Candida auris is an emerging yeast that is frequently resistant to antifungal drugs. C. auris can cause invasive infections associated with high mortality and can colonize patients asymptomatically, which facilitates transmission in health care settings. Since it was first reported in the United States in 2016, C. auris has been identified in multiple states, with increasing numbers of cases reported annually. Monitoring national trends in cases identified through clinical testing and screening for colonization is critical to guide infection prevention and control efforts. 2022-2024. State and jurisdictional health departments voluntarily report clinical and screening C. auris cases to CDC using standardized case definitions of the Council of State and Territorial Epidemiologists. Clinical cases are defined as detection of C. auris from specimens collected for diagnostic purposes; screening cases are defined as detection from colonization screening swabs. Cases were reported to CDC through the Research Electronic Data Capture (REDCap) or Data Collation and Integration for Public Health Event Response (DCIPHER) platforms. Data included patient age and sex, case type, specimen type (for clinical cases), health care facility type, Antimicrobial Resistance Laboratory Network geographic region, and specimen collection date. Analyses were descriptive and limited to cases with specimens collected during 2022-2024. During 2022-2024, a total of 13,507 clinical C. auris cases were reported to CDC, increasing from 2,882 in 2022 to 4,428 in 2023 and 6,197 in 2024, with smaller annual percentage increases over time (53.7% from 2022 to 2023 and 39.9% from 2023 to 2024). Most clinical cases occurred among adults aged ≥45 years (87.8%) and among males (61.0%). The most common specimen types among all clinical cases were urine (31.5%) and blood (30.2%); by year, the proportion of blood as the specimen type was 34.4% in 2022, 30.2% in 2023, and 25.6% in 2024. Most clinical cases were identified through specimens collected in acute care hospitals (76.6%) and long-term acute care hospitals (17.8%).During the same period, a total of 27,853 screening cases were reported to CDC, increasing from 6,226 in 2022 to 9,195 in 2023 and 12,432 in 2024. Screening cases most frequently occurred among adults aged ≥45 years (90.0%) and males (57.9%). Among cases with known facility type, the proportion of specimens collected in acute care hospitals increased from 24.7% in 2022 to 50.7% in 2024, whereas the proportion of specimens collected in long-term acute care hospitals decreased from 56.1% to 35.7% during the same period. The number of clinical and screening C. auris cases reported to CDC increased during 2022-2024, indicating ongoing transmission in U.S. health care settings. Although annual percentage increases in clinical cases declined over time, absolute case counts reported to CDC continued to rise. The increasing proportion of screening cases with specimens collected in acute care hospitals might reflect increased use of screening in acute care hospitals, including screening at admission. Because of increases in the number of reported C. auris cases, sustained infection prevention and control efforts in health care facilities, including adherence to transmission-based precautions, environmental disinfection with agents effective against C. auris, and communication of C. auris status during patient transfers remain essential to preventing clinical infections and colonization. Because this pathogen is frequently resistant to antifungal drugs, continued investment in laboratory capacity and surveillance, including antifungal susceptibility testing and screening of patients at high risk for C. auris infection, can support timely detection and guide prevention strategies. Ongoing public health coordination at federal, state, and local levels is critical to limit further spread and to address emerging antifungal drug resistance.

Recent studies have focused on oral frailty and hypofunction, and their relationship with swallowing function and dysphagia. These play especially important roles in patients with dysphagia in medical-dental cooperation at acute hospitals. This study aimed to assess oral frailty, in terms of nutritional intake by evaluating oral and swallowing functions simultaneously, in patients consulting at an acute hospital. This cross-sectional study was conducted at the Center for Dysphagia of Tohoku University Hospital and involved a comprehensive survey of 183 patients. Their oral function and oral status were evaluated, which included factors such as poor oral hygiene, oral dryness, tongue-lip motor function, tongue pressure, and masticatory performance. Additionally, swallowing status was evaluated using various methods, including a questionnaire related to swallowing, Hyodo-Komagane score, modified water-swallowing, and repetitive saliva swallowing tests. This thorough approach ensured the validity and reliability of our findings. Approximately 60% of patients had head and neck tumours, degenerative diseases, and muscular diseases. Therefore, a high prevalence of oral hypofunction was observed. Furthermore, since 41.5% of patients had limited tongue movement, a characteristic correlation existed between the oral diadochokinesis and Hyodo-Komagane score. These results suggest that oral dryness score, oral diadochokinesis, and tongue pressure are associated with oral hypofunction and dysphagia. Additionally, patients with hypofunction and decreased tongue pressure may have hypopharyngeal residuals. The medical-dental cooperation in an acute hospital allows for the simultaneous assessment of oral and swallowing functions. This suggests a potential to contribute to the practice of safe oral intake and appropriate rehabilitation.

