Arch Intern Med
-
Multicenter Study
Frequency and impact of active clinical issues and new impairments on hospital discharge in patients with hip fracture.
Hip fracture is associated with significant mortality and disability. Patients who are discharged from the hospital with active clinical problems may have worse outcomes than those patients without active clinical problems. ⋯ Clinicians should consider information about ACIs and NIs when deciding readiness for discharge and planning post-acute care.
-
Meta Analysis Comparative Study
Thrombolysis vs heparin in the treatment of pulmonary embolism: a clinical outcome-based meta-analysis.
In patients with acute pulmonary embolism, thrombolysis results in a more rapid resolution of pulmonary emboli than heparin treatment. Whether this advantage results in an improved clinical outcome is unclear. We sought to perform a clinical outcome-based meta-analysis of studies comparing thrombolytic and heparin treatment in patients with pulmonary embolism. ⋯ In patients with pulmonary embolism, thrombolysis had a lower composite end point of death/recurrence than heparin treatment. Excessive bleeding is the trade-off for improved efficacy. A comparative clinical outcome trial of thrombolysis and heparin treatment is warranted in patients with pulmonary embolism and selected for high risk of death and/or recurrence and low risk of bleeding.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Diabetes, plasma insulin, and cardiovascular disease: subgroup analysis from the Department of Veterans Affairs high-density lipoprotein intervention trial (VA-HIT).
Diabetes mellitus, impaired fasting glucose level, or insulin resistance are associated with increased risk of cardiovascular disease. ⋯ In men with CHD and a low high-density lipoprotein cholesterol level, gemfibrozil use was associated with a reduction in major cardiovascular events in persons with diabetes and in nondiabetic subjects with a high fasting plasma insulin level.