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Ensuring hospitalized patients' comfort requires understanding differences in comfort and adaptation to discomfort, as well as the role of the built environment therein. Shortcomings in this understanding result from limitations of existing research methods. Therefore the potential of a mixed methods research design to investigate when and why experiences of and adaption to (dis)comfort differ among hospitalized patients was explored. A convergent mixed methods case study was conducted in two hospital wards of a Belgian hospital. Qualitative data included interviews with 19 patients about their experiences and information about the patients at the two wards during the fieldwork; quantitative data included sensor measurements of indoor environmental quality parameters (i.e. illuminance and indoor temperature), a questionnaire among 238 patients about their assessment of the indoor conditions, and simulations of these conditions. Joint displays allowed comparing situations in which characteristics related to the patients or their setting differed in an integrated way. The displays provide an intermediate step between purely qualitative descriptions of comfort and adaptation and purely quantitative models that predict both. Scenarios that the joint displays allow identifying inform about characteristics that could improve these models, and about roles of the built environment in experiences. [ABSTRACT FROM AUTHOR]

Objective To systematically evaluate the incidence of constipation in hospitalized patients with acute myocardial infarction (AMI) in China, and to provide reference for the management of constipation in hospitalized patients with AMI. Methods The CNKI, Wanfang, VIP, China Biomedical Literature Data-base, PubMed, Cochrane Database. Embase and Web of Science were systematically searched, and the retrieval time was from to February 4,2024. Relevant studies on constipation in hospitalized patients with AMI in China were selected, and the standard literature quality was evaluated, and the meta-analysis of the rate was carried out by STATA17.0 software. Results A total of 34 studies were included, including 3 504 hospitalized patients with AMI and 1 134 patients with constipation. According to meta integration, the incidence of constipation in hospitalized patients with AMI in China was 37.4% [95% confidence (95%CI) 0.300-0.450]. Sub-group analysis showed that the highest rate of constipation was 50.6% (95%CI 0.414-0.598) in 2006-2011, and the lowest rate was 28.8% (95%CI 0.169-0.408) in 2017-2021; the incidence of constipation in traditional Chinese medicine hospitals (39.2%.95%CI 0.271-0.514) was higher than that in general hospitals (36.7%,95%CI 0.279-0.456); the incidence of constipation in the hospitalized patients with AMI in the north (42.0%,95%CI 0.313-0.527) was higher than that in the south (35.5%,95%CI 0.266-0.443); The incidence of constipation detected according to the guidelines for diagnosis and treatment of constipation (39.2%,95%CI 0.323-0.461) was higher than that defined by clinical definition (35.9%,95%CI 0.256-0.461). Conclusion The incidence of constipation in hospitalized patients with AMI is high in China. Clinical medical workers can take targeted measures to prevent and manage constipation in patients with AMI in combination with clinical practice. [ABSTRACT FROM AUTHOR]

Background: Cervical cancer (CC) is a serious public health concern, being the fourth most common cancer among women and a leading cause of cancer mortality. In Brazil, many women are diagnosed late, and in Mato Grosso, with its geographical diversity, there are specific challenges. This study analyzed hospital survival and its predictors using data from the Hospital Information System (SIH) of the Unified Health System (SUS) in Mato Grosso from 2011 to 2023. Methods: Cox regression and Kaplan-Meier models were applied to determine survival time and identify mortality predictors. The adjusted Hazard Ratio (AHR) with a 95% Confidence Interval (CI) was used to measure the association between the factors analyzed. Results: The hospital mortality rate was 9.88%. The median duration of hospitalization was 33 days (interquartile range [IQR]: 12–36), with a median survival of 43.7%. Patients were followed up for up to 70 days. In the multivariable Cox model, after adjusting for potential confounders, the risk of death during hospitalization was higher in patients aged 40–59 years (AHR = 1.39, p = 0.027) and 60–74 years (AHR = 1.54, p = 0.007), in the absence of surgical procedures (AHR = 4.48, p < 0.001), in patients with medium service complexity (AHR = 2.40, p = 0.037), and in the use of ICU (AHR = 4.97, p < 0.001). On the other hand, patients with hospital expenses above the median (152.971 USD) showed a reduced risk of death (AHR = 0.21, p < 0.001). Conclusion: This study highlights that hospitalized CC patients have reduced survival, underscoring the need for interventions to improve care, including strategies for early diagnosis and expanded access to adequately resourced health services. [ABSTRACT FROM AUTHOR]

Background: Tumor necrosis factor alpha (TNF-α) produces an inflammatory process and plays a critical role against infection and in the control of viral infection. The present study was conducted to determine the status of serum TNF-α in hospitalized patients with coronavirus disease-2019 (COVID-19). Methods: In this cross-sectional study the serum TNF-α level, sex, and age, were determined in patients with COVID-19. The association between variables was determined using the student t-test, analysis of variance (ANOVA) test, multiple logistic regression analysis, and the statistical package for the Social Sciences (SPSS)- 18 (p < 0.05). Results: A total of 91 (women 41.75%, and men 58.24%) patients with a mean serum TNF-α level of 9.9 picograms per milliliter (pg/mL) were considered. In all (100%) patients, the TNF-α serum level was more than the normal limit (P=0.95). 95.60% of patients suffered severe COVID-19, with a TNF-a serum level of 10.20 pg/mL (P=0.87). Mean TNF-α serum levels in women and men were 11.37 pg/mL and 8.8 pg/mL, respectively (P= 0.17). In the age group of > 70 years (11.30 pg/mL), serum TNF-α concentration was higher than the other age groups (p>0.05). Conclusion: A significant proportion of women and men patients with COVID-19 in the middle and old age had a high concentration of serum TNF-α which may indicate the severity of the disease. Serum TNF-α level is different in women and men of different ages, so it can contribute to treatment strategies. [ABSTRACT FROM AUTHOR]

Background: Studies suggested that COVID-19 virus causes neurological and psychiatric manifestations with different mechanisms. However, prevalence of neurological and psychiatric manifestations among COVID-19 patients varies across studies from 18.1%: 82.3%. The objective of this study was to determine neuropsychiatric manifestations in a sample of Egyptian COVID-19 hospitalized patients during the second wave of the pandemic and to detect factors affecting neurological and psychiatric prevalence. This cross-sectional study was conducted at Ain Shams university isolation hospitals and included 110 hospitalized COVID-19 patients, over a 2-month period from June 2021 to August 2021. Patients underwent a careful history taking, full neurological examination including Mini-Mental State Examination, the Structured Clinical Interview for DSM-IV (SCID I), COVID-19 severity criteria. Any available imaging and laboratory tests were recorded. Results: 83 (75.5%) patients had neurological manifestations. The most common neurological manifestations were headache (50.9%), hypogeusia (24.5%), hyposmia, paresthesia (23.6% each) and coma (15.5%). After exclusion of 17 patients who could not be examined by Mini-Mental State Examination, psychiatric manifestations were seen in 56 patients (61.5%) out of the remaining 91 patients. The most prevalent psychiatric disorders were delirium (30.8%), depression (19%), and adjustment disorder (17.5%). Moreover, hypertension, COVID-19 severity, place of admission, and high levels of LDH and ALT affected neurological manifestations prevalence. Conclusions: COVID-19 infection and its immune reaction along with its social and psychological effects have a great impact on mental and physical health. Hence, neuropsychiatric evaluation cannot be ignored in any case with COVID-19 infection. [ABSTRACT FROM AUTHOR]

Background and purpose: Acinetobacter species have emerged as major causes of nosocomial infections. Acinetobacter baumannii, the most common clinical subspecies, can cause a wide range of nosocomial infections, including pneumonia, bloodstream infections, and wound infections. These infections are often associated with high mortality rates due to the increasing prevalence of drug resistance among these bacteria. The production of β-lactamases is a significant mechanism of resistance to β-lactams. The transcription of these β-lactamase genes is enhanced by various insertion sequences (ISs) located nearby. The insertion sequences most commonly associated with carbapenem genes in multidrug-resistant Acinetobacter baumannii isolates are ISAba1, ISAba2, ISAba3, ISAba4, and IS18. This study aimed to evaluate the drug resistance patterns and molecular detection of ISAba1 and ISAba2 insertion sequences in A. baumannii isolates recovered from hospitalized patients in Sari teaching hospitals. Materials and methods: This study was conducted over six months, from March 2022 to August 2022, in Sari teaching hospitals. Ninety A. baumannii isolates were collected from various clinical specimens of hospitalized patients. To confirm the species of A. baumannii, various phenotypic tests such as TSI, oxidase, MR/VP, OF, urea, citrate, and SIM were employed. The antibiotic susceptibility pattern of the isolates was evaluated using the disk diffusion method according to the CLSI 2021 guidelines. The minimum inhibitory concentration (MIC) of colistin was determined using the micro broth method. To evaluate the presence of ISAba1 and ISAba2 genes, the Polymerase Chain Reaction (PCR) method was performed using specific primers. Data were analyzed using SPSS version 22 software. The chi-square test was used to determine significant differences, with a P-value less than or equal to 0.05 considered statistically significant. Results: The results of this study showed that A. baumannii isolates had a high level of resistance to several antibiotics, including ciprofloxacin, imipenem, doripenem, cefepime, ceftazidime, piperacillin/tazobactam, and piperacillin, with all isolates (100%) being resistant to these antibiotics. However, the highest susceptibility was observed for the antibiotic colistin (98.8%). Additionally, the frequencies of ISAba1 and ISAba2 genes among the isolates were 95.5% and 81.1%, respectively, indicating a high prevalence of these genetic elements among the study isolates. Conclusion: The results of this study indicate a high susceptibility of isolates to the antibiotic colistin, but due to the risk of resistance development and nephrotoxicity, it should be used with caution. The findings suggest that the presence of insertion elements such as ISAba1 and ISAba2 plays a significant role in increasing the expression of drug-resistance genes and their transfer in Acinetobacter baumannii. This can help explain the high prevalence of drug resistance in these bacteria and highlights the importance of detecting and controlling these factors to reduce nosocomial infections. Therefore, identifying and controlling these factors can be an effective step in improving prevention and treatment methods for infections caused by A .baumannii. [ABSTRACT FROM AUTHOR]

