NYC Health + Hospitals/Metropolitan Holds Annual Resident Research Day

Sonja Jauhal, M.D., emergency medicine resident, presented research findings from the Healthy East Harlem Initiative; George Ide, M.D., psychiatry resident, presented on a comparison of readmission rates of patients admitted to inpatient psychiatric units treated with first-generation versus second-generation long-acting antipsychotics; and internal medicine resident Monil Majmundar, M.D., presented on a retrospective cohort study on the absolute lymphocyte count as a predictor of mortality and readmission in heart failure hospitalization.

“Despite the challenges this year, it is an indication of the priority and importance of research during residency training that this event continues to be held at Metropolitan,” said Richard McCarrick, M.D., M.H.A., vice dean for graduate medical education and continuing medical education in the SOM and vice chancellor for college student services at New York Medical College (NYMC). “It's been said that research is both a means to an end and an end in itself. There are many barriers to resident participation in research, but those we have heard from today and all of the residents who submitted abstracts certainly have an added element of commitment discipline, energy, ambition and intellectual curiosity to have completed the projects that they did while they were residents. And this is an achievement that we're all very proud of.”

The relationship between Metropolitan and NYMC, which dates back to 1875, is particularly notable as the longest partnership between a public hospital and a private medical college in the history of the United States. The residency programs at Metropolitan are also unique in that they are directly sponsored by the NYMC SOM.

“For the past 146 years, our shared faculty, shared residents and our shared students have cared for patients and learned medicine together,” said Edward C. Halperin, M.D., chancellor and chief executive officer of NYMC. “At Metropolitan, we have a proud history, a great present and an exciting future ahead of us. All of us at the College are pleased to be your partner in this journey.”

The event concluded with the awards presentation with the Healthy East Harlem Initiative receiving a first-place award; the retrospective cohort study on the absolute lymphocyte count as a predictor of mortality and readmission in heart failure hospitalization winning second place, and the comparison of readmission rates of patients admitted to inpatient psychiatric units treated with first-generation versus second-generation long-acting antipsychotics placing third. 

First Place

Healthy East Harlem Initiative

Sonja Jauhal, M.D.

Other Authors:

Jaspreet Singh, M.D.

Jennifer Pusztay, M.D.

Mentor:

Samrina Kahlon, M.D., M.P.H., clinical associate professor of emergency medicine

In East Harlem, where Metropolitan plays a major role in providing medical care, obesity rates reach up to 35% of the served population. The main objective of this initiative was to implement an easier access to fruits and vegetables via farmer market vouchers for our obese patients and measure its effects. This study was done at Metropolitan Hospital from August 9, 2019 to January 31, 2020 with patients recruited from the emergency department, diabetes clinic, and pediatric clinic.

Results from the initiative showed increased fruits and vegetables access and consumption can result in a lowering of risk factors in obesity related disease. Both adult and pediatric demographics survey results showed a lower in average weight, waist circumference, BMI, systolic blood pressure and diastolic blood pressure, in comparison to the beginning of the program. Furthermore, adult patients also had a reduction in their HbA1c compared to the beginning of the program.

Second Place

Absolute Lymphocyte Count as a Predictor of Mortality and Readmission in Heart Failure Hospitalization – Retrospective Cohort Study of 1,029 Patients from the Department of Internal Medicine

Monil Majmundar, M.D.

Other Authors:

Tikal Kansara, M.D.

Hansang Park, M.D.

Gabriel Ibarra, M.D.

Joanna Marta Lenik, M.D.

Palak Shah, M.D.

Ferdinand Visco, M.D.

Mentor:

Shobhana Chaudhari, M.D., professor of medicine

Heart failure is a significant cause of morbidity and mortality. There is renewed interest in pursuing frugal and readily available laboratory markers to predict mortality and readmission in heart failure. Hematological indices have been associated with clinical outcomes in hospitalized heart failure patients. Data were collected from January 2005 to December 2018. Patients discharged with a primary diagnosis of heart failure without previous heart failure hospitalization were included in the study.

Hospitalized heart failure and HFrEF subgroups with ALC ≤1500 cells/mm3 on admission had a higher risk of mortality, all-cause readmission (30-day, 6 months), cardiac readmission (6 months) and a composite of death or readmission (6 months). Patients in lower groups of ALC category had a higher risk of mortality.

Third Place

A Comparison of 30-Day Readmission Rates in the Past Year of Patients Admitted to Inpatient Psychiatric Units Treated with First Generation Vs Second Generation Long-Acting Antipsychotics

George Ide, M.D.

Other Authors:

Valentino Vasy, M.D.

Mentors:

Ronnie G. Swift, M.D., professor of clinical psychiatry and behavioral sciences

Richard J. Gersh, M.D., assistant professor of psychiatry and behavioral sciences

Bechoy Abdelmalak, M.D.

Long-acting injectable (LAI) antipsychotics (APs) have proved effective in schizophrenia and other severe psychotic disorders because they assure stable blood levels, leading to a reduction of the risk of relapse. As a result of this well-known benefit of LAIs all patients admitted to Metropolitan inpatient psychiatric units with either a diagnosis of schizophrenia or schizoaffective disorder have been offered LAI formulations (when eligible) to be given during admission. This study aims to further explore this data as a retrospective cohort study and compare the relapse rates of first-generation LAIs versus second-generation LAIs given before discharge.

It would be suspected that risperidone, which is given biweekly, would have a greater rate of relapse due to patients not following up with their subsequent injections. However, the outcome was the opposite as expected and risperidone demonstrated a 0.22 decrease in relative risk when compared to first-generation APs given monthly. In conclusion, patients who are currently treated with the first-generation LAIs may benefit from switching to second-generation.