Digital Commons Network^™

Association Between Hospital Private Equity Acquisition And Outcomes Of Acute Medical Conditions Among Medicare Beneficiaries, Marcelo Cerullo, Kelly Yang, Karen E. Joynt Maddox, Ryan C. Mcdevitt, James M. Roberts, Anaeze C. Offodile

Open Access Publications

Importance: As private equity (PE) acquisitions of short-term acute care hospitals (ACHs) continue, their impact on the care of medically vulnerable older adults remains largely unexplored.

Objective: To investigate the association between PE acquisition of ACHs and access to care, patient outcomes, and spending among Medicare beneficiaries hospitalized with acute medical conditions.

Design, Setting, and Participants: This cross-sectional study used a generalized difference-in-differences approach to compare 21 091 222 patients admitted to PE-acquired vs non-PE-acquired short-term ACHs between January 1, 2001, and December 31, 2018, at least 3 years before to 3 years after PE acquisition. The analysis was conducted …

A Population-Based Assessment Of Severe Maternal Morbidity Among Non-Hispanic Black Women In The United States, Lisa R. Allen

All ETDs from UAB

Non-Hispanic Black women (Black women) are disproportionately affected by adverse maternal health outcomes as compared to women of other races. Little is known about the distribution of adverse maternal health outcomes among Black women. Using the 2014 National Inpatient Sample (NIS), Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality (AHRQ), a nationally representative sample of hospital discharges in the United States (U.S.) from January 1 through December 31, 2014, we examined severe maternal morbidity (SMM) experienced during delivery hospitalization among Black women. We conducted population-based, cross-sectional studies to examine the distribution of SMM prevalence; assess within-race …

Frequent Mental Distress Among Adults In The United States And Its Association With Socio-Demographic Characteristics, Unhealthy Lifestyle, And Chronic Physical Health Status, Mamunur Rashid, M. Mazharul Islam, Aiping Li, Naima Shifa

Mathematics Faculty Publications

Frequent mental distress (FMD) is a measure of poor mental health days for at least 14 days out of 30 days. It is one of the important dimensions of the health-related quality of life. The underlying causes of FMD are diverse. However, the issue has not been explored extensively due to the lack of reliable data on mental health. The aim of this study was to examine the level and trends of FMD among the adults of the United States (US) and identify the socio-demographic, lifestyles, and chronic health outcomes related correlates of FMD. The data for the study was …

Imago Dei Interrupted : Christocentric Measures To Reintegrate American Women Into New Communities After Having Survived Commercial Sexual Exploitation, Timothy Peter Robbins

ATS Dissertations

No abstract provided.

Hispanic Ethnicity And Mortality Among Critically Ill Patients With Covid-19, Ana C Ricardo, Jinsong Chen, Stephanie M Toth-Manikowski, Natalie Meza, Min Joo, Shruti Gupta, Deepa G Lazarous, David E Leaf, James P Lash

Faculty, Staff and Student Publications

BACKGROUND: Hispanic persons living in the United States (U.S.) are at higher risk of infection and death from coronavirus disease 2019 (COVID-19) compared with non-Hispanic persons. Whether this disparity exists among critically ill patients with COVID-19 is unknown.

OBJECTIVE: To evaluate ethnic disparities in mortality among critically ill adults with COVID-19 enrolled in the Study of the Treatment and Outcomes in Critically Ill Patients with COVID-19 (STOP-COVID).

