Background: The 2014 ACC/AHA Perioperative Guidelines suggest using the Revised Cardiac Risk Index (RCRI), myocardial infarction or cardiac arrest (MICA), or American College of Surgeons (ACS)-NSQIP calculators for combined patient-surgical risk assessment. Alrezk and colleagues recently published a new geriatric-sensitive cardiac risk index (GS-CRI) to predict MI or cardiac arrest in the geriatric population. We [...]

Background: Risk of having a major adverse cardiac event in the perioperative period is known to be raised among those with underlying cardiovascular disease undergoing noncardiac surgery. ACC/AHA 2014 guideline is an excellent tool for the physicians to evaluate perioperative cardiac risk. However, the evidence-based set of algorithms are often under- or inappropriately utilized due [...]

Background: CDC guidelines recommend and promote public awareness for Hepatitis C virus (HCV) screening for baby boomers (1945-1965) and individuals who report risk factors such as IDU. These strict guidelines and targeted educated are hindering positive patients who are non- baby boomers without risk factors from entering care due to the lack of education for [...]

Background: Complex patients represent a challenge in the health care system, as they are frequently associated with high health care utilization, longer hospital stays, and higher costs. Nonetheless, the characteristics of the complex patients in the hospital setting are not well known, and tools to help hospitals to identify them early in the process of [...]

Background: Recent data suggest that there are mortality benefits from preoperative statin therapy in patients at high risk for atherosclerotic cardiovascular disease (ASCVD). Current guidelines recommend moderate or high intensity statin for all patients with established ASCVD or 10-year risk of > 7.5%. In our preoperative evaluation clinic which is staffed by hospitalists, there were [...]

Background: Medication errors occur frequently at transitions of care and lead to significant patient harm. Robust medication reconciliation practices can mitigate these errors, but this process is complex and time-consuming. One of the conclusions of the first Multi-center Medication Reconciliation Quality Improvement Study (MARQUIS1) was that pharmacist team involvement in medication reconciliation is a key [...]

Background: HEART and TIMI risk scores that include 12-lead electrocardiogram (ECG) changes and troponin I (cTnI) have been used to stratify patients presenting with chest pain that may indicate the presence of an acute coronary syndrome (ACS). It has been shown that the 12-lead electrocardiogram (ECG) can be derived (dECG) from 3 measured leads displayed [...]

Case Presentation: Introduction: In a hospital medicine service, how often do we come across the conundrum of a high risk bleeder who has a high risk for clot? This is one of the more common clinical scenarios that plague us as providers. A double edged sword, we talk about the dire consequences on either side [...]