There are many practical skills you should hone if you are interested in becoming a team leader in your hospital medicine group—among them the ability to engage others, to effectively conduct an efficient meeting, and to meet project deadlines. But more basic than that, says Jasen Gundersen, MD, MBA, CPE, SFHM, president of the Acute Care Services Division for TeamHealth in the Miami/Fort Lauderdale area, is to first ask yourself, “Why do I want to be a leader? What is it about being a leader that draws me in?”

Early career hospitalists may think leadership roles automatically yield more money and free time, Dr. Gundersen says. Actually, being a leader requires stamina and the ability to weather the ups and downs that come with the leadership role. For example, will you be able to handle situations in which your decisions make others unhappy?

Deliver on Promises

Honest self-assessment is one of the most critical elements in becoming a leader, agrees Steven Deitelzweig, MD, MMM, FACP, FSVMB, RVT, VPMA, system chairman of hospital medicine and medical director of regional business development for Ochsner Health System in the greater New Orleans area. In addition to having good interpersonal skills, showing enthusiasm, and promoting your organization sincerely—what Dr. Deitelzweig labels “emotional intelligence”—prospective leaders need to be cognizant of delivering on promises.

“This is something I call a high ‘say/do’ ratio,” he explains, “and, simply put, it means that you accomplish what you say you will. At the end of the day, the only way anybody moves up is by being good at achieving results.”

If you start missing deadlines, you communicate that you are not reliable. Not all project implementation goes according to plan, of course, so when you encounter difficulties, early communication about obstacles is also key, he says.

Nuts and Bolts

Through SHM’s Leadership Academy, hospitalists can be trained in team management and other key leadership skills. An October 2015 session is scheduled in Austin.

Having trusted mentors is crucial, agreed both physicians, so that you can keep polishing your skill set and obtain honest feedback. These mentors should not be people to whom you directly report, and they need not be in the healthcare industry.

In fact, Dr. Gundersen says he’s known mentors for years “who have not been in the same specialty or even the same field, but who give me guidance and have helped make me into the leader I am.”

How do you assert your desire to be a leader? Dr. Deitelzweig suggests making your aspirations clear to your own group leaders. The annual review is an excellent juncture at which to discuss this, he says.

If you do not yet have project management or communications experience, ask your leaders whether they are familiar with training to help you develop those skills. In the current healthcare environment, the Affordable Care Act and reimbursement regulations mean that change will continue to be part of the leadership challenge.

“If you really want to be a leader,” Dr. Deitelzweig says, “you cannot be a naysayer. Make change work for you, look at it as an opportunity for you to innovate, and then show how valuable you can be.”

---

Gretchen Henkel is a freelance writer in California.

Listen Now

Listen to Dr. Gundersen dive further into the importance of mentors and assessing your personal qualities to be a good leader.

[audio mp3="http://www.the-hospitalist.org/wp-content/uploads/2015/03/Gundersen_CareerCenter1_FINAL_012515.mp3"][/audio]

There are many practical skills you should hone if you are interested in becoming a team leader in your hospital medicine group—among them the ability to engage others, to effectively conduct an efficient meeting, and to meet project deadlines. But more basic than that, says Jasen Gundersen, MD, MBA, CPE, SFHM, president of the Acute Care Services Division for TeamHealth in the Miami/Fort Lauderdale area, is to first ask yourself, “Why do I want to be a leader? What is it about being a leader that draws me in?”

Early career hospitalists may think leadership roles automatically yield more money and free time, Dr. Gundersen says. Actually, being a leader requires stamina and the ability to weather the ups and downs that come with the leadership role. For example, will you be able to handle situations in which your decisions make others unhappy?

Deliver on Promises

Honest self-assessment is one of the most critical elements in becoming a leader, agrees Steven Deitelzweig, MD, MMM, FACP, FSVMB, RVT, VPMA, system chairman of hospital medicine and medical director of regional business development for Ochsner Health System in the greater New Orleans area. In addition to having good interpersonal skills, showing enthusiasm, and promoting your organization sincerely—what Dr. Deitelzweig labels “emotional intelligence”—prospective leaders need to be cognizant of delivering on promises.

“This is something I call a high ‘say/do’ ratio,” he explains, “and, simply put, it means that you accomplish what you say you will. At the end of the day, the only way anybody moves up is by being good at achieving results.”

If you start missing deadlines, you communicate that you are not reliable. Not all project implementation goes according to plan, of course, so when you encounter difficulties, early communication about obstacles is also key, he says.

Nuts and Bolts

Through SHM’s Leadership Academy, hospitalists can be trained in team management and other key leadership skills. An October 2015 session is scheduled in Austin.

Having trusted mentors is crucial, agreed both physicians, so that you can keep polishing your skill set and obtain honest feedback. These mentors should not be people to whom you directly report, and they need not be in the healthcare industry.

In fact, Dr. Gundersen says he’s known mentors for years “who have not been in the same specialty or even the same field, but who give me guidance and have helped make me into the leader I am.”

How do you assert your desire to be a leader? Dr. Deitelzweig suggests making your aspirations clear to your own group leaders. The annual review is an excellent juncture at which to discuss this, he says.

If you do not yet have project management or communications experience, ask your leaders whether they are familiar with training to help you develop those skills. In the current healthcare environment, the Affordable Care Act and reimbursement regulations mean that change will continue to be part of the leadership challenge.

“If you really want to be a leader,” Dr. Deitelzweig says, “you cannot be a naysayer. Make change work for you, look at it as an opportunity for you to innovate, and then show how valuable you can be.”

---

Gretchen Henkel is a freelance writer in California.

Listen Now

Listen to Dr. Gundersen dive further into the importance of mentors and assessing your personal qualities to be a good leader.

[audio mp3="http://www.the-hospitalist.org/wp-content/uploads/2015/03/Gundersen_CareerCenter1_FINAL_012515.mp3"][/audio]

There are many practical skills you should hone if you are interested in becoming a team leader in your hospital medicine group—among them the ability to engage others, to effectively conduct an efficient meeting, and to meet project deadlines. But more basic than that, says Jasen Gundersen, MD, MBA, CPE, SFHM, president of the Acute Care Services Division for TeamHealth in the Miami/Fort Lauderdale area, is to first ask yourself, “Why do I want to be a leader? What is it about being a leader that draws me in?”

Early career hospitalists may think leadership roles automatically yield more money and free time, Dr. Gundersen says. Actually, being a leader requires stamina and the ability to weather the ups and downs that come with the leadership role. For example, will you be able to handle situations in which your decisions make others unhappy?

