Here are what the editors at HealthDay consider to be the most important developments in Critical Care for October 2017. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.
Fentanyl or Analogs Tied to More Than Half of All Opioid Deaths
TUESDAY, Oct. 31, 2017 (HealthDay News) — Fentanyl was involved in more than half of opioid overdose deaths reported in the second half of 2016, according to a study published online Oct. 27 in Morbidity and Mortality Weekly Report.
Culprit-Lesion-Only PCI Tied to Improved 30-Day Outcomes
TUESDAY, Oct. 31, 2017 (HealthDay News) — Percutaneous coronary intervention (PCI) of the culprit lesion is associated with better 30-day outcomes than immediate multivessel PCI among patients with multivessel coronary artery disease and acute myocardial infarction with cardiogenic shock, according to a study published online Oct. 30 in the New England Journal of Medicine to coincide with the Cardiovascular Research Foundation Transcatheter Cardiovascular Therapeutics meeting, being held Oct. 29 to Nov. 2 in Denver.
Delayed Cord Clamping Not Beneficial for Preterm Infants
TUESDAY, Oct. 31, 2017 (HealthDay News) — Delayed cord clamping does not result in lower incidence of death or major morbidity in preterm infants, according to a study published online Oct. 29 in the New England Journal of Medicine to coincide with the Vermont Oxford Network 2017 Annual Quality Congress, held Oct. 26 to 30 in Chicago.
Depressive Symptoms Increase During Internship Year
TUESDAY, Oct. 31, 2017 (HealthDay News) — Depressive symptoms increase during the internship year for training physicians, with a greater increase among women, according to a study published online Oct. 30 in JAMA Internal Medicine.
Incretin Tied to Better Outcomes in NOCS-Diabetes
FRIDAY, Oct. 27, 2017 (HealthDay News) — Incretin treatment appears to improve non-ST-elevation myocardial infarction (NSTEMI) outcomes in patients with type 2 diabetes and non-obstructive coronary artery stenosis (NOCS), according to a study published online Sept. 26 in Diabetes, Obesity and Metabolism.
ERs Contribute Large Portion of Medical Care Delivery
FRIDAY, Oct. 27, 2017 (HealthDay News) — Emergency departments are increasingly a major source of medical care in the United States, according to a study published online Oct. 17 in the International Journal of Health Services.
Afternoon Heart Surgery Linked to Better Patient Outcomes
FRIDAY, Oct. 27, 2017 (HealthDay News) — For patients undergoing aortic valve replacement, perioperative myocardial injury occurs more with morning surgery than with afternoon surgery, according to a study published online Oct. 26 in The Lancet.
Chewing Ticagrelor Loading Dose May Be Beneficial in STEMI
THURSDAY, Oct. 26, 2017 (HealthDay News) — For patients with ST-segment elevation myocardial infarction (STEMI), chewing a loading dose (LD) of ticagrelor facilitates better early platelet inhibition, according to a study published online Oct. 25 in JAMA Cardiology.
Borderline Pulmonary HTN Linked to Increased Mortality Risk
THURSDAY, Oct. 26, 2017 (HealthDay News) — For patients undergoing right heart catheterization (RHC), borderline pulmonary hypertension (PH) is associated with increased risk of mortality, according to a study published online Oct. 25 in JAMA Cardiology.
Gifts From Pharma Companies Influence Prescribing Behavior
THURSDAY, Oct. 26, 2017 (HealthDay News) — Receipt of gifts from pharmaceutical companies is associated with more prescriptions per patient and more costly prescriptions, according to a study published online Oct. 25 in PLOS One.
Early Transfusion Tied to Lower Mortality in Combat Casualties
WEDNESDAY, Oct. 25, 2017 (HealthDay News) — Blood product transfusion pre-hospital or within minutes of injury is associated with improved survival among medically evacuated U.S. military combat casualties in Afghanistan, according to a study published online Oct. 24 in the Journal of the American Medical Association.
Hypothermia May Help Newborns With Encephalopathy
WEDNESDAY, Oct. 25, 2017 (HealthDay News) — Hypothermia treatment initiated at six to 24 hours after birth for newborns with hypoxic-ischemic encephalopathy may reduce death or disability, but there is uncertainty about its effectiveness, according to a study published online Oct. 24 in the Journal of the American Medical Association.
Alterations in Gut Microbiome Noted Within 72 Hours of Injury
WEDNESDAY, Oct. 25, 2017 (HealthDay News) — Critically injured patients develop changes in the composition of the gut microbiome within 72 hours, according to a study published online Oct. 23 in Trauma Surgery & Acute Care Open.