Background Population screening for colorectal cancer (CRC) remains low, requiring alternative approaches for increasing participation. Opportunistic screening of hospitalized patients may aid in increasing uptake rates. Objective To assess whether inpatients can be recruited for opportunistic CRC screening using fecal immunochemical testing (FIT). Methods Inpatient charts were prospectively reviewed for study eligibility on admission of patients to the medical wards of 3 hospitals in Winnipeg, Canada. Eligible patients were approached for participation and consent. Inoculated FIT specimen collection tubes were sent to the hospital laboratory for testing. Patients with positive FIT results received a follow-up colonoscopy. Results In total, 1542 inpatient charts were screened for eligibility; 53 patients were identified for enrollment (51.9% were male; median age, 59 years), of whom 13 patients consented to participate but only 7 provided a stool specimen. One of those 7 patients had a positive FIT result. The overall screening rate was low, at 0.45%. The primary reason for exclusion of patients was age (outside of the range of 50-75 years), followed by patients having recent gastrointestinal bleeding and/or known intestinal diseases. Conclusions Our data suggest that it is infeasible to recruit inpatients for opportunistic CRC screening in routine clinical practice. [ABSTRACT FROM AUTHOR]

Hospitalized patients often have acute kidney disease (AKD) or chronic kidney disease (CKD), with important metabolic and nutritional consequences. Moreover, in case kidney replacement therapy (KRT) is started, the possible impact on nutritional requirements cannot be neglected. On this regard, the present guideline aims to provide evidence-based recommendations for clinical nutrition in hospitalized patients with KD. The standard operating procedure for ESPEN guidelines was used. Clinical questions were defined in both the PICO format, and organized in subtopics when needed, and in non-PICO questions for the more general topics. The literature search was from January 1st, 1999 until January 1st, 2020. Each question led to one or more recommendation/statement and related commentaries. Existing evidence was graded, as well as recommendations and statements were developed and agreed upon in a multistage consensus process. The present guideline provides 32 evidence-based recommendations and 8 statements, defining how to assess nutritional status, how to define patients at risk, how to choose the route of feeding, and how to integrate nutrition with KRT. In the final online voting, a strong consensus was reached in 84% at least of recommendations and 100% of statements. The presence of KD in hospitalized patients identifies a highly heterogeneous group of subjects with widely varying nutrient needs and intakes. Considering the high nutritional risk related with this clinical condition, an individualized approach consisting of nutritional status evaluation and monitoring, frequent evaluation of nutritional requirements, and careful integration with KRT should be planned to avoid both underfeeding and overfeeding. Practical recommendations and statements were developed, aiming at defining suggestions for everyday clinical practice in the individualization of nutritional support in this patient setting. Literature areas with scarce or without evidence were also identified, thus requiring further basic or clinical research. [ABSTRACT FROM AUTHOR]

Abstract Major earthquakes have occurred frequently in Japan throughout history, and the 2024 Noto earthquake is no exception. However, such natural disasters differ in some respects, and specific problems related to these events have also become clear. Kanazawa Medical University Hospital, which was the closest university hospital to the disaster area of the 2024 Noto earthquake, played a crucial role in serving the local community in the wake of the earthquake. The first method used to identify disaster-related patients is to tag them when they are examined by a physician. After confirming that a patient was eligible at the disaster-related patient-determination meeting, patients’ medical information was extracted from the tag name. A total of 421 disaster-related patients were transported and hospitalized by day 31. Fifty-two (14.4%) and 48 (13.3%) patients were admitted for orthopedic surgery and respiratory medicine, respectively. Forty (11.1%) and 38 (10.5%) patients were admitted to cardiology and nephrology departments, respectively. These four departments account for 49.3% of the total. The number of hospitalized patients in the nephrology and orthopedic surgery departments was high immediately after the 2024 Noto Earthquake. We also describe new hospital-specific initiatives and recommendations to improve Kanazawa Medical University Hospital’s system while sharing another hospital experience.

Background and purpose: Acinetobacter species have emerged as major causes of nosocomial infections. Acinetobacter baumannii, the most common clinical subspecies, can cause a wide range of nosocomial infections, including pneumonia, bloodstream infections, and wound infections. These infections are often associated with high mortality rates due to the increasing prevalence of drug resistance among these bacteria. The production of β-lactamases is a significant mechanism of resistance to β-lactams. The transcription of these β-lactamase genes is enhanced by various insertion sequences (ISs) located nearby. The insertion sequences most commonly associated with carbapenem genes in multidrug-resistant Acinetobacter baumannii isolates are ISAba1, ISAba2, ISAba3, ISAba4, and IS18. This study aimed to evaluate the drug resistance patterns and molecular detection of ISAba1 and ISAba2 insertion sequences in A. baumannii isolates recovered from hospitalized patients in Sari teaching hospitals. Materials and methods: This study was conducted over six months, from March 2022 to August 2022, in Sari teaching hospitals. Ninety A. baumannii isolates were collected from various clinical specimens of hospitalized patients. To confirm the species of A. baumannii, various phenotypic tests such as TSI, oxidase, MR/VP, OF, urea, citrate, and SIM were employed. The antibiotic susceptibility pattern of the isolates was evaluated using the disk diffusion method according to the CLSI 2021 guidelines. The minimum inhibitory concentration (MIC) of colistin was determined using the micro broth method. To evaluate the presence of ISAba1 and ISAba2 genes, the Polymerase Chain Reaction (PCR) method was performed using specific primers. Data were analyzed using SPSS version 22 software. The chi-square test was used to determine significant differences, with a P-value less than or equal to 0.05 considered statistically significant. Results: The results of this study showed that A. baumannii isolates had a high level of resistance to several antibiotics, including ciprofloxacin, imipenem, doripenem, cefepime, ceftazidime, piperacillin/tazobactam, and piperacillin, with all isolates (100%) being resistant to these antibiotics. However, the highest susceptibility was observed for the antibiotic colistin (98.8%). Additionally, the frequencies of ISAba1 and ISAba2 genes among the isolates were 95.5% and 81.1%, respectively, indicating a high prevalence of these genetic elements among the study isolates. Conclusion: The results of this study indicate a high susceptibility of isolates to the antibiotic colistin, but due to the risk of resistance development and nephrotoxicity, it should be used with caution. The findings suggest that the presence of insertion elements such as ISAba1 and ISAba2 plays a significant role in increasing the expression of drug-resistance genes and their transfer in Acinetobacter baumannii. This can help explain the high prevalence of drug resistance in these bacteria and highlights the importance of detecting and controlling these factors to reduce nosocomial infections. Therefore, identifying and controlling these factors can be an effective step in improving prevention and treatment methods for infections caused by A. baumannii.

Abstract Background Cervical cancer (CC) is a serious public health concern, being the fourth most common cancer among women and a leading cause of cancer mortality. In Brazil, many women are diagnosed late, and in Mato Grosso, with its geographical diversity, there are specific challenges. This study analyzed hospital survival and its predictors using data from the Hospital Information System (SIH) of the Unified Health System (SUS) in Mato Grosso from 2011 to 2023. Methods Cox regression and Kaplan-Meier models were applied to determine survival time and identify mortality predictors. The adjusted Hazard Ratio (AHR) with a 95% Confidence Interval (CI) was used to measure the association between the factors analyzed. Results The hospital mortality rate was 9.88%. The median duration of hospitalization was 33 days (interquartile range [IQR]: 12–36), with a median survival of 43.7%. Patients were followed up for up to 70 days. In the multivariable Cox model, after adjusting for potential confounders, the risk of death during hospitalization was higher in patients aged 40–59 years (AHR = 1.39, p = 0.027) and 60–74 years (AHR = 1.54, p = 0.007), in the absence of surgical procedures (AHR = 4.48, p

The annual incidence of symptomatic deep venous thrombosis (DVT) and venous thromboembolic (VTE) (DVT plus pulmonary embolism) in the adult population is estimated to be 50–100 and 75–150/100,000, respectively, and the incidence doubles for every 10-year increase in age. Patients admitted to hospitals, both surgical and medical, are at particularly increased risk for VTE, and the problem has been shown to continue after discharge. The risk is increased by age, obesity, malignancy, history of VTE, family history of DVT, stay in the intensive care unit, hereditary or acquired thrombophilia, and more recently, an elevated D-dimer. This risk is also affected by the nature and duration of the operation, type of anesthesia, immobility, dehydration, sepsis, varicose veins, inflammatory bowel disease, hormone replacement therapy, pregnancy, and pregnancy-related complications (stillborn infant, unplanned abortions, placental insufficiency, and growth retarded infant). Several risk assessment scoring systems are now available for clinical use. The ones most commonly used are the Rogers, Caprini, and Chao-Yang in surgical patients and the Padua, International Medical Prevention Registry on Venous Thromboembolism, and IMPROVEDD in acutely ill medical patients. The mandatory use of a risk assessment tool on admission and in high VTE risk patients at discharge as well and implementation of an evidence-based pathway for thromboprophylaxis have made the prevention of many fatal pulmonary emboli after surgery or hospitalization a reality.

