Publications by authors named "Steven Bondi"

11 Publications

  • Page 1 of 1

Patient Characteristics Associated With Readmission to 3 Neurology Services at an Urban Academic Center.

Neurohospitalist 2021 Jan 4;11(1):25-32. Epub 2020 Sep 4.

Department of Neurology, New York University Langone Health, New York, NY, USA.

Background And Purpose: Hospital 30-day readmissions in patients with primary neurological problems are not well characterized. We sought to determine patient characteristics associated with readmission across 3 different inpatient neurology services at New York University Langone Hospital.

Methods: We retrospectively reviewed all 30-day readmissions from the General Neurology, Epilepsy, and Stroke services at NYULH Brooklyn and Manhattan campuses from 2016-2017 and compared them to a random sample of non-readmitted neurology patients. We used univariate analyses to compare demographics, clinical characteristics, disease specific metrics, and discharge factors of non-readmitted and readmitted groups and binomial logistic regression to examine specific variables with adjustment for confounders.

Results: We included 284 patients with 30-day readmissions and 306 control patients without readmissions matched by discharge location and service. After adjusting for confounders, we found that the following factors were associated with increased readmission risk: a recent hospital encounter increased risk for all services, increased number of medications at discharge, intensive care unit stay, higher length of stay, and prior history of seizure for the General Neurology Service, increased number of medications at discharge for the Epilepsy Service, and active malignancy and higher discharge modified Rankin Scale score for the Stroke Service.

Conclusion: This study identifies potential risk factors for readmission in patients across multiple neurology services. Further research is needed to establish whether these risk factors hold across multiple institutions.
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http://dx.doi.org/10.1177/1941874420953320DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8022194PMC
January 2021

Taking a Strohl Through History: Putting Strohl Back in Guillain-Barré-Strohl Syndrome.

J Neuromuscul Dis 2020 ;7(4):521-522

New York University Langone Health, Department of Neurology, New York City, NY, USA.

Guillain-Barré Syndrome is a popular eponym that comes from a 1916 paper by Drs. Guillain, Barré, and Strohl. These physicians described two soldiers in the French Sixth Army during World War I who developed acute progressive motor weakness. Although Drs. Guillain and Barré have continued to be included in the syndrome's eponym, Dr. Strohl has been forgotten despite having strongly contributed to the original paper. The reasons previously mentioned for Dr. Strohl's absence appear trivial in contemporary practice and thus, his name deserves to be reintroduced to Guillain-Barré-Strohl Syndrome.
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http://dx.doi.org/10.3233/JND-200545DOI Listing
January 2020

Special considerations in the assessment of catastrophic brain injury and determination of brain death in patients with SARS-CoV-2.

J Neurol Sci 2020 10 8;417:117087. Epub 2020 Aug 8.

NYU Langone Medical Center, Department of Neurology, New York, NY 10016, United States of America; NYU Langone Medical Center, Department of Neurosurgery, New York, NY 10016, United States of America.

Introduction: The coronavirus disease 2019 (Covid-19) pandemic has led to challenges in provision of care, clinical assessment and communication with families. The unique considerations associated with evaluation of catastrophic brain injury and death by neurologic criteria in patients with Covid-19 infection have not been examined.

Methods: We describe the evaluation of six patients hospitalized at a health network in New York City in April 2020 who had Covid-19, were comatose and had absent brainstem reflexes.

Results: Four males and two females with a median age of 58.5 (IQR 47-68) were evaluated for catastrophic brain injury due to stroke and/or global anoxic injury at a median of 14 days (IQR 13-18) after admission for acute respiratory failure due to Covid-19. All patients had hypotension requiring vasopressors and had been treated with sedative/narcotic drips for ventilator dyssynchrony. Among these patients, 5 had received paralytics. Apnea testing was performed for 1 patient due to the decision to withdraw treatment (n = 2), concern for inability to tolerate testing (n = 2) and observation of spontaneous respirations (n = 1). The apnea test was aborted due to hypoxia and hypotension. After ancillary testing, death was declared in three patients based on neurologic criteria and in three patients based on cardiopulmonary criteria (after withdrawal of support (n = 2) or cardiopulmonary arrest (n = 1)). A family member was able to visit 5/6 patients prior to cardiopulmonary arrest/discontinuation of organ support.

Conclusion: It is feasible to evaluate patients with catastrophic brain injury and declare brain death despite the Covid-19 pandemic, but this requires unique considerations.
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http://dx.doi.org/10.1016/j.jns.2020.117087DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7414304PMC
October 2020

Trends in Pediatric Malpractice Claims 1987-2015: Results From the Periodic Survey of Fellows.

Pediatrics 2020 04 25;145(4). Epub 2020 Mar 25.

Department of General Pediatrics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.

Background: Pediatricians are less frequently sued than other physicians. When suits are successful, however, the average payout is higher. Little is known about changes in the risk of litigation over time. We sought to characterize malpractice lawsuit trends for pediatricians over time.

Methods: The Periodic Survey is a national random sample survey of American Academy of Pediatrics members. Seven surveys between 1987 and 2015 asked questions regarding malpractice ( = 5731). Bivariate and multivariable analyses examined trends and factors associated with risk and outcome of malpractice claims and lawsuits. Descriptive analyses examined potential change in indemnity amount over time.

