Curious

[newdude2009]

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Hey there comrades

I was just curious for those attending or residents who work in the community setting.
What are the top 10 diagnosis you guys admit to the internal medicine teams?

I'm more active in the internal med forums, but I wanted to know from your guys end.

Thanks for any replies in advance.

 

[Apollyon]

Chest pain r/o/NSTEMI, ileus, dehydration, urosepsis, cellulitis in diabetics, renal with a fever, pneumonia, SOB/COPD exacerbation.

Those are off the top of my head for most common admissions.

 

[Daiphon]

Chest pain r/o/NSTEMI, ileus, dehydration, urosepsis, cellulitis in diabetics, renal with a fever, pneumonia, SOB/COPD exacerbation.

Those are off the top of my head for most common admissions.

I would add:
23h psych clearance if MHC won't take them without it

HTN urgency/emergency

Syncope (non vasovagal)

-d

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[xaelia]

Malingering, zero-risk chest pain, adult failure to thrive, morbid obesity, persistently vegetative after TPA....

You tend to admit your hypertensive urgency patients? If they don't come to me tied up in a bow with the inpatient team expecting them, asymptomatic hypertension goes home without any acute BP lowering except in the most extraordinary examples.

 

[jendc08]

Chest pain, pna, copd

 

[deleted109597]

Chest pain, pneumonia, nursing home failure to water the plants, too stupid to live, too fat to live...

 

[Daiphon]

Malingering, zero-risk chest pain, adult failure to thrive, morbid obesity, persistently vegetative after TPA....

You tend to admit your hypertensive urgency patients? If they don't come to me tied up in a bow with the inpatient team expecting them, asymptomatic hypertension goes home without any acute BP lowering except in the most extraordinary examples.

Those are the ones I admit; typically at PMD request... Else they go home. d=)

-d

 

[kabab]

COPD/Ashma exacerbation, bad pneumonias, ACS, pulmonary edema, sepsis, strokes/vertigo, DVT/PE, DKA/NKHOS, suicide by drug overdose.

 

[BushDoc20]

nasal infections in teens from sniffing
uncontrolled diabetes
mostly infections and cardic issues

 

[Rendar5]

We don't do ACS admits so much, because we have CTCA ability at my institution, which weeds out all ACS admits in patients without established disease. I'd put it at the bottom of my top 10 instead of near the top like we used to do.

COPD Exac, Heart Failure Exac., Pneumonia, Urosepsis, Cellulitis, MVC's with some severe injury, DVT/PE, r/o ACS, head bleeds.

we are the only major tertiary care facility for about 1million pt's, and in a very busy suburban part of NY. so we get all major MVC's and all head bleeds.

 

[docB]

CP
CVA/TIA
Syncope
General weakness/failure to thrive
AMS
Dysrhythmia
Intractable and pain/intractable N/V
Dialysis related issues
Hip fx - goes to medicine in my area

 

[Groove]

Hey there comrades

I was just curious for those attending or residents who work in the community setting.
What are the top 10 diagnosis you guys admit to the internal medicine teams?

I'm more active in the internal med forums, but I wanted to know from your guys end.

Thanks for any replies in advance.

In no particular order of frequency...

1) R/O ACS (by far the most common admission)
2) PNA
3) COPD exac
4) CHF exac
5) NSTEMI
6) Dysrhythmia
7) AMS
8) Appy/Chole
9) Complicated UTI/Pyelo
10) Sepsis
11) TIA's and dizzy old people

All those can be handled at the community shop. I ship a lot of other stuff though and some of it depends on the pt and comfort level of the hospitalist working during those days/nights. For instance, the 88y/o NH NSTEMI might get taken or might get shipped depending on who is on even though we all know the management is going to be the same.

 

[Arcan57]

1) R/O ACS
2) COPD exacerbation
3) CHF exacerbation (could argue cards, but most have DM, HTN, and also COPD so they punt to med)
4) Sepsis secondary to : UTI, pneumonia, diabetic foot, sacral decub)
5) Syncope
6) Accelerated HTN
7) TIA >> CVA -to medicine with neuro consult
8) Hyperkalemia/volume overload in pt w/ failure to dialyze as outpatient
9) Encephalopathy (been on a run of hepatic, but in general NOS)
10) Sequelae of substance abuse/intentional OD