(Last Updated On: October 11, 2016)

Thank-you for attending my Grand Rounds.  Below are resources that I used for my discussions. Click each header to open up the bibliography and other resources I have found helpful.  Please post any questions or comments you have in the comment box below.

Admission Harm


James, John T. “A New, Evidence-Based Estimate of Patient Harms Associated with Hospital Care.” Journal of Patient Safety 9, no. 3 (2013): 122–128.
Chest Pain
CRACE Article
Weinstock, Michael B., Scott Weingart, Frank Orth, Douglas VanFossen, Colin Kaide, Judy Anderson, and David H. Newman. “Risk for Clinically Relevant Adverse Cardiac Events in Patients With Chest Pain at Hospital Admission.” JAMA Internal Medicine 175, no. 7 (July 1, 2015): 1207. doi:10.1001/jamainternmed.2015.1674.
  1. Young, Paul, Manoj Saxena, Rinaldo Bellomo, Ross Freebairn, Naomi Hammond, Frank van Haren, Mark Holliday, et al. “Acetaminophen for Fever in Critically Ill Patients with Suspected Infection.” New England Journal of Medicine 373, no. 23 (December 3, 2015): 2215–24. doi:10.1056/NEJMoa1508375.
  2. Berman, J. D., and F. A. Neva. “Effect of Temperature on Multiplication of Leishmania Amastigotes within Human Monocyte-Derived Macrophages in Vitro.” The American Journal of Tropical Medicine and Hygiene 30, no. 2 (March 1981): 318–21.
  3. Mackowiak, Philip A., E. Ruderman, Ralph M. Martin, Wickliff J. Many, James W. Smith, and James P. Luby. “Effects of Physiologic Variations in Temperature on the Rate of Antibiotic-Induced Bacterial Killing.” American Journal of Clinical Pathology 76, no. 1 (1981): 57–62.

Major Studies Discussed

  1. O’Malley, Catherine M. N., Robert J. Frumento, Mark A. Hardy, Alan I. Benvenisty, Tricia E. Brentjens, John S. Mercer, and Elliott Bennett-Guerrero. “A Randomized, Double-Blind Comparison of Lactated Ringer’s Solution and 0.9% NaCl During Renal Transplantation:” Anesthesia & Analgesia 100, no. 5 (May 2005): 1518–24. doi:10.1213/01.ANE.0000150939.28904.81.
  2. Young, Paul, Michael Bailey, Richard Beasley, Seton Henderson, Diane Mackle, Colin McArthur, Shay McGuinness, et al. “Effect of a Buffered Crystalloid Solution vs Saline on Acute Kidney Injury Among Patients in the Intensive Care Unit: The SPLIT Randomized Clinical Trial.” JAMA 314, no. 16 (October 27, 2015): 1701. doi:10.1001/jama.2015.12334.
  3. Sen, Ayan, Christopher M. Keener, Florentina E. Sileanu, Emily Foldes, Gilles Clermont, Raghavan Murugan, and John A. Kellum. “Chloride Content of Fluids Used for Large-Volume Resuscitation Is Associated With Reduced Survival:” Critical Care Medicine, September 2016, 1. doi:10.1097/CCM.0000000000002063.

Other Studies

  1. Bellomo, Rinaldo, Colin Hegarty, David Story, Lisa Ho, Michael Bailey, and others. “Association between a Chloride-Liberal vs Chloride-Restrictive Intravenous Fluid Administration Strategy and Kidney Injury in Critically Ill Adults.” Jama 308, no. 15 (2012): 1566–1572.
  2. McCluskey, Stuart A., Keyvan Karkouti, Duminda Wijeysundera, Leonid Minkovich, Gordon Tait, and W. Scott Beattie. “Hyperchloremia after Noncardiac Surgery Is Independently Associated with Increased Morbidity and Mortality: A Propensity-Matched Cohort Study.” Anesthesia and Analgesia 117, no. 2 (August 2013): 412–21. doi:10.1213/ANE.0b013e318293d81e.
  3. Modi, Manisha P., Kalapna S. Vora, Geeta P. Parikh, and Veena R. Shah. “A Comparative Study of Impact of Infusion of Ringer’s Lactate Solution versus Normal Saline on Acid-Base Balance and Serum Electrolytes during Live Related Renal Transplantation.” Saudi Journal of Kidney Diseases and Transplantation 23, no. 1 (January 1, 2012): 135.
  4. Raghunathan, Karthik, Andrew Shaw, Brian Nathanson, Til Stürmer, Alan Brookhart, Mihaela S. Stefan, Soko Setoguchi, Chris Beadles, and Peter K. Lindenauer. “Association between the Choice of IV Crystalloid and in-Hospital Mortality among Critically Ill Adults with Sepsis*.” Critical Care Medicine 42, no. 7 (July 2014): 1585–91. doi:10.1097/CCM.0000000000000305
  5. Shaw, Andrew D., Sean M. Bagshaw, Stuart L. Goldstein, Lynette A. Scherer, Michael Duan, Carol R. Schermer, and John A. Kellum. “Major Complications, Mortality, and Resource Utilization After Open Abdominal Surgery: 0.9% Saline Compared to Plasma-Lyte.” Annals of Surgery 255, no. 5 (May 2012): 821–29. doi:10.1097/SLA.0b013e31825074f5.
  6. Wang, Xudong, Chao Zhang, Guangsu Huang, Dahe Han, Xiaoyan Meng, Yi Guo, and Chen Kan. “Association between Chloride-Rich versus Chloride-Restrictive Intravenous Fluid Administration and Acute Kidney Injury in Cardiovascular Patients in ICU Wards.” Experimental and Therapeutic Medicine, June 6, 2016. doi:10.3892/etm.2016.3431.
P-Values and Fragility Index

