Background: Comanagement is a structured collaboration between hospitalists and a surgical service to improve outcomes of surgical patients perioperatively. We identified the potential to improve patient safety and throughput metrics on the Surgical Oncology and Otolaryngology (ENT) services at our institution. We partnered with these two services to create a novel Surgical Oncology Comanagement Service. [...]

Background: Surgical risk stratification tools have existed since Goldman created the cardiac risk index in 1977. Since then, there has been a proliferation of risk calculators: the three most notable being the Revised Cardiac Risk Index (RCRI), the American College of Surgeons-Surgical Risk Calculator (ACS-SRC), and the Gupta Myocardial Infarction and Cardiac Arrest calculator (MICA). [...]

Background: Choice of agent for venous thromboembolism prophylaxis (VTEP) after joint arthroplasty is a complex decision, the difficulty of which has been compounded by divergent guidelines. Specifically, the adequacy of aspirin monotherapy (ASA) for VTEP has long been debated between the American Academy of Orthopaedic Surgeons (AAOS) and the American College of Chest Physicians (ACCP). [...]

Background: The care of surgical patients is becoming more complex as patients with increasing comorbidities require surgical procedures. In adult hospital medicine, co-management of complex medical patients by hospital medicine and surgery has been shown to decrease length of stay and readmission for many procedures. It remains unclear, however, which patients are most likely to [...]

Background: Hip fractures are a major health problem in the geriatric population in the United States, with estimated costs of $18B annually. Hip fractures are highly morbid in the elderly, as deconditioning and acute complications compound chronic comorbidities. To improve care for this high-risk population, hip fracture patients are preferentially admitted to our medicine hospitalist [...]

Background: Increased life expectancy has raised the number of elderly patients suffering from hip fractures. This frail population and its surgical-related complications are scarcely known. We performed a single-center descriptive study involving centenarian patients to depict their management and complications. Methods: Centenarians with a hip fracture admitted to a single level I trauma center from [...]

Background: Hip fracture is a common reason for urgent inpatient surgery. In the last few years, several professional societies have identified preoperative echocardiography and stress testing for non-cardiac surgeries as low-value diagnostics. Delaying hip fracture surgery beyond 48 hours leads to worse outcomes. We sought to describe the prevalence of preoperative cardiac testing for inpatient [...]

Background: The use of intraoperative dexamethasone has been on the rise because of its ability to reduce postoperative nausea, vomiting, pain and accelerate post-operative recovery. Use of intraoperative dexamethasone can result in uncontrolled hyperglycemia in the postoperative period especially in patients with a diagnosis of diabetes. The extent and duration of post-operative steroid-induced hyperglycemia is [...]

Background: At Thomas Jefferson University Hospital (TJUH) in Philadelphia, Pennsylvania, 4th year medical students can complete an elective in Perioperative and Consultative Medicine. The Farber Hospitalist Division is a unique Hospital Medicine Division in the Department of Neurosurgery that runs the medicine consult service and specializes in neurosurgical co-management at both TJUH Main Campus and [...]

Case Presentation: A 66-year old woman with a history of obesity and hypertension presented with a right femoral neck fracture after a mechanical fall. She underwent a right total hip arthroplasty and the anesthesiologist reported transient intraoperative hypoxia during cement placement. In the recovery room, the patient was hypotensive, tachycardic and hypoxic requiring up to [...]