Journal of hospital medicine : an official publication of the Society of Hospital Medicine
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Malnutrition in hospitalized patients is associated increased length of stay, cost, readmission, and death. No recent studies have examined trends in prevalence or outcomes of hospitalized patients with a diagnosis of malnutrition. ⋯ Use of malnutrition diagnosis codes increased significantly from 2016 to 2019. During this time, mortality among hospitalizations with a diagnosis code for severe malnutrition decreased. Though the increased prevalence of malnutrition codes may represent a change in the clinical characteristics of hospitalized patients, the decline in mortality suggests some of the increase may be due to lower threshold for coding and assignment of the diagnosis to less ill patients.
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Burnout and lagging academic productivity are pressing challenges in hospital medicine, leading to stagnation and attrition. Mentoring shapes professional identity formation and enhances faculty vitality and retention, but has not been optimized among academic hospitalists. ⋯ Mentoring fosters academic thriving and retention in academic hospitalists. Access to effective mentoring remains lacking due to few senior mentors in the relatively new field of hospital medicine and reticence in academic identity, among other factors. Mentoring training, impact on underrepresented minority hospitalists, and integration into institutional culture should be considered for enhancing the career development of academic hospitalists.
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New-onset atrial fibrillation (AF) during sepsis is common, but models designed to stratify stroke risk excluded patients with secondary AF. We assessed the predictive validity of CHA2DS2VASc scores among patients with new-onset AF during sepsis and developed a novel stroke prediction model incorporating presepsis and intrasepsis characteristics. ⋯ Current models do not accurately stratify risk of stroke following new-onset AF secondary to sepsis. New tools are required to guide anticoagulation decisions following new-onset AF in sepsis.