Diabetes Tied to Worse Outcomes in Heart Failure Patients
WEDNESDAY, Oct. 25, 2017 (HealthDay News) — Among patients with acute heart failure (HF), long-term prognosis is worse in those who have diabetes than in those who do not, though prognosis has improved in both groups, according to a study published online Oct. 5 in Diabetes Care.
Secondary Prevention Meds Often Not Started Post-AMI in Seniors
WEDNESDAY, Oct. 25, 2017 (HealthDay News) — Thirty-seven percent of older nursing home (NH) residents do not initiate secondary prevention medications after acute myocardial infarction (AMI), according to a study published online Oct. 17 in the Journal of the American Geriatrics Society.
Sudden Death Most Common CV Death in T2DM/ASCVD
MONDAY, Oct. 23, 2017 (HealthDay News) — Among patients with type 2 diabetes and atherosclerotic cardiovascular disease (ASCVD), sudden death is the most common category of cardiovascular (CV) mortality, according to a study published online Oct. 6 in Diabetes Care.
Design Thinking Enables Med Students to Solve Challenges
MONDAY, Oct. 23, 2017 (HealthDay News) — A joint effort between students at Warren Alpert Medical School of Brown University and Rhode Island School of Design (RISD) is training future physicians in design thinking to help identify and repair health system issues that contribute to physician burnout, according to an article by the American Medical Association.
Leukemia Patients Who Survive Severe GVHD Often Fare Worse
MONDAY, Oct. 23, 2017 (HealthDay News) — After hematopoietic stem cell transplantation (HSCT) for acute leukemia, patients who survive severe acute graft-versus-host disease (aGVHD) have a higher risk of developing extensive chronic GVHD (cGVHD) and a higher rate of non-relapse mortality compared with those who did not develop severe aGVHD, according to a study published online Oct. 13 in the Journal of Internal Medicine.
Psychosocial Intervention May Boost Hospitalization Satisfaction
MONDAY, Oct. 23, 2017 (HealthDay News) — A brief psychosocial intervention in which physicians ask inpatients about their current situation and respond empathetically appears to improve the hospitalization experience, according to a study published in the October issue of Family Medicine.
Alcoholic Cirrhosis Linked to Increased Admissions, Costs
FRIDAY, Oct. 20, 2017 (HealthDay News) — Compared with patients who have non-alcoholic cirrhosis, those with alcoholic cirrhosis are sicker at presentation, have more admissions and readmissions, and have nearly double the health care costs, according to a study scheduled for presentation at The Liver Meeting, being held by the American Association for the Study of Liver Diseases from Oct. 20 to 24 in Washington, D.C.
H7N9 Avian Influenza May Be Capable of Pandemic
FRIDAY, Oct. 20, 2017 (HealthDay News) — A highly pathogenic H7N9 avian influenza variant has evolved and now has the potential to cause a pandemic, according to a study published online Oct. 19 in Cell Host & Microbe.
Clinician Job Satisfaction Linked to Improved Burnout Scores
FRIDAY, Oct. 20, 2017 (HealthDay News) — Clinicians’ job satisfaction is associated with improved burnout scores and reduced intention to leave their practices, according to a study published in the October issue of Health Affairs.
Conditions Tied to Clinician Dissatisfaction Are Modifiable
THURSDAY, Oct. 19, 2017 (HealthDay News) — Modifiable conditions, like chaos, incohesiveness, and lack of communication, contribute to unsatisfying workplaces for clinicians, according to a study published in the October issue of Health Affairs.
Diabetes Ups Risk of MACE in Acute Coronary Syndromes
THURSDAY, Oct. 19, 2017 (HealthDay News) — For patients with acute coronary syndromes (ACS), diabetes mellitus (DM), but not pre-DM, is associated with an increased risk of major adverse cardiac events (MACE), according to a study published online Oct. 18 in the Journal of the American College of Cardiology.
More Penalties With Hospital-Wide Readmission Measure
THURSDAY, Oct. 19, 2017 (HealthDay News) — Transition from a condition-specific to a hospital-wide readmission measure would result in a modest increase in the number of hospitals eligible for readmission penalties and would substantially increase penalties for safety-net hospitals, according to a study published online Oct. 18 in the New England Journal of Medicine.
MRI Findings Prognostic for Long-Term Recovery in Cardiac Arrest
THURSDAY, Oct. 19, 2017 (HealthDay News) — Measures of cerebral functional network connectivity measured within four weeks of cardiac arrest (CA) are associated with a favorable outcome (FO) at one year, according to a study published online Oct. 18 in Radiology.
