BMJ

BackgroundA substantial proportion of patients with acute COVID-19 develop post-acute sequelae of SARS-CoV-2 infection (Long COVID). The risk of adverse cardiovascular and related outcomes in Long COVID remain elusive. We hypothesized that individuals with Long COVID are at elevated risk for adverse cardiovascular, renal and pulmonary (CRP) outcomes compared to those who recovered from COVID-19 without developing Long COVID. MethodsWe performed a retrospective cohort study using the global TriN...

RationalePatients receiving prolonged mechanical ventilation are often discharged to long-term acute care hospitals (LTACHs) with hopes of recovery and ultimately return to the community. Among those who survive and undergo tracheostomy, little is known about their quality of life and social outcomes after LTACH discharge. ObjectiveMeasure health related quality of life in a cohort of critical illness survivors who underwent tracheostomy and an LTACH stay MethodsSingle center, prospective obse...

BackgroundIn-hospital cardiac arrest (IHCA) survival has improved over the past two decades, resulting from better acute resuscitation survival. Post-resuscitation care is a key link in the IHCA chain-of-survival, yet post-resuscitation survival has remained stagnant over time. HypothesisWe hypothesized substantial hospital-to-hospital variation exists in risk-standardized post-resuscitation survival rate (RSSR) and hospital-area social deprivation is associated with worse RSSR. MethodsWe perf...

ImportanceRecent reports have highlighted an intense influenza activity related to the circulation of the influenza A(H3N2) subclade k variant. There is no data available on the impact of the emergence of H3N2 subclade k on the severity of the 2025-2026 epidemic or on the clinical phenotype of patients requiring admission to the intensive care unit (ICU). ObjectiveTo compare the clinical presentation, hospital mortality and virological characteristics of patients with laboratory-confirmed influ...

BackgroundMulti-system impacts of long COVID remain unknown. We compared multi-system deficits between people with long COVID and controls. MethodsA case-control study recruited from the Avon Longitudinal Study of Parents and Children and TwinsUK population cohorts. Cases (141) had long COVID (evidence of COVID-19 infection and persistent symptoms [&ge;]4 weeks post infection); controls (280) included people making a full recovery in <4 weeks, people self-reporting long COVID like symptoms but ...

BackgroundSevere COVID-19 results in substantial economic burden and impacts quality of life. Assessing how non-hospitalized COVID-19 impacts health utilities during acute infection and long term is important to estimate the full economic impact of SARS-CoV-2 infection. MethodsWe analyzed EQ-5D-3L survey data from SARS-CoV-2 infected adults (aged [&ge;]16 years) and children (aged 8-15 years) from three community and household cohorts in the United States (2020-2022). EQ-5D-3L scores were analy...

BackgroundThe role of arterial blood gas (ABG) testing in the intensive care unit (ICU) remains debated within the "less is more" paradigm. While unnecessary testing may pose risks without benefit, timely ABGs provide critical information in unstable patients. Institutional variation in early ABG utilization and its association with outcomes remains unclear. MethodsWe conducted a multicenter retrospective cohort study using the Japanese Intensive Care PAtient Database (JIPAD) between April 2015...

BackgroundGLP-1 receptor agonists (GLP-1RAs) and SGLT2 inhibitors (SGLT2Is) have established cardiovascular benefits for patients with type 2 diabetes mellitus (T2DM), with similar class-level effectiveness found in previous studies. However, real-world comparative effectiveness assessments of individual agents remain limited. ObjectivesTo compare the cardiovascular effectiveness of individual GLP-1RAs and SGLT2Is. MethodsWe conducted a multi-national, retrospective, new-user active-comparator...

BackgroundMedication-related morbidity due to inappropriate prescribing, delays in appropriate treatment, and adverse drug events are major contributors to mortality in acutely hospitalized adults. Comprehensive medication management (CMM) is a standard for medication therapy care provided by pharmacists in collaboration with the interprofessional rounding team. Optimization of CMM via appropriate pharmacist staffing practices may reduce mortality. MethodsAdults admitted to an intensive care un...

Background and objectiveRespiratory Syncytial Virus (RSV) can cause severe illness in adults, leading to respiratory and non-respiratory complications, functional decline, hospitalisation, and death. This study describes French patients aged [&ge;]50 years hospitalised with RSV (2015-2022) and their care pathways, including hospitalisation and outpatient healthcare use and costs. MethodsData were extracted from the French National Health Data System (SNDS). Patients were classified into four ri...

