This study investigates the association between frailty, measured by the modified five-item frailty index (mFI-5), with inpatient mortality and hospital length of stay for geriatric patients with fall-related injuries. Despite falls being major contributors to morbidity and mortality in those over 65, the interaction between frailty and post-fall outcomes remains underexplored. Data for patients aged 65 and above, admitted between 2014-2020 to Rhode Island Hospital's trauma service for fall-related injuries, were extracted from its Trauma Registry. Frailty scores were retrospectively assigned using mFI-5. Logistic- and linear-regression analyses examined the relationship between mFI-5 scores, mortality, and hospital length-of-stay. Among 6,782 patients (mean age: 81.7 ± 8.66 years), higher frailty scores correlated with increased inpatient mortality (OR: 1.259; 95% CI: 1.14-1.39; P<0.000) and longer hospital stays (Coeff.: 0.460; 95% CI: 0.35-0.57, P<0.000). Notably, age showed a negative association with hospital length of stay but no significant association with inpatient mortality.
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JAMA Surg
January 2025
Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Importance: Surgeon stress can influence technical and nontechnical skills, but the consequences for patient outcomes remain unknown.
Objective: To investigate whether surgeon physiological stress, as assessed by sympathovagal balance, is associated with postoperative complications.
Design, Setting, And Participants: This multicenter prospective cohort study included 14 surgical departments involving 7 specialties within 4 university hospitals in Lyon, France.
JAMA
January 2025
Department of Emergency Medicine, Henry Ford Health, Detroit, Michigan.
Importance: The emergency department (ED) offers an opportunity to initiate palliative care for older adults with serious, life-limiting illness.
Objective: To assess the effect of a multicomponent intervention to initiate palliative care in the ED on hospital admission, subsequent health care use, and survival in older adults with serious, life-limiting illness.
Design, Setting, And Participants: Cluster randomized, stepped-wedge, clinical trial including patients aged 66 years or older who visited 1 of 29 EDs across the US between May 1, 2018, and December 31, 2022, had 12 months of prior Medicare enrollment, and a Gagne comorbidity score greater than 6, representing a risk of short-term mortality greater than 30%.
JAMA Netw Open
January 2025
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
Importance: Lung cancer in individuals who have never smoked (INS) is a growing global concern, with a rapidly increasing incidence and proportion among all lung cancer cases. Particularly in East Asia, opportunistic lung cancer screening (LCS) programs targeting INS have gained popularity. However, the sex-specific outcomes and drawbacks of screening INS remain unexplored, with data predominantly focused on women.
View Article and Find Full Text PDFJAMA Netw Open
January 2025
Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada.
Importance: There have been limited evaluations of the patients treated at academic and community hospitals. Understanding differences between academic and community hospitals has relevance for the design of clinical models of care, remuneration for clinical services, and health professional training programs.
Objective: To evaluate differences in complexity and clinical outcomes between patients admitted to general medical wards at academic and community hospitals.
Crit Care Explor
January 2025
All authors: Department of Pharmacy, Brigham and Women's Hospital, Boston, MA.
Importance: Recent studies have found an association between COVID-19 infection and deeper sedation in mechanically ventilated patients, raising concerns about the impact of the COVID-19 pandemic on pain, agitation, and delirium (PAD) management practices overall.
Objectives: This study aimed to assess differences in PAD management in patients without COVID-19 infection in pre- and peri-COVID-19 pandemic timeframes.
Design, Setting, And Participants: This was a single-center, retrospective, pre-/post-cohort analysis of mechanically ventilated adult patients without COVID-19 infection admitted to an ICU in Boston, MA.
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