METHODS: Multicenter cohort study of adults with laboratory-confirmed COVID-19 admitted to intensive care units (ICU) at 67 U.S. hospitals from March 4 to May 9, 2020. Multilevel logistic regression was used to evaluate …

‘I Went To The One Game In Town’: Obstetric And Maternity Unit Closures, Dwindling Birth Choices, And Resilience In Rural Appalachia, Sia Beasley

Theses and Dissertations--Anthropology

Obstetric and maternity health services are being rapidly eliminated in the rural United States, making maternal care more difficult to access and causing negative birth outcomes. Service closures have a magnified impact in Appalachia due to histories of systemic regional and state policy practices which devalue the lives of people living rural areas, local economic marginalization, geographic barriers, and insufficient health infrastructures. This research investigates how women living in rural Appalachia navigate pregnancy and birth amidst constant care closures. The Sunflower Mountain Region is a seven-county area in rural Southern Appalachia. The region has experienced ongoing obstetric closures over the …

Depression And Anxiety Are Common Among Patients With Cirrhosis, Ruben Hernaez, Jennifer R Kramer, Aisha Khan, Jessica Phillips, Katharine Mccallister, Kassie Chaffin, Adriana Portela Hernandez, Hannah Fullington, Cynthia Ortiz, James-Michael Blackwell, Adam Loewen, Yan Liu, Jasmin A Tiro, Simon C Lee, Amit G Singal

Faculty, Staff and Students Publications

BACKGROUND & AIMS: Depression and anxiety can have negative effects on patients and are important to treat. There have been few studies of their prevalence among patients with cirrhosis. We aimed to characterize the prevalence and risk factors for depression and anxiety in a large multi-center cohort of patients with cirrhosis.

METHODS: We conducted a telephone-based survey of patients with cirrhosis at 3 health systems in the United States (a tertiary-care referral center, a safety net system, and a Veterans hospital) from April through December 2018. Of 2871 patients approached, 1021 (35.6%) completed the survey. Depression and anxiety were assessed …

Aging With Long-Term Physical Disability: Cohort Analysis Of Survey Sample In The U.S., Kerri A Morgan, Michelle Putnam, Sandra M Espin-Tello, Marian Keglovits, Margaret Campbell, Yan Yan, Aimee Wehmeier, Susan Stark

2020-Current year OA Pubs

BACKGROUND: Chronic health conditions, secondary conditions, and decreasing functional ability related to aging and/or changes in underlying impairment may influence participation for persons aging with long-term physical disability (AwD).

OBJECTIVE: To examine sample integrity and baseline findings through exploration of associations of sociodemographic, health, and disability factors with social participation for persons AwD.

METHODS: This is a longitudinal cohort study following persons AwD over three years, reporting baseline cohort study data. A convenience sample of 474 persons AwD aged 45-65 reporting physical disability of ≥5 years' duration was recruited through community organizations and social media. The cohort was majority female …

An Introductory Point-Of-Care Ultrasound Curriculum For An Anesthesiology Residency Program, Susan C Lee, Edward C Yang, Jovany Cruz Navarro, Charles G Minard, Xiaofan Huang, Yi Deng

Faculty, Staff and Students Publications

INTRODUCTION: The use of point-of-care ultrasound (POCUS) is a growing trend in the field of anesthesiology. However, formal POCUS curriculums are still not widely implemented in residency programs. As the Accreditation Council for Graduate Medical Education and the American Board of Anesthesiology have both incorporated POCUS into their educational aims and expectations for graduates, we recognized the need for a formal POCUS curriculum for our residency program. We developed and implemented a comprehensive 3-week POCUS curriculum for our first-year anesthesiology residents (CA1s) in the latter half of their academic year.

METHODS: Twenty CA1s participated in this educational activity. The POCUS …

The Nhlbi Study On Long-Term Outcomes After The Multisystem Inflammatory Syndrome In Children (Music): Design And Objectives, Dongngan T Truong, Felicia L Trachtenberg, Gail D Pearson, Audrey Dionne, Matthew D Elias, Kevin Friedman, Kerri H Hayes, Lynn Mahony, Brian W Mccrindle, Matthew E Oster, Victoria Pemberton, Andrew J Powell, Mark W Russell, Lara S Shekerdemian, Mary Beth Son, Michael Taylor, Jane W Newburger

Faculty, Staff and Students Publications

BACKGROUND: The Long-terM OUtcomes after the Multisystem Inflammatory Syndrome In Children (MUSIC) study aims to characterize the frequency and time course of acute and long-term cardiac and non-cardiac sequelae in multisystem inflammatory syndrome in children associated with COVID-19 (MIS-C), which are currently poorly understood.