Abstract Background Studies suggested that COVID-19 virus causes neurological and psychiatric manifestations with different mechanisms. However, prevalence of neurological and psychiatric manifestations among COVID-19 patients varies across studies from 18.1%: 82.3%. The objective of this study was to determine neuropsychiatric manifestations in a sample of Egyptian COVID-19 hospitalized patients during the second wave of the pandemic and to detect factors affecting neurological and psychiatric prevalence. This cross-sectional study was conducted at Ain Shams university isolation hospitals and included 110 hospitalized COVID-19 patients, over a 2-month period from June 2021 to August 2021. Patients underwent a careful history taking, full neurological examination including Mini-Mental State Examination, the Structured Clinical Interview for DSM-IV (SCID I), COVID-19 severity criteria. Any available imaging and laboratory tests were recorded. Results 83 (75.5%) patients had neurological manifestations. The most common neurological manifestations were headache (50.9%), hypogeusia (24.5%), hyposmia, paresthesia (23.6% each) and coma (15.5%). After exclusion of 17 patients who could not be examined by Mini-Mental State Examination, psychiatric manifestations were seen in 56 patients (61.5%) out of the remaining 91 patients. The most prevalent psychiatric disorders were delirium (30.8%), depression (19%), and adjustment disorder (17.5%). Moreover, hypertension, COVID-19 severity, place of admission, and high levels of LDH and ALT affected neurological manifestations prevalence. Conclusions COVID-19 infection and its immune reaction along with its social and psychological effects have a great impact on mental and physical health. Hence, neuropsychiatric evaluation cannot be ignored in any case with COVID-19 infection.

Objective: This study describes the incidence and clinical profile of hypoglycemia (including mild, moderate, severe, and recurrent) and its correlation with the time of the day, duration of diabetes mellitus (DM), administration of insulin/oral hypoglycemic agents (OHAs) and diagnosis at admission in hospitalized adult patients. Materials and Methods: This retrospective, observational study analyzed the data of hospitalized patients with episode(s) of hypoglycemia. For each patient, clinical profiles such as age, gender, antidiabetic therapy, timing of hypoglycemic event, duration of diabetes, working diagnosis, place of hypoglycemia, dietary changes, and mode of corrective action were studied. Results: Of 100 patients with a mean ± standard deviation age of 62.72 ± 3.54 years, hypoglycemia was the most common among those aged 61–90 years. There were 134 hypoglycemic events and mild hypoglycemia was the most common (72.39% vs. moderate 21.64% and severe 5.97%). There were 59 (44%) events of recurrent hypoglycemia. Hypoglycemic events were maximum during 4:00 am–7:59 am (34%). Longer duration of DM (>15 years, 42%) and insulin therapy were the high-risk factors. There was a statistically significant association between hypoglycemia and duration of diabetes (P < 0.0133), insulin therapy (P < 0.0001), OHA (P < 0.0192), and a combination of insulin and OHA (P < 0.0059) within 24 h before the event but not with the incidence and dietary changes. Conclusion: Patients above 60 years were the most vulnerable population for hypoglycemia, especially during the early hours of the day. Patients who had diabetes for >15 years, on insulin therapy, and those with pulmonary and renal diseases were the most vulnerable to overall and recurrent hypoglycemic events, respectively.

Abstract Background Placement of peripheral intravenous catheters (PIVC) is a routine procedure in hospital settings. The primary objective is to explore the relationship between healthcare inequities and PIVC outcomes. Methods This study was a multicenter, observational analysis of adults with PIVC access established in the emergency department requiring inpatient admission between January 1st, 2021, and January 31st, 2023, in metro Detroit, Michigan, United States. Epidemiological, demographic, therapeutic, clinical, and outcomes data were collected. Health disparities were defined by the National Institute on Minority Health and Health Disparities. The primary outcome was the proportion of PIVC dwell time to hospitalization length of stay, expressed as the proportion of dwell time (hours) to hospital stay (hours) x 100%. Multivariable linear regression and a machine learning model were used for variable selection. Subsequently, a multivariate linear regression analysis was utilized to adjust for confounders and best estimate the true effect of each variable. Results Between January 1st, 2021, and January 31st, 2023, our study analyzed 144,524 ED encounters, with an average patient age of 65.7 years and 53.4% female. Racial demographics showed 67.2% White, and 27.0% Black, with the remaining identifying as Asian, American Indian Alaska Native, or other races. The median proportion of PIVC dwell time to hospital length of stay was 0.88, with individuals identifying as Asian having the highest ratio (0.94) and Black individuals the lowest (0.82). Black females had a median dwell time to stay ratio of 0.76, significantly lower than White males at 0.93 (p

Introduction 'Teachable moments', such as inpatient treatment periods, can be turned into opportunities for smokers to acquire healthy living behaviors. This study was conducted to evaluate outcomes of smoking cessation interventions at an inpatient hospital setting. Methods Data was collected for this single arm prospective intervention cohort study between October 2021 and March 2022 from hospitalized patients at Recep Tayyip Erdoğan University Training and Research Hospital in Türkiye. Smoker patients received smoking cessation counseling and brief smoking cessation interventions during their hospitalization and were informed about how to apply to our hospital's smoking cessation outpatient clinic after discharge. They were followed via phone at 3rd, 5th,7th days and 1st, 3rd, 6th, 12th months after their discharge regarding their quit status as well as admissions to smoking cessation clinics. Quitters were confirmed by exhaled air carbon monoxide testing. Logistic regression analysis was performad to evaluate the presence of admission to emergency department and family physicians at 1st year follow up, model was adjusted regarding age, sex, presence of malignancy and education level. Results Totally data of 183 patients included to the study, there were 163 participants who completed periodic follow-ups during 1 year and among them the quit rate was 47.2%. Rate of anxiety was higher among non-quitters, compared to quitters (9.4% vs 1.2%) (p:0.024). Non-quittters were 19 times more likely to have emergency department admissions (aOR: 19.64, 95% CI: 8.08-47.68) and 8 times more likely have family doctor admissions (aOR: 8.43, 95% CI: 4.05-17.53) than quitters. Conclusions This cessation program evaluated the quit rates of hospitalized patients at first year and revealed that rate of anxiety was higher in non-quitters compared to quitters. It would be an important approach to include psychiatric support in this practice.

Abstract Background The COVID-19 pandemic urged all healthcare providers to collaborate to defeat this mortal infection. SARS-CoV-2 almost hits the respiratory system and may have subsequent serious complications like pulmonary embolism and multi-organ damage. Objective To illustrate the rehabilitation program challenges encountered by physiotherapists in clinically managing hospitalized COVID-19 patients. The goal was to preclude the need for invasive mechanical ventilation and to improve the patient’s oxygen saturation and general health. Methods In this retrospective case-series study, we described the physiotherapy strategies implemented for 14 COVID-19 patients during the hospitalization period at an Egyptian governmental quarantine hospital. Results The rehabilitation program was customized by physiotherapists to accommodate the specific circumstances, conditions, and acquired complications of individual patients. Patients were under the care of physiotherapists in both the COVID ward and ICU. Overcoming challenges such as patient reluctance, co-morbidities, and the effects of aging was a task faced by these healthcare professionals. Consequently, the program had to be modified to suit the unique needs of each patient. These tailored programs encompassed techniques such as percussion, positioning, range of motion, circulatory exercises, and respiratory exercises. The patients exhibited positive responses to their designated physical therapy program, experiencing improvements on various levels based on the progression of their individual cases. Conclusion Physiotherapy has a major role in improving patient complications after being infected with COVID-19. In this desperate pandemic era, physiotherapists gave hospitalized patients support both psychologically and physically.

Abstract This study aimed to investigate the relationship between various prevention and control measures for nosocomial infections (NIs) in psychiatric hospitals and patients with mental disorders. This study aimed to determine the characteristics of NIs in psychiatric hospitals and provide a reference for infection prevention and control in this setting. Data from the NI monitoring system of a psychiatric hospital in southeastern China were analysed. Patients who were hospitalized for mental disorders from January 1, 2016, to November 30, 2019, were classified into the non-COVID-19 containment group (NC19C group, n = 898), while those who were hospitalized from January 25, 2020, to November 30, 2022, were classified into the COVID-19 containment group (C19C group, n = 840). The data were analysed using SPSS version 22.0, and independent sample t tests, chi-square tests, correlation analyses, and multivariate logistic regression analyses were performed. A significance level of P

Abstract Background Infections due to Citrobacter species are increasingly observed in hospitalized patients and are often multidrug-resistant. Yet, the magnitude and burden of Citrobacter spp. resistance in the hospital setting have not been reported. We aimed to evaluate the epidemiology of Citrobacter spp. infections among hospitalized patients, their main resistance patterns and Citrobacter spp. involvement in hospital outbreaks. Methods We conducted a systematic review and meta-analysis of published literature (PROSPERO registration Jan-2023, CRD42023390084). We searched Embase, Medline and grey literature for studies on hospitalized patients diagnosed with Citrobacter spp. infections, and nosocomial outbreaks due to Citrobacter spp. published during the years 2000–2022. We included observational, interventional, surveillance studies and outbreak reports. Outcomes of interest were the frequency of Citrobacter spp. infections among hospitalized patients and 3rd generation cephalosporin and/or carbapenem resistance percentages in these infections. We used random-effects models to generate pooled outcome estimates and evaluated risk of bias and quality of reporting of outbreaks. Results We screened 1609 deduplicated publications, assessed 148 full-texts, and included 41 studies (15 observational, 13 surveillance and 13 outbreak studies). Citrobacter spp. urinary tract- and bloodstream infections were most frequently reported, with Citrobacter freundii being the main causative species. Hospital-acquired infection occurred in 85% (838/990) of hospitalized patients with Citrobacter infection. After 2010, an increasing number of patients with Citrobacter spp. infections was reported in observational studies. Pooled frequency estimates for Citrobacter spp. infections could not be generated due to lack of data. The pooled prevalence of ESBL and carbapenemase producers among Citrobacter isolates were 22% (95%CI 4–50%, 7 studies) and 18% (95%CI 0–63%, 4 studies), respectively. An increased frequency of reported Citrobacter outbreaks was observed after 2016, with an infection/colonization ratio of 1:3 and a case-fatality ratio of 7% (6/89 patients). Common outbreak sources were sinks, toilets, contaminated food and injection material. Implemented preventive measures included environmental cleaning, isolation of positive patients and reinforcement of hand hygiene. Only seven out of 13 outbreaks (54%) were definitively controlled. Conclusion This review highlights the clinical importance of endemic and epidemic Citrobacter spp. in healthcare settings. As an emerging, multidrug‑resistant nosocomial pathogen it requires heightened awareness and further dedicated surveillance efforts.

