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Objectives Long-term hospitalized patients have a higher risk of adverse outcomes and mortality rate. These patients often rapidly deteriorate, leading to death. We aim to evaluate end-of-life laboratory values time trends among deceased long-term inpatients. Methods Time-stamped laboratory data for adult inpatients who had died in the hospital were extracted. The data were normalized and time-series analysis was performed. The patients were also clustered based on the laboratory result trends. Results Laboratory results from 257 patients were evaluated. Significant time trends were observed: serum urea nitrogen, aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, and potassium increased while platelets and albumin decreased. Most patients showed significant shifts in at least four major laboratory indices within the last week of life. Conclusions In the last week of life in chronically hospitalized patients, an alteration of the physiologic state of the patient occurs that manifests as subtle changes in metabolite levels compared with the patient's baseline.

We hypothesize that inclusion of pretest modifiers as an index in the reporting of troponin results can improve the diagnostic accuracy of troponin in identifying acute coronary events. The medical records of patients presenting to the emergency department with a clinical suspicion of acute coronary event were reviewed. All patients who had had troponin levels checked were included in …

Neoadjuvant chemoradiation is one of the cornerstones of colorectal adenocarcinoma management. This approach can lead to tumor regression in some patients and has shown to be prognostically beneficial. We report a case of rectal neuroendocrine tumor occurring following chemoradiation of a rectal adenocarcinoma. The patient is a 45-year-old …

Proliferative myositis is a rapidly growing benign intramuscular proliferative lesion that is believed to be incited by muscle trauma; these lesions are managed by either surgical excision or watchful waiting, as they have shown a tendency for spontaneous regression. The patient is a …