Deliver on Promises

Honest self-assessment is one of the most critical elements in becoming a leader, agrees Steven Deitelzweig, MD, MMM, FACP, FSVMB, RVT, VPMA, system chairman of hospital medicine and medical director of regional business development for Ochsner Health System in the greater New Orleans area. In addition to having good interpersonal skills, showing enthusiasm, and promoting your organization sincerely—what Dr. Deitelzweig labels “emotional intelligence”—prospective leaders need to be cognizant of delivering on promises.

“This is something I call a high ‘say/do’ ratio,” he explains, “and, simply put, it means that you accomplish what you say you will. At the end of the day, the only way anybody moves up is by being good at achieving results.”

If you start missing deadlines, you communicate that you are not reliable. Not all project implementation goes according to plan, of course, so when you encounter difficulties, early communication about obstacles is also key, he says.

Nuts and Bolts

Through SHM’s Leadership Academy, hospitalists can be trained in team management and other key leadership skills. An October 2015 session is scheduled in Austin.

Having trusted mentors is crucial, agreed both physicians, so that you can keep polishing your skill set and obtain honest feedback. These mentors should not be people to whom you directly report, and they need not be in the healthcare industry.

In fact, Dr. Gundersen says he’s known mentors for years “who have not been in the same specialty or even the same field, but who give me guidance and have helped make me into the leader I am.”

How do you assert your desire to be a leader? Dr. Deitelzweig suggests making your aspirations clear to your own group leaders. The annual review is an excellent juncture at which to discuss this, he says.

If you do not yet have project management or communications experience, ask your leaders whether they are familiar with training to help you develop those skills. In the current healthcare environment, the Affordable Care Act and reimbursement regulations mean that change will continue to be part of the leadership challenge.

“If you really want to be a leader,” Dr. Deitelzweig says, “you cannot be a naysayer. Make change work for you, look at it as an opportunity for you to innovate, and then show how valuable you can be.”

---

Gretchen Henkel is a freelance writer in California.

Listen Now

Listen to Dr. Gundersen dive further into the importance of mentors and assessing your personal qualities to be a good leader.

[audio mp3="http://www.the-hospitalist.org/wp-content/uploads/2015/03/Gundersen_CareerCenter1_FINAL_012515.mp3"][/audio]

A new report has found that only a small number of groups included in a government-funded experiment to cut Medicare readmissions actually produced results. However, the less-than-hoped-for results don't necessarily indicate failure, a hospitalist and readmissions expert says.

The Community-based Care Transitions Program (CCTP) is one of several test care-delivery models created by the Affordable Care Act. Its main goal is to improve transitions of Medicare patients from the hospital to community-based settings, such as nursing homes, rehabilitation facilities, and government agencies that provide services to the elderly, and thereby reduce readmissions.

However, a new report [PDF] commissioned by the Centers for Medicare & Medicaid Services found that only four CCTP groups of the 48 studied significantly cut readmissions compared with those of a control group. The report was finished in May 2014 but wasn't made public until January.

"There are so few examples in healthcare where resource alignment makes sense with what we believe are the ideal ways of practicing," says Jeffrey L. Greenwald, MD, associate professor of medicine at Harvard Medical School and a member of the Inpatient Clinician Educator Service at Massachusetts General Hospital, both in Boston. "Things like CCTP, where you have an opportunity to partner a hospital with a community-based organization that can help to support patient transitions still looks promising despite its warts."

CCTP, funded with $300 million over five years, signed its first round of deals with community agencies in late 2011. The report covered partial 2012 results from groups participating in the early rounds.

Dr. Greenwald is one of the cofounders of SHM's Project BOOST, a yearlong QI program in which hospital teams are paired with mentors to help them improve care transitions. He explained that BOOST teams typically need at least 18-24 months to show positive results on length-of-stay or readmissions reductions.

"These are long processes that don't turn around overnight," Dr. Greenwald adds. "If they do, it's probably because [the hospital team] put in place something that is not sustainable, and the minute they stop measuring and keeping an eye on it, it will likely deteriorate.

"There's no magic bullet in care transitions."

Visit our website for more information on ways hospitals can reduce readmissions.

A new report has found that only a small number of groups included in a government-funded experiment to cut Medicare readmissions actually produced results. However, the less-than-hoped-for results don't necessarily indicate failure, a hospitalist and readmissions expert says.

The Community-based Care Transitions Program (CCTP) is one of several test care-delivery models created by the Affordable Care Act. Its main goal is to improve transitions of Medicare patients from the hospital to community-based settings, such as nursing homes, rehabilitation facilities, and government agencies that provide services to the elderly, and thereby reduce readmissions.

However, a new report [PDF] commissioned by the Centers for Medicare & Medicaid Services found that only four CCTP groups of the 48 studied significantly cut readmissions compared with those of a control group. The report was finished in May 2014 but wasn't made public until January.

"There are so few examples in healthcare where resource alignment makes sense with what we believe are the ideal ways of practicing," says Jeffrey L. Greenwald, MD, associate professor of medicine at Harvard Medical School and a member of the Inpatient Clinician Educator Service at Massachusetts General Hospital, both in Boston. "Things like CCTP, where you have an opportunity to partner a hospital with a community-based organization that can help to support patient transitions still looks promising despite its warts."

CCTP, funded with $300 million over five years, signed its first round of deals with community agencies in late 2011. The report covered partial 2012 results from groups participating in the early rounds.

Dr. Greenwald is one of the cofounders of SHM's Project BOOST, a yearlong QI program in which hospital teams are paired with mentors to help them improve care transitions. He explained that BOOST teams typically need at least 18-24 months to show positive results on length-of-stay or readmissions reductions.

"These are long processes that don't turn around overnight," Dr. Greenwald adds. "If they do, it's probably because [the hospital team] put in place something that is not sustainable, and the minute they stop measuring and keeping an eye on it, it will likely deteriorate.

"There's no magic bullet in care transitions."

Visit our website for more information on ways hospitals can reduce readmissions.

A new report has found that only a small number of groups included in a government-funded experiment to cut Medicare readmissions actually produced results. However, the less-than-hoped-for results don't necessarily indicate failure, a hospitalist and readmissions expert says.

The Community-based Care Transitions Program (CCTP) is one of several test care-delivery models created by the Affordable Care Act. Its main goal is to improve transitions of Medicare patients from the hospital to community-based settings, such as nursing homes, rehabilitation facilities, and government agencies that provide services to the elderly, and thereby reduce readmissions.

However, a new report [PDF] commissioned by the Centers for Medicare & Medicaid Services found that only four CCTP groups of the 48 studied significantly cut readmissions compared with those of a control group. The report was finished in May 2014 but wasn't made public until January.

