SHM Converge Scientific Abstract ePoster Gallery-A Hospitalist-Run Procedure Service Safely Streamlines Inpatient Intrathecal Chemotherapy

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This retrospective cohort study evaluated whether a hospitalist-run medical procedure service (MPS) could safely perform inpatient intrathecal (IT) chemotherapy faster than radiology referrals. The study included all hospitalized patients who received IT chemotherapy at an academic hospital from August 2019 to November 2022.<br /><br />The researchers compared MPS and radiology-guided lumbar punctures using several outcomes: traumatic taps (defined as CSF red blood cells ≥500 cells/mm³), review for possible radiologic complications within 7 days, time to procedure, and number of platelet transfusions. Because many patients had thrombocytopenia, the analysis adjusted for platelet count.<br /><br />Results showed that MPS performed IT chemotherapy safely, with complication rates similar to radiology-guided procedures. The significant complication rate was low in both groups (about 1.3% for MPS vs 1.6% for radiology). After adjustment, MPS had fewer traumatic taps and shorter wait times to procedure, despite patients in the MPS group having lower platelet counts overall. Patients with platelet counts between 20,000 and 50,000 did not appear to have a higher risk of traumatic tap.<br /><br />Importantly, MPS did not require more platelet transfusions than radiology. The findings suggest that a bedside hospitalist-led procedure service can expedite care for patients needing IT chemotherapy, potentially reducing hospital length of stay and easing workload on radiology services.<br /><br />The authors conclude that MPS is a safe and efficient alternative for inpatient IT chemotherapy, and they recommend further research on cost impact and the optimal platelet threshold for lumbar puncture in hematologic malignancy patients.

Asset Subtitle

Ghadi Ghanem

Meta Tag

Author List Alexandra M. Glaeser, Allyson Malone, Gary Feigenbaum, Ghadi Ghanem, Lillian Chen

Category Research

Concept Hospitalist-Run Medical Procedure Services

Concept Intrathecal Chemotherapy

Concept Lumbar Puncture

Concept Radiology-Guided Procedure

Concept Safety Profile

Distinguished Non-Finalist

Presenter Organization Univeristy of California Los Angeles, Department of Medicine

Presenting Author Ghadi Ghanem

Track Outcomes Research

Keywords

intrathecal chemotherapy

hospitalist-run procedure service

medical procedure service

lumbar puncture

radiology-guided procedure

traumatic tap

thrombocytopenia

platelet transfusion

inpatient care

hematologic malignancy

Hospitalist-Run Medical Procedure Services

Intrathecal Chemotherapy

Lumbar Puncture

Radiology-Guided Procedure

Safety Profile