BackgroundRisk stratification tools are essential for guiding care and allocating limited resources in intensive care units (ICUs). Evidence on the performance of the Acute Physiology and Chronic Health Evaluation II (APACHE II) score in Nepal is limited. We evaluated the association of APACHE II measured within 24 hours of ICU admission with mortality, ICU length of stay, and discharge disposition in a tertiary hospital in Nepal. Methods and findingsWe conducted a prospective observational coh...

BackgroundThe Epic End of Life Care Index (EOLCI) predicts one-year mortality and was developed to improve serious illness care. However, prior external EOLCI evaluations had limited sample sizes, populations, and equity evaluations. In preparation for a multi-system pragmatic clinical trial, we sought to evaluate the EOLCI performance and equity in the trials two participating health systems. ObjectiveEvaluate EOLCI model performance overall and across key subgroups. Design/Setting/PatientsRe...

ObjectiveThe objective was to estimate unique patterns of change in fatigue in people with the Post-Covid Syndrome (PCS) over 15 months. Design/SubjectsThe Quebec Action for Post-COVID (QAPC) study was a prospective study designed to provide a patient-centered understanding of symptoms, function, and quality of life in a self-identified Quebec sample. MethodsParticipants were queried every 3 months about symptoms and function. Fatigue was measured with the 10-item Post-COVID Syndrome Fatigue S...

UK-based quantitative research on the health and education outcomes of Unaccompanied Asylum-Seeking Children (UASC) remains limited, especially at national level. Linked administrative data provide an unprecedented opportunity to study these outcomes among UASC. This paper lays a foundation for further research, particularly examining the influence of socio-demographic, legal and environmental factors on UASCs health and educational outcomes. We described the UASC population with a first record...

BackgroundThe self-management of type 2 diabetes (T2D) typically requires enacting various lifestyle changes, which can challenge people living with T2D. Clinical encounters between people with T2D and their clinicians, however, are often focused on metabolic management, leaving less time available for other self-management topics. The QBSAFE cards help patients articulate aspects of their experience with diabetes and prioritize issues for discussion. MethodsThis report details secondary outcom...

IntroductionRecent evidence from randomized controlled trials and meta-analyses in the critically ill suggest small but clinically important differences in death and requirement for renal replacement therapy that favor Ringers lactate as compared to normal saline. To futher contribute to this evidence base, we will perform a secondary analysis of the FLUID trial with a focus on critically ill patients (FLUID - ICU). The FLUID trial was hospital wide cluster randomized cross-over trial that compa...

ObjectiveDespite substantial variability in the severity of post-anoxic encephalopathy, all comatose patients after cardiac arrest are usually treated according to the same standardized intensive care protocol, including sedation, mechanical ventilation, and targeted temperature management (TTM). We hypothesize that patients with a favourable EEG pattern (continuous EEG within 12 hours after cardiac arrest) may not benefit from prolonged sedation and TTM. We studied the feasibility and safety of...

BackgroundPulse oximeters are typically validated on cohorts of 200-500 subjects under controlled conditions. Whether these cohorts capture the demographic heterogeneity of national clinical practice -- and whether measurement error is associated with patient outcomes -- has not been established at scale. MethodsWe analyzed paired SpO2/SaO2 readings from three independent sources spanning 209 U.S. hospitals: MIMIC-IV (1 hospital; 12,934 ICU stays), eICU-CRD (208 hospitals; 55,178 stays), and th...

BackgroundReliable identification of early predictors of adverse outcomes was essential during the pre-vaccination phase of the COVID-19 pandemic. Few studies have comprehensively integrated clinical presentation, laboratory parameters including arterial blood gas analysis, and chest computed tomography (CT) findings within a single well-characterized cohort, particularly in underrepresented regions of Brazil. MethodsThis retrospective cohort study included 482 consecutive adults (median age 61...

ObjectiveTo develop and validate a predictive model incorporating behavioral telemetry signals--documentation pattern anomalies derived from routine EHR charting--alongside clinical variables for ICU mortality prediction in patients with low acute physiologic derangement. Materials and MethodsRetrospective cohort study of 46,002 adult ICU stays from MIMIC-IV v3.1 (2008-2022) with SOFA scores 0-2, excluding neurological units. We extracted 66 variables spanning demographics, acuity, behavioral t...