Hospital practice (1995)最新文献

{"title":"Patient outcomes after interhospital transfer: the impact of early intensive care unit upgrade.","authors":"Saqib H Baig, James D Lee, Erika J Yoo","doi":"10.1080/21548331.2025.2470107","DOIUrl":"10.1080/21548331.2025.2470107","url":null,"abstract":"<p><strong>Background: </strong>There is little known about the prevalence and outcomes of medical patients requiring early intensive care unit upgrade (EIU) following interhospital transfer, and previous studies of EIU focus on patients admitted through the emergency room. We aimed to examine the characteristics and risk factors for poor outcome among medical patients undergoing EIU after interhospital transfer.</p><p><strong>Materials and methods: </strong>The publicly available Medical Information Mart for Intensive Care (MIMIC) IV database (2008-2019) was queried to identify non-surgical patients undergoing interhospital transfer. Patients who subsequently underwent EIU, defined as ICU admission within 24 hours of arrival after interhospital transfer, were compared to those who did not experience EIU for differences in mortality and length-of-stay (LOS.) We used multivariate logistic regression to identify risk factors for hospital death in this population and negative binomial regression to estimate the impact of EIU on hospital LOS.</p><p><strong>Results: </strong>We identified 5,619 patients who underwent interhospital transfer, of which 339 (6.0%) experienced EIU and 5280 (94.0%) did not. Patients undergoing EIU after interhospital transfer were significantly older (median age 69 vs. 64 years; <i>p</i> = 0.001,) but there was no difference in sex. After risk-adjustment, we found an association between EIU and a higher risk of mortality (aOR 6.9, 95%CI 5.24-9.08). Increased comorbidity burden as measured by Charlson Comorbidity Index (CCI) was linked to higher odds of death (aOR 1.26, 95% CI 1.22-1.31,) as was nonwhite race (aOR 1.69, 95% CI 1.34-2.14). EIU was associated with a longer hospital LOS (IRR 1.40, 95%CI 1.28-1.54).</p><p><strong>Conclusion: </strong>EIU after interhospital transfer is associated with higher mortality and longer LOS. Further study will help identify process features of transfer and patient characteristics contributing to poor outcome after arrival from an outlying facility and guide efforts to mitigate risk and provide equitable care across the transfer continuum.</p>","PeriodicalId":35045,"journal":{"name":"Hospital practice (1995)","volume":" ","pages":"2470107"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modified infusion of recombinant tissue plasminogen activator in high-risk pulmonary thromboembolism with high bleeding risk: a case report.","authors":"Mohammad Hussein Hasin, Mostafa Ahmadi, Vafa Baradaran Rahimi, Bahram Shahri, Asal Yadollahi","doi":"10.1080/21548331.2024.2433934","DOIUrl":"10.1080/21548331.2024.2433934","url":null,"abstract":"<p><p>High-risk pulmonary thromboembolism (PTE) is a form of venous thromboembolism that refers to severe obstruction of pulmonary vessels, which causes right ventricular failure and hemodynamic instability. High-risk PTE has a high mortality rate unless immediate reperfusion treatment is done. Systemic thrombolysis is recommended for patients with high-risk PTE. The approved regimen for high-risk PTE is the accelerated intravenous administration of recombinant tissue-type plasminogen activator (rtPA) 100 mg over 2 hours. Herein, we present a case of high-risk PTE in a 74-year-old woman with a high risk of bleeding due to a recent pelvic fracture and head trauma who was successfully treated with a slower infusion of 100 mg rtPA over 4 hours. The modified infusion rate of 100 mg rtPA over 4 hours is an effective regimen for thrombolysis in acute high-risk PTE. It might have a lower risk of bleeding complications, which makes it a good option for patients with high bleeding risk.</p>","PeriodicalId":35045,"journal":{"name":"Hospital practice (1995)","volume":" ","pages":"2433934"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inpatient complications and mortality in cirrhotic patients undergoing bariatric surgery: a comprehensive analysis.","authors":"Eun Seo Kwak, Abdulmajeed Alharbi, Ahmad Bosaily, Anas Alsughayer, Amna Igbal, Oscar Salichs, Sadik Khuder, Matthew Fourman, Ragheb Assaly","doi":"10.1080/21548331.2025.2455921","DOIUrl":"10.1080/21548331.2025.2455921","url":null,"abstract":"<p><strong>Introduction: </strong>Liver cirrhosis, a complex and progressive disease, imposes a significant global health burden, characterized by irreversible liver tissue scarring and various life-threatening complications. Traditionally linked to factors like chronic alcohol consumption and viral hepatitis infections, the rising prevalence of obesity introduces a new dimension to its etiology. As obesity rates continue to climb worldwide, the confluence of liver cirrhosis and bariatric surgery has become an increasingly pertinent and clinically relevant topic of inquiry.