David H. Wesorick, MD; Vineet Chopra, MD, MSc
Disclosures: Dr. Chopra reports grants from the Agency for Healthcare Research and Quality. Dr. Wesorick has disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M16-1400.
This analysis suggests that use of sacubitril–valsartan therapy in this patient population would be very cost-effective, based in large part on the increase in survival.
An editorial discusses slow adoption of this therapy, despite significant evidence of its superiority over conventional renin–angiotensin inhibitors. The editorial suggests that clinicians may not be aware of the evidence supporting use of these medications.
FMT is a valuable treatment option in management of patients with recurrent C difficile infection.
As discussed in an editorial, hospitalists should avoid overdiagnosis of CDI recurrence. It can lead to postinfectious irritable bowel syndrome (which can cause abnormal bowel movements after recovery from an infection), and results of stool tests can remain positive even after clinical cure.
This study corroborates the notion that frailty (i.e., reduced physiologic reserve) is predictive of poorer outcomes after surgical procedures. Consequently, measures of frailty might assist in decision making on surgical candidacy for some elderly patients.
However, the optimal strategy for measuring frailty remains uncertain, secondary to heterogeneity in the measurement tools in this study (which included measures of mobility, disability, and nutrition).
An editorial notes that translation of this knowledge into practice is limited because of the backdrop of complicated decisions regarding surgery in this patient population. More research will be needed to help clinicians know how to use these assessments to assist patients in making better decisions.
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Wesorick DH, Chopra V. Annals for Hospitalists - 15 November 2016. Ann Intern Med. ;165:HO1. doi: 10.7326/AFHO201611150
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Published: Ann Intern Med. 2016;165(10):HO1.
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