Nursing dying people in an acute hospital: A focused ethnography.

BackgroundPredicting post-stroke cognitive impairment (PSCI) remains challenging.ObjectiveThis study validated two brain age metrics-Gray Matter Brain Age (GMBA) and Predicted Age Difference (PAD)-as independent predictors of 12-month cognitive decline following ischemic stroke.MethodsWe analyzed 39 patients with ischemic stroke. Brain age was estimated using a machine learning model trained on healthy controls (n = 362). Baseline assessments, including demographics, clinical severity, and thick-sliced (7 mm) 2D T1- and T2-weighted MRI, were performed during acute hospitalization (median 5 days post-stroke). Change in Clinical Dementia Rating-Sum of Boxes (ΔCDR-SB) was measured between baseline and 12 months. Multiple linear regression (MLR) and receiver operating characteristic (ROC) analysis identified predictors of ΔCDR-SB.ResultsMLR identified two significant models. In Model 1, PAD (β = 0.109, p = 0.035) and chronological age (β = 0.082, p = 0.038) were independent predictors (Adjusted R2 = 0.183). In Model 2, GMBA emerged as the sole robust predictor (β = 0.092, p = 0.002; Adjusted R2 = 0.201). ROC analysis showed GMBA possessed the highest discriminative ability (AUC = 0.717, p = 0.026), followed by PAD (AUC = 0.691, p = 0.050), while chronological age was not significant (AUC = 0.629, p = 0.188).ConclusionsBoth GMBA and PAD are independent predictors of PSCI. Notably, these metrics maintained high predictive utility even when derived from real-world, thick-sliced MRI protocols. Integrating brain age estimation into routine clinical workflows can potentially facilitate early identification of patients at high risk for PSCI.

To identify and synthesise existing evidence on family-centred care for Lesbian, Gay, Bisexual, Transgender, Queer and other diverse identities (LGBTQ+) people in acute hospital settings, including hospital-based palliative care, oncology, general in-patient and intensive care. A scoping review guided by the JBI methodology. Nine databases and grey literature sources were searched. Inclusion criteria focused on LGBTQ+ adults and family-related care experiences in hospital-based acute settings. After screening, qualitative, quantitative, and narrative data were extracted. Thematic analysis synthesised findings, with quantitative data narratively integrated. Searches were conducted across nine databases and grey literature up to April 2025. Five studies met inclusion criteria: three qualitative, one quantitative, and one reflective narrative. Four themes emerged: (1) invisibility and disclosure dilemmas, (2) exclusion of chosen families from visiting and decision-making, (3) barriers to inclusive communication and provider competence, and (4) enabling conditions for affirming care. Challenges occurred at interpersonal (e.g., provider assumptions, discomfort) and structural (e.g., lack of inclusive protocols, failure to recognise legal surrogates) levels. In the two studies reporting gender identity, transgender participants described heightened misrecognition and exclusion. LGBTQ+ individuals and their chosen families face relational and structural barriers in acute hospital care. Inclusive interventions, protocols, and training are urgently needed to ensure affirming care. Acute and intensive care providers should promote inclusive family engagement by using patient-preferred terminology, recognising chosen families, and advocating for inclusive policies and staff training. This scoping review adhered to PRISMA-ScR guidelines. No Patient or Public Contribution. Registered with the Open Science Framework: 10.17605/OSF.IO/FSU8D (23/02/2025).