Key Stakeholders Discuss How to Make EHRs More Usable
THURSDAY, Oct. 19, 2017 (HealthDay News) — Key stakeholders and physicians discussed electronic health record (EHR) usability and optimization in the American Medical Association Running Your Practice Community.
Sharing Passwords Is Widespread Among Medical Staff
WEDNESDAY, Oct. 18, 2017 (HealthDay News) — Sharing of passwords to access electronic medical records is common among medical staff members, according to a study published in the July issue of Healthcare Informatics Research.
Men Now Comprise ~10 Percent of RN Workforce
WEDNESDAY, Oct. 18, 2017 (HealthDay News) — The increasing participation of men in registered nursing can be attributed to multiple factors, including increasing educational attainment, rising labor demand in health care, and liberalizing gender role attitudes, according to a working paper published by the Washington Center for Equitable Growth.
No Increased Risks for DOAC Use Versus Warfarin in VTE
WEDNESDAY, Oct. 18, 2017 (HealthDay News) — For patients with venous thromboembolism, direct oral anticoagulant (DOAC) use is not associated with increased risk of major bleeding or mortality within the first 90 days compared with warfarin use, according to a study published online Oct. 17 in the BMJ.
Tau May Predict Neurological Outcome After Cardiac Arrest
WEDNESDAY, Oct. 18, 2017 (HealthDay News) — Serum tau is a promising novel biomarker for prediction of neurological outcome in patients with cardiac arrest, according to a study published online Oct. 5 in the Annals of Neurology.
Mortality Up for Male Recipients of Blood From Ever-Pregnant
TUESDAY, Oct. 17, 2017 (HealthDay News) — For males, receipt of a red blood cell transfusion from an ever-pregnant female is associated with increased rate of all-cause mortality compared with a male donor, according to a study published online Oct. 17 in the Journal of the American Medical Association.
Female Physicians May Be Especially at Risk of Burnout
TUESDAY, Oct. 17, 2017 (HealthDay News) — Female physicians are more burned out than their male colleagues, but there are steps they can take to reduce the stress associated with burnout, according to a blog post published in Medical Economics.
Venovenous Hemodiafiltration Improves Metformin Toxicity
TUESDAY, Oct. 17, 2017 (HealthDay News) — High-volume continuous venovenous hemodiafiltration (CVVH) and resin-sorbent hemoperfusion is effective for eliminating metformin, according to a case study published online Oct. 5 in the Journal of Diabetes Investigation.
Screening Tools Identify Potentially Inappropriate Meds
TUESDAY, Oct. 17, 2017 (HealthDay News) — Internal medicine patients are frequently prescribed potentially inappropriate medications (PIMs), but screening tools can detect clinically relevant PIMs, according to a study published online Oct. 8 in the Journal of Clinical Pharmacy and Therapeutics.
Kneeling Posture Impacts Chest Compressions’ Effectiveness
MONDAY, Oct. 16, 2017 (HealthDay News) — During cardiopulmonary resuscitation (CPR) performed by males, self-adjusted and nearest kneeling postures are more effective for chest compression, with lower perceived exertion, according to a study published online Oct. 5 in the Journal of Clinical Nursing.
Most Female Physicians Have Faced Sexist Patient Comments
MONDAY, Oct. 16, 2017 (HealthDay News) — Most female physicians have been sexually harassed by patients at some point in their careers, according to a blog post published in Medical Economics.
Serious Suffering Affects Almost Half of Those Who Die Yearly
FRIDAY, Oct. 13, 2017 (HealthDay News) — In 2015, more than 25.5 million people who died worldwide experienced serious health-related suffering (SHS), and the vast majority lacked access to palliative care and pain relief, according to a report published online Oct. 12 in The Lancet.
Disparity Seen in Nephrology Follow-Up Care
FRIDAY, Oct. 13, 2017 (HealthDay News) — There is a large disparity between the reported clinical opinions of nephrologists and real-world care for nephrology evaluation of patients after hospitalization with severe acute kidney injury (AKI), according to a study published online Oct. 12 in the Clinical Journal of the American Society of Nephrology.
Freestanding ERs More Likely in Areas With Higher Incomes
FRIDAY, Oct. 13, 2017 (HealthDay News) — Freestanding emergency departments (EDs) tend to be located in areas with significantly higher household incomes, according to a study published in the October issue of Health Affairs.
Quality Issues for Both Paper-, Electronic-Based Health Records
FRIDAY, Oct. 13, 2017 (HealthDay News) — Both paper-based and electronic health records (EHRs) have shortcomings in terms of quality of content, process, and structure, with poor quality of nursing documentation seen for both methods, according to a study published online Oct. 5 in the Journal of Clinical Nursing.