"There are so few examples in healthcare where resource alignment makes sense with what we believe are the ideal ways of practicing," says Jeffrey L. Greenwald, MD, associate professor of medicine at Harvard Medical School and a member of the Inpatient Clinician Educator Service at Massachusetts General Hospital, both in Boston. "Things like CCTP, where you have an opportunity to partner a hospital with a community-based organization that can help to support patient transitions still looks promising despite its warts."

CCTP, funded with $300 million over five years, signed its first round of deals with community agencies in late 2011. The report covered partial 2012 results from groups participating in the early rounds.

Dr. Greenwald is one of the cofounders of SHM's Project BOOST, a yearlong QI program in which hospital teams are paired with mentors to help them improve care transitions. He explained that BOOST teams typically need at least 18-24 months to show positive results on length-of-stay or readmissions reductions.

"These are long processes that don't turn around overnight," Dr. Greenwald adds. "If they do, it's probably because [the hospital team] put in place something that is not sustainable, and the minute they stop measuring and keeping an eye on it, it will likely deteriorate.

"There's no magic bullet in care transitions."

Visit our website for more information on ways hospitals can reduce readmissions.

Hospital medicine will descend on Washington, D.C., again.

At least 2,500 attendees are expected at SHM's annual meeting, HM15, which kicks off March 29 at the Gaylord National Resort & Convention Center in National Harbor, Md. The four-day conference—SHM's third in the nation's capital in six years—ends April 1 and encompasses:

• Seven pre-courses on March 29 that can be applied toward continuing medical education credits;
• Dozens of educational sessions over three days, including the debut of its "Young Hospitalists" track on March 30;
• The largest Research, Innovations, and Clinical Vignettes poster competition ever; and
• Plenary sessions from patient-safety guru Peter Pronovost, MD, PhD, FCCM; HM pioneer Robert Wachter, MD, MHM; and Maureen Bisognano, president and CEO of the Institute for Healthcare Improvement.

"The opportunity to learn about faculty development, the opportunity to learn about administrative concerns in running a hospital medicine program, the opportunity to address quality improvement…the opportunity to meet other folks who are doing very similar work and learn from them, all of those things exist,” says assistant course director Melissa Mattison, MD, SFHM.

In addition, SHM's advocacy event, Hospitalists on the Hill Day, is scheduled for April 1 and will see physicians holding hundreds of meetings with Capitol Hill legislators and staffers.

"Every congressman has physicians in their community, and they value the opinion of those physicians," SHM Public Policy Committee Chair Ron Greeno, MD, MHM, says. "Nothing is more effective than having one of our members meet with a representative from their home district about the issues that we care about."

Visit our website for more information on HM15.

Hospital medicine will descend on Washington, D.C., again.

At least 2,500 attendees are expected at SHM's annual meeting, HM15, which kicks off March 29 at the Gaylord National Resort & Convention Center in National Harbor, Md. The four-day conference—SHM's third in the nation's capital in six years—ends April 1 and encompasses:

• Seven pre-courses on March 29 that can be applied toward continuing medical education credits;
• Dozens of educational sessions over three days, including the debut of its "Young Hospitalists" track on March 30;
• The largest Research, Innovations, and Clinical Vignettes poster competition ever; and
• Plenary sessions from patient-safety guru Peter Pronovost, MD, PhD, FCCM; HM pioneer Robert Wachter, MD, MHM; and Maureen Bisognano, president and CEO of the Institute for Healthcare Improvement.

"The opportunity to learn about faculty development, the opportunity to learn about administrative concerns in running a hospital medicine program, the opportunity to address quality improvement…the opportunity to meet other folks who are doing very similar work and learn from them, all of those things exist,” says assistant course director Melissa Mattison, MD, SFHM.

In addition, SHM's advocacy event, Hospitalists on the Hill Day, is scheduled for April 1 and will see physicians holding hundreds of meetings with Capitol Hill legislators and staffers.

"Every congressman has physicians in their community, and they value the opinion of those physicians," SHM Public Policy Committee Chair Ron Greeno, MD, MHM, says. "Nothing is more effective than having one of our members meet with a representative from their home district about the issues that we care about."

Visit our website for more information on HM15.

Hospital medicine will descend on Washington, D.C., again.

At least 2,500 attendees are expected at SHM's annual meeting, HM15, which kicks off March 29 at the Gaylord National Resort & Convention Center in National Harbor, Md. The four-day conference—SHM's third in the nation's capital in six years—ends April 1 and encompasses:

• Seven pre-courses on March 29 that can be applied toward continuing medical education credits;
• Dozens of educational sessions over three days, including the debut of its "Young Hospitalists" track on March 30;
• The largest Research, Innovations, and Clinical Vignettes poster competition ever; and
• Plenary sessions from patient-safety guru Peter Pronovost, MD, PhD, FCCM; HM pioneer Robert Wachter, MD, MHM; and Maureen Bisognano, president and CEO of the Institute for Healthcare Improvement.

"The opportunity to learn about faculty development, the opportunity to learn about administrative concerns in running a hospital medicine program, the opportunity to address quality improvement…the opportunity to meet other folks who are doing very similar work and learn from them, all of those things exist,” says assistant course director Melissa Mattison, MD, SFHM.

In addition, SHM's advocacy event, Hospitalists on the Hill Day, is scheduled for April 1 and will see physicians holding hundreds of meetings with Capitol Hill legislators and staffers.

"Every congressman has physicians in their community, and they value the opinion of those physicians," SHM Public Policy Committee Chair Ron Greeno, MD, MHM, says. "Nothing is more effective than having one of our members meet with a representative from their home district about the issues that we care about."

Visit our website for more information on HM15.

PHOENIX – Twice-daily ranolazine following adult cardiac surgery seemed to protect against atrial fibrillation, based on a retrospective cohort study at the University of Florida Jacksonville Medical Center.

Ranolazine (Ranexa) was dosed orally at 1,000 mg the morning of surgery, and then resumed after extubation, generally the night of surgery. The goal was 1,000 mg orally twice a day, for a maximum of 7 hospital days; patients usually went home before then, so they received an average of nine doses. The drug was discontinued at discharge.

Six (10.5%) of 57 patients in the ranolazine group developed postoperative atrial fibrillation (POAF) versus 26 (45.6%) of 57 matched controls (P < .0001). The first case came at postop day 3 in the ranolazine group, but within 24 hours in the control group. One person in the ranolazine group and one in the control group had a history of AF.

There was no statistical difference in ICU length of stay, 30-day readmission for cardiac causes, or 30-day cardiovascular mortality; the one cardiovascular death was in the control group.