The Gaylord Occupational Therapy Cognitive screen (GOT-Cog™) is a novel cognitive screening tool developed to support inpatient occupational therapy treatment planning. It has demonstrated excellent content, construct, and criterion validity, as well as good internal consistency. To assess GOT-Cog rater reliability and responsiveness. Repeated-measures design. GOT-Cog was administered to participants twice at admission and once at discharge. When different investigators collected the first two assessments, interrater reliability was tested; when collected by the same investigator, intrarater reliability was tested. The first and final GOT-Cog scores were used to assess responsiveness. Single long-term acute care hospital (LTACH). 192 participants, recruited from inpatients admitted with an order for occupational therapy services. GOT-Cog total score was the primary outcome measure. Rater reliability was evaluated using interclass correlation coefficients (ICCs); responsiveness was calculated using effect size and score change. Scale-level interrater reliability of GOT-Cog was moderate to good, ICC(2, 1) = .80 (95% confidence interval [CI] [.71, .87], r = .81, n = 87); intrarater reliability was good to excellent, ICC(2, 1) = .84 (95% CI [.76, .90], r = .86, n = 89). Domain-level rater reliability ranged from poor to excellent. A small effect size was demonstrated from admission to discharge (d = .37, n = 149) over a mean length of stay of 24.06 d (95% CI [20.70, 27.41]; n = 192). Previous findings are supported, which indicates that GOT-Cog has the validity and reliability needed to support its use in the LTACH setting with a mixed medically complex inpatient population. Plain-Language Summary: Conducted in the long-term care setting, this study explains how consistent the Gaylord Occupational Therapy Cognitive screen (GOT-Cog™) is when given to the same person, multiple times, and by the same or different people, as well as how sensitive it is to change over time. To test this, GOT-Cog was given to participants twice at inpatient admission and once at discharge. GOT-Cog was found to have moderate to good consistency when delivered by different people and good to excellent consistency when used by the same person. Over an average of 24 days, GOT-Cog showed a small level of change in participants who were tested admission and again at discharge.

Normothermic machine perfusion (NMP) has improved liver preservation, but cradle compression (CC)-a pressure-related graft injury during perfusion-remains poorly characterized. This study evaluated the incidence, risk factors, and clinical impacts of CC after NMP. Among 145 liver transplants with NMP, 78 recipients underwent postoperative abdominal computed tomography within 30 d and were analyzed. CC was classified radiologically into grades 1-3. Postoperative outcomes, complications, and graft survival were compared by CC severity, and logistic regression was used to identify risk factors. CC was identified in 27 patients (34.6%): grade 1 (n = 6), grade 2 (n = 12), and grade 3 (n = 9). Patients with CC had significantly higher peak alanine aminotransferase within 7 d (2059 ± 188 versus 336 ± 83 U/L; P < 0.001), higher bilirubin and international normalized ratio at day 7, and more frequent early allograft dysfunction (61% versus 13%; P < 0.001), particularly in grade 3 CC (89%). Grade 3 CC was also associated with prolonged vasopressor use (78.4 ± 15.9 versus 10.3 ± 7.0 h; P < 0.001), longer ventilation ( P = 0.008), severe acute kidney injury (60%, all stage 3; P = 0.030), extended ICU and hospital stays ( P < 0.05), and higher Comprehensive Complication Index at discharge (50.9 ± 9.6 versus 29.1 ± 4.3; P = 0.041). Liver-related graft survival decreased with CC severity ( P = 0.036), with the poorest outcomes in grade 3. Donor age >48 y and graft weight >1900 g were independent risk factors. Although limited to recipients who underwent postoperative computed tomography, CC was strongly associated with adverse outcomes, especially in grade 3 cases. Donor age and graft weight were the risk factors.

