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1/3 Wow what a day for mentees at #sgim19! First up future @nyuschoolofmed student Kanan Shah showing that docs who see patients 4-5 days a week have to spend almost 3 hours in #EHR on each day off to keep up Image
2/3 next, future med student Emma Simon showing that a simple #EHR template can give internists the info they need post procedure, have >95% uptake and reduce calls to proceduralists #sgim19 Image
3/3 and finally junior faculty Himali Weerahandi with an oral presentation showing that patients given home health services do better after discharge from SNF than those just sent home #sgim19 ImageImage
And lastly thanks to @AHRQNews and @CMSinnovates for funding!
And one more last word thanks to Mike Morrison for the excellent new poster format idea youtube.com/watch?v=1RwJbh…
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Leora Horwitz
@leorahorwitzmd
Now online @bmj_latest! #COVID19 outcomes & risks @nyulangone among 5,279 patients (2,741 hospitalized). Thread with details and some special twitter bonus content. @petrillimd @jones_prof @WhiteCoatLuke @Cerf_MD @Francois1Fritz bmj.com/content/369/bm…
Those of you who saw our previous preprint: this version is substantially altered – updated data, comprehensive follow up, new analyses. E.g., 94% of the hospitalized patients have been discharged or died, giving us robust estimates of final outcomes. Some highlights follow.
Context: we include all patients testing positive for #COVID19 between March 1 and April 8, with follow up (in the paper) through May 5 (and here in this thread, through this morning!). We restrict to those positive before April 9 to ensure adequate follow up for outcomes.
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Leora Horwitz
@leorahorwitzmd
As discussion starts to turn to easing of shelter in place restrictions, I am seeing a lot of what I consider to be magical thinking about our ability to protect our most vulnerable loved ones from #COVID19.
Much of this is coming my way because we have posted some early pre-print data on high risk characteristics. A common question I am getting is, so if we know who is most high risk, can't we keep them isolated and let everyone else go back to work?
Let's do a thought experiment to see how this might play out. We know that advanced age is far and away the greatest risk for adverse outcome in this epidemic. So, imagine for a moment we take our elders and do everything possible to isolate them from the community.
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Leora Horwitz
@leorahorwitzmd
@eliowa @jgitchell Yup, debated about O2/labs. I think depends on question. Rationale for including is that as a clinician, I want to know not just what demo/comorbidities assoc with bad outcomes, but also what clinical presentation, so I know who to worry about, perhaps understand disease better.
@eliowa @jgitchell For instance, many of us have noticed remarkable persistence of high fevers. If bacterial sepsis, would be very bad prognostic sign. But, anecdotally doesn't seem to be the case with #COVID19, nor here with presenting temp (looking at trends next).
@eliowa @jgitchell Similarly, many reporting deaths from myocarditis/arrhythmia, thrombosis, intractable renal failure - not obvious that these should necessarily correlate with degree of hypoxia. Or compare death rates PJP (typically profound hypoxia) vs bacterial pneumonia.
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