The patient has a legitimate role in evaluating the healthcare services provided to them; this evaluation can be measured through patient satisfaction, which is considered an effective tool to evaluate the provided services and the quality program for hospitals. This study aims to examine the association between patient satisfaction and hospital accreditation status. Cross-sectional design with a random sampling technique for adult hospitalized patients. The SERVQUAL instrument was utilized to measure the patient's satisfaction. The sample size included 800 patients from the two phases based on the inclusion and exclusion criteria. The obtained data was analyzed using SPSS version 26. The study revealed that patient satisfaction was high both before and after accreditation. The order of the patient satisfaction dimensions was as follows: assurance, reliability, tangibles, responsiveness, and empathy. The highest subscale in this phase was assurance, with a mean of (4.49), and the lowest score was empathy, with a mean of (4.25). In the pre-accreditation phase, reliability was the highest subscale, with a mean of (4.46), and the lowest score was responsiveness, with a mean of (4.13). In addition, the study revealed that there is an association between the satisfaction subscales (tangibles, responsiveness, and assurance) and accreditation status, except for reliability and empathy. The study concludes that the high level of satisfaction in the post-accreditation phase may relate to the high level of patient care standards and safety environment implemented in the hospital as requirements of accreditation, which gives evidence that the hospital accreditation status had a positive impact on patient satisfaction.

Abstract Excessive and improper use of antibiotics causes antimicrobial resistance which is a major threat to global health security. Hospitals in sub-Saharan Africa (SSA) has the highest prevalence of antibiotic use. This systematic review and meta-analysis aimed to determine the pooled point prevalence (PPP) of evidence-based antimicrobial use among hospitalized patients in SSA. Literature was retrieved from CINAHL, EMBASE, Google Scholar, PubMed, Scopus, and Web of Science databases. Meta-analysis was conducted using STATA version 17. Forest plots using the random-effect model were used to present the findings. The heterogeneity and publication bias were assessed using the I 2 statistics and Egger’s test. The protocol was registered in PROSPERO with code CRD42023404075. The review was conducted according to PRISMA guidelines. A total of 26, 272 study participants reported by twenty-eight studies published from 10 countries in SSA were included. The pooled point prevalence of antimicrobial use in SSA were 64%. The pooled estimate of hospital wards with the highest antibiotic use were intensive care unit (89%). The pooled prevalence of the most common clinical indication for antibiotic use were community acquired infection (41%). The pooled point prevalence of antimicrobial use among hospitalized patients were higher in SSA. Higher use of antibiotics was recorded in intensive care units. Community acquired infection were most common clinical case among hospitalized patients. Health systems in SSA must design innovative digital health interventions to optimize clinicians adhere to evidence-based prescribing guidelines and improve antimicrobial stewardship.

Background: Community-acquired pneumonia (CAP) is one of the leading causes of death worldwide. Antibiotic stewardship program (ASP) has been implemented to improve rational and responsible antibiotic use by encouraging guideline adherence. Objective: This retrospective observational before-after study aimed to evaluate whether the ASP may improve guideline adherence, antibiotic exposure, and clinical outcomes in patients hospitalized due to CAP in Hungary. Methods: The study was conducted at a pulmonology department of a tertiary care medical center in Hungary. The ASP implementation consisted of written and published guidelines available to all professionals, continuous supervision, and counseling services on antibiotic therapies at an individual level, with the aim of ensuring compliance with CAP guidelines. Overall guideline adherence (agent selection, route of administration, and dose), clinical outcomes (length of stay and 30-day mortality), antibiotic exposure, and direct costs were compared between the two periods. Fisher's exact test and t-test were applied to compare categorical and continuous variables, respectively. P-values below 0.05 were defined as significant. Results: Significant improvement in overall CAP guideline adherence (30.2%), sequential therapy (10.5%), and a significant reduction in the total duration of antibiotic therapy (13.5%) were observed. Guideline non-adherent combination therapies with metronidazole decreased significantly by 28.1%. Antibiotic exposure decreased by 7.2%, leading to a significant decrease in direct costs (23.6%). Moreover, the ASP had benefits for clinical outcomes, and length of stay decreased by 13.5%. Conclusion: The ASP may play an important role in optimizing empirical antibiotic therapy in CAP having a sustained long-term effect. [ABSTRACT FROM AUTHOR]

Background: Placement of peripheral intravenous catheters (PIVC) is a routine procedure in hospital settings. The primary objective is to explore the relationship between healthcare inequities and PIVC outcomes. Methods: This study was a multicenter, observational analysis of adults with PIVC access established in the emergency department requiring inpatient admission between January 1st, 2021, and January 31st, 2023, in metro Detroit, Michigan, United States. Epidemiological, demographic, therapeutic, clinical, and outcomes data were collected. Health disparities were defined by the National Institute on Minority Health and Health Disparities. The primary outcome was the proportion of PIVC dwell time to hospitalization length of stay, expressed as the proportion of dwell time (hours) to hospital stay (hours) x 100%. Multivariable linear regression and a machine learning model were used for variable selection. Subsequently, a multivariate linear regression analysis was utilized to adjust for confounders and best estimate the true effect of each variable. Results: Between January 1st, 2021, and January 31st, 2023, our study analyzed 144,524 ED encounters, with an average patient age of 65.7 years and 53.4% female. Racial demographics showed 67.2% White, and 27.0% Black, with the remaining identifying as Asian, American Indian Alaska Native, or other races. The median proportion of PIVC dwell time to hospital length of stay was 0.88, with individuals identifying as Asian having the highest ratio (0.94) and Black individuals the lowest (0.82). Black females had a median dwell time to stay ratio of 0.76, significantly lower than White males at 0.93 (p < 0.001). After controlling for confounder variables, a multivariable linear regression demonstrated that Black males and White males had a 10.0% and 19.6% greater proportion of dwell to stay, respectively, compared to Black females (p < 0.001). Conclusions: Black females face the highest risk of compromised PIVC functionality, resulting in approximately one full day of less reliable PIVC access than White males. To comprehensively address and rectify these disparities, further research is imperative to improve understanding of the clinical impact of healthcare inequities on PIVC access. Moreover, it is essential to formulate effective strategies to mitigate these disparities and ensure equitable healthcare outcomes for all individuals. [ABSTRACT FROM AUTHOR]

Access to palliative care (PC) holds significance for hospital-admitted patients grappling with the symptoms of life limiting illnesses. Nonetheless, numerous such patients who could gain from PC fail to receive it promptly or even at all. We can leverage the prior year's historical data extracted from electronic health records of hospitalized patients to train a machine learning (ML) model. This model's purpose would be to prognosticate the requirement for PC consultation using real-time data. The model, operating as a semi-supervised system, will be integrated into institutional data pipelines, and utilized by a downstream display application overseen by the PC team. In cases where the PC team deems it suitable, a team member will communicate with the respective care team of the patient. The ML model's training efficacy will be assessed using the area under the curve (AUC) metric, employing a 20% reserved validation set. The threshold for PC consultations will be grounded in historical data. To enhance the ML model's precision, the pivotal variables within the model will be pinpointed, and any sources of biases or errors in the model will be identified for meticulous refinement. The AUC values of successive ML models will be juxtaposed with cross-validation data. Automatizing the referral procedure through electronic health record systems has the potential to usher in a more effective and streamlined approach to healthcare delivery. [ABSTRACT FROM AUTHOR]

Efficacy of remdesivir for COVID-19 remains unclear. We updated our published systematic review to better inform on the use of remdesivir for COVID-19. We searched for randomized controlled trials (RCTs) among hospitalized COVID-19 patients. Meta-analysis was conducted using an inverse variance, random-effects model, presenting relative risk (RR) or mean difference (MD) and their associated 95% confidence intervals (CIs). Statistical heterogeneity was calculated using the I2 statistic. In addition, we conducted trial sequential analysis (TSA). Outcomes with additional data were clinical progression, hospitalization days, and all-cause mortality. We included nine RCTs (12,876 individuals). Three trials each were of a low, unclear, and a high risk of bias. Compared with no treatment/placebo, remdesivir (100 mg daily, over 10 days) significantly improved clinical progression (RR 1.06, CI 1.02–1.11), but did not significantly reduce hospitalization days (MD −0.48, CI −2.18–1.21) and all-cause mortality (RR 0.92, CI 0.84–1.01). TSA suggested that further information is not required to conclude on the efficacy of remdesivir in improving clinical progression, and that, while more information is required for hospitalization days and all-cause mortality, further RCTs to prove fewer hospitalization days may be futile, as efficacy of remdesivir for this outcome is unlikely. Remdesivir appeared promising for COVID-19, but there is insufficient evidence of its efficacy. High quality RCTs are needed for a stronger evidence base. [ABSTRACT FROM AUTHOR]

