Background: Trauma co-management is a growing field within hospital medicine. While improvements in quality metrics have been documented in other co-management services, the impact of co-management of trauma patients is uncertain. This study aimed to determine whether a hospitalist trauma co-management program improves clinical outcomes. Methods: This was a pre- and post-implementation study comparing trauma [...]

Background: Hospitalists increasingly confront patient care and policy dilemmas due to financial incentives created by bundled payments, single payments that “bundle” acute and post-acute care for specific diagnoses. The most common and most successful bundled payment has been for total joint replacement, where cost savings have been achieved through discharging patients to home rather than [...]

Background: Two-thirds of surgical inpatients have at least 2 medical comorbidities, and 14% have six or more. Since 2001, there has been exponential growth of comanagement services, in which hospitalists embedded on surgical services take ownership over medical management. While advanced practice providers (APPs) increasingly manage surgical inpatients, successful comanagement models between hospitalists and APPs [...]

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: Our institution is a Level 1 regional trauma center with a large inpatient volume. A large percentage of these patients are elderly, with the traumatic events occurring as sequelae of their age, debility or medical complications. Last year, we developed a Trauma/Acute Care Surgery Hospitalist Co-Management program, due to, in large part, the increasing [...]

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: Intense inflammatory response and the releasing of cytokines are one of the known inflammatory responses in COVID19. Activation of inflammatory cascade increases the production of cytokines and chemokines such as IL-1, IL-6, IL-8, which can increase the risk of the perioperative complication rate.1,2,3 Therefore, we hypothesized that the intense inflammatory response due to COVID19 [...]

Background: The aging population along with increasing multi-morbidity and stricter regulations on house staff duty hours have played an integral role in fueling the drive for medical co-management of surgical patients. Parallel to these trends is an increasing demand for surgical services and risk for postoperative complications. While a positive impact on clinical outcomes has [...]

Background: A higher Helicobacter pylori (H. pylori) prevalence was associated with increased rates of post-operative complications including increased marginal ulceration and leak rates. Limited studies described prevalence of H. pylori in patients undergoing bariatric surgery and H. pylori associated upper and lower gastrointestinal bleeding (GIB). Primary Aim of our study was to evaluate the prevalence [...]

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. However, there is no published data comparing their performance. Methods: We retrospectively reviewed records of 663 patients seen in our preop clinic who [...]