The Burden of COVID-19 Mortality Due to Referrals From Skilled Nursing Facilities in a Small Community Hospital.

Background: Amidst the COVID-19 pandemic, nursing home residents have seen a significant increase in hospitalizations. However, there is a lack of published data on the healthcare provided to these individuals in community hospitals. This knowledge gap hinders our understanding and evaluation of the quality and outcomes of care received by nursing home residents when they are hospitalized for COVID-19 or other medical conditions.

Artificial Intelligence for Diagnosis of Acute Coronary Syndromes: A Meta-analysis of Machine Learning Approaches.

Background: Machine learning (ML) encompasses a wide variety of methods by which artificial intelligence learns to perform tasks when exposed to data. Although detection of myocardial infarction has been facilitated with introduction of troponins, the diagnosis of acute coronary syndromes (ACS) without myocardial damage (without elevation of serum troponin) remains subjective, and its accuracy remains highly dependent on clinical skills of the health care professionals. Application of a ML algorithm may expedite management of ACS for either early discharge or early initiation of ACS management.

Drug Overdose Deaths Among Women Aged 30-64 Years - United States, 1999-2017.

The drug epidemic in the United States continues to evolve. The drug overdose death rate has rapidly increased among women (1,2), although within this demographic group, the increase in overdose death risk is not uniform. From 1999 to 2010, the largest percentage changes in the rates of overall drug overdose deaths were among women in the age groups 45-54 years and 55-64 years (1); however, this finding does not take into account trends in specific drugs or consider changes in age group distributions in drug-specific overdose death rates.

Circulating Troponin I Level in Patients with Acute Ischemic Stroke.

Purpose Of Review: Cardiac troponin levels in the blood are an important biomarker of acute coronary events, but may also be elevated in the context of acute ischemic stroke without an obvious concurrent myocardial insult. The objective of this study and systematic review is to determine how high the circulating troponin I level can rise due to ischemic stroke.

Recent Findings: Anonymized medical records from Vanderbilt University Medical Center were reviewed identifying 151,972 unique acute ischemic stroke events, of which 1226 met criteria for inclusion in this study.

Isothermal assay targeting class 1 integrase gene for environmental surveillance of antibiotic resistance markers.

Antimicrobial resistance genes (ARGs) present in the environment pose a risk to human health due to potential for transfer to human pathogens. Surveillance is an integral part of mitigating environmental dissemination. Quantification of the mobile genetic element class 1 integron-integrase gene (intI1) has been proposed as a surrogate to measuring multiple ARGs.

Cost-utility of osteoarticular allograft versus endoprosthetic reconstruction for primary bone sarcoma of the knee: A markov analysis.

Background: The most cost-effective reconstruction after resection of bone sarcoma is unknown. The goal of this study was to compare the cost effectiveness of osteoarticular allograft to endoprosthetic reconstruction of the proximal tibia or distal femur.

Methods: A Markov model was used.

STRATEGIES FOR EQUITABLE PHARMACOGENOMIC-GUIDED WARFARIN DOSING AMONG EUROPEAN AND AFRICAN AMERICAN INDIVIDUALS IN A CLINICAL POPULATION.

The blood thinner warfarin has a narrow therapeutic range and high inter- and intra-patient variability in therapeutic doses. Several studies have shown that pharmacogenomic variants help predict stable warfarin dosing. However, retrospective and randomized controlled trials that employ dosing algorithms incorporating pharmacogenomic variants under perform in African Americans.

Higher Charlson Comorbidity Index Scores Are Associated With Increased Hospital Length of Stay After Lower Extremity Orthopaedic Trauma.

Objectives: The purpose of this study was to explore the relationship between preoperative Charlson Comorbidity Index (CCI) and postoperative length of stay (LOS) for lower extremity and hip/pelvis orthopaedic trauma patients.

Design: Retrospective.

Setting: Urban level 1 trauma center.

Evaluating electronic health record data sources and algorithmic approaches to identify hypertensive individuals.

Objective: Phenotyping algorithms applied to electronic health record (EHR) data enable investigators to identify large cohorts for clinical and genomic research. Algorithm development is often iterative, depends on fallible investigator intuition, and is time- and labor-intensive. We developed and evaluated 4 types of phenotyping algorithms and categories of EHR information to identify hypertensive individuals and controls and provide a portable module for implementation at other sites.

Risk Factors for Deep Venous Thrombosis Following Orthopaedic Trauma Surgery: An Analysis of 56,000 patients.

Background: Deep venous thrombosis (DVT) and pulmonary embolism (PE) are recognized as major causes of morbidity and mortality in orthopaedic trauma patients. Despite the high incidence of these complications following orthopaedic trauma, there is a paucity of literature investigating the clinical risk factors for DVT in this specific population. As our healthcare system increasingly emphasizes quality measures, it is critical for orthopaedic surgeons to understand the clinical factors that increase the risk of DVT following orthopaedic trauma.

Does Admission to Medicine or Orthopaedics Impact a Geriatric Hip Patient's Hospital Length of Stay?

Objectives: The aim of our study was to determine the association between admitting service, medicine or orthopaedics, and length of stay (LOS) for a geriatric hip fracture patient.

Design: Retrospective.

Setting: Urban level 1 trauma center.

National Veterans Health Administration inpatient risk stratification models for hospital-acquired acute kidney injury.

Objective: Hospital-acquired acute kidney injury (HA-AKI) is a potentially preventable cause of morbidity and mortality. Identifying high-risk patients prior to the onset of kidney injury is a key step towards AKI prevention.

Materials And Methods: A national retrospective cohort of 1,620,898 patient hospitalizations from 116 Veterans Affairs hospitals was assembled from electronic health record (EHR) data collected from 2003 to 2012.

Validity of the Medical College Admission Test for predicting MD-PhD student outcomes.

The Medical College Admission Test (MCAT) is a quantitative metric used by MD and MD-PhD programs to evaluate applicants for admission. This study assessed the validity of the MCAT in predicting training performance measures and career outcomes for MD-PhD students at a single institution. The study population consisted of 153 graduates of the Vanderbilt Medical Scientist Training Program (combined MD-PhD program) who matriculated between 1963 and 2003 and completed dual-degree training.

Ocular findings at initial pan retinal photocoagulation for proliferative diabetic retinopathy predict the need for future pars plana vitrectomy.

Purpose: To determine the 1-year and 2-year likelihood of vitrectomy in diabetic patients undergoing initial pan retinal photocoagulation (PRP).

Methods: Diabetic eyes receiving initial PRP for proliferative diabetic retinopathy (PDR) were analyzed to determine their risk for vitrectomy based on clinical findings.

Results: In total, 374 eyes of 272 patients were analyzed.

Machine learning for risk prediction of acute coronary syndrome.

Acute coronary syndrome (ACS) accounts for 1.36 million hospitalizations and billions of dollars in costs in the United States alone. A major challenge to diagnosing and treating patients with suspected ACS is the significant symptom overlap between patients with and without ACS.

A decision model of therapy for potentially resectable pancreatic cancer.

Background: Optimal treatment for potentially resectable pancreatic cancer is controversial. Resection is considered the only curative treatment, but neoadjuvant chemoradiotherapy may offer significant advantages.

Materials And Methods: We developed a decision model for potentially resectable pancreatic cancer.