METHODS: This multicenter observational cohort study will enroll at least 600 patientsyears, and optional genetic testing. Cardiac imaging at specific time points includes standardized echocardiographic assessment (all participants) and cardiac magnetic resonance imaging (CMR) in those with left ventricular ejection fraction (LVEF)

CONCLUSION: The MUSIC study, with the largest cohort of MIS-C patients and the longest …

The First 20 Months Of The Covid-19 Pandemic: Mortality, Intubation And Icu Rates Among 104,590 Patients Hospitalized At 21 United States Health Systems, Michael C. Fiore, Li-Shiun Chen, Et Al.

2020-Current year OA Pubs

MAIN OBJECTIVE: There is limited information on how patient outcomes have changed during the COVID-19 pandemic. This study characterizes changes in mortality, intubation, and ICU admission rates during the first 20 months of the pandemic.

STUDY DESIGN AND METHODS: University of Wisconsin researchers collected and harmonized electronic health record data from 1.1 million COVID-19 patients across 21 United States health systems from February 2020 through September 2021. The analysis comprised data from 104,590 adult hospitalized COVID-19 patients. Inclusion criteria for the analysis were: (1) age 18 years or older; (2) COVID-19 ICD-10 diagnosis during hospitalization and/or a positive COVID-19 PCR …

Voting Behavior During Fda Medical Device Advisory Committee Panel Meetings, Amanda Maisel-Campbell, Daniel I Schlessinger, Arianna F. Yanes, Emir Veledar, Kelly A. Reynolds, Sarah A. Ibrahim, Bianca Y. Kang, Noor Anvery, Emily Poon, Murad Alam

2020-Current year OA Pubs

OBJECTIVES: During premarket review, the US Food and Drug Administration may ask its Medical Device Advisory Committee (MDAC) Panels to assess the safety and effectiveness of medical devices being considered for approval. The objective of this study is to assess the relationship, if any, between individual votes and Panel recommendations and: (1) the composition of Panels, specifically the expertise and demographic features of individual members; or (2) Panel members' propensity to speak during Panel deliberations.

METHODS: This was a retrospective cohort study of routinely collected data from voting members of MDAC panels convened between January 2011 to June 2016 to …

Barriers And Facilitators To Diabetes Screening And Prevention After A Pregnancy Complicated By Gestational Diabetes, Drishti D. Sinha, Roxann C. Williams, Laura N. Hollar, Hannah R. Lucas, Bethany Johnson-Javois, Heidi B. Miller, Amanda Stoermer, Graham A. Colditz, Aimee S. James, Cynthia J. Herrick

2020-Current year OA Pubs

OBJECTIVE: Gestational diabetes mellitus (GDM) is increasing in the United States, with higher rates among minoritized racial and ethnic populations and lower income populations. GDM increases risk for type 2 diabetes (T2DM), and postpartum diabetes screening and prevention are imperative. This qualitative study examines barriers and facilitators to postpartum T2DM screening and prevention among non-privately insured individuals with a history of GDM in a state prior to Medicaid expansion.

METHODS: Thirty-six non-privately insured women with a history of GDM completed semi-structured interviews. Four focus groups and seven interviews were conducted with 30 nurse practitioners, physicians, physician assistants, nurses and registered …

Transcranial Magnetic Stimulation To Assess Motor Neurophysiology After Acute Stroke In The United States: Feasibility, Lessons Learned, And Values For Future Research, Yi-Ling Kuo, David J. Lin, Isha Vora, Julie A. Dicarlo, Dylan J. Edwards, Teresa J. Kimberley

Research outputs 2022 to 2026

Transcranial magnetic stimulation (TMS) has been widely applied in both basic and clinical neuroscience since its introduction in 1985 . . .