Two-thirds of the patients had coronary artery bypass grafts, and the rest had either valve surgery or a combination of both surgeries. Patients were 60 years old on average, and two-thirds were men, Drayton Hammond, Pharm.D., said at the Critical Care Congress, sponsored by the Society for Critical Care Medicine.

Ranolazine is indicated for chronic angina, not POAF prevention, but some previous investigations have suggested a possible benefit. A randomized, controlled clinical trial is currently looking into the matter.

At least retrospectively, the drug was “beneficial, definitely. There is about a 35% absolute-risk reduction,” said Dr. Hammond, who conducted the study while at the Jacksonville hospital.

Doctors there continue to use ranolazine for postop AF prophylaxis, as they see fit, said Dr. Hammond, now an assistant professor of pharmacy practice at the University of Arkansas for Medical Sciences, in Little Rock.

Gilead, the maker of the Ranexa, is also working on a ranolazine-dronedarone combination for paroxysmal AF.

More than half of the ranolazine patients in the study developed symptomatic hypotension within 72 hours of surgery, versus about a third in the control group (P = .0004). The drug was discontinued in one ranolazine patient because of hypotension. The problem resolved after 72 hours.

“We don’t have a good explanation” for the side effect. Perhaps there were differences in myocardial stunning or vasopressor use between the groups, but “we had the same three surgeons” for all the cases, Dr. Hammond said.

Ranolazine labeling notes the risk of hypotension and orthostatic hypotension. Labeling also warns of QT interval prolongation and renal failure in susceptible patients. The investigators found no between-group differences in bradycardia, new renal failure, or neurological events.

Overall, 53 (93%) patients in the ranolazine group were on postoperative beta-blockers, and 54 (94.7%) on postop statins; 48 (84.2%) in the control group were on beta-blockers postop and 47 (82.5%) on statins. Beta-blockers are first-line treatment to prevent postop AF; patients on any other antiarrhythmic were excluded from the trial, as were those who died during surgery.

[email protected]

PHOENIX – Twice-daily ranolazine following adult cardiac surgery seemed to protect against atrial fibrillation, based on a retrospective cohort study at the University of Florida Jacksonville Medical Center.

Ranolazine (Ranexa) was dosed orally at 1,000 mg the morning of surgery, and then resumed after extubation, generally the night of surgery. The goal was 1,000 mg orally twice a day, for a maximum of 7 hospital days; patients usually went home before then, so they received an average of nine doses. The drug was discontinued at discharge.

Six (10.5%) of 57 patients in the ranolazine group developed postoperative atrial fibrillation (POAF) versus 26 (45.6%) of 57 matched controls (P < .0001). The first case came at postop day 3 in the ranolazine group, but within 24 hours in the control group. One person in the ranolazine group and one in the control group had a history of AF.

There was no statistical difference in ICU length of stay, 30-day readmission for cardiac causes, or 30-day cardiovascular mortality; the one cardiovascular death was in the control group.

Two-thirds of the patients had coronary artery bypass grafts, and the rest had either valve surgery or a combination of both surgeries. Patients were 60 years old on average, and two-thirds were men, Drayton Hammond, Pharm.D., said at the Critical Care Congress, sponsored by the Society for Critical Care Medicine.

Ranolazine is indicated for chronic angina, not POAF prevention, but some previous investigations have suggested a possible benefit. A randomized, controlled clinical trial is currently looking into the matter.

At least retrospectively, the drug was “beneficial, definitely. There is about a 35% absolute-risk reduction,” said Dr. Hammond, who conducted the study while at the Jacksonville hospital.

Doctors there continue to use ranolazine for postop AF prophylaxis, as they see fit, said Dr. Hammond, now an assistant professor of pharmacy practice at the University of Arkansas for Medical Sciences, in Little Rock.

Gilead, the maker of the Ranexa, is also working on a ranolazine-dronedarone combination for paroxysmal AF.

More than half of the ranolazine patients in the study developed symptomatic hypotension within 72 hours of surgery, versus about a third in the control group (P = .0004). The drug was discontinued in one ranolazine patient because of hypotension. The problem resolved after 72 hours.

“We don’t have a good explanation” for the side effect. Perhaps there were differences in myocardial stunning or vasopressor use between the groups, but “we had the same three surgeons” for all the cases, Dr. Hammond said.

Ranolazine labeling notes the risk of hypotension and orthostatic hypotension. Labeling also warns of QT interval prolongation and renal failure in susceptible patients. The investigators found no between-group differences in bradycardia, new renal failure, or neurological events.

Overall, 53 (93%) patients in the ranolazine group were on postoperative beta-blockers, and 54 (94.7%) on postop statins; 48 (84.2%) in the control group were on beta-blockers postop and 47 (82.5%) on statins. Beta-blockers are first-line treatment to prevent postop AF; patients on any other antiarrhythmic were excluded from the trial, as were those who died during surgery.

[email protected]

PHOENIX – Twice-daily ranolazine following adult cardiac surgery seemed to protect against atrial fibrillation, based on a retrospective cohort study at the University of Florida Jacksonville Medical Center.

Ranolazine (Ranexa) was dosed orally at 1,000 mg the morning of surgery, and then resumed after extubation, generally the night of surgery. The goal was 1,000 mg orally twice a day, for a maximum of 7 hospital days; patients usually went home before then, so they received an average of nine doses. The drug was discontinued at discharge.

Six (10.5%) of 57 patients in the ranolazine group developed postoperative atrial fibrillation (POAF) versus 26 (45.6%) of 57 matched controls (P < .0001). The first case came at postop day 3 in the ranolazine group, but within 24 hours in the control group. One person in the ranolazine group and one in the control group had a history of AF.

There was no statistical difference in ICU length of stay, 30-day readmission for cardiac causes, or 30-day cardiovascular mortality; the one cardiovascular death was in the control group.

Two-thirds of the patients had coronary artery bypass grafts, and the rest had either valve surgery or a combination of both surgeries. Patients were 60 years old on average, and two-thirds were men, Drayton Hammond, Pharm.D., said at the Critical Care Congress, sponsored by the Society for Critical Care Medicine.

Ranolazine is indicated for chronic angina, not POAF prevention, but some previous investigations have suggested a possible benefit. A randomized, controlled clinical trial is currently looking into the matter.

At least retrospectively, the drug was “beneficial, definitely. There is about a 35% absolute-risk reduction,” said Dr. Hammond, who conducted the study while at the Jacksonville hospital.

Doctors there continue to use ranolazine for postop AF prophylaxis, as they see fit, said Dr. Hammond, now an assistant professor of pharmacy practice at the University of Arkansas for Medical Sciences, in Little Rock.