Key summary points: Aim: What is the association between dexamethasone and delirium in hospitalized COVID-19 patients? Findings: The use of dexamethasone in a dose of 6 mg daily in hospitalized COVID-19 patients did not affect the incidence of delirium. Message: Treatment with 6 mg dexamethasone daily did not increase the incidence of delirium in COVID-19 patients and should, therefore, not be withheld because of fear for delirium. Purpose: Delirium has been suggested to be a complication associated with corticosteroid use. Therefore, the association between dexamethasone use and delirium in COVID-19 patients was studied herein. Methods: In this single-center retrospective cohort study, 412 patients who were hospitalized because of COVID-19 between March 2020 and January 2021 were included. Delirium was diagnosed using the Delirium Observation Screening Scale. The association between the daily use of dexamethasone 6 mg and delirium was measured via multivariable logistic regression analysis. Results: The incidence of delirium was 11.4% in patients treated with dexamethasone (n = 245) and 9.6% in patients not treated with dexamethasone (n = 167) (RR 1.19, CI 0.67–2.13, p = 0.55). After adjusting for age (mean 69 years) and comorbidity score, the odds ratio for developing delirium when using dexamethasone was 1.11 (CI 0.56–2.21, p = 0.76). Conclusion: The use of dexamethasone in hospitalized COVID-19 patients did not affect the incidence of delirium. [ABSTRACT FROM AUTHOR]

Background: Acute Infectious Diarrhea (AID) and the short- and long-term complications associated with it are major causes of hospitalization worldwide. In Italy, due to a lack of robust surveillance programs, only limited data has been collected on their prevalence and circulation. This study aims to evaluate the resistance pattern of enteric pathogens and their epidemiological trends over a six-year period. Methods: This cross-sectional retrospective study was conducted from January 2018 to December 2023. Stool samples were analyzed during routine diagnosis with culture methods, syndromic molecular tests, and enzyme immunoassay. Results: Bacteria were the most isolated enteric pathogens (62.2%), followed by fungi (29.0%), viruses (8.2%), and parasites (0.6%). Most bacteria were isolated from outpatients (29.5%) and from patients in the Oncology ward (26.2%). The most prevalent target was EPEC (11.1%), followed by C. difficile toxin A/B-producing strains (8.3%), C. jejuni (2.5%), and S. enterica, (1%.). Norovirus and Candida spp. were the most prevalent in pediatric patients (6.5% and 39.6%, respectively). In the last years, enteric pathogens have been a frequent cause of infections characterized by a problematic resistance to common antimicrobials. In our study, S. enterica showed resistance to amikacin, gentamicin, ampicillin, levofloxacin, and ciprofloxacin. C. jejuni was susceptible to all tested drugs. Conclusion: Timely notification of gastroenteric infections is crucial in identifying potential outbreak sources and ensuring strict adherence to food safety and hygiene practices, so as to protect the most vulnerable populations. The present study offers insights into the epidemiological characteristics and the antibiotic susceptibility of the main enteric AID pathogens in order to implement infection control measures in health care settings. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the relationship between various prevention and control measures for nosocomial infections (NIs) in psychiatric hospitals and patients with mental disorders. This study aimed to determine the characteristics of NIs in psychiatric hospitals and provide a reference for infection prevention and control in this setting. Data from the NI monitoring system of a psychiatric hospital in southeastern China were analysed. Patients who were hospitalized for mental disorders from January 1, 2016, to November 30, 2019, were classified into the non-COVID-19 containment group (NC19C group, n = 898), while those who were hospitalized from January 25, 2020, to November 30, 2022, were classified into the COVID-19 containment group (C19C group, n = 840). The data were analysed using SPSS version 22.0, and independent sample t tests, chi-square tests, correlation analyses, and multivariate logistic regression analyses were performed. A significance level of P < 0.0024 was applied. The incidence rate of NIs was higher in autumn in the NC19C group, while no seasonal difference was detected in the C19C group (P < 0.0024). Further analysis revealed that in the C19C group, the risk of hospitalized patients with mental disorders developing hospital-acquired pneumonia in spring was 0.362 times that in winter (OR = 0.362, 95% CI = 0.200 ~ 0.656, P = 0.001), and in summer, the risk was 0.342 times that in winter (OR = 0.342, 95% CI = 0.185 ~ 0.633 P = 0.001). Patients aged 18–44 years had a 4.260 times higher risk of developing hospital-acquired upper respiratory tract infections than did those aged 60 years and older (OR = 4.260, 95% CI = 2.143 ~ 8.470; P = 0.000). The risk of acquiring urinary tract infections in the hospital was 0.324 times greater among patients aged 18–44 years than for patients aged 60 years and older (OR = 0.324, 95% CI = 0.171–0.613; P = 0.001). The NC19C group did not exhibit the aforementioned differences. During the NC19C period, differences were observed in the diagnosis of hospital-acquired infections and sex (all P = 0.000). Psychiatric hospitals exhibit distinct nosocomial infection characteristics under the context of various infection control measures. Against the backdrop of strengthened infection control, the nosocomial infection characteristics of psychiatric hospitals may be associated with the features of mental disorders. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic urged all healthcare providers to collaborate to defeat this mortal infection. SARS-CoV-2 almost hits the respiratory system and may have subsequent serious complications like pulmonary embolism and multi-organ damage. Objective: To illustrate the rehabilitation program challenges encountered by physiotherapists in clinically managing hospitalized COVID-19 patients. The goal was to preclude the need for invasive mechanical ventilation and to improve the patient's oxygen saturation and general health. Methods: In this retrospective case-series study, we described the physiotherapy strategies implemented for 14 COVID-19 patients during the hospitalization period at an Egyptian governmental quarantine hospital. Results: The rehabilitation program was customized by physiotherapists to accommodate the specific circumstances, conditions, and acquired complications of individual patients. Patients were under the care of physiotherapists in both the COVID ward and ICU. Overcoming challenges such as patient reluctance, co-morbidities, and the effects of aging was a task faced by these healthcare professionals. Consequently, the program had to be modified to suit the unique needs of each patient. These tailored programs encompassed techniques such as percussion, positioning, range of motion, circulatory exercises, and respiratory exercises. The patients exhibited positive responses to their designated physical therapy program, experiencing improvements on various levels based on the progression of their individual cases. Conclusion: Physiotherapy has a major role in improving patient complications after being infected with COVID-19. In this desperate pandemic era, physiotherapists gave hospitalized patients support both psychologically and physically. [ABSTRACT FROM AUTHOR]

Background: Combination therapy was associated with an increased risk of drug-drug interactions (DDIs) in patients with type 2 diabetes mellitus (T2DM). The present study aimed to investigate the epidemiology of potential DDIs (pDDIs), including potential chemical drug-drug interactions (pCDIs) and potential herb-drug interactions (pHDIs), and classify the influencing factors of pDDIs in these patients. Methods: A retrospective study of the epidemiology of pDDIs among T2DM hospitalized patients older than 18 years and treated with at least two drugs during hospitalization was conducted over a 12-month period in 2019. PDDIs were identified with C (monitor therapy), D (consider therapy modification), and X (avoid combination) risk ratings. Binary logistic regression was used to analyze the risk factors of pDDIs. Results: A total of 6796 pDDIs were identified from 737 T2DM hospitalized patients during hospitalization, with 0.87% classified as X risk rating, 13.39% as D risk rating. Additionally, 1753 pDDIs were identified after discharge, with 0.11% as X and 25.73% as D risk rating. The drug-drug association networks showed that the majority of pCDIs were associated with cardiovascular system drugs. Chlorphenamine-potassium chloride and danshen-warfarin were the most prevalent interacting pairs of pCDIs and pHDIs with X rating during hospitalization. Multivariate analysis indicated that the likelihood of developing over 4 pDDIs was significantly higher among T2DM patients who had received over 8 medications. The presence of pDDIs after discharge was strongly associated with the complications of T2DM and the number of discharge medications. Conclusions: T2DM patients were frequently exposed to pDDIs, including pCDIs and pHDIs, both during hospitalization and after discharge. Multi-drug combination was the primary risk factor for pDDIs. Strategies such as enhancing the monitoring and warning for pDDIs, increasing clinical pharmacological experience, as well as developing universally applicable clinical guidelines for pDDIs may be beneficial in reducing the incidence of potentially harmful drug-combinations. [ABSTRACT FROM AUTHOR]

Background: Infections due to Citrobacter species are increasingly observed in hospitalized patients and are often multidrug-resistant. Yet, the magnitude and burden of Citrobacter spp. resistance in the hospital setting have not been reported. We aimed to evaluate the epidemiology of Citrobacter spp. infections among hospitalized patients, their main resistance patterns and Citrobacter spp. involvement in hospital outbreaks. Methods: We conducted a systematic review and meta-analysis of published literature (PROSPERO registration Jan-2023, CRD42023390084). We searched Embase, Medline and grey literature for studies on hospitalized patients diagnosed with Citrobacter spp. infections, and nosocomial outbreaks due to Citrobacter spp. published during the years 2000–2022. We included observational, interventional, surveillance studies and outbreak reports. Outcomes of interest were the frequency of Citrobacter spp. infections among hospitalized patients and 3rd generation cephalosporin and/or carbapenem resistance percentages in these infections. We used random-effects models to generate pooled outcome estimates and evaluated risk of bias and quality of reporting of outbreaks. Results: We screened 1609 deduplicated publications, assessed 148 full-texts, and included 41 studies (15 observational, 13 surveillance and 13 outbreak studies). Citrobacter spp. urinary tract- and bloodstream infections were most frequently reported, with Citrobacter freundii being the main causative species. Hospital-acquired infection occurred in 85% (838/990) of hospitalized patients with Citrobacter infection. After 2010, an increasing number of patients with Citrobacter spp. infections was reported in observational studies. Pooled frequency estimates for Citrobacter spp. infections could not be generated due to lack of data. The pooled prevalence of ESBL and carbapenemase producers among Citrobacter isolates were 22% (95%CI 4–50%, 7 studies) and 18% (95%CI 0–63%, 4 studies), respectively. An increased frequency of reported Citrobacter outbreaks was observed after 2016, with an infection/colonization ratio of 1:3 and a case-fatality ratio of 7% (6/89 patients). Common outbreak sources were sinks, toilets, contaminated food and injection material. Implemented preventive measures included environmental cleaning, isolation of positive patients and reinforcement of hand hygiene. Only seven out of 13 outbreaks (54%) were definitively controlled. Conclusion: This review highlights the clinical importance of endemic and epidemic Citrobacter spp. in healthcare settings. As an emerging, multidrug‑resistant nosocomial pathogen it requires heightened awareness and further dedicated surveillance efforts. [ABSTRACT FROM AUTHOR]

