Development and validation of a bedside risk score for MRSA among patients hospitalized with complicated skin and skin structure infections.

Background: Methicillin-resistant Staphylococcus aureus (MRSA) is a frequent cause of complicated skin and skin structure infections (cSSSI). Patients with MRSA require different empiric treatment than those with non-MRSA infections, yet no accurate tools exist to aid in stratifying the risk for a MRSA cSSSI. We sought to develop a simple bedside decision rule to tailor empiric coverage more accurately.

Pattern of clopidogrel use in hospitalized patients receiving percutaneous coronary interventions.

Purpose: The pattern of clopidogrel loading in patients who had undergone percutaneous coronary intervention (PCI) was studied in a retrospective analysis of clinical records.

Methods: A database of deidentified electronic medical records from hospitals and hospital-affiliated outpatient facilities throughout the United States was analyzed for PCI patients with or without a diagnosis of acute coronary syndrome (ACS) who received clopidogrel loading doses of > or =300 mg between 48 hours before and 6 hours after PCI. A high dose was defined as > or =600 mg, and pretreatment was defined as more than 6 hours before PCI for 300-599 mg and 2 or more hours before PCI for > or =600 mg.

Glucose normalization and outcomes in patients with acute myocardial infarction.

Background: Elevated blood glucose levels on admission are associated with increased mortality in patients with acute myocardial infarction. Whether glucose normalization after admission is associated with improved survival remains controversial. In addition, whether outcomes differ in patients who have spontaneous resolution of hyperglycemia vs those who achieve normoglycemia after treatment with insulin is also unknown.

Glucometrics in patients hospitalized with acute myocardial infarction: defining the optimal outcomes-based measure of risk.

Background: Hyperglycemia on admission is associated with an increased mortality rate in patients with acute myocardial infarction. Whether metrics that incorporate multiple glucose assessments during acute myocardial infarction hospitalization are better predictors of mortality than admission glucose alone is not well defined.

Methods And Results: We evaluated 16,871 acute myocardial infarction patients hospitalized from January 2000 to December 2005.

Age, but not sex, influences the measurement of ejection fraction in elderly patients hospitalized for heart failure.

Background: Current US and European guidelines recommend that ejection fraction (EF) be measured at least once in patients with congestive heart failure (CHF). However, it is not known how age and sex influence adherence to this recommendation.

Methods: We reviewed a national sample of Medicare patients discharged with a principal diagnosis of heart failure and sought to determine the frequency of measurement of EF and the frequency of preserved systolic function (EF > 40%) by age and sex.