Abstract:
:Esophageal variceal bleeding (EVB) is a frequent complication in cirrhotic patients resulting in considerable mortality and morbidity. The aim of this study was to investigate the occurrence, impact, and trends of EVB in hospitalized cirrhotic patients on a nationwide level in the United States. We interrogated data from the Nationwide Inpatient Sample from 2002 to 2012. Utilizing International Classification of Diseases, Ninth Revision, Clinical Modification codes, we analyzed hospital discharges for cirrhosis and related EVB in adult patients. EVB in cirrhotic patients was independently associated with overall worse outcomes with respect to in-hospital mortality (10% vs 5%; P < 0.01) and hospital charges (median $41,000 vs $26,000; P < 0.01). In the period from 2002 to 2012, the number of cirrhosis-related hospitalizations increased from 337,956 to 570,220 (P < 0.01). Concurrently, the incidence of EVB in hospitalized cirrhotic patients declined from 8.60% to 5.78%, with an overall decreased trend (P < 0.01). The decline in the rate of EVB in hospitalized cirrhotic patients from 2002 to 2012 likely reflects the effectiveness of primary and secondary prophylaxis.
journal_name
J Hosp Medjournal_title
Journal of hospital medicineauthors
Pant C,Desai M,Deshpande A,Taylor R,Olyaee M,Gilroy Rdoi
10.1002/jhm.2360subject
Has Abstractpub_date
2015-07-01 00:00:00pages
453-6issue
7eissn
1553-5592issn
1553-5606journal_volume
10pub_type
杂志文章abstract:OBJECTIVE:To examine the relationship between pediatric obesity and inpatient length of stay (LOS), resource utilization, readmission rates, and total billed charges for in-hospital status asthmaticus. DESIGN/METHODS:We conducted a cross-sectional study of patients 5 to 17 years old hospitalized with status asthmaticu...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2296
更新日期:2015-03-01 00:00:00
abstract:BACKGROUND:While patients with anorexia nervosa have a high mortality rate, more are living into adulthood. Patients with severe malnutrition secondary to anorexia nervosa often require hospitalization for medical stabilization prior to treatment in eating disorders programs. METHODS:We developed the ACUTE Center at D...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.1906
更新日期:2012-04-01 00:00:00
abstract::Improving early discharges may improve patient flow and increase hospital capacity. We conducted a national survey of academic medical centers addressing the prevalence, importance, and effectiveness of early-discharge initiatives. We assembled a list of hospitalist and general internal medicine leaders at 115 US-base...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.2885
更新日期:2018-06-01 00:00:00
abstract:OBJECTIVE:There is growing demand for safe and effective procedural sedation in pediatric facilities nationally. Currently, these needs are being met by a variety of providers and sedation techniques, including anesthesiologists, pediatric intensivists, emergency medicine physicians, and pediatric hospitalists. There i...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.979
更新日期:2012-04-01 00:00:00
abstract:BACKGROUND:Approaches of trainees to diagnosis in teaching hospitals are poorly understood. Identifying cognitive and system-based barriers and facilitators to diagnosis may improve diagnosis in these settings. METHODS:We conducted a focused ethnography of trainees at 2 academic medical centers to understand the barri...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.2966
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:Angiotensin-converting enzyme inhibitors (ACE-Is) are a widely used class of cardiovascular medication. However, limited data exist on the risks of postoperative nonresumption of an ACE-I. OBJECTIVE:To evaluate the factors and 30-day mortality risks associated with the postoperative nonresumption of an ACE-...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2182
更新日期:2014-05-01 00:00:00
abstract:OBJECTIVE:To examine the association of health literacy with the number and type of transitional care needs (TCN) among patients being discharged to home. DESIGN, SETTING, PARTICIPANTS:A cross-sectional analysis of patients admitted to an academic medical center. MEASUREMENTS:Nurses administered the Brief Health Lite...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.2841
更新日期:2017-11-01 00:00:00
abstract:BACKGROUND:Patient safety indicators (PSI) were developed for hospitals to screen for healthcare-associated adverse events. PSIs are believed to be preventable and have become a part of major pay-for-performance programs. PSI-12 captures perioperative venous thromboembolism (VTE), which contributes to morbidity and mor...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.3298
更新日期:2019-11-20 00:00:00
abstract:BACKGROUND:Gender earnings disparities among physicians exist even after considering differences in specialty, part-time status, and practice type. Little is known about the role of job satisfaction priorities on earnings differences. OBJECTIVE:To examine gender differences in work characteristics and job satisfaction...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2400
更新日期:2015-08-01 00:00:00
abstract:: ...