Introduction: 'Teachable moments', such as inpatient treatment periods, can be turned into opportunities for smokers to acquire healthy living behaviors. This study was conducted to evaluate outcomes of smoking cessation interventions at an inpatient hospital setting. Methods: Data was collected for this single arm prospective intervention cohort study between October 2021 and March 2022 from hospitalized patients at Recep Tayyip Erdoğan University Training and Research Hospital in Türkiye. Smoker patients received smoking cessation counseling and brief smoking cessation interventions during their hospitalization and were informed about how to apply to our hospital's smoking cessation outpatient clinic after discharge. They were followed via phone at 3rd, 5th,7th days and 1st, 3rd, 6th, 12th months after their discharge regarding their quit status as well as admissions to smoking cessation clinics. Quitters were confirmed by exhaled air carbon monoxide testing. Logistic regression analysis was performad to evaluate the presence of admission to emergency department and family physicians at 1st year follow up, model was adjusted regarding age, sex, presence of malignancy and education level. Results: Totally data of 183 patients included to the study, there were 163 participants who completed periodic follow-ups during 1 year and among them the quit rate was 47.2%. Rate of anxiety was higher among non-quitters, compared to quitters (9.4% vs 1.2%) (p:0.024). Non-quittters were 19 times more likely to have emergency department admissions (aOR: 19.64, 95% CI: 8.08-47.68) and 8 times more likely have family doctor admissions (aOR: 8.43, 95% CI: 4.05-17.53) than quitters. Conclusions: This cessation program evaluated the quit rates of hospitalized patients at first year and revealed that rate of anxiety was higher in non-quitters compared to quitters. It would be an important approach to include psychiatric support in this practice. [ABSTRACT FROM AUTHOR]

Background Multiplex gastrointestinal (GI) panel testing is widely used for outpatient diagnosis of diarrhea. However, the clinical practicality of multiplex testing in hospitalized diarrheal subjects has not yet been thoroughly elucidated. Methods We enrolled hospitalized subjects with acute diarrhea. The subjects' stool samples were collected in triplicate; 1 sample was tested using traditional diagnoses, and the other 2 were tested using Allplex (AP) and FilmArray (FA) GI panel testing. Clinical data were reviewed and analyzed. Results Of the 199 subjects, 92 (46.5%) were male, and the mean age was 66.3 years. The median (interquartile range) onset of diarrhea was 6 (2-–14) days after hospitalization. One hundred fifty-one patients (75.9%) had sepsis, and 166 (83.4%) had received prior or were receiving current antimicrobial therapy. Positive stool cultures were obtained from 4/89 (4.5%), and Clostridioides difficile toxin gene tests were positive in 14/188 (7.4%) patients. AP and FA multiplex tests were positive for GI pathogens in 49/199 (24.6%) and 40/199 (20.1%), respectively. The target most frequently detected by AP was Aeromonas spp. Both assays commonly detected enteropathogenic E. coli (EPEC), C. difficile toxin gene, and Salmonella spp.; neither assay detected pathogens in 75.4% and 79.9%. Fever (odds ratio [OR], 2.05; 95% CI, 1.08–3.88; P =.028), watery diarrhea (OR, 2.69; 95% CI, 1.25–5.80; P =.011), and antimicrobial therapy (OR, 2.60; 95% CI, 1.18–5.71; P =.018) were independent factors associated with the negative multiplex test result. Conclusions Multiplex GI panel testing effectively detects enteric pathogens associated with diarrhea in hospitalized subjects. The etiology remains undiagnosed in >75% of cases. Factors contributing to negative test results should be considered before implementing the tests. [ABSTRACT FROM AUTHOR]

Background: This study was conducted to investigate the incidence of deep venous thrombosis (DVT), outcomes and its characteristics in patients with chronic heart failure (CHF) in a retrospective setting. Outcomes: Patients died of cardiac shock or acute exacerbation of heart failure (HF), admitted to intensive care unit (ICU) due to acute exacerbation of HF, patients decided to withdraw treatment and return home due to acute exacerbation of HF. Methods: From January 2015 to June 2022, we admitted 359 patients diagnosed with CHF, and lower limb ultrasonography was performed for the examination of DVT after admission. The incidence of DVT was recorded and patients with known risk factors of VTE were identified and excluded after incidence of DVT was calculated. Patients' clinical data were then collected. Results: The occurrence of DVT was 10.0% (36/359), as calf intramuscular vein thrombosis was the main constitution (n = 28, 75%). DVT patients with other factors (carcinoma, surgery, stroke, previous history of DVT) constituted a considerable part (33.3%, 12/36). Age, history of Diabetes Mellitus (DM), levels of DDi (D-Dimer), levels of alanine transferase (ALT) and left ventricular end-diastolic diameter (LVEDd) were independent predictors or risk factors of DVT in CHF patients, while chronic kidney disease (CKD) stage 1–4, white blood cell (WBC) and direct oral anticoagulant (DOAC) were protective factors. Incidence of DVT was correlated with a poor outcome of CHF patients (Pearson Chi-Square test, Value 19.612, P < 0.001). Conclusions: In this retrospective study, incidence of DVT was found to be relatively high among hospitalized CHF patients, while patients with DVT was associated with a poor prognosis. [ABSTRACT FROM AUTHOR]

The objective of this analysis is to investigate the risk of hyperkalemia in hospitalized patients using sulfamethoxazole-trimethoprim (Co-trimoxazole) and a potassium-sparing drug (potassium-sparing diuretic or renin-angiotensin system [RAS]-inhibitor). Researchers conducted a nested case control study within a cohort of hospitalized patients using a potassium-sparing diuretic and/or a RAS-inhibitor from the PHARMO Database Network. Researchers estimated the odds ratios (ORs) and 95% confidence intervals (CI) for the risk of hyperkalemia in patients receiving both Co-trimoxazole and a potassium-sparing drug compared with patients only receiving a potassium-sparing drug. Among a cohort of 25,849 patients, researchers identified 2054 cases of hyperkalemia during hospitalization in patients also using a potassium-sparing drug. Using Co-trimoxazole in addition to a potassium-sparing drug was associated with an increased risk of hyperkalemia in hospitalized patients (ORadj = 1.65, 95% CI 1.26-2.16) compared with using only a potassium-sparing drug. There was a trend of a more pronounced association between hyperkalemia and the co-use of Co-trimoxazole and potassium-sparing drugs in patients with an estimated GFR of 15-29 mL/min (ORadj = 3.15, 95% CI 1.29-7.70). The number needed to harm for hyperkalemia induced by adding Cotrimoxazole to patients receiving a potassium-sparing drug is 19.5. Using the combination of Co-trimoxazole with a potassium-sparing drug in hospitalized patients increases the risk of hyperkalemia compared with using only a potassium-sparing drug. Physicians and other prescribers should be aware of hyperkalemia and routinely monitor serum potassium levels in hospitalized patients using this combination of drugs. [ABSTRACT FROM AUTHOR]

Hospital malnutrition remains a significant public health issue, particularly in developing countries. The Global Leadership Initiative on Malnutrition (GLIM) proposed homogenizing criteria to standardize malnutrition diagnosis. This study aimed to retrospectively determine the prevalence of nutritional risk and malnutrition diagnoses among hospitalized patients using the Nutritional Risk Screening (NRS)-2002 screening instrument and the GLIM criteria, respectively. We conducted a retrospective, cross-sectional study from nutritional records of patients hospitalized in a single centre 2021. Nutrition data from records included medical diagnosis, gender, length of stay, age, weight, height, body mass index, weight loss, calf circumference, and middle upper arm circumference. Nutritional risk and malnutrition were evaluated using NRS-2002 and GLIM criteria. Its concordance was further evaluated by using a Kappa test. The study included 616 records of patients; 52.3% (n = 322) of the population were male. The prevalence of nutritional risk, according to NRS-2002, was 69.5% (n = 428). Nutritional risk as well as malnutrition diagnosis according to GLIM criteria was observed in 87.8% (n = 374) of patienttritional risk and malnutrition were evaluated using NRS-2002 and GLIM criteria. Its concordance was further evaluated by using a Kappa test. Ws. Tools showed a strong concordance (κ= 0.732). All anthropometric data, except for height, were found to be significantly different between patients with moderate and severe malnutrition (p < 0.05). Our findings highlight a high prevalence of malnutrition in this group of hospitalized patients in Mexico. NRS-2002 demonstrated good agreement with the diagnosis of malnutrition according to GLIM criteria and could be considered part of the straightforward two-step approach for malnutrition; however, further studies are needed. [ABSTRACT FROM AUTHOR]