Court Considering Fate of Noneconomic Damages Cap
THURSDAY, Oct. 12, 2017 (HealthDay News) — The Wisconsin Supreme Court is considering whether it will hear a case that will determine the fate of the state’s $750,000 cap on noneconomic damages, according to an article published by the American Medical Association (AMA).
New System Streamlines CME Credit Approval Process
THURSDAY, Oct. 12, 2017 (HealthDay News) — The American Academy of Family Physicians (AAFP) and the American Board of Family Medicine (ABFM) have launched a new performance improvement activity credit reporting process called the AAFP Credit System, according to an article published by the AAFP.
Low-Cost Services a Major Player in Unnecessary Health Spending
THURSDAY, Oct. 12, 2017 (HealthDay News) — The costs associated with low-cost, low-value health services are nearly twice as high as those of high-cost, low-value services, according to a study published in the October issue of Health Affairs.
Medical License Questions Sway Doctors’ Mental Health Help
WEDNESDAY, Oct. 11, 2017 (HealthDay News) — Medical licensure application questions (MLAQs) regarding mental health contribute to physicians’ reluctance to seek help for mental health, according to a study published in the October issue of Mayo Clinic Proceedings.
Physician Salaries Appear to Be Flat or Declining
WEDNESDAY, Oct. 11, 2017 (HealthDay News) — Anecdotally, physician career coaches report that physician salaries are flat at best, according to an article published in Medical Economics.
Critical Care Nurses Should Be Prepared for Open Abdomen
WEDNESDAY, Oct. 11, 2017 (HealthDay News) — Critical care nurses need to be prepared to manage patients with open abdomen, according to a report published in the October issue of Critical Care Nurse.
Educational Intervention in Hospital Can Cut Catheter Use
WEDNESDAY, Oct. 11, 2017 (HealthDay News) — A simple multimodal educational intervention targeting nurses and physicians can reduce mean catheter days per patient (CDPP) and the proportion of patients catheterized, according to a study published online Sept. 23 in the Journal of the American Geriatrics Society.
Guide Offers Doctors Tips for Choosing a Health System
TUESDAY, Oct. 10, 2017 (HealthDay News) — A guide has been developed to assist physicians considering joining a physician-led integrated health system, according to a report published by the American Medical Association (AMA).
2HELPS2B Model Identifies Seizure Risk in Critically Ill
TUESDAY, Oct. 10, 2017 (HealthDay News) — For critically ill patients, a model comprising six variables can identify the probability of seizure, according to a study published online Oct. 9 in JAMA Neurology.
Novel Metrics Suggested for Assessing EHR Use
TUESDAY, Oct. 10, 2017 (HealthDay News) — Novel metrics have been developed to assess electronic health record (EHR) use and are described in an opinion article published online Oct. 9 in the Annals of Internal Medicine.
Adding Albumin to Risk Score Improves Mortality Prediction
MONDAY, Oct. 9, 2017 (HealthDay News) — Serum albumin, as a marker of frailty, can significantly improve the ability of the Society of Thoracic Surgeons (STS) and European System for Cardiac Operative Risk Evaluation (EuroSCORE-2) scores to predict transcatheter aortic valve replacement (TAVR)-related mortality, according to a study published online Sept. 23 in the Journal of the American Geriatrics Society.
2016 Physician Quality Reporting System Reports Available
MONDAY, Oct. 9, 2017 (HealthDay News) — The 2016 Physician Quality Reporting System (PQRS) and the 2016 annual Quality and Resource Use reports have been released for individuals and group practices, according to a report published by the American Academy of Family Physicians.
Injured Patients Want More Info on Safety Improvement Efforts
MONDAY, Oct. 9, 2017 (HealthDay News) — Communication-and-resolution program (CRP) experiences are positive overall for a small majority of patients and families, but they report that hospitals rarely share information about preventing recurrences, according to a study published online Oct. 9 in JAMA Internal Medicine.
Short-Lived Benefits for Abusive Supervisory Behavior
FRIDAY, Oct. 6, 2017 (HealthDay News) — Engaging in abusive supervisory behavior may be associated with short-term beneficial effects, but over longer periods of time, abusive supervisory behavior is negatively related to supervisors’ recovery level and engagement, according to a study published online Sept. 11 in the Academy of Management Journal.
Electrolyte Issues With Chronic Alcohol Use Span Social Spectrum
FRIDAY, Oct. 6, 2017 (HealthDay News) — Electrolyte disturbances and acid-base disorders are common occurrences in patients with chronic alcohol-use disorder regardless of social circumstances, according to a review published online Oct. 4 in the New England Journal of Medicine.