</p><p><strong>Methods: </strong>In this study, we aimed to investigate the impact of liver cirrhosis on patients who underwent bariatric surgery, using data from the 2020 National Inpatient Sample (NIS) database. We compared the outcomes of 82,414 patients who had bariatric surgery, stratifying them based on the presence or absence of liver cirrhosis. We assessed baseline demographic characteristics and comorbidities, in-hospital outcomes, and complications related to the surgery.</p><p><strong>Results: </strong>Patients with liver cirrhosis who underwent bariatric surgery demonstrated several distinct trends. On average, they were older (mean age 63 years) and predominantly female (52%) compared to those without cirrhosis (mean age 52, 71% female). Furthermore, comorbidities such as hypertension, diabetes with chronic complications, and alcohol abuse were more prevalent in the cirrhosis group. In terms of outcomes, patients with liver cirrhosis faced significantly higher inpatient mortality rates (4%) compared to those without cirrhosis (1%) with <i>p</i> < 0.001. They also experienced a notably longer average length of hospital stay (2.35 days longer, 95% CI: -3.46 --1.25, <i>p</i> < 0.001) and incurred higher hospitalization costs (add AOR and <i>p</i> value here). Additionally, patients with cirrhosis had increased odds of experiencing acute heart failure (adjusted odds ratio: 1.87, 95% CI: 1.14-2.57, <i>p</i> = 0.01) and requiring blood transfusions (adjusted odds ratio: 1.71,95% CI: 1.13-3.09, <i>p</i> = 0.009). Although the adjusted odds ratio for inpatient mortality was higher in cirrhosis patients (1.58, 95% CI: 0.76-3.30, <i>p</i> = 0.21), it did not reach statistical significance.</p><p><strong>Conclusion: </strong>This study highlights the substantial impact of liver cirrhosis on post-bariatric surgery outcomes. Patients with cirrhosis who undergo bariatric surgery face higher inpatient mortality rates and a greater risk of complications, particularly acute heart failure and the need for blood transfusions. The longer hospital stays and increased costs further emphasize the challenges in managing this unique patient population. These findings emphasize the need for careful patient selection, risk assessment, and a multidisciplinary approach when considering bariatric surgery for individuals with both liver cirrhosis and obesity.</p>","PeriodicalId":35045,"journal":{"name":"Hospital practice (1995)","volume":" ","pages":"2455921"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is temporary staffing a solution to the deeper crisis of the hospital workforce shortage?","authors":"Suyog Mokashi, Peter Cappelli","doi":"10.1080/21548331.2025.2472734","DOIUrl":"10.1080/21548331.2025.2472734","url":null,"abstract":"","PeriodicalId":35045,"journal":{"name":"Hospital practice (1995)","volume":" ","pages":"2472734"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Direct oral anticoagulant assay utilization and associated bleeding events: a multi-center cohort study.","authors":"Brandon Stretton, Joshua Kovoor, Stephen Bacchi, Aashray Gupta, Suzanne Edwards, Jir Ping Boey, Samuel Gluck, Benjamin Reddi, Guy Maddern, Mark Boyd","doi":"10.1080/21548331.2024.2433937","DOIUrl":"10.1080/21548331.2024.2433937","url":null,"abstract":"<p><strong>Background: </strong>There is a lack of evidence regarding direct oral anticoagulant (DOAC) assay plasma concentrations and their association with bleeding events or transfusion requirements. This multicenter study aimed to characterize the use and plasma levels of DOAC assays of anticoagulated patients who present to emergency with a bleeding event and their association with bleeding severity.</p><p><strong>Methods: </strong>A multicenter retrospective cohort study of consecutive emergency bleeding presentations with a DOAC assay over a five-year period was conducted. Linear regressions were performed for continuous outcomes, binary logistic regression for categorical outcomes.