scholarly journals 702. Characteristics of Infective Endocarditis (IE) and Predictors of 90-day Mortality Among People Who Do and Do Not Inject Drugs with IE in Seattle, Washington

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S401-S402
Author(s):  
Maria A Corcorran ◽  
Jenell C Stewart ◽  
Kristine F Lan ◽  
Ayushi Gupta ◽  
Tanner N Muggli ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
The United States ◽  
Academic Medical Centers ◽  
Medical Centers ◽  
Kaplan Meier ◽  
Academic Medical ◽  
Key Characteristics ◽  
Study Team ◽  
Cox Proportional Hazard Models ◽  
State Death

Abstract Background People who inject drugs (PWID) are at high risk for IE and account for a growing proportion of IE cases in the United States. We describe key characteristics of IE and predictors of 90-day mortality among people who do and do not inject drug at two large academic medical centers. Methods We used a string-searching and pattern-matching algorithm within all discharge (DC) summaries to query the electronic medical record (EMR) for cases of IE among adults ≥18 years of age at two academic medical centers in Seattle, Washington from December 1, 2013 to July 31, 2019. All cases were chart reviewed by a member of the study team to confirm a clinical diagnosis of IE and verify housing and PWID status, the latter defined as any injection drug use in the 3 months prior to admission. Microbiology and valve involvement were extracted from DC summaries and chart-reviewed where needed. Deaths were obtained from Washington state death index, which links to our EMR. Descriptive statistics were used to compare PWID and non-PWID with IE, and Kaplan-Meier log rank tests and Cox proportional hazard models were used to assess for predictors of 90-day mortality. Results We identified 387 patients with IE, 44% (n=166) of whom were PWID. When compared to non-PWID, PWID were younger (median age 33 vs. 55 years, p< 0.001) and more likely to be female (48% vs. 31%, p=0.001), homeless (41% vs. 9%, p< 0.001), have coagulase-positive Staphylococcal IE (69% vs. 32%, p< 0.001), and have right sided IE (66% vs. 26%, p< 0.001). Seventeen percent (n=64) of patients died within 90 days of admission, including 14% (n=23) of PWID and 19% (n=41) of non-PWID, with no difference in 90-day mortality between these groups (log-rank p=0.3). In univariate analyses, having left sided IE was the only predictor of 90-day mortality (HR 4.79, 95% CI 2.18 – 10.5). Conclusion Despite PWID being significantly younger and having a much higher frequency of right sided IE, they had similar 90-day mortality to non-PWID in this contemporary, urban cohort of hospitalized IE patients. Table 1. Demographic Characteristics of People Who Do and Do Not Inject Drugs with Infective Endocarditis at Two Seattle Hospitals, 2014 – 2019 Disclosures All Authors: No reported disclosures

Abstract 30: Sex Differences in Faculty Rank Among Academic Vascular Neurologists in the United States

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Lindsay A Bliss ◽  
Carol A Vitellas ◽  
Nayanika Challa ◽  
Vivien H Lee
Keyword(s):  
United States ◽  
Assistant Professor ◽  
The United States ◽  
Associate Professor ◽  
Academic Medical Centers ◽  
Full Professor ◽  
Academic Rank ◽  
Faculty Rank ◽  
Medical Centers ◽  
Academic Medical

