Medicine and Health Sciences Commons^™

Outcomes Of A Modification Of The Brain Injury Guidelines (Big) On Resource Utilization And Its Impact On Outcomes, Jay Getzinger, Alison Karadjoff Do, Alita Pitogo, Samantha Tarras Md Facs

Medical Student Research Symposium

Background:

Brain injury guidelines (BIG) were developed to classify traumatic brain injury (TBI) patients and identify those that did not require ICU admission. Our aim was to implement our modified BIG (mBIG) in hopes of decreasing use of ICU beds for small TBI hemorrhages without compromising outcomes.

Methods:

Our mBIG protocol was implemented in January 2021 at Detroit Receiving Hospital with patients classified per the Table. Concurrent and retrospective data collected included demographics, ICU admission, outcomes, head CT scans and need for neurosurgical intervention. One-way ANOVA and chi-squared analysis were used with a p-value of ≤0.05 being significant.

Results:

125 …

Aging With Hiv In The United States: Trends And Impact Of Hospital Stays On Inpatient Resource Utilization, And Costs Of Care, 2003-2015, Khairul Alam Siddiqi

Theses and Dissertations

Background:

Due to advances in Antiretroviral Therapy (ART), people living with HIV (PLWH) live longer in the United States. Aging prolongs exposure to HIV and antiretroviral drugs, which could lead to an elevated risk of developing multiple age-related comorbidities [HIV Associated Non-AIDS (HANA) conditions], earlier for PLWH. Higher comorbidity burdens among older PLWH may require greater use of inpatient care, i.e., higher hospitalization, inpatient resource utilization, and costs. This study examined the trends and characteristics of comorbidities, resource utilization, and costs of hospital stays with HIV (HSWH) compared to hospital stays without HIV (HSWOH). We also assessed trends for resource …

Resource Utilization And Costs Associated With Off-Label Use Of Atypical Antipsychotics In An Adult Population, Della Varghese

Theses and Dissertations

Introduction: Atypical Antipsychotics (AAPs) are approved by the Food and Drug Administration (FDA) for the treatment of schizophrenia and bipolar disorder. AAPs are commonly used off-label to treat depression, post-traumatic stress disorder and neuropsychiatric symptoms in dementia due to lack of alternative treatment options and treatment resistance. Concerns for off-label use arise since AAPs increase the risk of cardiovascular events and death. The objectives were 1) describe patterns of RU and costs among off-label AAPs users in a nationally representative population 2) identify prevalence of off-label use in the Medicare population 3) compare RU and costs between off-label AAPs …

Paediatric Trauma On The Last Frontier: An 11-Year Review Of Injury Mechanisms, High-Risk Injury Patterns And Outcomes In Alaskan Children, Christopher W. Snyder, Oliver J. Muensterer, Frank Sacco, Shawn D. Safford

Surgery Faculty Publications

Background: Paediatric trauma system development in Alaska is complicated by a vast geographic coverage area, wide regional variations in environment and culture, and a lack of available published data.

Objective: To provide a detailed description of paediatric trauma mechanisms, high-risk injury patterns and outcomes in Alaska.

Design: This retrospective study included all children aged 17 years or younger in the State of Alaska Trauma Registry database admitted with traumatic injury between 2001 and 2011. Each injury record was reviewed individually and assigned a mechanism based on Centers for Disease Control E-codes. Geographic definitions were based on existing Emergency Medical Services …

Contrasting Views Of Physicians And Nurses About An Inpatient Computer-Based Provider Order-Entry System, Todd W. Gress, Michael Weiner, David R. Thiemann, Mollie Jenckes, Stephanie L. Reel, Steven F. Mandell, Eric B. Bass

Todd W. Gress

Objective: Many hospitals are investing in computer-based provider order-entry (POE) systems, and providers’ evaluations have proved important for the success of the systems. The authors assessed how physicians and nurses viewed the effects of one modified commercial POE system on time spent patients, resource utilization, errors with orders, and overall quality of care. Design: Survey. Measurements: Opinions of 271 POE users on medicine wards of an urban teaching hospital: 96 medical house officers, 49 attending physicians, 19 clinical fellows with heavy inpatient loads, and 107 nurses. Results: Responses were received from 85 percent of the sample. Most physicians and nurses …

Region 11 Meld Na Exception Prospective Study, Robert A. Fisher, Douglas M. Heuman, Ann M. Harper, Martha K. Behnke, Alastair D. Smith, Mark W. Russo, Steven Zacks, John W. Mcgillicuddy, James Eason, Michael K. Porayko, Patrick Northup, Michael R. Marvin, Johnathan Hundley, Satheesh Nair

Surgery Faculty Publications

Introduction. Hyponatremia complicates cirrhosis and predicts short term mortality, including adverse outcomes before and after liver transplantation.

Material and methods. From April 1, 2008, through April 2, 2010, all adult candidates for primary liver transplantation with cirrhosis, listed in Region 11 with hyponatremia, were eligible for sodium (Na) exception.

Results. Patients with serum sodium (SNa) less than 130 mg/dL, measured two weeks apart and within 30 days of Model for End Stage Liver Disease (MELD) exception request, were given preapproved Na exception. MELD Na was calculated [MELD + 1.59 (135-SNa/30 days)]. MELD Na was capped at 22, and subject to …

Contrasting Views Of Physicians And Nurses About An Inpatient Computer-Based Provider Order-Entry System, Todd W. Gress, Michael Weiner, David R. Thiemann, Mollie Jenckes, Stephanie L. Reel, Steven F. Mandell, Eric B. Bass

Internal Medicine

Objective: Many hospitals are investing in computer-based provider order-entry (POE) systems, and providers’ evaluations have proved important for the success of the systems. The authors assessed how physicians and nurses viewed the effects of one modified commercial POE system on time spent patients, resource utilization, errors with orders, and overall quality of care.

Design: Survey.

Measurements: Opinions of 271 POE users on medicine wards of an urban teaching hospital: 96 medical house officers, 49 attending physicians, 19 clinical fellows with heavy inpatient loads, and 107 nurses.

Results: Responses were received from 85 percent of the sample. Most physicians and nurses …