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 demonstrates that the U.S. opioid crisis has been accompanied by a large increase in the number of patients with DUA-IE.
The demographic and microbiologic profiles of patients with DUA-IE differ from those of traditional (non-DUA) endocarditis patients. DUA-IE patients are more likely to be young (median age 33 years), be white (89%), have Medicare or no insurance (73%), and be infected with methicillin-resistant Staphylococcus aureus.
An editorialist notes that the rising rates of DUA-IE highlight the urgency of treating the underlying substance use disorder in patients who are admitted with this complication.
This meta-analysis highlights the significant benefits of catheter ablation of AF in patients with heart failure.
Hospitalists might consider electrophysiology referrals for heart failure patients with AF, especially if these patients are hospitalized frequently.
The authors note that several ongoing trials are further examining this issue, so additional evidence will be forthcoming.
These results suggest that the trend of increasingly restrictive transfusion practices in patients with moderate anemia is associated with decreased rates of rehospitalization and transfusion over the 6 months after hospitalization and is associated with lower mortality rates.
An editorialist notes that this study did not explore other important outcomes, such as quality of life, and points out that the persistence of anemia demonstrated in this study suggests a need for more aggressive treatment strategies (other than transfusion) for these patients.
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Wesorick DH, Chopra V. Annals for Hospitalists - 15 January 2019. Ann Intern Med. ;170:HO1. doi: 10.7326/AFHO201901150
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Published: Ann Intern Med. 2019;170(2):HO1.
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