Primary Study

A Korean multicentre registry finds 22.9% of previously non-frail sepsis patients develop new-onset frailty by discharge, with fewer than half of newly-frail survivors discharged home.

A large Swedish cohort study finds newer composite frailty indices predict institutionalisation, mortality and hospitalisation more accurately than commonly used guideline tools.

A single-centre implementation study of therapeutic drug monitoring-guided dalbavancin dosing achieved a full treatment course in three administration visits, with high target attainment and low discontinuation.

A UK cohort study of people with dementia and their carers finds advance care planning uptake tracks carer education and resourcing more closely than clinical need.

The HERO multicentre randomised controlled trial (740 participants, 15 UK sites) found a 24-week therapist-delivered home exercise programme after discharge produced no improvement in 12-month physical health-related quality of life for older people with frailty, at an incremental cost of £1,401 per participant; the authors recommend against routine commissioning.

A UK propensity-matched cohort study found pre-existing multiple long-term conditions cut the odds of full recovery one year after COVID-19 hospitalisation by 34%, driven mainly by pre-existing respiratory disease.

A retrospective cohort study of 2,533 remotely monitored virtual ward admissions found that the National Early Warning Score (NEWS2) had poor predictive accuracy for hospital readmission in this setting, with an area under the curve of 0.55 — raising governance questions for risk stratification in community-based acute care.

A single-centre randomised clinical trial (n=111) found that a hybrid Hospital-at-Home model significantly increased early physical activity — patients took 1,763 more steps in the first 24 hours than inpatients — with higher patient satisfaction and no signal of excess harm.

A systematic review and meta-analysis of 11 studies (n=2,568) found ceftriaxone associated with significantly increased 30-day mortality (OR 3.33, 95% CI 2.17–5.10) compared with antistaphylococcal penicillins or cefazolin for MSSA bloodstream infections. A concurrent cost analysis of CADD-pump-based OPAT demonstrated 88% cost savings versus inpatient care, providing the delivery mechanism for safer beta-lactam alternatives.

A national NHS England-approved analysis of over 970,000 decedent records found that specialist palliative care contacts are recorded in GP records for only 4–5% of patients on average, a rate insufficient to function as a service quality indicator.

A pragmatic NIHR-funded randomised controlled trial across 15 NHS sites found no significant improvement in physical health-related quality of life from a 24-week therapist-delivered home exercise programme for older adults with mild, moderate or severe frailty following hospital discharge.

A retrospective cohort of 2,533 NHS virtual ward admissions found NEWS2 achieved an AUC of 0.55 for predicting unplanned hospital readmission across all pathways — a performance that does not support its use as a decisional threshold in remotely monitored populations, including frailty and OPAT.

A nationwide Finnish cohort found specialist palliative referral more than thirty days before death reduced final-month acute hospitalisation from 38% to 21% and increased hospital-at-home use from 4% to 40%, replicating an NHS heart failure study.

A meta-analysis of eleven studies found ceftriaxone use for MSSA bloodstream infections associated with OR 3.33 for 30-day mortality compared with anti-staphylococcal penicillins or cefazolin.