Reviews of Reseach on Perioperative Morbidity, Capnography with Diabetic Ketoacidosis in the ED, Mortality Rate for Elective Surgeries

The Hospitalist. 2013 October;2013(10):

October 1, 2013|Breast Cancer ICYMI

Dennis Chang, MD, FHM;Andrew Dunn, MD, FACP, SFHM;Brian Markoff, MD, SFHM, FACP;Alan Briones, MD, FHM;Maria Anaizza Reyna, MD;Hyung J. Cho, MD;Division OF

Preventable costs were higher per capita in areas with higher numbers of primary-care and specialist physicians, but it’s unclear if this was a supply or demand issue. The study also used algorithms that possibly overestimate the amount of preventable acute care.

Bottom line: In the highest Medicare utilizers, cost savings aimed at preventable acute care may be limited and might be better targeted at efficiency during acute-care episodes.

Citation: Joynt KE, Gawande AA, Orav EJ, Jha AK. Contribution of preventable acute care spending to total spending for high-cost Medicare patients. JAMA. 2013;309:2572-2578.

Clinical Shorts

INCIDENCE, PRESENTATION, AND OUTCOMES OF DRUG-INDUCED LIVER INJURY IN ICELAND

In a prospective, population-based cohort study in Iceland, the incidence of drug-induced liver injury is high (19.1 per 100,000 inhabitants) and amoxicillin-clavulanate was the most implicated drug.

Citation: Björnsson ES, Bergmann OM, Björnsson HK, Kvaran RB, Olafsson S. Incidence, presentation, and outcomes in patients with drug-induced liver injury in the general population of Iceland. Gastroenterology. 2013;144(7):1419-1425.

NOVEL CORONAVIRUS OUTBREAK SPREADING OUTSIDE THE ARABIAN PENINSULA

The Middle East respiratory syndrome coronavirus (MERS-CoV) has been characterized by mild to severe respiratory symptoms and a predilection for immunosuppressed patients and has been recently identified in Europe.

Citation: Centers for Disease Control and Prevention. Update: Severe respiratory illness associated with Middle East respiratory syndrome coronavirus (MERS-CoV)—Worldwide, 2012-2013. Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6223a6.htm?s_cid=mm6223a6_w. Accessed Sept. 8, 2013.

NSAIDS MAY BE SUPERIOR TO PANCREATIC DUCT STENTING FOR PREVENTING ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY PANCREATITIS

A meta-analysis found rectal NSAIDs alone were superior to pancreatic duct stenting alone for preventing post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis. Further randomized trials are needed.

Citation: Akbar A, Dayyeh BKA, Baron TH, Wang Z, Altayar O, Murad MH. Rectal nonsteroidal anti-inflammatory drugs are superior to pancreatic duct stents in preventing pancreatitis after endoscopic retrograde cholangiopancreatography: a network meta-analysis. Clin Gastroenterol Hepatol. 2013;11:778-783.