Results: In 2015, 21% of pediatricians reported ever having been the subject of any claim or lawsuit, down from a peak of 33% in 1990. Report of successful outcomes in the most-recent suit trended upward between 1987 and 2015, greatest in 2015 at 58%. Median indemnity was unchanged, averaging $128 000 in 2018 dollars. In multivariate analysis, male sex, hospital-based subspecialty (neonatology, pediatric critical care, pediatric emergency medicine, and hospital medicine), longer career, and more work hours were associated with a greater risk of malpractice claim.

Conclusions: From 1987 to 2015, the proportion of pediatricians sued has decreased and median indemnity has remained unchanged. Male pediatricians and hospital-based subspecialists were more likely to have been sued. Greater knowledge of the epidemiology of malpractice claims against pediatricians is valuable because it can impact practice arrangements, advise risk-management decisions, influence quality and safety projects, and provide data to guide advocacy for appropriate tort reform and future research.
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http://dx.doi.org/10.1542/peds.2019-0711DOI Listing
April 2020

Bundled Consent Raises Questions of Legal Validity in Addition to Ethical Concerns.

Crit Care Med 2020 03;48(3):e261-e262

University of Rochester School of Medicine and Dentistry, Rochester, NY Case Western Reserve University School of Medicine/Rainbow Babies & Children's Hospital, Cleveland, OH.

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http://dx.doi.org/10.1097/CCM.0000000000004134DOI Listing
March 2020

Dealing With the Caretaker Whose Judgment Is Impaired by Alcohol or Drugs: Legal and Ethical Considerations.

Pediatrics 2019 12;144(6)

Heritage Valley Pediatrics, Beaver, Pennsylvania.

An estimated 8.7 million children live in a household with a substance-using parent or guardian. Substance-using caretakers may have impaired judgment that can negatively affect their child's well-being, including his or her ability to receive appropriate medical care. Although the physician-patient relationship exists between the pediatrician and the child, obligations related to safety and confidentiality should be considered as well. In managing encounters with impaired caretakers who may become disruptive or dangerous, pediatricians should be aware of their responsibilities before acting. In addition to fulfilling the duty involved with an established physician-patient relationship, the pediatrician should take reasonable care to safeguard patient confidentiality; protect the safety of their patient, other patients in the facility, visitors, and employees; and comply with reporting mandates. This clinical report identifies and discusses the legal and ethical concepts related to these circumstances. The report offers implementation suggestions when establishing anticipatory procedures and training programs for staff in such situations to maximize the patient's well-being and safety and minimize the liability of the pediatrician.
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http://dx.doi.org/10.1542/peds.2019-3153DOI Listing
December 2019

Aminophylline infusion for status asthmaticus in the pediatric critical care unit setting is independently associated with increased length of stay and time for symptom improvement.

Pulm Pharmacol Ther 2014 Feb 19;27(1):57-61. Epub 2013 Mar 19.

Vanderbilt University School of Medicine, Department of, Pediatrics, Division of Emergency Medicine, USA; Center for Asthma & Environmental Sciences Research, USA. Electronic address:

Introduction: The role of aminophylline in the treatment of severe acute asthma in the pediatric critical care unit (PCCU) is not clear. We sought to examine the association of aminophylline treatment with PCCU length of stay and time to symptom improvement.

Material And Methods: Patients with severe acute asthma who were admitted to our PCCU and received aminophylline infusion were retrospectively compared with similar patients who did not receive aminophylline. The primary outcome measure was functional length of stay (i.e. time to which patients could be transferred to a general pediatric ward bed). A secondary outcome was time to symptom improvement.

Results: Adjusted functional length of stay was longer for subjects who received aminophylline (n = 49) than for the patients who did not (n = 47) (hazard ratio 0.396, p < 0.001), as well as the time for symptom improvement (hazard ratio 0.359, p < 0.001). In the group of subjects receiving aminophylline, those with a serum theophylline level ≥ 10 mcg/ml (therapeutic) (n = 31) had longer functional length of stay (hazard ratio 0.457, p = 0.0225) and time to symptom improvement (hazard ratio 0.403, p = 0.0085) than those with levels < 10 mcg/ml (sub-therapeutic) (n = 18).

Conclusions: The addition of aminophylline to therapy with corticosteroids and inhaled β-agonists was associated with statistically and clinically significant increases in functional length of stay and time to symptom improvement in the PCCU. This potential morbidity supports the National Asthma Education and Prevention Program guideline proscribing aminophylline use in acute asthma.
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http://dx.doi.org/10.1016/j.pupt.2013.03.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3732550PMC
February 2014

The birthday party.

Authors:
Steven A Bondi

JAMA Pediatr 2013 Jan;167(1)

Division of Critical Care, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee 37232, USA.

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http://dx.doi.org/10.1001/jamapediatrics.2013.440DOI Listing
January 2013

Contemporary aminophylline use for status asthmaticus in pediatric ICUs.

Chest 2012 Apr;141(4):1122-1123

Division of Emergency Medicine, Vanderbilt University School of Medicine, Nashville, TN; Center for Asthma and Environmental Sciences Research, Nashville, TN.

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http://dx.doi.org/10.1378/chest.11-2873DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3318953PMC
April 2012

Neonatal euthanasia?

Pediatrics 2006 Mar;117(3):983; author reply 983-4

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http://dx.doi.org/10.1542/peds.2005-2515DOI Listing
March 2006

Clinical inquiries. Does cranberry juice prevent or treat urinary tract infection?

J Fam Pract 2003 Feb;52(2):154-5

Wayne State University Medical School, Dearborn, MI USA.

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February 2003