Background: Sepsis is a common and life-threatening complication of infection that disproportionately affects patients with chronic comorbidities. Timely fluid resuscitation is a key initial management strategy for reducing sepsis mortality; however, patients with serious comorbidities are often excluded from clinical trials. The Surviving Sepsis guidelines suggest that patients meeting severe sepsis criteria should be administered […]

Background: In patients hospitalized with heart failure (HF) exacerbations, physicians routinely supplement potassium to maintain levels ≥4.0 mEq/L. The evidence basis for this practice is relatively weak. We aimed to evaluate the association between serum potassium levels and outcomes in patients hospitalized with HF. Methods: We identified patients admitted with acute HF exacerbations to hospitals […]

Background: We have presented our experience with a novel percutaneous approach for axillary artery implant of intra-aortic balloon pumps. The axillary approach permits up-right posture and ambulation, but such enhanced mobility may predispose to higher risk of IABP malposition with unique complications. We present a few complications here. Methods: We conducted a retrospective review of […]

Background: Over 5 million people in the United States are diagnosed with heart failure (HF) and many continue to be hospitalized for exacerbations of this disease. An estimated 20 million Americans have been diagnosed with some form of thyroid disease. Thyroid hormones significantly impact cardiac muscle functions and elevated levels of thyroxine (T4), as seen […]

Background: Palliative care in seriously ill patients has been shown in some studies to improve satisfaction, symptoms, inpatient mortality rates, healthcare utilization and cost. While inpatient palliative care has been shown to improve symptoms and quality of life measures, the literature on its association with 30-day readmissions have been mixed for heart failure hospitalizations. We […]

Background: Acute decompensated heart failure exacerbation is the leading cause of hospitalization in the United States. It was associated with total medical costs of more than $30 billion in 2012 with projections estimating around $70 billion in costs by 2030. Currently, six million people in the U.S. have heart failure, with a little over half […]

Background: Heart failure (HF) is a major cause of hospital readmissions and healthcare costs. HF patients have the highest rate of unexpected readmission of all diseases tracked by the Centers for Medicare and Medicaid Services (CMS), at 21.2% (1). HF prevalence is also projected to increase 46% from 2012 to 2030, with total costs rising […]

Background: Effective teams share common attitudes, behaviors, and cognitions that support teamwork. Within patient safety literature, effective teamwork is a core feature of interventions that reduce adverse events. However, research on teamwork in healthcare has focused on teams of healthcare professionals and has not examined how patients and their family caregivers experience teamwork as part […]

Background: In a learning healthcare system, data collected as part of routine care is used to fuel innovation and improvement. Predictive models for post-discharge adverse events have relied on data that is available prior to hospital discharge. Post-discharge care (e.g. appointments, phone calls) can be collected from electronic health records and may impact patient risk […]

Background: Heart Failure (HF) is an important health care issue given its high prevalence, mortality, and cost of care. By 2030, greater than 8 million Americans will be living with HF. The projected cost will increase to close to 70 billion with the majority of the cost attributed to hospitalization. Despite numerous evidence-based strategies in […]