</p><p><strong>Results: </strong>There were 86 patients on a DOAC, who presented with a major bleeding event, and had a DOAC assay performed. Assays were performed within a median time of 4.8 hours (IQR = 9,14.4) from presentation and had a median result of 122.9 ng/ml(IQR = 42,160). DOAC assay plasma level was not significantly associated with type or severity of bleed however, for every 10 unit increase in DOAC assay plasma level, the odds of administering reversal increases by 4% (OR = 1.04, 95%CI:1.00-1.08).</p><p><strong>Conclusion: </strong>A wide range of plasma levels can be expected in patients who present with bleeding events. Higher DOAC plasma levels do not necessarily confer a worse bleeding event or increased transfusion requirements; however, it is associated with an increased likelihood of anticoagulant reversal administration.</p>","PeriodicalId":35045,"journal":{"name":"Hospital practice (1995)","volume":" ","pages":"2433937"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of transition from use of alteplase to tenecteplase in the treatment of acute ischemic stroke in a large system of community hospitals.","authors":"Adam Hasse, Kimberly Korwek, Jeffrey Guy, Russell E Poland","doi":"10.1080/21548331.2024.2438592","DOIUrl":"10.1080/21548331.2024.2438592","url":null,"abstract":"<p><strong>Objective: </strong>Pharmacologic thrombolytic treatment for acute ischemic stroke has primarily been managed by intravenous alteplase. Tenecteplase is a variant that has been shown to be non-inferior to alteplase in clinical trials. In this study, we present a real-world assessment of patient outcomes with the facility-wide transition to the use of tenecteplase versus altepase for acute ischemic stroke in a large system of community hospitals in the United States.</p><p><strong>Methods: </strong>This retrospective analysis assessed adult patients who received either alteplase or tenecteplase between 1 April 2020 and 31 March 2023. Propensity matching was used to estimate the covariate-adjusted association with outcomes of discharge expired/hospice, intracranial hemorrhage and readmission to a facility in the same healthcare system within 30, 60, or 90 days.</p><p><strong>Results: </strong>Among 12,766 patients, gross mortality was 7.6% (<i>n</i> = 285) with tenecteplase and 8.2% (<i>n</i> = 739) with alteplase (<i>p</i> = 0.314); intracranial hemorrhage was 2.4% with either. The propensity match analysis found that the relative risk of mortality/hospice for patients given tenecteplase versus alteplase was 0.993 (95% CI: 0.848-1.162, <i>p</i> = 1.000). When limited to five facilities with the highest volume of thrombolytic use, there were no significant differences in outcomes. While the time from emergency department arrival to thrombolytic administration (door-to-needle) was shorter among patients receiving tenecteplase, there was no significant difference in the odds of mortality based on door-to-needle time.</p><p><strong>Conclusion: </strong>In alignment with previous studies, these findings demonstrate the lack of potential harm with a transition from alteplase to tenecteplase in clinical practice for acute ischemic stroke patients treated in community hospitals.</p>","PeriodicalId":35045,"journal":{"name":"Hospital practice (1995)","volume":" ","pages":"2438592"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142839625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of proactive care model for patients with chronic kidney disease stage 4-5 to clinical outcomes and quality of life: an action research.","authors":"Malinee Jitnuk, Waree Jullaket, Ausanee Wanchai","doi":"10.1080/21548331.2024.2437977","DOIUrl":"10.1080/21548331.2024.2437977","url":null,"abstract":"<p><strong>Background: </strong>Patients with chronic kidney disease often struggle to control clinical symptoms and need help from the healthcare team. This study aimed to develop a proactive care model for stage 4-5 chronic kidney disease patients and investigate its effectiveness on their clinical outcomes and quality of life in Thailand.</p><p><strong>Methods: </strong>The study was a comprehensive, collaborative effort conducted in North Thailand involving a multidisciplinary team of healthcare professionals. This team, which included physicians, professional nurses, pharmacists, and nutritionists from the Chronic Kidney Disease Clinic at a secondary hospital, worked together to develop and implement a proactive care model for stage 4-5 chronic kidney disease patients. The research instruments used were a proactive care model for CKD stages 4-5 patients, the clinical outcomes assessment form, and the Kidney Disease Quality of Life Short Form. Quantitative data were analyzed using descriptive statistics, Chi-Square, and dependent t-tests, while qualitative data were analyzed using content analysis.