Gilead, the maker of the Ranexa, is also working on a ranolazine-dronedarone combination for paroxysmal AF.

More than half of the ranolazine patients in the study developed symptomatic hypotension within 72 hours of surgery, versus about a third in the control group (P = .0004). The drug was discontinued in one ranolazine patient because of hypotension. The problem resolved after 72 hours.

“We don’t have a good explanation” for the side effect. Perhaps there were differences in myocardial stunning or vasopressor use between the groups, but “we had the same three surgeons” for all the cases, Dr. Hammond said.

Ranolazine labeling notes the risk of hypotension and orthostatic hypotension. Labeling also warns of QT interval prolongation and renal failure in susceptible patients. The investigators found no between-group differences in bradycardia, new renal failure, or neurological events.

Overall, 53 (93%) patients in the ranolazine group were on postoperative beta-blockers, and 54 (94.7%) on postop statins; 48 (84.2%) in the control group were on beta-blockers postop and 47 (82.5%) on statins. Beta-blockers are first-line treatment to prevent postop AF; patients on any other antiarrhythmic were excluded from the trial, as were those who died during surgery.

[email protected]

PHOENIX – For every unit increase in baseline CHADS₂ score, the risk of postop atrial fibrillation increases by 17%, according to a retrospective chart review of 1,550 adults who had major vascular or thoracic surgery at the Mayo Clinic in Rochester, Minn.

On multivariate analysis, postop day 1 Sequential Organ Failure Assessment score (HR 1.08, 95% CI 1.03-1.12, per unit increase) and cumulative fluid balance (HR 1.03, 95% CI 1.01-1.06, per 1,000 mL) also correlated with the risk for new-onset atrial fibrillation (AF).

Baseline calcium channel blockers protected against new-onset AF (HR 0.52, 95% CI 0.37-0.73), but, paradoxically, the risk increased with baseline (HR 1.78, 95% CI 1.24-2.56) and postop (HR 1.44, 95% CI 1.05-1.99) beta-blocker use.

The relationship of CHADS₂ to new-onset AF (HR 1.17, 95% CI 1.04-1.31) could prove handy in the surgical ICU because “everyone is familiar with it, and it’s easy to calculate.” CHADS₂ (heart failure, hypertension, age, diabetes, prior stroke) has also recently been shown to predict AF after cardiac surgery, said lead investigator Kirstin Kooda, Pharm.D., a critical care pharmacist at Mayo.

The beta-blocker finding was a surprise, since beta-blockers are a standard AF treatment, Dr. Kooda said at the Critical Care Congress, sponsored by the Society for Critical Care Medicine. About 80% (175) of new-onset AF patients were on baseline beta-blockers, versus about 68% (892) who did not develop AF. Patients using beta-blockers received them the morning of surgery, and resumed them a median of 7 hours afterward. There were no significant differences in heart rates during surgery.

The team excluded patients with any history of AF and censored patients if they developed it, so the drugs’ use probably wasn’t related to a concern about the condition. Just under 70% of patients in both groups had baseline hypertension, another indication for the drugs.

Even so, the finding is probably real given the number of patients in the study. Most likely, the drugs were markers for additional risk factors not captured in the study, Dr. Kooda said.

Overall, 112 (20.7%) of the 540 thoracic patients and 107 (11%) of the 1,010 vascular patients developed new-onset AF a median of 55 hours after surgery. The incidence difference and timing are in line with previous reports.

The mean age in the AF group was 70 years, and in the non-AF group it was 66 years. In both, 65% were men, 5% had heart failure, 30% had diabetes, and 10% had prior strokes. Patients with pacemakers and recent myocardial infarctions – also possible settings for beta-blockers – were excluded from the trial.

The majority of the vascular cases were open aortic aneurysms, aortic bypasses, and thrombectomies or endarterectomies of central arteries. Most of the thoracic surgeries were lobectomies, pneumonectomies, and wedge or chest wall resections.

[email protected]

PHOENIX – For every unit increase in baseline CHADS₂ score, the risk of postop atrial fibrillation increases by 17%, according to a retrospective chart review of 1,550 adults who had major vascular or thoracic surgery at the Mayo Clinic in Rochester, Minn.

On multivariate analysis, postop day 1 Sequential Organ Failure Assessment score (HR 1.08, 95% CI 1.03-1.12, per unit increase) and cumulative fluid balance (HR 1.03, 95% CI 1.01-1.06, per 1,000 mL) also correlated with the risk for new-onset atrial fibrillation (AF).

Baseline calcium channel blockers protected against new-onset AF (HR 0.52, 95% CI 0.37-0.73), but, paradoxically, the risk increased with baseline (HR 1.78, 95% CI 1.24-2.56) and postop (HR 1.44, 95% CI 1.05-1.99) beta-blocker use.

The relationship of CHADS₂ to new-onset AF (HR 1.17, 95% CI 1.04-1.31) could prove handy in the surgical ICU because “everyone is familiar with it, and it’s easy to calculate.” CHADS₂ (heart failure, hypertension, age, diabetes, prior stroke) has also recently been shown to predict AF after cardiac surgery, said lead investigator Kirstin Kooda, Pharm.D., a critical care pharmacist at Mayo.

The beta-blocker finding was a surprise, since beta-blockers are a standard AF treatment, Dr. Kooda said at the Critical Care Congress, sponsored by the Society for Critical Care Medicine. About 80% (175) of new-onset AF patients were on baseline beta-blockers, versus about 68% (892) who did not develop AF. Patients using beta-blockers received them the morning of surgery, and resumed them a median of 7 hours afterward. There were no significant differences in heart rates during surgery.

The team excluded patients with any history of AF and censored patients if they developed it, so the drugs’ use probably wasn’t related to a concern about the condition. Just under 70% of patients in both groups had baseline hypertension, another indication for the drugs.

Even so, the finding is probably real given the number of patients in the study. Most likely, the drugs were markers for additional risk factors not captured in the study, Dr. Kooda said.

Overall, 112 (20.7%) of the 540 thoracic patients and 107 (11%) of the 1,010 vascular patients developed new-onset AF a median of 55 hours after surgery. The incidence difference and timing are in line with previous reports.

The mean age in the AF group was 70 years, and in the non-AF group it was 66 years. In both, 65% were men, 5% had heart failure, 30% had diabetes, and 10% had prior strokes. Patients with pacemakers and recent myocardial infarctions – also possible settings for beta-blockers – were excluded from the trial.