Women And Ethnoracial Minorities With Poor Cardiovascular Health Measures Associated With A Higher Risk Of Developing Mood Disorder, Aixia Guo, Kari A Stephens, Yosef M Khan, James R Langabeer, Randi E Foraker

2020-Current year OA Pubs

BACKGROUND: Mood disorders (MDS) are a type of mental health illness that effects millions of people in the United States. Early prediction of MDS can give providers greater opportunity to treat these disorders. We hypothesized that longitudinal cardiovascular health (CVH) measurements would be informative for MDS prediction.

METHODS: To test this hypothesis, the American Heart Association's Guideline Advantage (TGA) dataset was used, which contained longitudinal EHR from 70 outpatient clinics. The statistical analysis and machine learning models were employed to identify the associations of the MDS and the longitudinal CVH metrics and other confounding factors.

RESULTS: Patients diagnosed with MDS …

Real-World Impact Of Fremanezumab On Migraine Symptoms And Resource Utilization In The United States, Peter Mcallister, Lois Lamerato, Lynda J. Krasenbaum, Joshua M. Cohen, Krishna Tangirala, Stephen Thompson, Maurice Driessen, Julian Casciano, Zenobia Dotiwala, Alexander Mauskop

Public Health Sciences Articles

BACKGROUND: Fremanezumab, a fully humanized monoclonal antibody (IgG2Δa) that selectively targets calcitonin gene-related peptide (CGRP), is approved for migraine prevention in adults. Real-world data on the effectiveness of fremanezumab are limited. This retrospective, observational cohort study assessed patient-reported migraine symptoms, health care resource utilization (HCRU), and direct medical costs before and after fremanezumab treatment initiation.

METHODS: Data were extracted from September 2018 through June 2020 from the Midwest component of EMRClaims+®, an integrated health services database containing > 20 million medical records from national commercial insurance claims, Medicare claims, and regional electronic medical records. Patients included in the cohort analysis were …

Phase 3 Safety And Efficacy Of Azd1222 (Chadox1 Ncov-19) Covid-19 Vaccine, Ann R Falsey, Magdalena E Sobieszczyk, Ian Hirsch, Stephanie Sproule, Merlin L Robb, Lawrence Corey, Kathleen M Neuzil, William Hahn, Julie Hunt, Mark J Mulligan, Charlene Mcevoy, Edwin Dejesus, Michael Hassman, Susan J Little, Barbara A Pahud, Anna Durbin, Paul Pickrell, Eric S Daar, Larry Bush, Joel Solis, Quito Osuna Carr, Temitope Oyedele, Susan Buchbinder, Jessica Cowden, Sergio L Vargas, Alfredo Guerreros Benavides, Robert Call, Michael C Keefer, Beth D Kirkpatrick, John Pullman, Tina Tong, Margaret Brewinski Isaacs, David Benkeser, Holly E Janes, Martha C Nason, Justin A Green, Elizabeth J Kelly, Jill Maaske, Nancy Mueller, Kathryn Shoemaker, Therese Takas, Richard P Marshall, Menelas N Pangalos, Tonya Villafana, Antonio Gonzalez-Lopez

Faculty, Staff and Student Publications

BACKGROUND: The safety and efficacy of the AZD1222 (ChAdOx1 nCoV-19) vaccine in a large, diverse population at increased risk for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the United States, Chile, and Peru has not been known.

METHODS: In this ongoing, double-blind, randomized, placebo-controlled, phase 3 clinical trial, we investigated the safety, vaccine efficacy, and immunogenicity of two doses of AZD1222 as compared with placebo in preventing the onset of symptomatic and severe coronavirus disease 2019 (Covid-19) 15 days or more after the second dose in adults, including older adults, in the United States, Chile, and Peru.