Millions of individuals sustain traumatic injuries each year, yet the emotional impact of hospitalization and acute medical care remains understudied. Trauma-informed care (TIC) offers a framework for reducing retraumatization and supporting both patients and providers, but little is known about how TIC is understood or applied in trauma centers. This qualitative study used a human-centered design approach to examine healthcare workers' experiences, perceptions, and training needs related to TIC within a Level 1 trauma center to inform development of a training on TIC. This study employed a qualitative approach guided by principles of Human-Centered Design (HCD) to explore healthcare workers' perceptions, experiences, and training needs related to trauma-informed care (TIC) within a high-acuity trauma setting. Healthcare workers, including nursing assistants, registered nurses, physical therapists, advanced practice providers, and physicians were included as key informants in defining the relevance, challenges, and applicability of trauma-informed practice at the trauma center. Participants were recruited from the Trauma and Acute Care Division and hospital unit serving predominantly traumatically injured patients. Using thematic reflexive analysis, semi-structured interviews (range: 10-25min) with 20 multidisciplinary staff revealed three overarching themes: the emotional toll and burnout associated with trauma work; TIC-aligned practices (including empathetic communication and perspective taking); and training needs including format and content and skills needed to deliver TIC effectively. Participants emphasized the need for practical, hands-on training tailored to the realities of trauma care. Trauma-informed approaches have the potential to improve patient recovery, reduce psychological distress, and lessen strain on healthcare systems. Study findings can inform broader behavioral medicine practices by guiding the development of scalable TIC interventions that meet providers' identified needs which are adaptable to trauma centers, emergency care, and other high-acuity medical settings to enhance patient-centered care.

Acute post-streptococcal glomerulonephritis (APSGN) is one of the most critical health conditions. It remains an important cause of acute kidney injury, hospitalization, and long-term complications for children. Thus, this study aimed to assess the treatment outcome of APSGN and its predictors among pediatric patients at Comprehensive Specialized Hospitals in Northwest Ethiopia. An institutional retrospective cohort study was conducted on pediatric patients, reviewing medical records from admission to treatment outcome between September 01, 2018, and August 30, 2024. The collected data were entered using the Epi Data software (version 4.6.0.0) and exported to SPSS version 25.0. Adjusted odds ratio (AOR) with a corresponding 95% confidence interval (CI) and p value < 0.05 were used to identify significant factors affecting the treatment outcome. Most patients with acute post-streptococcal glomerulonephritis demonstrated positive treatment outcomes, with 70.2% recovering completely. The majority of patients arrived at the hospital more than 2 weeks after infection, with 70.8% hospitalized for over 2 weeks. Children aged 5-9 years faced significantly higher odds of negative outcomes (AOR = 2.61, 95% CI: 1.34-5.10, p = 0.006), while those aged 10-15 years did not show a significant association. Acute kidney injury (AOR = 1.70, 95% CI: 1.08-2.93, p = 0.032) and an infection duration over 2 weeks (AOR = 2.14, 95% CI: 1.06-4.32, p = 0.024) were linked to worse outcomes. Additionally, an evident source of infection was associated with negative outcomes (AOR = 2.13, 95% CI: 1.25-5.13). The majority of patients with acute post-streptococcal glomerulonephritis recovered completely. Significant predictors of negative treatment outcomes included age, the evident source of infection, the duration of infection at admission, and the presence of acute kidney infection at admission. There should be a focus on treatment outcomes through thorough evaluation, follow-up, and monitoring.

To assess the interrater reliability, concurrent validity, and responsiveness of the Children's Eating and Drinking Activity Scale (CEDAS). Interrater reliability was assessed using an online questionnaire completed by speech and language therapists working in hospital and community settings. Participants (n=39) applied CEDAS to 12 vignettes. Interrater reliability was calculated using Krippendorff's alpha (α). Additionally, CEDAS was applied retrospectively to consecutive speech and language therapy referrals at a single hospital (n=85, median age 11 years 2 months, range 1 week-17 years 1 month). Responsiveness was assessed by comparing median CEDAS scores at referral, after initial speech and language therapy assessment, and at discharge. The Functional Status Scale (FSS) feeding domain was used to evaluate concurrent validity. Interrater reliability was excellent (Krippendorff's α=0.927). CEDAS was responsive to change, with expected score increases seen between referral and discharge (Z=-4.37, p < 0.001), and initial assessment and discharge (Z=-3.23, p < 0.001). Strong concurrent validity was established with the FSS (rs=-0.77 to -0.99, p < 0.003). CEDAS demonstrates excellent interrater reliability across clinical settings. It is a responsive tool with established construct validity when used in an acute hospital setting.

