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This RCT demonstrated modest reduction in 30-day mortality for patients with community-acquired pneumonia (CAP) in Kenya who received a 10-day course of glucocorticoids.
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A Pragmatic Trial of Glucocorticoids for Community-Acquired Pneumonia. N Engl J Med. 2025 Dec 4;393(22):2187-2197. doi: 10.1056/NEJMoa2507100. Epub 2025 Oct 29. PMID: 41159889; PMCID: PMC12659994.
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Older adults discharged from the ED with delirium had almost 3 times the risk of 30-day mortality compared to those discharged without delirium.
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Outcomes of Older Adults With Delirium Discharged From the Emergency Department. Ann Emerg Med. 2025 Nov;86(5):484-495. doi: 10.1016/j.annemergmed.2025.02.003. Epub 2025 Mar 12. PMID: 40072382; PMCID: PMC12353625.
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Presyncope has a 30-day serious cardiac outcome risk that is identical to patients with true syncope—despite presyncope patients being admitted less often and considered lower risk.
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Serious Cardiac Outcomes and Physician Estimation of Risk in Emergency Department Patients With Presyncope Versus Syncope. Ann Emerg Med. 2025 Sep 23:S0196-0644(25)01155-2. doi: 10.1016/j.annemergmed.2025.08.014. Epub ahead of print. PMID: 40990887; PMCID: PMC12462893.
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This review of ground-level falls in older adults found focal neurologic signs, external signs of head trauma, loss of consciousness, and male sex were associated with a higher risk of intracranial hemorrhage (ICH). Pre-injury anticoagulant use was not associated with increased risk for ICH.
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Risk Factors for Traumatic Intracranial Hemorrhage in Older Adults Sustaining a Head Injury in Ground-Level Falls: A Systematic Review and Meta-analysis. Ann Emerg Med. 2025 Jul 22:S0196-0644(25)00313-0. doi: 10.1016/j.annemergmed.2025.05.021. Epub ahead of print. PMID: 40699169.
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Not everything that can bleed will bleed. This retrospective study of elderly mild-TBI patients showed no significant association between antithrombotic medication use and risk of traumatic ICH.
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Association between antithrombotic medications and intracranial hemorrhage among older patients with mild traumatic brain injury: a multicenter cohort study. Eur J Emerg Med. 2025 Jul 1. doi: 10.1097/MEJ.0000000000001246. Epub ahead of print. PMID: 40590793
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This meta-analysis suggests that patients with hypernatremia may have a mortality and length of stay benefit with a faster correction goal than current guidelines.
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Systematic review and meta-analysis of the treatment of hypernatremia in adult hospitalized patients: impact on mortality, morbidity, and treatment-related side effects. J Crit Care. 2025 Jun;87:155012. doi: 10.1016/j.jcrc.2024.155012. Epub 2025 Jan 6. PMID: 39765195
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There is no benefit or harm from taking antihypertensive medications in the morning or at bedtime for frail older adults.
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Bedtime vs Morning Antihypertensive Medications in Frail Older Adults: The BedMed-Frail Randomized Clinical Trial. JAMA Netw Open. 2025 May 1;8(5):e2513812. doi: 10.1001/jamanetworkopen.2025.13812. PMID: 40354050
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In the BedMed RCT, there was no difference in outcomes between bedtime versus morning administration of once-daily antihypertensive medications.
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Antihypertensive Medication Timing and Cardiovascular Events and Death: The BedMed Randomized Clinical Trial. JAMA. 2025 Jun 17;333(23):2061-2072. doi: 10.1001/jama.2025.4390. PMID: 40354045
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For adults ≥60 years, antidepressant initiation was associated with postural hypotension for the first month, regardless of drug mechanism.
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Antidepressants and risk of postural hypotension: a self-controlled case series study in UK primary care. Br J Gen Pract. 2025 May 19:BJGP.2024.0429. doi: 10.3399/BJGP.2024.0429. Epub ahead of print. PMID: 39824621
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This randomized control trial of older ICU patients with septic shock in Japan showed higher mortality and more frequent adverse events in patients randomized to a high MAP goal (80-85 mmHg) compared to usual care (65-70 mmHg).
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Efficacy of targeting high mean arterial pressure for older patients with septic shock (OPTPRESS): a multicentre, pragmatic, open-label, randomised controlled trial. Intensive Care Med. 2025 May;51(5):883-892. doi: 10.1007/s00134-025-07910-4. Epub 2025 May 13. PMID: 40358717