</p><p><strong>Results: </strong>The proactive care model for patients with chronic kidney disease stage 4-5 consists of 1) a multidisciplinary team providing chronic kidney disease standards, 2) providing knowledge and counseling for behavior change, and 3) supporting self-management of patients with chronic kidney disease. After the experiment, mean systolic blood pressure, diastolic blood pressure, and mean potassium were significantly lower than before, and Hematocrit significantly increased. In contrast, glomerular rate, fasting blood sugar, and hemoglobin A1C did not change after the intervention compared to before (<i>p</i> > .05). After the experiment, patients' overall quality of life significantly increased.</p><p><strong>Conclusions: </strong>This study demonstrated that the proactive care model for Chronic Kidney Disease stage 4-5 patients significantly improved clinical outcomes and profoundly impacted quality of life. Therefore, all components of the proactive care model should be applied, including working as a multidisciplinary team and helping patients adjust their behaviors and manage their health.</p>","PeriodicalId":35045,"journal":{"name":"Hospital practice (1995)","volume":" ","pages":"2437977"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142786873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends of trauma team physicians toward patients with bleeding in Saudi Arabia: a cross-sectional study.","authors":"Abdulaziz Mohammad Al-Sharydah, Faisal Ahmad Katbi, Razan Essam AlHarbi, Faisal Al-Ghamdi, Saleh AlShreadah","doi":"10.1080/21548331.2024.2442299","DOIUrl":"10.1080/21548331.2024.2442299","url":null,"abstract":"<p><strong>Objectives: </strong>Trauma poses a significant health burden in Saudi Arabia, with high rates of morbidity and mortality rates. We evaluated the trends among trauma team (TT) physicians in Saudi Arabia regarding their awareness and referral practices for percutaneous endovascular arterial embolization (EAE) in bleeding patients.</p><p><strong>Methods: </strong>A 13-question survey developed by consultants from various specialties assessed the knowledge of TT physicians regarding decision-making and appropriate approaches for managing traumatic bleeding. The surveys were administered in person to 135 TT physicians.</p><p><strong>Results: </strong>Among them, 38.52% had five or more years of independent practice, and 87.41% routinely encountered patients with bleeding patients. Physicians who routinely treated patients with bleeding patients exhibited higher median scores, in line with current management standards (<i>p</i> = 0.634). Tertiary care physicians and academic- and military-affiliated physicians exhibited higher median scores (<i>p</i> =  <0.001 and <i>p</i> < 0.006, respectively). Amongst TT physicians, 47.41% preferred EAE for unstable pelvic ring fractures with active bleeding, while 68.15% favored splenectomy for unstable patients with grade V splenic injuries. For traumatic aortic injuries, 67.42% considered TEVAR/EVAR safer options. Notably, 84.44% viewed an INR > 3 as a contraindication for EAE in hemodynamically stable patients. General surgeons scored the highest in management decision-making, followed by neurosurgeons (<i>p</i> = 0.001). Orthopedics, emergency medicine, intensive care (ICU), and anesthesia specialists exhibited similarly high median scores for appropriate management approaches (<i>p</i> = 0.003). Overall, general surgeons, orthopedic surgeons, and ICU specialists exhibited the highest median correct responses, adhering to the current standard of practice (<i>p</i> = 0.001).</p><p><strong>Conclusions: </strong>To address the potentially life-threatening condition of traumatic bleeding, raising awareness of the appropriate management and referral patterns for EAE is crucial.