Excessive and improper use of antibiotics causes antimicrobial resistance which is a major threat to global health security. Hospitals in sub-Saharan Africa (SSA) has the highest prevalence of antibiotic use. This systematic review and meta-analysis aimed to determine the pooled point prevalence (PPP) of evidence-based antimicrobial use among hospitalized patients in SSA. Literature was retrieved from CINAHL, EMBASE, Google Scholar, PubMed, Scopus, and Web of Science databases. Meta-analysis was conducted using STATA version 17. Forest plots using the random-effect model were used to present the findings. The heterogeneity and publication bias were assessed using the I2 statistics and Egger's test. The protocol was registered in PROSPERO with code CRD42023404075. The review was conducted according to PRISMA guidelines. A total of 26, 272 study participants reported by twenty-eight studies published from 10 countries in SSA were included. The pooled point prevalence of antimicrobial use in SSA were 64%. The pooled estimate of hospital wards with the highest antibiotic use were intensive care unit (89%). The pooled prevalence of the most common clinical indication for antibiotic use were community acquired infection (41%). The pooled point prevalence of antimicrobial use among hospitalized patients were higher in SSA. Higher use of antibiotics was recorded in intensive care units. Community acquired infection were most common clinical case among hospitalized patients. Health systems in SSA must design innovative digital health interventions to optimize clinicians adhere to evidence-based prescribing guidelines and improve antimicrobial stewardship. [ABSTRACT FROM AUTHOR]

Background: The prompt identification of malnutrition among hospitalized patients using the appropriate screening tool is paramount. The objective of our study is to compare the most recommended screening tools concerning the new GLIM criteria for malnutrition in hospitalized patients. Methods: In this cross-sectional study, we analyzed the data on 1,397 patients receiving inpatient treatment at Bandırma Training and Research Hospital between August 2022 and May 2023 to assess and compare malnutrition in them. Patients who received inpatient treatment in the internal and surgical clinics of Bandırma Training and Research Hospital. In addition to the GLIM criteria, we used nutritional screening and assessment tools such as NRS-2002, MST, GMS, MUST, and SNAQ. The GLIM criteria were considered the gold standard for the evaluation of sensitivity and specificity. Receiver operating characteristic (ROC) curves for the five screening tools were also used to assess the ability to distinguish malnutrition-risk patients accurately. Results: The comparison of the performances of different screening tools in detecting malnutrition demonstrated that while the GMS had the highest sensitivity (87.40%), the NRS-2002 had the highest specificity (91.70%). The area under the Curve (AUC) value indicated that the predictive values of the NRS-2002, MST, GMS, and SNAQ were excellent, and the predictive value of the MUST was good (p < 0.001). While the GLIM criteria in particular appear to be an effective tool for detecting malnutrition in hospitalized individuals, other screening tools are also useful in assessing their malnutrition risk. Conclusions: We emphasized MST's alignment with GLIM criteria, underscoring the importance of a multidisciplinary approach for early malnutrition diagnosis. Patients at risk of malnutrition can be diagnosed more quickly and accurately with appropriate screening tools and the effectiveness of treatments can be increased. [ABSTRACT FROM AUTHOR]

Aim. The main aim of the study was to test the Morse Fall Scale (MFS) in the Czech population of hospitalized patients and to determine the predictive validity of the scale by assessing its specificity, sensitivity, positive predictive value, negative predictive value and cut-off points. Material and methods. The study was a prospective follow-up study. Ten acute and long-term care units in two selected hospitals participated in the study. The sample consisted of 4383 patients. To assess the patients' risk of falls, the MFS was chosen. The patients were assessed on admission. Results. The reliability of the Morse Fall Scale measured by Cronbach's alpha was 0.484. Using a cut-off point of 35, the sensitivity was 61.1% and the specificity was 53%. The positive predictive value was 10.5% and the negative predictive value was 90.6%. Conclusions. Results of the study revealed only moderate predictive accuracy of the Morse Fall Scale. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to clarify the relationship between oral frailty and oral dysbiosis among hospitalized patients aged ≥ 50 years. Methods: A prospective observational study was conducted. Number of teeth, masticatory ability, articulatory oral motor skill, tongue pressure, swallowing pressure, and choking were used to assess oral frailty. Saliva samples were collected from the oral cavity for bacterial culture. Results: A total 103 in patients enrolled and 53.4% suffered from oral frailty. Oral frailty was found to have a 3.07‐fold correlation with the presence of Enterobacterales in the oral cavity (p = 0.037), especially in poor articulatory oral motor skill, which showed at greater risk of Enterobacterales isolated from the oral cavity by 5.58‐fold (p = 0.01). Conclusion: Half of hospitalized patients was found to have oral frailty that was related to more Enterobacterales in the oral cavity. This evidence suggests that the enhancement of articulatory oral motor skills may serve as a potential strategy for mitigating the presence of Enterobacterales within the oral cavity. [ABSTRACT FROM AUTHOR]

Objectives: this study aimed to investigate the relationship between oral manifestations and depression, anxiety, and stress among covid-19 patients. Methods: This cohort study investigated 125 Covid-19 patients hospitalized at Covid-19 wards at Kashan Shahid Beheshti Hospital., After hospitalization, the patients were subjected to an oral examination and filled out the DASS-21 questionnaire to measure Psychological disorders at the beginning of hospitalization, one month and two months after discharge. Then we calculated the occurrence of oral manifestations and their relationship with depression, anxiety and, stress in the patients. Results: On the day of admission, 98.4% of patients had at least one type of oral manifestation. Coated tongue (75.2%), scallop tongue (67.2%) and xerostomia (66.4%) were the most common oral manifestations, respectively. As the severity of depression, anxiety and stress increased, the incidence of oral manifestations also did. However, we found no statistically significant relationship between these two factors (P<0.05); Temporomandibular disorders, xerostomia, changes in smell and taste were significantly related to Psychological disorders in some follow-ups (P<0.05). Conclusion: The study showed no statistically significant relationship between the severity of depression, anxiety and, stress with oral manifestations at any time, but with the increase in the severity of Psychological disorders, the incidence of oral manifestations also increased. A separate examination of the manifestations showed a statistically significant relationship between depression, anxiety and stress with xerostomia, temporomandibular disorders, changes in smell and taste at some follow-up times. [ABSTRACT FROM AUTHOR]

Objective This study harnesses the power of text mining to quantitatively investigate the causative factors of falls in adult inpatients, offering valuable references and guidance for fall prevention measures within hospitals.Methods Employing KH Coder 3.0, a cutting-edge text mining software, we performed co-occurrence network analysis and text clustering on fall incident reports of 2,772 adult patients from a nursing quality control platform in a particular city in Jiangsu Province, spanning January 2017 to December 2022.Results Among the 2,772 patients who fell, 80.23% were aged above 60, and 73.27% exhibited physical frailty. Text clustering yielded 16 distinct categories, with four clusters implicating patient factors, four linking falls to toileting processes, four highlighting dynamic interplays between patients, the environment, and objects, and another four clusters revealing the influence of patient-caregiver interactions in causing falls.Conclusion This study highlights the complex, multifactorial nature of falls in adult inpatients. Effective prevention requires a collaborative effort among healthcare staff, patients, and caregivers, focusing on patient vulnerabilities, environmental factors, and improved care coordination. By strengthening these aspects, hospitals can significantly reduce fall risks and promote patient safety.

A randomized, double-blind, placebo-controlled clinical trial was conducted to investigate the efficacy of infliximab, abatacept, and cenicriviroc in treating patients hospitalized with COVID-19. The patient's clinical status was assessed daily on an 8-point ordinal scale. We evaluated the totality of evidence on the efficacy of the 3 immunomodulators by considering all possible changes in the clinical status of each patient over time. We demonstrated that infliximab accelerated improvement and reduced deterioration of clinical status when added to standard of care. There was also evidence for the benefit of abatacept. There was no evidence for the benefit of cenicriviroc.

Fang-Fang Lin,1 Wei-Yuan Yang,1 Jun-Xiang Zhou,1 Luo-Yuan Cao,2 Ling-Ling Huang1 1Department of Rehabilitation, Ningde Municipal Hospital Affiliated to Ningde Normal University, Ningde, 352000, People’s Republic of China; 2Department of Central Laboratory, Ningde Municipal Hospital Affiliated to Ningde Normal University, Ningde, 352000, People’s Republic of ChinaCorrespondence: Jun-Xiang Zhou; Wei-Yuan Yang, Department of Rehabilitation, Ningde Municipal Hospital Affiliated to Ningde Normal University, No. 7 of Jiaocheng North Road, Jiaocheng District, Ningde, 352000, People’s Republic of China, Tel +86-15159370026 ; +86-13004929861, Email zhoujunxiangz@126.com; weiyuanyang9@126.comObjective: We investigated the clinical characteristics, fall outcomes, and related factors of falls in patients who were hospitalized in the rehabilitation department, and explored strategies to reduce the incidence of falls and prevent falls in patients.Methods: Data from 60 patients who fell in the rehabilitation department between 2016 and 2021 were analyzed for clinical characteristics, associated factors, incidence of falls, injuries, and patient demographics. Under the random stratified sampling method, 60 patients who did not fall during the same period were selected as the control group, and relevant data was collected. Measurement data were compared using an independent sample t-test. Enumeration data were compared using chi-squared (χ2) test was employed to compare these data between the two groups. Non-parametric data were analyzed using the Mann–Whitney U-test. Factors potentially influencing falls were scrutinized through both univariate and binary logistic regression analyses.Results: The median annual incidence of falls among patients who were hospitalized in the rehabilitation department was 0.04%, while the overall fall injury rate was 60%. Falls were most prevalent within 30 days of hospitalization (71.67%). The most common fall-related condition was craniocerebral disease (83.33%). The incidents of falls location of fall were mainly reported in nearby areas of rehabilitation ward (70%). Most accidents occurred between 7:00 a.m.– 12:00 p.m. and 3:01 p.m.– 6:00 p.m. (63.33%), and dyskinesia was the most common cause of falls (71.67%). There were 39 patients (65.00%) with Barthel Index (BI) scores ranging between 40– 60.Conclusion: Patients in the rehabilitation department had a greater incidence of falls and fall injuries. Within 30 days of admission, patients with moderately dependent craniocerebral disorders and dyskinesia frequently experienced falls during typical daytime shifts in areas characterized by endemic conditions.Keywords: daily living activities, dyskinesia, fall, hospitalized patients, rehabilitation department, retrospective analysis

