Reducing Hospitalisations Through Risk Prediction  In ICU Mon, 7 Jul 2025 Preventing unplanned hospital admissions among older adults is an ongoing challenge for hospitals seeking to maintain patient safety while optimising resource use. Emergency admissions are associated with adverse outcomes, including cognitive decline, hospital-acquired infections and repeat admissions. Understanding the factors that contribute to such admissions is critical ...

Mortality and Antibiotic Timing in Deep Learning-Derived Sepsis Risk Groups In Sepsis Tue, 15 Jul 2025 Sepsis affects over 1.7 million people annually in the U.S., causing more than 350,000 deaths and over $62 billion in healthcare costs. The 2021 Surviving Sepsis Campaign (SSC) guidelines recommend antibiotic timing based on illness severity and sepsis probability, creating four risk categories, but this classification is subjective and ofte...

Comment Reducing just-in-case primary care antibiotic prescribing in children Alastair D Hay, Emily Brown Lancet 2025; 406: 1538-1540 As health-care workers around the world will attest, infections are extremely common in children in primary care and community settings.1, 2 In The Lancet, Jan Yvan Verbakel and colleagues' pragmatic, cluster-randomised, controlled trial (ARON),3 set in a high-income primary care system, reports the culminati...

Invited Commentary  Reducing Missed Doses of VTE Prophylaxis John T. Simpson, Krista L. Haines, Suresh Agarwal JAMA Surg Published Online: October 8, 2025 doi: 10.1001/jamasurg.2025.4142 In their prospective cohort study, Haut et al1 apply a quality improvement intervention to reduce missed venous thromboembolism (VTE) chemoprophylaxis among patients hospitalized in a community hospital. Through nursing education, real-time missed dose alerts, and a pa...

Predicting ED Stay and Disposition with Interpretable ML  In ICU Sun, 6 Jul 2025 Emergency departments (EDs) face increasing challenges related to patient flow, overcrowding and resource allocation. Predicting key outcomes such as patient length of stay (LOS) and disposition decision (DD) can significantly improve operational efficiency. However, existing machine learning (ML) models often lack transparency and transferability, limiting their broa...

EDITORIAL Time to Reconsider Mucoactive Agents for Airway Clearance John Hansen-Flaschen, Gregory Tino N Engl J Med Published September 28, 2025 DOI: 10.1056/NEJMe2512146 Bronchiectasis is characterized by multifocal airway dilatation and wall thickening observed on computed tomography of the chest and is commonly accompanied by persistent or recurrent infection of the airways.1 Bronchiectasis is a hallmark of cystic fibrosis and often overlaps with as...

Ventilator-Associated Pneumonia: Bridging Global Disparities In ICU Wed, 9 Jul 2025 Ventilator-associated pneumonia (VAP) is the most frequent hospital-acquired infection in patients receiving invasive mechanical ventilation (IMV) globally. It affects up to 40% of ventilated patients, with mortality rates up to 50% for all-cause mortality and 13% for direct VAP-related mortality. VAP significantly increases hospital length of stay, diagnostic testing, ...

Invited Commentary  Antibiotic Prophylaxis in Variceal Hemorrhage—Time to Stop? Catherine Mezzacappa, Guadalupe Garcia-Tsao JAMA Intern Med 2025;185;(10):1204-1205. doi:10.1001/jamainternmed.2025.3841 In their systematic review and bayesian meta-analysis published in this issue of JAMA Internal Medicine, Prosty et al1 assess the evidence supporting the universally recommended practice of administering prophylactic broad-spectrum antibiotics to patients wi...

Using Nonpatient Features in Machine Learning for Hospital-Onset Bacteraemia  In ICU Wed, 9 Jul 2025 Hospital-onset bacteraemia and fungaemia (HOB) are frequent, often preventable hospital complications linked to high mortality, morbidity, and costs. While many studies have focused on patient-related, non-modifiable factors (e.g., demographics, comorbidities), these offer limited prevention opportunities.  Since up to two-thirds of HOB cas...

Prolonged Mechanical Ventilation in ICU Patients In ICU Tue, 15 Jul 2025 About 25% of ICU patients require mechanical ventilation, with most discontinuing it after 3–4 days. However, around 5% need prolonged mechanical ventilation (PMV), typically defined as ventilation for 21 or more days or 4+ days with tracheostomy.  The number of PMV patients has been rising. PMV is associated with high in-hospital mortality (~29%), a 50% weaning ...