Hip fractures are a major global health issue with high mortality and morbidity, especially in older adults. One-year mortality post-surgery ranges from 22% to 36%, with many patients never regaining baseline mobility. While several predictors of mortality have been identified, their relative contribution to mortality risk within a unified survival prediction framework remains unclear. This study used machine learning to rank key perioperative predictors of mortality following hip fracture surgery. Over 11,000 patients from the Australian and New Zealand Hip Fracture Registry were analyzed. Twenty demographic, clinical, and perioperative variables were assessed using a Random Survival Forest (RSF) model. Model performance was evaluated using the concordance index and Brier scores. Permutation-based feature importance ranked predictors according to their contribution to predictive performance for mortality risk. During the follow-up period (median 630 days), 31% of patients died. The RSF model performed well (test C index: 0.7305). The four most important predictors of mortality were American Society of Anesthesiologists (ASA) grade (importance score: 0.051), pre-existing dementia (0.036), age (0.019), and preadmission walking ability (0.016). Other factors like male sex (0.009) and acute hospital stay (0.006) had weaker associations with mortality prediction in this model. Machine learning identified ASA grade, dementia, age, and mobility as the top predictors of mortality after hip fracture surgery. RSF modeling offered strong performance and better interpretability than traditional methods. These findings support individualized stratification to inform perioperative discussions and goals-of-care planning in this high-risk population.

Nurses in German acute care hospitals face high levels of work-related stress, including symptoms of burnout, depression, and anxiety. This study investigates whether engaging leadership is associated with burnout, depressive, and anxiety symptoms among nurses and whether these associations operate through job resources. A cross-sectional online survey was conducted among registered nurses working in acute care hospitals participating in the German branch of Magnet4Europe. Data collection took place between September and December 2023. Engaging leadership was measured with a validated twelve-item scale. Job resources included role clarity, skill use, autonomy, performance feedback and opportunities for development. Burnout symptoms were measured using the Burnout Assessment Tool. Depressive and anxiety symptoms were assessed with the PHQ-2 and GAD-2. The preregistered analysis used complete case analysis and structural equation modelling to test direct and indirect associations. In total, 1,502 nurses from eighteen hospitals were included in the analysis. Engaging leadership was strongly associated with perceived job resources. Job resources were associated with lower burnout, depressive, and anxiety symptoms. Engaging leadership also showed small direct associations with burnout and depressive symptoms, but not with anxiety symptoms. Indirect effects were significant across all three models, suggesting that job resources may be an important mechanism linking engaging leadership to nurses' mental health. Nurses who experience more engaging leadership also report more job resources and fewer symptoms of mental ill-health. These findings suggest that leadership practices which support meaning, competence, connection and autonomy may strengthen resilience and reduce psychological strain among nursing staff in Germany. Leadership development and resource strengthening may therefore represent important strategies for improving nurses' well-being and retention in German hospital settings. Not applicable. This cross-sectional secondary analysis was conducted within the Magnet4Europe project, which is registered in the ISRCTN registry (ISRCTN10196901, registered on 10 April 2020).

This is a protocol for a Cochrane Review (prognosis). The objectives are as follows: To determine whether prognostic models can be used for predicting the occurrence of ICU admission and mortality within the index hospital admission, and post-discharge survival at reported follow-up time points, up to one year, in critically ill adults not yet admitted to the ICU. The objective in PICOTS format is as follows. critically ill adults not yet admitted to the ICU Index prognostic model: available prognostic models with or without external validation Comparator: not applicable Outcomes: ICU admission, ICU and hospital mortality, and post-discharge survival Timing: for ICU admission or transfer, ICU mortality, and hospital mortality outcomes, the timing will be in hospital. For post-discharge survival, the timing will be up to 28 days, 1 to 3 months, 6 months, and 1 year after hospital discharge. acute hospital wards and emergency care departments.

Family carer's experience of a delirium resource (PREDICT) to support care partnerships with healthcare professionals: A qualitative study.