RESULTS: …

The Five Ds Of Outpatient Antibiotic Stewardship For Urinary Tract Infections, Melanie C Goebel, Barbara W Trautner, Larissa Grigoryan

Faculty, Staff and Students Publications

Urinary tract infections (UTI) are one of the most common indications for antibiotic prescriptions in the outpatient setting. Given rising rates of antibiotic resistance among uropathogens, antibiotic stewardship is critically needed to improve outpatient antibiotic use, including in outpatient clinics (primary care and specialty clinics) and emergency departments. Outpatient clinics are in general a neglected practice area in antibiotic stewardship programs, yet most antibiotic use in the United States is in the outpatient setting. This article provides a comprehensive review of antibiotic stewardship strategies for outpatient UTI in the adult population, with a focus on the "five Ds" of stewardship …

Covid–19, Housing And Evictions: A Comparative Case Study Of Housing Law And Policy In The United States And Argentina Through An International Human Rights Lens, Lily Frances Fontenot

University of Miami Inter-American Law Review

This Note seeks to address the impact of international human rights obligations on domestic housing laws and policies through a comparative case study of Argentina and the United States. Specifically, it will discuss each country’s response to the COVID-19 pandemic, their housing obligations under international human rights law, and how each country is addressing their own unique housing and eviction crises. Finally, this Note will offer recommendations on how each country should modify their housing policies in light of the pandemic in order to comply with international human rights standards.

Legal And Ethical Implications Of U.S. And Canadian Vaccine Contracts: The Impact Of Vaccine Nationalism On The Global Pandemic Response, Ryan S. Tahiri

University of Miami Inter-American Law Review

This note explores the COVID-19 vaccine contracts between the U.S. and Canada and the impact of these types of agreements on the global pandemic response. These “pre-purchases,” many of which were executed before the development of a vaccine, have afforded a select few nations the opportunity to stockpile vaccines, while other nations with fewer resources are unable to secure any doses. An effective method to counter the effects of the pandemic is the creation of a global vaccine network that provides equitable access to vaccine doses for nations in need. COVAX was launched to ensure that lower and middle-income nations …

Electronically Available Patient Claims Data Improve Models For Comparing Antibiotic Use Across Hospitals: Results From 576 Us Facilities, Katherine E Goodman, Lisa Pineles, Laurence S Magder, Deverick J Anderson, Elizabeth Dodds Ashley, Ronald E Polk, Hude Quan, William E Trick, Keith F Woeltje, Surbhi Leekha, Sara E Cosgrove, Anthony D Harris

2020-Current year OA Pubs

BACKGROUND: The Centers for Disease Control and Prevention (CDC) uses standardized antimicrobial administration ratios (SAARs)-that is, observed-to-predicted ratios-to compare antibiotic use across facilities. CDC models adjust for facility characteristics when predicting antibiotic use but do not include patient diagnoses and comorbidities that may also affect utilization. This study aimed to identify comorbidities causally related to appropriate antibiotic use and to compare models that include these comorbidities and other patient-level claims variables to a facility model for risk-adjusting inpatient antibiotic utilization.

METHODS: The study included adults discharged from Premier Database hospitals in 2016-2017. For each admission, we extracted facility, claims, and …

Telehealth During The Covid-19 Pandemic: A Cross-Sectional Survey Of Registered Dietitian Nutritionists, Mary Rozga, Deepa Handu, Kathryn Kelley, Elizabeth Yakes Jimenez, Hannah Martin, Marsha Schofield, Alison Steiber

Pediatrics Research and Scholarship

During the current coronavirus disease 2019 (COVID-19) pandemic, health care practices have shifted to minimize virus transmission, with unprecedented expansion of telehealth. This study describes self-reported changes in registered dietitian nutritionist (RDN) practice related to delivery of nutrition care via telehealth shortly after the onset of the COVID-19 pandemic in the United States. This cross-sectional, anonymous online survey was administered from mid-April to mid-May 2020 to RDNs in the United States providing face-to-face nutrition care prior to the COVID-19 pandemic. This survey included 54 questions about practitioner demographics and experience and current practices providing nutrition care via telehealth, including billing …

Fostering Distance Education: Lessons From A United States-England Partnered Collaborative Online International Learning Approach, Lucy A. Ingram, Courtney M. Monroe, Haley Wright, Amy Burrell, Rebecca Jenks, Simon Cheung, Daniela B. Friedman Ph.D.

