Comprehensive Hospital Medicine E-Book , livre ebook

COMPREHENSIVE HOSPITAL MEDICINE
An Evidence-Based Approach
First Edition

Mark V. Williams, M.D., F.A.C.P.
Professor of Medicine, Chief, Division of Hospital Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois

Scott A. Flanders, M.D.
Associate Professor of Internal Medicine, University of Michigan
Director, Hospitalist Program
Associate Director, Inpatient Programs, University of Michigan Health System, Ann Arbor, Michigan

Winthrop F. Whitcomb, M.D.
Assistant Professor of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts
Director, Clinical Performance Improvement, Mercy Medical Center, Springfield, Massachusetts

Steven L. Cohn, M.D., F.A.C.P.
Clinical Professor of Medicine, State University of New York–Downstate
Chief, Division of General Internal Medicine
Director, Medical Consultation Service, Kings County Hospital, Brooklyn, New York

Franklin A. Michota, M.D.
Head, Section of Hospital Medicine, Department of General Internal Medicine, The Cleveland Clinic Foundation, Cleveland, Ohio

Russell Holman, M.D.
Chief Operating Officer, National Medical Director, Cogent Healthcare, Nashville, Tennessee

Richard Gross, M.D., F.A.C.P.
Professor of Medicine, Departments of Medicine and Interdisciplinary Oncology, University of South Florida College of Medicine
Chief, Division of Internal and Hospital Medicine, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida

Geno J. Merli, M.D., F.A.C.P.
Senior Vice President, Chief Medical Officer, Director, Jefferson Center for Vascular Disease, Thomas Jefferson University Hospital, Jefferson Medical College, Philadelphia, Pennsylvania
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COMPREHENSIVE HOSPITAL MEDICINE: AN EVIDENCE-BASED APPROACH
Expert Consult: Online and Print: ISBN: 978-1-4160-0223-9
Expert Consult Premium Edition Enhanced Online Features and Print: ISBN: 978-1-4160-0297-0
Copyright © 2007 by Saunders, an imprint of Elsevier Inc.
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Notice
Knowledge and best practice in this field are constantly changing. As new research and experience broaden our knowledge, changes in practice, treatment, and drug therapy may become necessary or appropriate. Readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of the practitioner, relying on their own experience and knowledge of the patient, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions. To the fullest extent of the law, neither the Publisher nor the Author assumes any liability for any injury and/or damage to persons or property arising out of or related to any use of the material contained in this book.
The Publisher

Library of Congress Cataloging-in-Publication Data
Comprehensive hospital medicine: an evidence-based approach / [edited by]
Mark V. Williams.—1st ed.
p.; cm.
Includes bibliographical references.
ISBN 1-4160-0223-5
1. Hospital care. 2. Evidence-based medicine. 3. Internal medicine. I. Williams, Mark, 1959 Nov. 7-[DNLM: 1. Inpatients. 2. Patient Care. 3. Evidence-Based Medicine. 4. Hospitalization. WX 162 C7375 2007]
RA972.C662 2007
362.11—dc22
2006046170
Senior Acquisition Editor: Rolla Couchman
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Multi-Media Producer: David Wisner
Marketing Manager: Laura Meiskey
Printed in China
Last digit is the print number: 9 8 7 6 5 4 3 2 1
Dedication
To Mom and Dad for helping me believe that becoming a doctor was possible. Heartfelt love and gratitude to my patient, supportive wife, Karee, and my considerate children, Caroline, Stephen, and Jason. Not so many more hours away from you at the computer.

Mark V. Williams
To Juliet, Tessana, Colin, and Malia Flanders, for your unwavering love and support.

Scott A. Flanders
To my two finest teachers, my wife and my father, both consummate physicians and healers.

Winthrop F. Whitcomb
To my wife, Deborah, and children, Alison and Jeffrey, for your patience, understanding, and support during this project. Hopefully, I will now have more time to spend with my family.

Steven L. Cohn
To my wife, Niki, and my children, Michael, Ryan, and Olivia.

Franklin A. Michota
To my family, past and present, with love and gratitude.

Richard Gross
To my wife, Charlotte, for all her support.