Nursing documentation is a fundamental component of safe clinical practice, supporting effective communication, continuity of care and patient safety. However, the increasing demands associated with electronic health records have contributed to a growing administrative workload for nurses. In response, artificial intelligence (AI) technologies are being explored as tools to support clinical documentation and improve the management of healthcare information. This narrative overview examines emerging evidence on the impact of AI on nursing documentation and patient safety, with particular focus on acute hospital care. The author reviews the literature on key AI technologies, including natural language processing, machine learning, generative AI and ambient AI, and their potential applications in nurses' record-keeping.

Acute hospitalization is a critical stressor that often leads to functional decline in older patients, highlighting the need for simple markers to identify at-risk individuals. Ultrasound is a feasible bedside tool for muscle mass assessment and has been proposed as a marker of physical function, but its prognostic value remains unclear. This study aimed to explore the association between ultrasound-derived muscle thickness (US-MT) and physical performance over time-gait speed (GS) and 30-s sit-to-stand (30s STS)-and selected clinical outcomes. In this prospective cohort study conducted in a geriatric department, adults aged ≥ 65 years with admission-related walking limitations were assessed at admission, discharge, 1 month, and 3 months. US-MT of the vastus lateralis was assessed at admission using ultrasonography. Longitudinal associations between US-MT and GS and 30s STS were examined using mixed-effects models. Associations with length of hospital stay (LOS), 3-month falls incidence, and 3-month mortality were examined using regression models. Among 243 participants, GS and 30s STS increased from admission to follow-up. Greater admission US-MT was modestly associated with faster GS in women (0.037 m/s; 95% CI 0.022-0.051) and with better 30s STS performance across sexes (IRR 1.24; 95% CI 1.00-1.53) across all time points. US-MT was not associated with trajectories of physical performance or with LOS, falls, or mortality. These findings suggest that admission US-MT may provide complementary bedside information on physical performance level, rather than serving as a standalone marker of recovery or clinical prognosis. ClinicalTrials.gov: NCT05798169.

Clinical audits compare clinical practice against defined standards to identify areas for improvement and showcase excellence. International literature provides limited insight into how they are governed and sustained. Using the IHFD, a mature national audit, this paper reviews its development, evolution and sustained momentum from 2013 to 2024. Longitudinal data were captured via the Hospital Inpatient Enquiry (HIPE) system, encompassing all eligible Irish acute hospitals. Included cases were patients aged ≥ 60 years with hip fractures, as defined by IHFD. Three organisational surveys (2016, 2020, 2024) were undertaken to assess hospital resources, care pathways, governance structures and audit supports. In total, 41,304 cases were included in the analysis. National coverage exceeded 90% from 2017. Demographic characteristics remain consistent. Improvements in data quality, adherence to Irish Hip Fracture Standards were observed, including geriatrician assessment (11% in 2013 to 86% in 2024) and bone health assessment (65% in 2013 to 90% in 2024). Service reconfigurations and resourcing to support hip fracture care occurred over this period. Engagement with the audit remained robust despite major challenges including COVID-19, a national cyberattack and ongoing health system reform. Sustained success of a national hip fracture clinical audit requires strong leadership, effective governance, clear clinical standards, accessible data and timely reporting. Continued relevance requires agility and alignment with evolving system needs.