Faculty Publications

Collaborative Online International Learning (COIL) is a teaching and learning approach whereby entire courses or modules are co-developed and team taught by instructors from different institutions for students of both institutions. Since 2006, the approach has been gaining in mass appeal; however, considering our present-day global coronavirus pandemic, COILs have a renewed relevance in academia. Faculty from the University of South Carolina (United States) and Coventry University (England) embarked on a COIL partnership yielding a valuable experience that can serve as a model for other institutions that are interested in developing innovative and cross-cultural distance learning opportunities. The purpose of …

Reproducibility Of Hospital Rankings Based On Centers For Medicare & Medicaid Services Hospital Compare Measures As A Function Of Measure Reliability, Laurent G. Glance, David R. Nerenz, Karen E. Joynt Maddox, Bruce L. Hall, Andrew W. Dick

Center for Health Policy and Health Services Research Articles

Importance: Unreliable performance measures can mask poor-quality care and distort financial incentives in value-based purchasing.

Objective: To examine the association between test-retest reliability and the reproducibility of hospital rankings.

Design, Setting, and Participants: In a cross-sectional design, Centers for Medicare & Medicaid Services Hospital Compare data were analyzed for the 2017 (based on 2014-2017 data) and 2018 (based on 2015-2018 data) reporting periods. The study was conducted from December 13, 2020, to September 30, 2021. This analysis was based on 28 measures, including mortality (acute myocardial infarction, congestive heart failure, pneumonia, and coronary artery bypass grafting), readmissions (acute myocardial infarction, …

Lessons Learned: Timothy Massad, Yasemin Esmen

Documents

Esmen, Yasemin (2021) "Lessons Learned: Timothy Massad," The Journal of Financial Crises: Vol. 3 : Iss. 4, 34-37. Available at: https://elischolar.library.yale.edu/journal-of-financial-crises/vol3/iss4/5

Pragmatic Randomized Trial Evaluating Pre-Operative Aqueous Antiseptic Skin Solution In Open Fractures (Aqueous-Prep): The Feasibility Of A Cluster Randomized Crossover Study, Sheila Sprague, Paige Guyatt, Sofia Bzovsky, Uyen Nguyen, Mohit Bhandari, Lehana Thabane, Brad Petrisor, Herman S. Johal, Jordan Leonard, Shannon Dodds, Franca Mossuto, Robert V. O’Toole, Andrea Howe, Haley K. Demyanovich, Megan Camara, Nathan N. O’Hara, Gerard P. Slobogean, Jeffrey Wells, Jean Claude D’Alleyrand, Anthony D. Harris, Daniel C. Mullins, Amber Wood, Gregory J. Della Rocca, Joan Hebden, Lucas Marchand, Lyndsay M. O’Hara, Robert Zura, Michael J. Gardner, Jenna Blasman, Jonah Davies, Stephen Liang

Orthopaedic Surgery Faculty Publications

Background: Approximately 1 in 10 patients with a surgically treated open fracture will develop a surgical site infection. The Aqueous-PREP trial will investigate the effect of 10% povidone-iodine versus 4% chlorhexidine in aqueous antiseptic solutions in reducing infections after open fracture surgery. The study protocol was published in April 2020.