Geno J. Merli
Editors of Manual of Evidence-Based Admitting Orders and Therapeutics, 5th Edition: PocketConsult Handheld Software

Karen A. McDonaugh, M.D., Assistant Professor of Medicine, Director, Inpatient Hospitalist Service, University of Washington Medical Center, Consultative & Hospital Medicine Program, Seattle, Washington

Eric B. Larson, M.D., M.P.H., F.A.C.P., Executive Director, Group Health Cooperative, Center for Health Studies, Seattle, Washington
CONTRIBUTORS

Alpesh N. Amin, M.D., M.B.A., Professor of Medicine, Executive Director, Hospitalist Program, Vice Chair for Clinical Affairs and Quality, Department of Medicine, University of California–Irvine, Irvine, California

Frank A. Anania, M.D., F.A.C.P., Associate Professor of Medicine, Emory University School of Medicine, Director of Hepatology, Emory Clinic and Emory University Hospital, Emory Healthcare, Atlanta, Georgia

Ashish Aneja, M.D., Associate Staff, Section of Hospital and Perioperative Medicine, The Cleveland Clinic Foundation, Cleveland, Ohio

Rendell W. Ashton, M.D., Assistant Professor of Pulmonary and Critical Care Medicine, Upstate Medical University, Syracuse, New York

David J. Axelrod, M.D., J.D., Instructor of Medicine, Jefferson Medical College, Co-Medical Director, Palliative Care Consultation Service, Associate, Jefferson Internal Medicine Associates, Thomas Jefferson University, Philadelphia, Pennsylvania

Vanitha Bala, M.D., Instructor in Hospital Medicine, Emory Healthcare, Emory University School of Medicine, Atlanta, Georgia

John R. Bartholomew, M.D., Head, Section of Vascular Medicine, Departments of Cardiovascular Medicine and Hematology/Oncology, The Cleveland Clinic Foundation, Cleveland, Ohio

Darrin Beaupre, M.D., Ph.D., Associate Director, Medical Sciences Early Development, Amgen, Thousands Oaks, California

Rodney Bell, M.D., Professor of Neurology, Thomas Jefferson Medical College, Vice Chairman, Department of Neurology for Hospital Affairs, Chief, Division of Neurocritical Care and Cerebrovascular Disease, Thomas Jefferson University, Philadelphia, Pennsylvania

Glen Bergman, M.M.Sc., R.D., L.D., C.N.S.D., Clinical Preceptor, Dietetic Internship Program, Clinical Nutritionist, Nutrition and Metabolic Support Service, Emory University Hospital, Atlanta, Georgia

Lisa Bernstein, M.D., Assistant Professor of Medicine, Director, Clinical Methods Course, Emory University School of Medicine, Atlanta, Georgia

Suzanne F. Bradley, M.D., Associate Professor of Internal Medicine, University of Michigan Medical School, Staff Physician, Geriatric Research Education and Clinical Center, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan

William T. Branch, M.D., Carter Smith, Sr., Professor of Medicine, Director, Division of General Internal Medicine, Emory University School of Medicine, Chief, General Internal Medicine, Grady Memorial Hospital, Atlanta, Georgia

William F. Bria, II, M.D., Adjunct Clinical Associate Professor of Medicine, University of Michigan, Ann Arbor, Michigan, Clinical Associate Professor of Medicine, University of South Florida, Chief Medical Information Officer, Shriners Hospitals for Children System, Tampa, Florida

Erica Brownfield, M.D., F.A.C.P., Associate Professor of Medicine, Clerkship Director, Internal Medicine, Emory University School of Medicine, Staff Physician, Grady Health System, Atlanta, Georgia

Debora Bruno, M.D., Hematologist/Medical Oncologist, Nebraska Cancer Care, Hastings, Nebraska

Gregory M. Bump, M.D., Assistant Professor, Division of General Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania

Jada Bussey-Jones, M.D., Assistant Professor, Emory University School of Medicine, Director, Primary Care Center, Grady Memorial Hospital, Atlanta, Georgia

Joan Cain, M.D., Fellow, Hematology/Oncology, Emory University School of Medicine, Atlanta, Georgia

Paul Cantey, M.D., M.P.H., Assistant Professor of Medicine, Emory University School of Medicine, Atlanta, Georgia

Kulsum K. Casey, D.O., Clinical Instructor