Abstract Background Antimicrobial resistant bacteria among hospitalized patients are becoming a major public health threat worldwide, mainly in developing countries. Infections by these multidrug resistant pathogens cause high rate of mortality, prolong hospital stays, and affect individual and country economies in greater amounts. Thus, this study aimed to assess the bacterial profile, antimicrobial susceptibility status, and associated factors of isolates from hospitalized patients at the Dessie Comprehensive Specialized Hospital. Methodology This hospital-based cross-sectional study was conducted between February and April 2021. Consecutive sampling was used to select the study participants. All bacterial isolates were identified using standard bacteriological techniques. Antibiotic susceptibility testing was performed using disk diffusion technique. The data was analyzed using SPSS version 25. Descriptive statistics and logistic regression were used. A P-value of less than 0.05 was considered statistically significant. Results Of 384 clinical samples (blood, urine, stool, wound, vaginal discharge, and ear discharge) processed 180 (46.9%) were culture positive. Overall, Escherichia coli was the predominant isolate (41; 22.8%), followed by Staphylococcus aureus (36; 20%). Most of the isolates were from blood (70; 38.9%). The level of overall drug resistance of the gram-negative bacteria isolates for ampicillin, tetracycline, and cotrimoxazole was (104; 88.1%), (79; 75.9%), and (78; 75.0%), respectively. The overall multidrug rate of isolates was 143 (79.4%). Variables such as history of invasive procedures, chronic underlying diseases, history of hospitalization, and habit of eating raw animal products were statistically significant for the acquisition of bacterial infection. Conclusions and recommendation E. Coli and S. aureus were the most common isolates. Most of the isolates were resistant to commonly prescribed antibiotics. And also, consumption of raw animal products, chronic underlying disease, previous hospitalization, history of invasive procedures, and educational status were associated with the acquisition of bacterial infections. Therefore, routine antimicrobial susceptibility testing, proper patient management, wise use of antibiotics in clinical settings and health education are recommended.

Background & Objectives: The COVID-19 pandemic has had a devastating global impact, with millions of cases and varying severity of illness. Southeastern Iran has been particularly hard hit, with a high number of patients requiring hospitalization. This study aimed to identify risk factors associated with mortality from COVID-19 among hospitalized patients in this region. Materials & Methods: A case-control study compared hospitalized COVID-19 patients who succumbed to the disease (confirmed by death certificates and positive PCR tests) with those who recovered, from February 27, 2020, to June 30, 2021. Researchers analyzed data using t-tests and chi-square tests to identify significant factors associated with mortality (p < 0.05). Variables significant at a less stringent level (p < 0.2) were then included in a backward logistic regression model to explore independent predictors of mortality. Results: This retrospective study examined data from 473 patients, of whom 158 were in the case group and 315 were in the control group. Among the case group, 80.4% were elderly, compared to 41% in the control group. A significantly higher proportion of patients in the case group (12.7%) experienced critical symptoms leading to ICU hospitalization, compared to the control group (7.3%). Multivariable regression analysis identified several factors significantly associated with increased mortality risk. These included ICU hospitalization (OR=5.27, CI: 3.09-8.98), advanced age (OR=4.06, CI: 2.43-6.80), hypertension (OR=4.44, CI: 1.52-12.93), cardiovascular diseases (OR=2.56, CI: 1.1-5.98), and critical symptoms (OR=2.74, CI: 1.92-8.04). Diabetes, pregnancy, nationality, and gender did not statistically increase mortality risk (p-value ≥ 0.05). Conclusion: Advanced age, severe symptoms requiring ICU care, hypertension, and cardiovascular diseases are all critical mortality risk factors in hospitalized COVID-19 patients.

Background: Our aim was to examine the frequency and prescription pattern of breakthrough (BTO) and scheduled (SCH) opioids and their ratio (BTO/SCH ratio) of use, prior to and after referral to an inpatient supportive care consult (SCC) for cancer pain management (CPM). Methods and Materials: Patients admitted at the MD Anderson Cancer Center and referred to a SCC were retrospectively reviewed. Cancer patients receiving SCH and BTO opioids for ≥24 h were eligible for inclusion. Patient demographics and clinical characteristics, including the type and route of SCH and BTO opioids, daily opioid doses (MEDDs) of SCH and BTO, and BTO/SCH ratios were reviewed in patients seen prior to a SCC (pre-SCC) and during a SCC. A normal BTO ratio was defined as 0.5–0.2. Results: A total of 665/728 (91%) patients were evaluable. Median pain scores (p < 0.001), BTO MEDDs (p < 0.001), scheduled opioid MEDDs (p < 0.0001), and total MEDDs (p < 0.0001) were higher, but the median number of BTO doses was fewer (2 vs. 4, p < 0.001), among patients seen at SCC compared to pre-SCC. A BTO/SCH ratio over the recommended ratio (>0.2) was seen in 37.5% of patients. The BTO/SCH ratios in the pre-SCC and SCC groups were 0.10 (0.04, 0.21) and 0.17 (0.10, 0.30), respectively, p < 0.001. Hydromorphone and Morphine were the most common BTO and SCH opioids prescribed, respectively. Patients in the early supportive care group had higher pain scores and MEDDs. Conclusions: BTO/SCH ratios are frequently prescribed higher than the recommended dose. Daily pain scores, BTO MEDDs, scheduled opioid MEDDs, and total MEDDs were higher among the SCC group than the pre-SCC group, but the number of BTO doses/day was lower.

Abstract Background Accumulating evidence on the neurological sequelae of COVID-19 is a serious concern, with patients possibly being at risk of permanent debilitation if not managed appropriately. We aimed to determine the prevalence and pattern of neurological manifestations and diagnostic and therapeutic findings among hospitalized COVID-19 patients consulted with the neurology service for neurological disorders. We conducted a retrospective, observational study at the Golestan Hospital of Ahvaz, Iran, between March 20, 2020, and March 19, 2021. Patients' demographic, clinical, paraclinical, and therapeutic characteristics were extracted from medical records and then subjected to statistical analysis. Results Overall, 6.7% (157/2340) of COVID-19 patients at Golestan Hospital had a neurological disorder. Most of the patients (90/157) were men, and the mean age of patients was 62.91 ± 91 years. A total of 56.68% of patients (89/157) were SARS-CoV-2 RT-PCR positive. The mean chest CT severity score was 8.26 ± 4.4, ranging from 1 to 19. The most common neurologic disorders were cerebrovascular disease (72.6%), encephalopathy (8.9%), and Guillain–Barre syndrome (6.4%). The CSF SARS-CoV-2 PCR test was positive in one patient with Guillain–Barre syndrome. The in-hospital mortality rate was 43.9%. Definite COVID-19, ICU admission, history of stroke and dementia, and comorbidities were associated with an increased mortality risk in these patients. Conclusions Patients with COVID-19 can present with serious neurological disorders such as cerebrovascular disease and impaired consciousness, even without typical COVID-19 symptoms. Close monitoring for neurological symptoms may help improve prognosis in hospitalized COVID-19 patients.

To assess the impact of vaccines on clinical outcomes among hospitalized COVID-19-infected patients requiring oxygen supplementation during the Beijing Omicron outbreak. We conducted a retrospective cohort study at Beijing Chaoyang Hospital, Capital Medical University, from November 15, 2022, to March 31, 2023. Vaccination statuses were categorized into 3 doses, 2 doses, and unvaccinated (0 dose). The primary outcome was 28-day all-cause mortality. Secondary outcomes included poor outcomes, intensive care unit admission, cardiovascular thromboembolism events, and hospital readmission. Among the included patients, 117 were 2 doses, 285 received booster doses, and 503 were unvaccinated. After propensity score inverse probability weighting, the 3 doses group showed a significantly lower 28-day all-cause mortality compared to the unvaccinated group (inverse probability of treatment weighting-adjusted HR: 0.64, 95% CI: 0.50–0.81). No significant difference was observed in all-cause mortality between the 2 doses and unvaccinated groups. No significant differences were observed in secondary outcome analyses when comparing the 3 doses or 2 doses group to the unvaccinated group. Subgroup analysis revealed significant benefits of booster vaccination in patients with shorter symptom duration, lower Charlson Comorbidity Index, and without immunosuppression status. Our study highlights the significant reduction in all-cause mortality among hospitalized Omicron-infected patients who received a third dose vaccine. These findings underscore the importance of prioritizing booster vaccinations, especially among the elderly. Further research is warranted to confirm and extend these observations.

Objectives: This retrospective case-controlled study aimed to evaluate the association between the severity of fall-related injuries and fall-risk-increasing drugs (FRIDs) in hospitalized patients. Methods: Data were collected from Changhua Christian Hospital, Taiwan, of all adult inpatients who experienced falls between January 2017 and December 2021, and were divided into two groups based on whether they sustained severe fall-related injuries. Retrospective data that may affect the severity of fall-related injuries and the use of FRIDs were investigated. Results: Among 1231 documented cases of falls, 26 patients sustained severe fall-related injuries. Older patients and those with osteoporosis were more susceptible to more severe injuries from a fall. The use of mobility aids and osteoporosis medications showed protective effects against fall injuries. No significant association was observed between fall-related injuries and comorbidities or FRIDs. Multivariate analysis confirmed the inverse correlation between the use of mobility aids, osteoporosis medications, and fall severity. Patients with osteoporosis exhibited significantly higher odds of sustaining more severe injuries with a fall (odds ratio = 3.02, 95% confidence interval: 1.21–7.53). Conclusions: This study highlights the importance of addressing risk factors associated with fall severity among hospitalized patients. Providing mobility aids to persons at greater risk. [ABSTRACT FROM AUTHOR]