Cefazolin and Carbapenem Combination to Treat Persistent Methicillin-sensitive Staphylococcus aureus Bacteremia in Preterm Infants.

Encouraged by bacteremia clearance using antistaphylococcal beta-lactams plus carbapenem combination in adults with refractory methicillin-sensitive Staphylococcus aureus infection, we present our experience with 2 preterm infants and review 1 previously published case. Noted successful bacteremia clearance in all 3 must be weighed against possible adverse effects associated with carbapenem use.

The Association Between Body Mass Index, Frailty and Long-Term Clinical Outcomes in Hospitalized Older Adults.

Background: While frailty is thought to be a wasting disorder, there is scarce data regarding the association between frailty and body mass index (BMI). The aim of this study was to determine the relationship between BMI, frailty, and mortality among hospitalized older adults.

Methods: This is a secondary analysis of a prospective cohort study of patients aged ≥65 years admitted to a tertiary center between 2014 and 2016.

The association of cognitive impairment as screened by the Mini-Cog with long term post-hospitalization outcomes.

Background: Prior studies have suggested that patients with cognitive impairment are at increased risk for adverse post-hospitalization outcomes. We aimed to determine if cognitive status assessed by the Mini-Cog, a quick bedside screening test, is associated with long-term outcomes.

Methods: In this secondary analysis of data from a prospective cohort study, 668 patients >65 years of age admitted to a tertiary care academic hospital over a two-year period were screened for cognitive impairment with the Mini-Cog within 24 h of admission.

An Acute Care for Elders Quality Improvement Program for Complex, High-Cost Patients Yields Savings for the System.

Background: Acute Care for Elders (ACE) programs improve outcomes for older adults; however, little is known about whether impact varies with comorbidity severity.

Objective: To describe differences in hospital-level outcomes between ACE and routine care across various levels of comorbidity burden.

Design: Cross-sectional quality improvement study.

A Quality Improvement Initiative to Improve Medication Management in an Acute Care for Elders Program Through Integration of a Clinical Pharmacist.

Purpose: To describe the implementation and impact of integrating a clinical pharmacist into interdisciplinary Acute Care for Elderly (ACE) rounds at a teaching hospital.

Methods: Pre- and postanalyses were performed 6 months before and 12 months after the intervention. We report the total number, type, and frequency of recommendations made by the clinical pharmacist, the acceptance rate by the physician, and interventions on potentially inappropriate medications (PIM).

Long-term outcomes of elders discharged on antipsychotics.

Background: Despite limited evidence of efficacy, antipsychotics (APs) are commonly used to treat delirium. There has been little research on the long-term outcomes of patients who are started on APs in the hospital.

Methods: Using a previously described retrospective cohort of 300 elders (≥65 years old) who were newly prescribed APs while hospitalized between October 1, 2012 and September 31, 2013, we examined the 1-year outcomes of patients alive at the time of discharge.

A collaborative national model to assess competencies for medical students, residents, and other healthcare practitioners in gait and falls risk evaluation.

To ensure that the healthcare workforce is adequately prepared to care for the growing population of older adults, minimum competencies in geriatrics have been published for medical students and primary care residents. Approaches to teaching and assessing these competencies are needed to guide medical schools, residencies, and continuing medical education programs. With sponsorship by the Education Committee and Teachers Section of the American Geriatrics Society (AGS), geriatrics educators from multiple institutions collaborated to develop a model to teach and assess a major domain of student and resident competency: Gait and Falls Risk Evaluation.

Do elderly patients fare well in the ICU?

Background: A recent update of the Mortality Probability Model (MPM)-III found 14% of intensive care patients had age as their only MPM risk factor for hospital mortality. This subgroup had a low mortality rate (2% vs 14% overall), and pronounced differences were noted among elderly patients. This article is an expanded analysis of age-related mortality rates in patients in the ICU.

Postprandial hypotension.

Postprandial hypotension is both common in geriatric patients and an important but under-recognized cause of syncope. Other populations at risk include those with Parkinson disease and autonomic failure. The mechanism is not clearly understood, but appears to be secondary to a blunted sympathetic response to a meal.

Recognition and management of chronic kidney disease in an elderly ambulatory population.

Background: Chronic kidney disease (CKD) is a growing problem among the elderly. Early detection is considered essential to ensure proper treatment and to avoid drug toxicity, but detection is challenging because elderly patients with CKD often have normal serum creatinine levels. We hypothesized that most cases of CKD in the elderly would go undetected, resulting in inappropriate prescribing.

Potentially inappropriate medication use in hospitalized elders.

Background: Prescribing of potentially harmful medications has not been well documented in hospitals.

Objective: The objective of the study was to determine the rate of and factors associated with potentially inappropriate medication (PIM) prescribing in a large inpatient sample.

Design: The study was a retrospective cohort of the period between September 1, 2002, and June 30, 2005.

Adverse outcomes of geriatric patients undergoing abdominal surgery who are at high risk for delirium.

Hypothesis: Among geriatric patients undergoing abdominal surgery who are at high risk for in-hospital delirium, clinical factors associated with delirium correlate with adverse outcomes.

Design: Retrospective case series study.

Setting: University-affiliated referral hospital.

The long-term impact of dialysis discontinuation on families.

Background: Little is known about the long-term psychological impact of stopping life support treatments on surviving loved ones.

Objective: The authors sought to determine if there was an increase in pathologic grief in family members left behind after deaths that followed dialysis discontinuation.

Design: Phone interviews were used to collect data on demographics, attitudes, and families' comfort levels with the decision to withdraw dialysis.