Background: Cardiac arrest on the wards may be preceded by unmet palliative care needs, including advance care planning and specialty palliative consultation that can seek to align patients’ prognoses and goals for care. Identification of hospitalized patients with limited life expectancy allows for the delivery of appropriate palliative interventions. However, the prognosis on admission of [...]

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: Among patients undergoing cardiac surgery on cardiopulmonary bypass (CPB), post-operative complications are common, occurring in up to 67% of patients, and significantly impact long-term outcomes. We conducted a Phase 2 clinical trial of RBT-1, a pharmacologic preconditioning drug, to assess cytoprotective biomarkers and clinical outcomes. Herein, we report our final results. Methods: This randomized, [...]

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: Continuous cardiac monitoring (telemetry) is a vital but resource intensive component of patient care, allowing providers to quickly respond to signs of cardiovascular instability. Despite its importance, and existence of American Heart Association (AHA) guidelines, overreliance of telemetry is common. Since telemetry is restricted to specific units, over-use creates a bottleneck in patient flow [...]

Background: The relation of a patient’s age to survival in cardiac arrest is often discussed at the bedside when clinicians, patients, and families are faced with the question of whether CPR is medically appropriate for elderly individuals. Few studies are available to help guide this conversation. This study sought to evaluate in-hospital cardiac arrest (IHCA) [...]

Background: As more hospitalists have gained basic point-of-care ultrasound (POCUS) skills, the desire for training in more advanced POCUS applications has increased as well as the need for developing faculty with an advanced POCUS skillset, that can support expansion of training and clinical integration into practice. Current certificate and credentialing pathways help build basic POCUS [...]

Background: The estimated total annual cost of syncope-related hospitalizations in the year 2005 was about $2.4 billion with a mean cost of $5,400 per hospitalization. Syncope of cardiac etiology has 18-33% mortality in comparison to 0-12% with non-cardiac etiology. We sought to evaluate the role cardiac biomarkers in patients presenting with syncope to evaluate their [...]

Background: Acute kidney injury (AKI) following cardiac surgery occurs in 30% of cases with 1% requiring dialysis resulting in significant morbidity and mortality.  HMG-CoA Reductase Inhibitors (“statins”) have been postulated to be of benefit in this population, however results from existing clinical studies have been inconsistent. Since there is abundance of evidence showing that short-term [...]

Background: The Modified Early Warning Score (MEWS) is a physiological scoring system developed to identify patients in early stages of clinical deterioration and prevent delays in proper care. It consists of systolic blood pressure, heart rate, respiratory rate, temperature and level of consciousness. Higher MEWS are associated with greater mortality and need for intensive care. [...]