Hospital Medicine Alert – March 1, 2012

March 1, 2012

• Can Potential Acute MI Patients be Triaged Faster?

  Newer, more sensitive troponin assays have the potential to identify acute myocardial infarction (AMI) earlier, but some detect troponin in 50% of normal populations, which renders them clinically useless.

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• Risk vs. Benefit of Atrial Fibrillation Ablation Procedures

  Shah et al used an administrative database, the California State Inpatient Database from the Healthcare Utilization Project, to analyze the short and intermediate success and complication rates associated with catheter ablation for atrial fibrillation (AF).

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• Absence of Pathogens in Intestinal Tissue of Patients with Necrotizing Enterocolitis

  28 surgical specimens from patients with necrotizing enterocolitis (NEC) were examined using multiplex real-time polymerase chain reaction (RT-PCR) to detect gastrointestinal pathogens. Infectious enteritis pathogens were not detected in any specimens.

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• Posterior Reversible Encephalopathy Syndrome, Seizures, and the EEG

  This clinical study evaluated patients with posterior reversible encephalopathy syndrome to determine the kind of seizures they experienced, abnormalities on EEG, and to correlate this with findings on neuroimaging (MRI).

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• High Mortality in Patients with COPD Exacerbations Who Fail Noninvasive Ventilation

  Wider use of noninvasive ventilation in managing severe COPD exacerbations has improved overall outcomes, but this study of a large nationwide database shows that increasing numbers of patients fail NIV and require intubation. This subset of patients has substantially higher mortality and hospital costs.

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• Patients Placed in Contact Isolation Are at Increased Risk for Delirium

  This retrospective study of all non-psychiatric patients admitted to an academic medical center found that although those placed in contact isolation from the time of admission had no increased risk for delirium, patients moved into isolation after admission were twice as likely to develop delirium during the hospital stay.

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