of standard-duration in-hospital prophylaxis and hospital discharge. The APEX study evaluated Betrixaban for in-hospital to home VTE prophylaxis and is the first FDA approved anticoagulant [...]

Background: Venous thromboembolism (VTE) in hospitalized medically ill patients is a leading preventable cause of morbidity and mortality in the United States. About half of VTE events occur following discontinuation of standard-duration in-hospital prophylaxis and hospital discharge. The APEX study evaluated Betrixaban for in-hospital to home VTE prophylaxis and is the first FDA approved anticoagulant [...]

Background: Modified Early Warning System(MEWS) is a scoring system based on vitals sign and clinical observation which has been implemented in 2007 as a useful tool to timely recognition and early intervention. The effectiveness of implementation of MEWS as an important tool for rapid response team has been a question and the main objective of [...]