journal_title:Journal of hospital medicine
pub_type: 评论,社论
doi:10.12788/jhm.3116
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:The economic burden of acute kidney injury (AKI) is not well understood. OBJECTIVE:To estimate the effects of AKI on hospitalization costs and length of stay (LOS). DESIGN:Using data from the 2012 National Inpatient Sample, we compared hospitalization costs and LOS with and without AKI. We used a generaliz...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.2683
更新日期:2017-02-01 00:00:00
abstract:BACKGROUND:Efforts to curb healthcare spending have included interventions that target frequently hospitalized individuals. It is unclear the extent to which the most frequently hospitalized individuals also represent the costliest individuals. OBJECTIVE:To examine the relationship between 2 types of "high users" comm...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2096
更新日期:2013-12-01 00:00:00
abstract:BACKGROUND:Interhospital transfer is an understudied area within transitions of care. The process by which hospitals accept and transfer patients is not well described. National trends and best practices are unclear. OBJECTIVE:To describe the demographics of large transfer centers, to identify common handoff practices...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2577
更新日期:2016-06-01 00:00:00
abstract:BACKGROUND:Little is known about the state of research in academic hospital medicine (HM) despite the substantial growth of this specialty. METHODS:We used the Society of Hospital Medicine (SHM) membership database to identify research programs and their leadership. In addition, the members of the SHM Research Committ...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.3136
更新日期:2019-04-01 00:00:00
abstract:BACKGROUND:Hospital care on weekends has been associated with reduced quality and poor clinical outcomes, suggesting that decreases in overall intensity of care may have important clinical effects. We describe a new measure of hospital intensity of care based on utilization of the electronic health record (EHR). METHO...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2068
更新日期:2013-09-01 00:00:00
abstract:BACKGROUND:A lack of cost-conscious medication use is a major contributor to excessive healthcare expenditures in the inpatient setting. Expensive medicines are often utilized when there are comparable alternatives available at a lower cost. Increasing prescriber awareness of medication cost at the time of ordering may...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.2779
更新日期:2017-08-01 00:00:00
abstract::Gallstone ileus is a rare etiology of small bowel obstruction, occurring typically in the elderly population. The delay in diagnosis often results in significant morbidity and mortality. Here, we describe a case of 67 year old woman who presented with non specific abdominal symptoms and on evaluation was found to have...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.582
更新日期:2010-02-01 00:00:00
abstract:BACKGROUND:Half of patients admitted to hospital for reasons unrelated to childbirth are age 65 years or older. Nonetheless, few hospital-based physicians have received training in geriatric medicine, and few geriatricians practice in the hospital. This paper describes the state of the science of hospital care for olde...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,评审
doi:10.1002/jhm.11
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND:Warfarin reduces stroke in patients with atrial fibrillation. However, its narrow therapeutic index and need for chronic monitoring are barriers to its optimal utilization in many patients. The recent introduction of 3 novel oral anticoagulants (NOACs), as alternatives to warfarin, may change the eligibility...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,评审
doi:10.1002/jhm.2201
更新日期:2014-06-01 00:00:00
abstract:OBJECTIVES:This study aimed to describe variation in imaging practices and examine the association between early imaging and outcomes in children hospitalized with cervical lymphadenitis. METHODS:This multicenter cross-sectional study included children between two months and 18 years hospitalized with cervical lymphad...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.3333
更新日期:2020-04-01 00:00:00
abstract:BACKGROUND:Knowing the number of discharges that will occur is important for administrators when hospital occupancy is close to or exceeds 100%. This information will facilitate decision making such as whether to bring in extra staff, cancel planned surgery, or implement measures to increase the number of discharges. W...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.2802
更新日期:2018-03-01 00:00:00
abstract:BACKGROUND/OBJECTIVE:Pediatric patients hospitalized with bacterial infections often receive intravenous (IV) antibiotics. Early transition to enteral antibiotics can reduce hospital duration, cost, and complications. We aimed to identify opportunities to transition from IV to enteral antibiotics, describe variation of...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.3538
更新日期:2021-02-01 00:00:00
abstract::Hyponatremia is relatively common in patients admitted with pneumonia, and it is associated with higher disease severity. The precise mechanism is incompletely understood, but the syndrome of inappropriate antidiuretic hormone secretion is felt to play a significant role. Traditional options to manage hyponatremia in ...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,评审
doi:10.1002/jhm.1933
更新日期:2012-04-01 00:00:00
abstract:BACKGROUND:Computerized clinical knowledge mana-gement systems hold enormous potential for improving quality and efficiency. However, their impact on clinical practice is not well known. OBJECTIVE:To examine the impact of UpToDate on outcomes of care. DESIGN:Retrospective study. SETTING:National sample of US inpatie...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.944
更新日期:2012-02-01 00:00:00
abstract:BACKGROUND:Problems experienced after hospital discharge can result in rehospitalizations and unscheduled urgent and emergent care. OBJECTIVE:To identify opportunities for improving discharge processes by examining calls to an advice line (AL). DESIGN:Prospective cohort. SETTING:A 500-bed, university-affiliated hosp...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2252
更新日期:2014-11-01 00:00:00
abstract:WHAT'S NEW:This is the first study of a pediatric hospitalist preoperative clinic. Pediatric hospitalists frequently make significant recommendations for patients with neuromuscular scoliosis prior to spinal surgery, especially those with medical complexity. Certain clinical criteria are statistically significantly ass...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2101
更新日期:2013-12-01 00:00:00
abstract::Dr. Pham, a practicing general internist and health policy researcher, recalls her experience, as a granddaughter, of how patients, families, and physicians are often complicit in foiling the good coordination of care. ...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.410
更新日期:2009-04-01 00:00:00
abstract::Pain management is a core competency of hospital medicine, and effective acute pain management should be a goal for all hospital medicine providers. The prevalence of opioid use in the United States, both therapeutic and non-medical in origin, has dramatically increased over the past decade. Although nonopioid medicat...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,评审
doi:10.12788/jhm.2733
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:Care coordination is critical in settings characterized by high levels of uncertainty, time constraints, and interdependent work processes. The effects of provider characteristics on coordination in comanaged teams has never been examined. OBJECTIVE:To characterize individual providers based on their contri...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.797
更新日期:2010-11-01 00:00:00
abstract:BACKGROUND:Few studies have examined alternative structures for inpatient clerkships. OBJECTIVE:Compare 2 inpatient clerkship structures using multiple outcome variables. DESIGN:Prospective, randomized controlled trial. SETTING:Tertiary-care, freestanding children's hospital. SUBJECTS:All medical students enrolled ...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,随机对照试验
doi:10.1002/jhm.250
更新日期:2007-11-01 00:00:00