Berks County Medical Society Medical Record Fall 2018 - 20

Reading Hospital/Tower Health

Student Sum mer Research Projects
Influence of Hypochloremia
on 30-day Readmission Rate
in Patients with Acute Heart
Failure Exacerbation
by Jessica Reyer; Adam Sigal, MD, FAAEM; Jared
Green, DO; Muhammad Sohail Khan, MD; Roman
Marchenko, MD; Christopher Mercogliano, DO;
Anthony Donato, MD, MHPE;
Reading Hospital, West Reading, Pennsylvania
INTRODUCTION:
Despite advances in goal-directed heart failure care, US
readmission rates for heart failure patients remain at 30%.
Numerous psychosocial, clinical and biochemical parameters have
been identified that are associated with readmission, but there is
recent interest in levels of serum chloride and their association with
rehospitalization.

METHODS:
A retrospective review of adult patients admitted to Reading
Hospital for decompensated heart failure was performed. Data on
demographics, admission sodium, chloride, serum BNP, discharge
sodium, chloride, total diuretic dose, and ejection fraction were
analyzed in patients, comparing those with a 30-day readmission
from those without. Univariate and logistic multivariable analysis
was performed using SPSS version 25 (Armonk, NY).

RESULTS/CONCLUSIONS:
954 patients were screened with 162 excluded. Of the remaining
792 patients, 487 patients were not readmitted and 304 patients
were readmitted within 30 days. Comparing groups, those
readmitted had lower admission serum chloride (101.7 mEq/L
vs. 102.5 mEq/L, p=0.03), lower admission serum sodium (136.8
mEq/L vs. 137.5 mEq/L, p=0.01), similar serum BNP levels (1230
vs. 1226 ng/ml, p=NS), lower discharge serum chloride levels (98.9
vs. 99.8, p=0.024) and lower discharge serum sodium levels (136.5
vs. 136.9 mEq/L, p=0.12). A multivariable model created from all
five parameters found that both discharge chloride (p=0.08) and
admission sodium (p=0.15) trended toward independent significance,
both with negative correlations.

Jessica Reyer is a senior in the Pennsylvania State
University Eberly College of Science at University
Park, PA.

Acute Uncomplicated Cystitis:
A Retrospective Review of
Prescribing Practices in Urgent
Care Centers
by Arianna Morton MLS(ASCP) OMSII;
Rebecca S. Cofsky, PharmD; Debra Powell, MD

20

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www.berkscms.org

BACKGROUND:
Acute uncomplicated cystitis (AUC) is a frequent infection
in women who seek care in outpatient settings such as urgent
care centers that requires antibiotic treatment1. There are clinical
practice guidelines for the management of AUC in this patient
population1. Nevertheless, it has been widely reported that
treatment practices vary in the management of AUC. With the
rise in antibiotic resistance, antibiotic stewardship is important and
efforts need to be made to ensure patients receive optimal care with
the correct antibiotic, dose, and duration. Consequently, the focus
of this study is to evaluate the prescribing practices of healthcare
providers in treating women diagnosed with acute uncomplicated
cystitis.
http://www.berkscms.org
Berks County Medical Society Medical Record Fall 2018

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