P- Values

  1. Nuzzo, Regina. “Scientific Method: Statistical Errors.” Nature 506, no. 7487 (February 12, 2014): 150–52. doi:10.1038/506150a.
PulmCrit – Great resource for discussion of many areas of critical care, research, and interventions.  
  1. http://emcrit.org/pulmcrit/demystifying-the-p-value/
  2. http://emcrit.org/pulmcrit/2×2-table-maximal-bayes-factor/

Fragility Index


  1. RebelEM – http://rebelem.com/fragility-index-assessing-usefulness-randomized-clinical-trials/
  2. LITFL – http://lifeinthefastlane.com/ccc/fragility-index/

Journal Articles

  1. Walsh, Michael, Sadeesh K. Srinathan, Daniel F. McAuley, Marko Mrkobrada, Oren Levine, Christine Ribic, Amber O. Molnar, et al. “The Statistical Significance of Randomized Controlled Trial Results Is Frequently Fragile: A Case for a Fragility Index.” Journal of Clinical Epidemiology 67, no. 6 (June 1, 2014): 622–28. doi:10.1016/j.jclinepi.2013.10.019.
  2. Ridgeon, Elliott E., Paul J. Young, Rinaldo Bellomo, Marta Mucchetti, Rosalba Lembo, and Giovanni Landoni. “The Fragility Index in Multicenter Randomized Controlled Critical Care Trials.” Critical Care Medicine 44, no. 7 (July 2016): 1278–84. doi:10.1097/CCM.0000000000001670.

Thought Provoking

  1. PulmCrit – http://emcrit.org/pulmcrit/fragility-index-ninds/
Other Resources
  1. Martínez-Sellés, Manuel, Héctor Bueno, Alberto Sacristán, Álvaro Estévez, Javier Ortiz, Laura Gallego, and Francisco Fernández-Avilés. “Chest Pain in the Emergency Department: Incidence, Clinical Characteristics, and Risk Stratification.” Revista Española de Cardiología (English Edition) 61, no. 9 (January 2008): 953–59. doi:10.1016/S1885-5857(08)60256-X.
  2. Rosenthal, G. E., D. L. Harper, A. Shah, and K. E. Covinsky. “A Regional Evaluation of Variation in Low-Severity Hospital Admissions.” Journal of General Internal Medicine 12, no. 7 (July 1997): 416–22.
  3. Talan, David A., William R. Mower, Anusha Krishnadasan, Fredrick M. Abrahamian, Frank Lovecchio, David J. Karras, Mark T. Steele, Richard E. Rothman, Rebecca Hoagland, and Gregory J. Moran. “Trimethoprim–Sulfamethoxazole versus Placebo for Uncomplicated Skin Abscess.” New England Journal of Medicine 374, no. 9 (March 3, 2016): 823–32. doi:10.1056/NEJMoa1507476.
  4. Wu, Kuan-Han, I.-Chuan Chen, Chao-Jui Li, Wen-Cheng Li, and Wen-Huei Lee. “The Influence of Physician Seniority on Disparities of Admit/Discharge Decision Making for ED Patients.” The American Journal of Emergency Medicine 30, no. 8 (October 2012): 1555–60. doi:10.1016/j.ajem.2012.01.011.
  5. Rodos, Adam, Meehan, Timothy. http://www.emdocs.net/admission-variability-emergency-department/