Prescribing appropriate doses of drugs requiring weight-based dosing is challenging in overweight patients due to a lack of data. With 68% of the US population considered overweight and these patients being at an increased risk for hospitalization, clinicians need guidance on dosing weight-based drugs. The purpose of this study was to identify “real-world” dose ranges of high-risk medications administered via continuous infusion requiring weight-based dosing and determine the reasons for dosing changes (ineffectiveness or adverse drug reactions). A prospective, multicenter, observational study was conducted in four intensive care units at three institutions. A total of 857 medication orders representing 11 different high-risk medications in 173 patients were reviewed. It was noted that dosing did not increase in proportion to weight classification. Overall, 14 adverse drug reactions occurred in nine patients with more in overweight patients (9 of 14). A total of 75% of orders were discontinued due to ineffectiveness in groups with higher body mass indexes. Ineffectiveness leads to dosing adjustments resulting in the opportunity for medication errors. Also, the frequent dosing changes further demonstrate our lack of knowledge of appropriate dosing for this population. Given the medications' increased propensity to cause harm, institutions should aggressively monitor these medications in overweight patients.

As of December 2020, there were over 450,000 confirmed coronavirus disease 2019 cases in New York City (NYC) with approximately 25,000 deaths. Previous literature identified advanced age, higher severity of illness, elevated inflammatory biomarkers, acute organ dysfunction, comorbidities, and presentation from long-term care facility as risk factors for mortality in patients from Wuhan, China, and the United States. Additional studies conducted in NYC are warranted to confirm these findings.The objective of this study was to assess the risk factors for in-hospital mortality in patients with confirmed COVID-19 infections. This was a retrospective case-control study at The Brooklyn Hospital Center, a 464-bed community teaching hospital. Adult patients with a confirmed COVID-19 infection and who received at least 24 h of COVID-19 therapy were included. Univariate and multivariate logistic regression analyses were conducted to identify the risk factors for in-hospital mortality. Twohundred and eighty four patients were included, of whom 95 (33.5%) were nonsurvivors and 189 (66.5%) patients were survivors. Multivariate analysis showed higher in-hospital mortality with advanced age (odds ratio [OR] 6.476; 95% confidence interval [CI], 1.827-22.953), presentation from long-term care facility (OR 4.259; 95% CI 1.481-12.250), elevated total bilirubin (OR 4.947; 95% CI 1.048-23.350), vasopressor initiation (OR 36.262; 95% CI 5.319-247.216), and development of renal failure (OR 36.261; 95% CI 2.667-493.046). Risk factors associated with mortality for patients with COVID-19 in a community teaching hospital included advanced age, vasopressor initiation, development of renal failure, elevated total bilirubin, and presentation from long-term care facility.

We recommend that hospitals consider developing protocols on conversion of intravenous to oral antihypertensives in an attempt to reduce unnecessarily prolonged intravenous therapy. Information contained in this article can be used as a toolkit to select information specific to the characteristics of individual health-care systems.

Knowledge regarding hyperglycemia management was suboptimal across a sample of health care workers when compared to clinical best practices. Hyperglycemia management was perceived to be important but convenience seemed to influence the management approach more than efficacy. Knowledge, perceptions, and barriers seem to play an important role in patient care and should be considered when developing education programs prior to implementation of optimized glycemic protocols.