Introduction: The lower proportion of women at the rank of full professor compared to men has been documented in nearly all specialties. Women are under-represented in academic stroke neurology, but there is limited data. Methods: We reviewed all 160 U.S. medical schools and the associated medical centers for vascular neurologists. An internet search of stroke team websites and neurology department websites was performed from August 1, 2020 to August 25, 2020. We included 117 academic medical centers that had at least 1 vascular neurologist on faculty. We included vascular neurology ABPN certified or board eligible (fellowship-trained) neurologists. Data was collected on sex, academic rank, and American Board of Psychiatry and Neurology (ABPN) certification status. ABPN board certification status was verified on the ABPN verify CERT website. Social medical women’s neurology groups were also queried for names of women full professor to cross check. Results: Among 540 academic ABPN vascular neurologists, 182 (33.8%) were women and 358 (66.3%) were men. Among academic ranks, women made up 108/269 (40.1%) of Assistant professors, 49/137 (35.8%) of Associate professors, and 25/134 (18.8%) of full professors. Twenty two academic centers had vascular neurology female professors on faculty, compared to 70 academic centers with male full professors on faculty. Twenty nine academic centers had multiple male professors on faculty compared to only 3 centers with multiple female full professors. Among women, 108 (59.3%) were assistant professor, 49 (26.7%) were associate professor, 25 (13.7%) were full professor. Among men, 161 (45.0%) were assistant professor, 88 (24.6%) were associate professor, and 109 (30.5%) were professor. There was a significant difference between academic rank based upon sex (p <0.0001). Conclusion: Among academic medical centers in the United States, significant sex differences were observed in academic faculty rank for ABPN vascular neurologists, with women less likely than men to be full professors. Further study is warranted to address the gender gap in the field of stroke.

A Survey of Intravenous Remifentanil Use for Labor Analgesia at Academic Medical Centers in the United States

2017 ◽  
Vol 124 (4) ◽  
pp. 1208-1210 ◽  
Author(s):  
Jaime Aaronson ◽  
Sharon Abramovitz ◽  
Richard Smiley ◽  
Virginia Tangel ◽  
Ruth Landau
Keyword(s):  
United States ◽  
The United States ◽  
Labor Analgesia ◽  
Academic Medical Centers ◽  
Medical Centers ◽  
Academic Medical

Gastroenterology, Academic Medicine and a Changing Landscape

2015 ◽  
Vol 33 (Suppl. 1) ◽  
pp. 57-60
Author(s):  
Daniel K. Podolsky
Keyword(s):  
Health Care ◽  
The United States ◽  
Cost Of Care ◽  
Academic Medical Centers ◽  
Value Proposition ◽  
Common Elements ◽  
Human Welfare ◽  
Medical Centers ◽  
Use Of Resources ◽  
Academic Medical

The forces that are reshaping the delivery of health care through much of the developed world are especially acute within academic centers that carry the responsibility for delivering that care while advancing medical knowledge and ensuring well-trained physicians. Gastroenterology will not be spared any of those forces, and in some ways represents the leading edge of their impact. Though the dynamics vary within the context of the health-care delivery and scientific enterprise of individual countries, common elements are demands for greater accountability and transparency in how academic medical centers demonstrate their value while assuring broad access to their expertise. In the United States, underlying many forms of change in the payment scheme are the common elements that will increasingly place the risk for the cost of care on providers rather than on the payers, be it government or private, as has historically been true. At the same time, academic medical centers, with gastroenterology responsible for addressing the burden of digestive diseases, must remain the stem cells for health care integrating all their missions and providing the foundation of medical advances which will ultimately improve human welfare. What will academic gastroenterology units look like if they are able to effectively respond to these forces? Gastrointestinal (GI) divisions and faculty will own new roles including responsibility for system success in caring for patients. They will evolve their training programs to provide the next generation with skills needed to succeed, including the discipline of system improvement, team leadership and others. And there will be new models that will drive the organization of research that are not as conventionally self-contained within the gastroenterology units, but fostering research teams that have hubs and spokes. The vitality of GI divisions will depend on the willingness to seize ownership of the new value proposition of disease management ensuring that each patient achieves the best outcome with the most effective use of resources and endeavor within their systems to capture some of that value to invest in their training and research missions. In the course of that evolution, gastroenterology will be well served by rebalancing the dependence on existing modalities. If procedural gastroenterology becomes the sole value proposition, it will lead to an increasingly narrow view of the field.

The autopsy in academic medical centers in the United States

1988 ◽  
Vol 19 (12) ◽  
pp. 1369-1371 ◽  
Author(s):  
Robert E. Anderson ◽  
Rolla B. Hill
Keyword(s):  
United States ◽  
The United States ◽  
Academic Medical Centers ◽  
Medical Centers ◽  
Academic Medical
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