Pulmonary artery catheters are used widely in cardiac surgery despite conflicting associations with patient outcomes. We evaluated the associations between pulmonary artery catheter use and clinical outcomes following cardiac surgery using a large cohort of patients treated at a US academic center. We performed a retrospective entropy-balanced cohort study of consecutive adults undergoing cardiac surgery from a single tertiary center in Boston, Massachusetts, from 2008 to 2022. We used entropy balancing to achieve exact covariate balance on prespecified baseline characteristics and then estimated the average treatment effect of pulmonary artery catheter use on clinical and mechanistic outcomes. The primary outcome was mortality measured 90 days after surgery. Secondary outcomes were acute kidney injury, hospital and intensive care unit (ICU) length of stay, time in postoperative organ dysfunction measured at 7 days, prolonged inotrope use (>4 hours), significant peak vasopressor requirement (>0.1 μg/kg/min in norepinephrine equivalents), net fluid balance at 24 hours, number of fluid boluses administered, volume of allogeneic red blood cells transfused, and total duration of mechanical ventilation. We included 10,044 patients, of whom 5850 (58.2%) were managed with a pulmonary artery catheter. Pulmonary artery catheter use was not associated with 90-day mortality (risk ratio [RR], 0.966; 95% confidence interval [CI], 0.719-1.30; P =.816) nor in-hospital mortality (RR, 0.921; 95% CI, 0.632-1.34; P =.670). There was no between-group difference in hospital length of stay (median difference [MD], 0.050 days; 95% CI, 0.0477-0.148; P =.269), but patients managed with a pulmonary artery catheter had greater ICU length of stay (MD = 13.1 hours; 95% CI, 9.74-16.4; P <.001). Pulmonary artery catheters were also associated with increased incidence of acute kidney injury (RR, 1.12; 95% CI, 1.07-1.17; P <.001). Patients who received a pulmonary artery catheter were more likely to have prolonged inotrope requirements (RR, 4.13; 95% CI, 3.42-4.98; P <.001), significant vasopressor requirements (RR, 1.37; 95% CI, 1.28-1.46; P <.001), higher positive fluid balances (MD, 566 mL; 95% CI, 453-678; P <.001), higher volumes of allogeneic RBCs transfused (MD, 226 mL; 95% CI, 183-269; P <.001), higher time in postoperative organ dysfunction (MD, 3.96 hours; 95% CI, 3.01-4.90; P <.001), and longer durations of mechanical ventilation (MD, 11.3 hours; 95% CI, 7.33-15.2; P <.001). In a large entropy-balanced cohort study of adults undergoing cardiac surgery, pulmonary artery catheter use was not associated with mortality, but was linked with a higher treatment intensity and longer ICU stay.

A novel face scale and National Early Warning Score 2 prediction model to assess deteriorating patients in hospital wards: A quick visual early warning score study.

Anterior cruciate ligament (ACL) injuries are the most common knee ligament injuries and ACL reconstruction (ACLR) is often required to restore stability and facilitate return-to-sport. However, kinesiophobia-fear of movement due to risk of reinjury-is prevalent post-ACLR (62% to 78%) and linked to poor return-to-sport outcomes despite good physical recovery. Patient, injury, surgery, and rehabilitation factors can be associated with elevated kinesiophobia in patients undergoing primary ACLR. Retrospective cohort study. Level 3. A retrospective review was conducted using data from a tertiary acute hospital's ACL registry between June 1, 2019 and June 1, 2023. Included were patients aged 18 years to 60 years undergoing primary ACLR. Exclusions were revision ACLR, multiligament injuries, and incomplete 1-year dataset. Demographics, injury/surgery/rehabilitation factors and patient-reported outcomes were measured preoperatively, and at 6 months and 1 year. Tampa Scale of Kinesiophobia-17 (TSK-17, with ≥37 indicating elevated kinesiophobia), was recorded preoperatively and 1 year postoperatively. Multivariate regression was used to identify predictors of elevated 1-year kinesiophobia. Data from 200 patients were analyzed (8 excluded due to incomplete data). Baseline TSK-17 was 38.6 ± 5.6, improving to 32.6 ± 7.6 at 1 year (P < 0.001), with 59% showing elevated kinesiophobia at baseline and 29% at 1 year. The average TSK-17 reduction was 6.1 ± 8.6, meeting the minimal clinically important difference (MCID) level. Prehabilitation was attended by 106 patients (55.21%), with a median of 1 session (range 0-10). Elevated 1-year kinesiophobia was associated significantly with higher baseline TSK-17 scores (odds ratio [OR], 2.004; 95% CI, 1.013-3.968; P = 0.05) and inversely associated with attending ≥1 prehabilitation session (OR, 0.513; 95% CI, 0.264-0.997; P = 0.05). Prehabilitation before ACLR should be standard-of-care, to reduce risk of elevated kinesiophobia at 1-year. High baseline kinesiophobia predicts sustained elevated 1-year kinesiophobia, hence assessment (TSK-17 scores) and early intervention targeting kinesiophobia should be included in preoperative ACLR protocols.