The majority of the vascular cases were open aortic aneurysms, aortic bypasses, and thrombectomies or endarterectomies of central arteries. Most of the thoracic surgeries were lobectomies, pneumonectomies, and wedge or chest wall resections.

[email protected]

PHOENIX – For every unit increase in baseline CHADS₂ score, the risk of postop atrial fibrillation increases by 17%, according to a retrospective chart review of 1,550 adults who had major vascular or thoracic surgery at the Mayo Clinic in Rochester, Minn.

On multivariate analysis, postop day 1 Sequential Organ Failure Assessment score (HR 1.08, 95% CI 1.03-1.12, per unit increase) and cumulative fluid balance (HR 1.03, 95% CI 1.01-1.06, per 1,000 mL) also correlated with the risk for new-onset atrial fibrillation (AF).

Baseline calcium channel blockers protected against new-onset AF (HR 0.52, 95% CI 0.37-0.73), but, paradoxically, the risk increased with baseline (HR 1.78, 95% CI 1.24-2.56) and postop (HR 1.44, 95% CI 1.05-1.99) beta-blocker use.

The relationship of CHADS₂ to new-onset AF (HR 1.17, 95% CI 1.04-1.31) could prove handy in the surgical ICU because “everyone is familiar with it, and it’s easy to calculate.” CHADS₂ (heart failure, hypertension, age, diabetes, prior stroke) has also recently been shown to predict AF after cardiac surgery, said lead investigator Kirstin Kooda, Pharm.D., a critical care pharmacist at Mayo.

The beta-blocker finding was a surprise, since beta-blockers are a standard AF treatment, Dr. Kooda said at the Critical Care Congress, sponsored by the Society for Critical Care Medicine. About 80% (175) of new-onset AF patients were on baseline beta-blockers, versus about 68% (892) who did not develop AF. Patients using beta-blockers received them the morning of surgery, and resumed them a median of 7 hours afterward. There were no significant differences in heart rates during surgery.

The team excluded patients with any history of AF and censored patients if they developed it, so the drugs’ use probably wasn’t related to a concern about the condition. Just under 70% of patients in both groups had baseline hypertension, another indication for the drugs.

Even so, the finding is probably real given the number of patients in the study. Most likely, the drugs were markers for additional risk factors not captured in the study, Dr. Kooda said.

Overall, 112 (20.7%) of the 540 thoracic patients and 107 (11%) of the 1,010 vascular patients developed new-onset AF a median of 55 hours after surgery. The incidence difference and timing are in line with previous reports.

The mean age in the AF group was 70 years, and in the non-AF group it was 66 years. In both, 65% were men, 5% had heart failure, 30% had diabetes, and 10% had prior strokes. Patients with pacemakers and recent myocardial infarctions – also possible settings for beta-blockers – were excluded from the trial.

The majority of the vascular cases were open aortic aneurysms, aortic bypasses, and thrombectomies or endarterectomies of central arteries. Most of the thoracic surgeries were lobectomies, pneumonectomies, and wedge or chest wall resections.

[email protected]

Through genetic analysis, researchers used gene expression profiles to differentiate between several clinical phenotypes of VTE and distinguish high-risk patients from both low-risk patients and healthy controls, in a study published in Thrombosis Research.

Dr. Deborah A. Lewis of Duke University Medical Center and her associates used differential expression analysis to find several genes previously identified as potentially having a role in the development of thrombotic disorders, including SELP, KLKB1, ANXA5, andCD46. They then compared the genetic profiles of 107 patients, separated into low-, moderate-, or high-risk groups based on their clinical presentations of VTE, as well as 25 controls.

The most accurate comparisons were between the high-risk and low-risk groups, the high-risk group and the healthy controls, and the low-risk group and healthy controls, where the AUC levels were 0.81, 0.84 and 0.80 respectively.

“The profiles obtained … provide insights into approaches that might be useful in the identification of individuals with a single thrombotic event who are at highest risk for a recurrent VTE after completing a standard course of therapy,” the investigators wrote.

For the full article, click here (Thromb. Res. 2015 [doi:10.1016/j.thromres.2015.02.003]).

Through genetic analysis, researchers used gene expression profiles to differentiate between several clinical phenotypes of VTE and distinguish high-risk patients from both low-risk patients and healthy controls, in a study published in Thrombosis Research.

Dr. Deborah A. Lewis of Duke University Medical Center and her associates used differential expression analysis to find several genes previously identified as potentially having a role in the development of thrombotic disorders, including SELP, KLKB1, ANXA5, andCD46. They then compared the genetic profiles of 107 patients, separated into low-, moderate-, or high-risk groups based on their clinical presentations of VTE, as well as 25 controls.

The most accurate comparisons were between the high-risk and low-risk groups, the high-risk group and the healthy controls, and the low-risk group and healthy controls, where the AUC levels were 0.81, 0.84 and 0.80 respectively.

“The profiles obtained … provide insights into approaches that might be useful in the identification of individuals with a single thrombotic event who are at highest risk for a recurrent VTE after completing a standard course of therapy,” the investigators wrote.

For the full article, click here (Thromb. Res. 2015 [doi:10.1016/j.thromres.2015.02.003]).

Through genetic analysis, researchers used gene expression profiles to differentiate between several clinical phenotypes of VTE and distinguish high-risk patients from both low-risk patients and healthy controls, in a study published in Thrombosis Research.

Dr. Deborah A. Lewis of Duke University Medical Center and her associates used differential expression analysis to find several genes previously identified as potentially having a role in the development of thrombotic disorders, including SELP, KLKB1, ANXA5, andCD46. They then compared the genetic profiles of 107 patients, separated into low-, moderate-, or high-risk groups based on their clinical presentations of VTE, as well as 25 controls.

The most accurate comparisons were between the high-risk and low-risk groups, the high-risk group and the healthy controls, and the low-risk group and healthy controls, where the AUC levels were 0.81, 0.84 and 0.80 respectively.

“The profiles obtained … provide insights into approaches that might be useful in the identification of individuals with a single thrombotic event who are at highest risk for a recurrent VTE after completing a standard course of therapy,” the investigators wrote.

For the full article, click here (Thromb. Res. 2015 [doi:10.1016/j.thromres.2015.02.003]).

Incidence rates for developing venous thromboembolism (VTE) among esophagogastric cancer patients undergoing neoadjuvant chemotherapy in combination with curative intended surgery were significantly higher among patients with initial stage III and IV cancers and gastric cancer, according to a new study published in Thrombosis Research.

