Browsing by Author "Kuebler, Kari"

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    Assessment of a Universal Preprocedural Screening Program for COVID-19
    (Cambridge, 2021) Dbeibo, Lana; Kuebler, Kari; Keen, Alyson; George, Annie; Kelley, Kristen; Sadowski, Josh; Basham, Laura; Beeson, Terrie; Schmidt, C. Max; Beeler, Cole; Webb, Douglas; Medicine, School of Medicine
    Objectives Study objectives were to: (1) Determine the value of a COVID-19 universal preprocedural screening program; and (2) Using the results of asymptomatic positive screens, determine the safety of resuming elective procedures. Design This was a descriptive study detailing the process and findings from implementation of a COVID-19 universal preprocedural screening program. Setting An adult academic tertiary center in Indiana. Patients Patients were included in the analysis if they were screened 96 hours prior to or within 24 hours after undergoing a procedure in the operating room, cardiac catheterization lab, or endoscopy. Methods A report was generated from the electronic health record of patients undergoing procedures from a six week period of time (May 4th-June 14th, 2020). Health records for positive screens were reviewed and classified as symptomatic if they met either criteria: (1) screen performed due to presence of COVID-19 symptoms; (2) documentation of symptoms at the time of the screen. Patients with a positive screen that did not meet symptomatic criteria were classified as asymptomatic. Descriptive statistics were used to calculate frequencies and percentages for the included sample. Results The initial sample included 2,194 patients, comprised of 46 positive and 2,148 negative screens. Out of the 46 patients who had a positive test, 17 were asymptomatic, resulting in an asymptomatic rate of 0.79% (17/2165). Conclusion Findings validated the value of the program through identification of a low rate of asymptomatic positive screens and procedural team adoption and sustainment. Findings may help inform decision making of like organizations attempting to enhance safety while resuming elective procedures.
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    “Clinical Characteristics, Outcomes and Prognosticators in Adult Patients Hospitalized with COVID-19”
    (Elsevier, 2020-07-08) Gavin, Warren; Campbell, Elliott; Zaidi, Adeel; Gavin, Neha; Dbeibo, Lana; Beeler, Cole; Kuebler, Kari; Abdel-Rahman, Ahmed; Luetkemeyer, Mark; Kara, Areeba; Medicine, School of Medicine
    Background: COVID-19 is a novel disease caused by SARS-CoV-2. Methods: We conducted a retrospective evaluation of patients admitted with COVID-19 to one site in March 2020. Patients were stratified into three groups: survivors who did not receive mechanical ventilation (MV), survivors who received MV and those who received MV and died during hospitalization. Results: There were 140 hospitalizations; 22 deaths (mortality rate 15.7%), 83 (59%) survived and did not receive MV, 35 (25%) received MV and survived; 18 (12.9%) received MV and died. Thee mean age of each group was 57.8 , 55.8 and 72.7 years respectively (p=.0001). Of those who received MV and died, 61% were male (p=.01). More than half the patients ( n=90, 64%) were African American. First measured d-dimer >575.5 ng/mL, procalcitonin > 0.24 ng/mL, LDH > 445.6 units/L and BNP > 104.75 pg/mL had odds ratios of 10.5, 5 , 4.5 and 2.9 respectively forMV (p < .05 for all). Peak BNP > 167.5 pg/mL had an odds ratio of 6.7 for inpatient mortalitywhen mechanically ventilated (p= .02).Conclusions: Age and gender may impact outcomes in COVID-19. D-dimer, procalcitonin, LDH and BNP may serve as early indicators of disease trajectory.