Stronger Nocebo Effect When Inert Rx Labeled As Expensive
FRIDAY, Oct. 6, 2017 (HealthDay News) — Nocebo hyperalgesia is stronger when an inert treatment is labeled as being an expensive medication rather than a cheap one, according to a study published online Oct. 5 in Science.
21 Percent of Americans Report Experiencing a Medical Error
THURSDAY, Oct. 5, 2017 (HealthDay News) — More than one in five patients report having experienced a medical error, according to a survey released Sept. 28 by the Institute for Healthcare Improvement (IHI)/National Patient Safety Foundation Lucian Leape Institute and NORC at the University of Chicago.
Reasons Physicians Are Delaying Retirement Vary
THURSDAY, Oct. 5, 2017 (HealthDay News) — Physicians are delaying retirement, often because they feel they are providing a useful service to patients or because of concerns about social interaction in retirement, according to an article published online Sept. 25 in Medical Economics.
Night Shift Tied to Increased Odds of Abdominal Obesity
THURSDAY, Oct. 5, 2017 (HealthDay News) — Night shift workers have increased odds of obesity/overweight, especially abdominal obesity, according to a meta-analysis published online Oct. 4 in Obesity Reviews.
Delivery Characteristics Predict Early-Onset Sepsis Risk
THURSDAY, Oct. 5, 2017 (HealthDay News) — Delivery characteristics of extremely preterm infants can be used to identify those with significantly lower incidence of early-onset sepsis (EOS), according to a study published online Oct. 5 in Pediatrics.
Pay Inequality, Work-Life Balance Top Concerns for Female Docs
WEDNESDAY, Oct. 4, 2017 (HealthDay News) — Many female physicians report feeling disadvantaged when negotiating contracts and feel that they are assessed for promotion using different criteria than those used for men, according to a report published by the American Medical Association (AMA).
ER Risk Score Predicts 30-Day Mortality in Acute Heart Failure
WEDNESDAY, Oct. 4, 2017 (HealthDay News) — For patients with acute heart failure (AHF) admitted to the emergency department (ED), a risk score based on 13 independent risk factors can predict 30-day mortality, according to a study published online Oct. 2 in the Annals of Internal Medicine.
Scientists Support Genome Editing to Prevent Disease
WEDNESDAY, Oct. 4, 2017 (HealthDay News) — Many basic scientists and clinical researchers support somatic genome editing in adults for prevention of serious disease but not for human enhancement; they also believe the public should be consulted before any clinical application of germline gene editing proceeds, according to survey results published online Oct. 3 in Circulation: Cardiovascular Genetics.
Communication Program Doesn’t Raise Hospital Liability Costs
TUESDAY, Oct. 3, 2017 (HealthDay News) — A communication-and-resolution program, in which hospitals and liability insurers communicate with patients when adverse events occur, does not lead to higher liability costs, according to a study published online Oct. 2 in Health Affairs.
Clinical Exome Sequencing Useful for Critically Ill Infants
TUESDAY, Oct. 3, 2017 (HealthDay News) — Clinical exome sequencing is an effective diagnostic tool for infants suspected of having monogenic disorders, according to a study published online Oct. 2 in JAMA Pediatrics.
Vancomycin + Piperacillin/ Tazobactam Ups Kidney Risk
MONDAY, Oct. 2, 2017 (HealthDay News) — For hospitalized children, coadministration of intravenous (IV) vancomycin and piperacillin/tazobactam is associated with increased risk of acute kidney injury (AKI), according to a study published online Oct. 2 in JAMA Pediatrics.
Low-Dose Alteplase No Better for Acute Ischemic Stroke
MONDAY, Oct. 2, 2017 (HealthDay News) — For key demographic subgroups of patients with acute ischemic stroke (AIS), low-dose alteplase does not differ from standard-dose alteplase in terms of treatment effects on death or disability, according to a study published online Oct. 2 in JAMA Neurology.
Recent Immigrants to Canada More Likely to Die in ICU
MONDAY, Oct. 2, 2017 (HealthDay News) — Recent immigrants to Canada are more likely to receive aggressive care and die in intensive care than long-standing residents, according to a study published online Oct. 2 in the Journal of the American Medical Association.
Electronic Triage System Risk-Stratifies ER Patients
MONDAY, Oct. 2, 2017 (HealthDay News) — An electronic triage (e-triage) system based on machine learning can predict the likelihood of acute outcomes, enabling improved patient differentiation, according to a study published online Sept. 6 in the Annals of Emergency Medicine.
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