In the clinical prospective study, 129 patients with lower esophageal, gastroesophageal, and gastric cancer were examined between 2008 and 2011. Baseline assessments were recorded via bilateral compression ultrasound (biCUS) for deep vein thrombosis and computer tomography pulmonary angiography for pulmonary embolism. The patients received a chemotherapy regimen of oxaliplatin, capecitabine, and epirubicin, with curative intended surgery, and were examined before undergoing preoperative chemotherapy, surgery, and postoperative chemotherapy. The researchers encountered 21 VTE cases, or 16% of the total number of patients examined, with VTE incidences twice as likely to be asymptomatic than symptomatic.

The authors noted that state-of-the-art technology helped boost VTE detection rates among asymptomatic patients, and older studies may have underreported incidences of the disease.

“Although our study only included 129 patients, the systematic use of biCUS strongly suggests that the frequency of VTE is much greater than that previously reported for these types of cancer,” wrote Dr. Anders Christian Larsen and his associates at Aalborg University Hospital, Denmark.

Read more here (Thrombosis Research 2015 [doi:10.1016/j.thromres.2015.01.021]).

Incidence rates for developing venous thromboembolism (VTE) among esophagogastric cancer patients undergoing neoadjuvant chemotherapy in combination with curative intended surgery were significantly higher among patients with initial stage III and IV cancers and gastric cancer, according to a new study published in Thrombosis Research.

In the clinical prospective study, 129 patients with lower esophageal, gastroesophageal, and gastric cancer were examined between 2008 and 2011. Baseline assessments were recorded via bilateral compression ultrasound (biCUS) for deep vein thrombosis and computer tomography pulmonary angiography for pulmonary embolism. The patients received a chemotherapy regimen of oxaliplatin, capecitabine, and epirubicin, with curative intended surgery, and were examined before undergoing preoperative chemotherapy, surgery, and postoperative chemotherapy. The researchers encountered 21 VTE cases, or 16% of the total number of patients examined, with VTE incidences twice as likely to be asymptomatic than symptomatic.

The authors noted that state-of-the-art technology helped boost VTE detection rates among asymptomatic patients, and older studies may have underreported incidences of the disease.

“Although our study only included 129 patients, the systematic use of biCUS strongly suggests that the frequency of VTE is much greater than that previously reported for these types of cancer,” wrote Dr. Anders Christian Larsen and his associates at Aalborg University Hospital, Denmark.

Read more here (Thrombosis Research 2015 [doi:10.1016/j.thromres.2015.01.021]).

Incidence rates for developing venous thromboembolism (VTE) among esophagogastric cancer patients undergoing neoadjuvant chemotherapy in combination with curative intended surgery were significantly higher among patients with initial stage III and IV cancers and gastric cancer, according to a new study published in Thrombosis Research.

In the clinical prospective study, 129 patients with lower esophageal, gastroesophageal, and gastric cancer were examined between 2008 and 2011. Baseline assessments were recorded via bilateral compression ultrasound (biCUS) for deep vein thrombosis and computer tomography pulmonary angiography for pulmonary embolism. The patients received a chemotherapy regimen of oxaliplatin, capecitabine, and epirubicin, with curative intended surgery, and were examined before undergoing preoperative chemotherapy, surgery, and postoperative chemotherapy. The researchers encountered 21 VTE cases, or 16% of the total number of patients examined, with VTE incidences twice as likely to be asymptomatic than symptomatic.

The authors noted that state-of-the-art technology helped boost VTE detection rates among asymptomatic patients, and older studies may have underreported incidences of the disease.

“Although our study only included 129 patients, the systematic use of biCUS strongly suggests that the frequency of VTE is much greater than that previously reported for these types of cancer,” wrote Dr. Anders Christian Larsen and his associates at Aalborg University Hospital, Denmark.

Read more here (Thrombosis Research 2015 [doi:10.1016/j.thromres.2015.01.021]).

The anticoagulant response to dabigatran, as measured by five coagulation laboratory assays, is consistent over childhood and comparable to the adult response, according to a research article published in Thrombosis Research.

In the in vitro study, lead author Dr. Kevin Dietrich of the University of Alberta, Canada, and his associates measured pooled plasma samples spiked with increasing concentrations of dabigatran from healthy children aged 0 to <1, 1 to <5, 5 to <10, 10 to <17 years, and adults. There were no differences in responses to dabigatran over all pediatric age groups, and these were comparable to adults.

The researchers found the dilute thrombin time (dTT) to be the most accurate measurement for assessing dabigatran concentrations in children and adults, as the ecarin time and TT were found to be overly sensitive.

“From a practical perspective, the dTT is an appropriate tool for measuring dabigatran concentrations. The dTT performed consistently across all age groups, and showed good reproducibility between repeat measurements and appropriate sensitivity and linearity of response within and above the therapeutic range,” they wrote.

For the full article, click here (Thrombosis Research 2015 [doi:10.1016/j.thromres.2015.01.017]).

The anticoagulant response to dabigatran, as measured by five coagulation laboratory assays, is consistent over childhood and comparable to the adult response, according to a research article published in Thrombosis Research.

In the in vitro study, lead author Dr. Kevin Dietrich of the University of Alberta, Canada, and his associates measured pooled plasma samples spiked with increasing concentrations of dabigatran from healthy children aged 0 to <1, 1 to <5, 5 to <10, 10 to <17 years, and adults. There were no differences in responses to dabigatran over all pediatric age groups, and these were comparable to adults.

The researchers found the dilute thrombin time (dTT) to be the most accurate measurement for assessing dabigatran concentrations in children and adults, as the ecarin time and TT were found to be overly sensitive.

“From a practical perspective, the dTT is an appropriate tool for measuring dabigatran concentrations. The dTT performed consistently across all age groups, and showed good reproducibility between repeat measurements and appropriate sensitivity and linearity of response within and above the therapeutic range,” they wrote.

For the full article, click here (Thrombosis Research 2015 [doi:10.1016/j.thromres.2015.01.017]).

The anticoagulant response to dabigatran, as measured by five coagulation laboratory assays, is consistent over childhood and comparable to the adult response, according to a research article published in Thrombosis Research.

In the in vitro study, lead author Dr. Kevin Dietrich of the University of Alberta, Canada, and his associates measured pooled plasma samples spiked with increasing concentrations of dabigatran from healthy children aged 0 to <1, 1 to <5, 5 to <10, 10 to <17 years, and adults. There were no differences in responses to dabigatran over all pediatric age groups, and these were comparable to adults.

The researchers found the dilute thrombin time (dTT) to be the most accurate measurement for assessing dabigatran concentrations in children and adults, as the ecarin time and TT were found to be overly sensitive.