</p>","PeriodicalId":35045,"journal":{"name":"Hospital practice (1995)","volume":" ","pages":"2442299"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nomophobia: a challenge among healthcare professionals in Africa.","authors":"Reena Shah, Shan Lakhani, Jasmit Shah, Annastacia Mbithi, Aakanksha Singh, Zainab Gandhi, Priyal Mehta, Rahul Kashyap, Salim Surani","doi":"10.1080/21548331.2024.2432858","DOIUrl":"10.1080/21548331.2024.2432858","url":null,"abstract":"<p><strong>Objectives: </strong>This study delves into implementing Global Provider's phone-lessness phobia (Global 3-P Study) within the healthcare sector in Africa through a multinational, cross-sectional, web-based survey from April 1st to 30 June 2023.</p><p><strong>Methods: </strong>Utilizing a modified Nomophobia Questionnaire (NMP-Q), the research explores four dimensions of nomophobia: the inability to communicate, loss of connectedness, difficulty accessing information, and sacrificing convenience. The Global Remote Research Scholars Program (GRRSP) conducted the study, employing a 'snowball technique' for survey dissemination.</p><p><strong>Results: </strong>A total of 1636 responses were collected from healthcare professionals in Africa, predominantly aged 26-45, with a majority identifying as Black-African (86.5%) and residing mainly in Kenya (61.6%). The survey revealed a higher prevalence of Android smartphone users (71.4%) than Apple iOS (25.6%). Participants reported spending substantial time on personal (3.1-5 hours) and work-related (up to 3 hours) smartphone activities. A significant portion of respondents felt uncomfortable (74.3%), annoyed (72.0%), and nervous (61.4%) at the prospect of not having constant smartphone access to information. Concerns about disruptions to smartphone connections, such as running out of battery or data, were prevalent among participants. Analysis of nomophobia levels revealed that 46.9% experienced moderate Nomophobia Level I and 41.1% reported severe levels, while Nomophobia Level II was reported by 51.8% with moderate levels and 37.2% with severe levels. Comparative analysis based on gender and age groups showed statistically significant differences. Males exhibited lower severity levels of nomophobia compared to females, and the 36-45 age group reported the highest prevalence of severe nomophobia.</p><p><strong>Conclusion: </strong>This study highlights the significant impact of nomophobia among healthcare professionals in Africa, indicating a need for interventions to mitigate its effects and promote healthy smartphone habits in this critical sector.</p>","PeriodicalId":35045,"journal":{"name":"Hospital practice (1995)","volume":" ","pages":"2432858"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unraveling the unforeseen: anuric acute kidney injury induced by alectinib.","authors":"Viet Nghi Tran, Yusuf Hussein Kebato, Chau Doan Nguyen, Tahira Qadeer, Shehzad Ali, Amro Taha","doi":"10.1080/21548331.2025.2470606","DOIUrl":"10.1080/21548331.2025.2470606","url":null,"abstract":"<p><strong>Introduction: </strong>Alectinib, a second-generation anaplastic lymphoma kinase (ALK) inhibitor, is pivotal in managing ALK-positive non-small cell lung cancer (NSCLC) due to its efficacy and favorable safety profile. However, severe renal toxicity, including acute kidney injury (AKI), remains a rare but significant adverse effect.</p><p><strong>Case report: </strong>We present the case of a 71-year-old female with a history of diabetes and recently diagnosed ALK-positive NSCLC. She had been on alectinib therapy (600 mg twice daily) for two months. The patient was admitted with symptoms of shortness of breath and anuria. Initial laboratory results revealed a significant rise in serum creatinine from a baseline of 1.0 mg/dL to 3.64 mg/dL, indicating AKI. Alectinib was discontinued, and the patient underwent a single session of hemodialysis. The patient exhibited rapid clinical improvement with significant recovery of renal function, and she was discharged without the need for further dialysis. A subsequent switch to brigatinib was well-tolerated, with stable renal function observed at the 4-month follow-up.</p><p><strong>Conclusion: </strong>This case underscores the potential for severe AKI associated with alectinib therapy, highlighting the importance of vigilant renal function monitoring in patients undergoing treatment, especially those with predisposing conditions. Early recognition and prompt intervention are crucial to mitigate renal complications and optimize patient outcomes. Brigatinib may serve as a suitable alternative for patients intolerant to alectinib.</p>","PeriodicalId":35045,"journal":{"name":"Hospital practice (1995)","volume":" ","pages":"2470606"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}