Methods and design: The Aqueous-PREP trial is a pragmatic, multicenter, open-label, randomized multiple period cluster crossover trial. Each participating cluster is randomly assigned in a 1:1 ratio to provide 1 of the 2 study interventions on all eligible patients during a study period. The intervention periods are 2 months in …

Ai And The Future Of Work: What We Know Today, Steven M. Miller, Thomas H. Davenport

Research Collection School Of Computing and Information Systems

To contribute to a better understanding of the contemporary realities of AI workplace deployments, the authors recently completed 29 case studies of people doing their everyday work with AI-enabled smart machines. Twenty-three of these examples were from North America, mostly in the US. Six were from Southeast Asia, mostly in Singapore. In this essay, we compare our findings on job and workplace impacts to those reported in the MIT Task Force on the Work of the Future report, as we consider that to be the most comprehensive recent study on this topic.

Insulin And Glucose Metabolism With Olanzapine And A Combination Of Olanzapine And Samidorphan: Exploratory Phase 1 Results In Healthy Volunteers, Frederico G S Toledo, William F Martin, Linda Morrow, Carine Beysen, Daiva Bajorunas, Ying Jiang, Bernard L Silverman, David Mcdonnell, Mark N Namchuk, John W Newcomer, Christine Graham

Open Access Publications

A combination of olanzapine and samidorphan (OLZ/SAM) received US Food and Drug Administration approval in May 2021 for the treatment of adults with schizophrenia or bipolar I disorder. OLZ/SAM provides the efficacy of olanzapine, while mitigating olanzapine-associated weight gain. This exploratory study characterized the metabolic profile of OLZ/SAM in healthy volunteers to gain mechanistic insights. Volunteers received once-daily oral 10 mg/10 mg OLZ/SAM, 10 mg olanzapine, or placebo for 21 days. Assessments included insulin sensitivity during an oral glucose tolerance test (OGTT), hyperinsulinemic-euglycemic clamp, other measures of glucose/lipid metabolism, and adverse event (AE) monitoring. Treatment effects were estimated with analysis …

Limitations Of Available Blood Products For Massive Transfusion During Mass Casualty Events At Us Level 1 Trauma Centers, James Williams, Michael Gustafson, Yu Bai, Samuel Prater, Charles E Wade, Oscar D Guillamondegui, Mansoor Khan, Megan Brenner, Paula Ferrada, Derek Roberts, Tal Horer, David Kauvar, Andrew Kirkpatrick, Carlos Ordonez, Bruno Perreira, Artai Priouzram, Juan Duchesne, Bryan A Cotton

Faculty, Staff and Student Publications

INTRODUCTION: Exsanguination remains a leading cause of preventable death in traumatically injured patients. To better treat hemorrhagic shock, hospitals have adopted massive transfusion protocols (MTPs) which accelerate the delivery of blood products to patients. There has been an increase in mass casualty events (MCE) worldwide over the past two decades. These events can overwhelm a responding hospital's supply of blood products. Using a computerized model, this study investigated the ability of US trauma centers (TCs) to meet the blood product requirements of MCEs.

METHODS: Cross-sectional survey data of on-hand blood products were collected from 16 US level-1 TCs. A discrete …

The Landscape Of Renal Replacement Therapy In Veterans Affairs Medical Center Intensive Care Units, Chandan Vangala, Maulin Shah, Natasha N Dave, Layth Al Attar, Sankar D Navaneethan, Venkat Ramanathan, Susan Crowley, Wolfgang C Winkelmayer

Faculty, Staff and Students Publications

BACKGROUND: Outpatient dialysis is standardized with several evidence-based measures of adequacy and quality that providers aim to meet while providing treatment. By contrast, in the intensive care unit (ICU) there are different types of prolonged and continuous renal replacement therapies (PIRRT and CRRT, respectively) with varied strategies for addressing patient care and a dearth of nationally accepted quality parameters. To eventually describe appropriate quality measures for ICU-related renal replacement therapy (RRT), we first aimed to capture the variety and prevalence of basic strategies and equipment utilized in the ICUs of Veteran Affairs (VA) medical facilities with inpatient hemodialysis capabilities.

METHODS: …