“From a practical perspective, the dTT is an appropriate tool for measuring dabigatran concentrations. The dTT performed consistently across all age groups, and showed good reproducibility between repeat measurements and appropriate sensitivity and linearity of response within and above the therapeutic range,” they wrote.

For the full article, click here (Thrombosis Research 2015 [doi:10.1016/j.thromres.2015.01.017]).

Ablative fractional laser–assisted delivery of topical fluorouracil resulted in 100% histologic clearance in patients with squamous cell carcinoma in situ and 71% in patients with superficial basal cell carcinoma, based on data from 28 patients (mean age 71 years). Each patient underwent one pass with an ablative fractional laser, followed by one application of topical 5-FU 5% under occlusion for 7 days.

Histologic clearance and patient satisfaction were assessed 4-8 weeks after treatment; no serious adverse events were reported, and all patients said they would recommend the treatment to others.

“This treatment modality may be particularly useful for older patients, tumors located on lower extremities or back, and multiple tumors scattered on different areas of the body,” although controlled studies in diverse populations with longer follow-up times are needed, wrote Dr. Bichchau T. Nguyen of Tufts University, Boston, and colleagues (JAAD 2015; 72:558-60).

Read the full article from the Journal of the American Academy of Dermatology here.

Ablative fractional laser–assisted delivery of topical fluorouracil resulted in 100% histologic clearance in patients with squamous cell carcinoma in situ and 71% in patients with superficial basal cell carcinoma, based on data from 28 patients (mean age 71 years). Each patient underwent one pass with an ablative fractional laser, followed by one application of topical 5-FU 5% under occlusion for 7 days.

Histologic clearance and patient satisfaction were assessed 4-8 weeks after treatment; no serious adverse events were reported, and all patients said they would recommend the treatment to others.

“This treatment modality may be particularly useful for older patients, tumors located on lower extremities or back, and multiple tumors scattered on different areas of the body,” although controlled studies in diverse populations with longer follow-up times are needed, wrote Dr. Bichchau T. Nguyen of Tufts University, Boston, and colleagues (JAAD 2015; 72:558-60).

Read the full article from the Journal of the American Academy of Dermatology here.

Ablative fractional laser–assisted delivery of topical fluorouracil resulted in 100% histologic clearance in patients with squamous cell carcinoma in situ and 71% in patients with superficial basal cell carcinoma, based on data from 28 patients (mean age 71 years). Each patient underwent one pass with an ablative fractional laser, followed by one application of topical 5-FU 5% under occlusion for 7 days.

Histologic clearance and patient satisfaction were assessed 4-8 weeks after treatment; no serious adverse events were reported, and all patients said they would recommend the treatment to others.

“This treatment modality may be particularly useful for older patients, tumors located on lower extremities or back, and multiple tumors scattered on different areas of the body,” although controlled studies in diverse populations with longer follow-up times are needed, wrote Dr. Bichchau T. Nguyen of Tufts University, Boston, and colleagues (JAAD 2015; 72:558-60).

Read the full article from the Journal of the American Academy of Dermatology here.

An investigation of hospitalization costs for venous thromboembolism patients revealed that deep vein thrombosis (DVT) patients incurred an average cost of $1,594 per hospitalization day, while pulmonary embolism (PE) patients accounted for $1,735 per day. The costs stabilized on the third day for both groups, according to an investigation published in Thrombosis Research.

Joseph F. Dasta of the University of Texas College of Pharmacy, Round Rock, and his associates examined 28,953 DVT and 35,550 PE patients, identified from January 2009 to March 2013, in a longitudinal, cohort-based study. The mean lengths of stay for the DVT and PE cohorts were 4.7 days and 5.4 days, respectively. The room and board costs were the biggest, accounting for 40%-53% of the total costs of the DVT cohort and 38%-59% of the costs of the PE cohort, depending on the day. Pharmacy costs for both groups remained stable throughout the hospital stay.

The researchers noted that there may be a higher degree of severity in DVT patients vs. those with PE, as DVT patients had qualitatively higher surgery, supply, and pharmacy costs relative to PE patients. “The results of this study suggest that any change in treatment strategies or protocols that could effect [length of stay] may impact the hospitalization costs of DVT and PE populations,” they concluded.

Read more here: (Thromb. Res. 2015;135:303-10).

An investigation of hospitalization costs for venous thromboembolism patients revealed that deep vein thrombosis (DVT) patients incurred an average cost of $1,594 per hospitalization day, while pulmonary embolism (PE) patients accounted for $1,735 per day. The costs stabilized on the third day for both groups, according to an investigation published in Thrombosis Research.

Joseph F. Dasta of the University of Texas College of Pharmacy, Round Rock, and his associates examined 28,953 DVT and 35,550 PE patients, identified from January 2009 to March 2013, in a longitudinal, cohort-based study. The mean lengths of stay for the DVT and PE cohorts were 4.7 days and 5.4 days, respectively. The room and board costs were the biggest, accounting for 40%-53% of the total costs of the DVT cohort and 38%-59% of the costs of the PE cohort, depending on the day. Pharmacy costs for both groups remained stable throughout the hospital stay.

The researchers noted that there may be a higher degree of severity in DVT patients vs. those with PE, as DVT patients had qualitatively higher surgery, supply, and pharmacy costs relative to PE patients. “The results of this study suggest that any change in treatment strategies or protocols that could effect [length of stay] may impact the hospitalization costs of DVT and PE populations,” they concluded.

Read more here: (Thromb. Res. 2015;135:303-10).

An investigation of hospitalization costs for venous thromboembolism patients revealed that deep vein thrombosis (DVT) patients incurred an average cost of $1,594 per hospitalization day, while pulmonary embolism (PE) patients accounted for $1,735 per day. The costs stabilized on the third day for both groups, according to an investigation published in Thrombosis Research.

Joseph F. Dasta of the University of Texas College of Pharmacy, Round Rock, and his associates examined 28,953 DVT and 35,550 PE patients, identified from January 2009 to March 2013, in a longitudinal, cohort-based study. The mean lengths of stay for the DVT and PE cohorts were 4.7 days and 5.4 days, respectively. The room and board costs were the biggest, accounting for 40%-53% of the total costs of the DVT cohort and 38%-59% of the costs of the PE cohort, depending on the day. Pharmacy costs for both groups remained stable throughout the hospital stay.

The researchers noted that there may be a higher degree of severity in DVT patients vs. those with PE, as DVT patients had qualitatively higher surgery, supply, and pharmacy costs relative to PE patients. “The results of this study suggest that any change in treatment strategies or protocols that could effect [length of stay] may impact the hospitalization costs of DVT and PE populations,” they concluded.

Read more here: (Thromb. Res. 2015;135:303-10).