JAMA Internal Medicine

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IMPORTANCE: It is uncertain whether preoperative medical consultation reduces adverse postoperative clinical outcomes. OBJECTIVE: To investigate the association of preoperative medical consultation with reduction in adverse postoperative outcomes and use of processes of care. DESIGN, SETTING, AND PARTICIPANTS: This was a retrospective cohort study using linked administrative databases from an independent research institute housing routinely collected health data for Ontario's 14 million residents, including sociodemographic features, physician characteristics and services, and receipt of inpatient and outpatient care...

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IMPORTANCE: Patients with septic shock may benefit from the initiation of corticosteroids. However, the comparative effectiveness of the 2 most studied corticosteroid regimens (hydrocortisone with fludrocortisone vs hydrocortisone alone) is unclear. OBJECTIVE: To compare the effectiveness of adding fludrocortisone to hydrocortisone vs hydrocortisone alone among patients with septic shock using target trial emulation. DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study from 2016 to 2020 used the enhanced claims-based Premier Healthcare Database, which included approximately 25% of US hospitalizations...

IMPORTANCE: Patients receiving maintenance dialysis experience intensive patterns of end-of-life care that might not be consistent with their values. OBJECTIVE: To evaluate the association of patients' health care values with engagement in advance care planning and end-of-life care. DESIGN, SETTING, AND PARTICIPANTS: Survey study of patients who received maintenance dialysis between 2015 and 2018 at dialysis centers in the greater metropolitan areas of Seattle, Washington, and Nashville, Tennessee, with longitudinal follow-up of decedents...

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IMPORTANCE: Post-COVID-19 condition (PCC) is a complex heterogeneous disorder that has affected the lives of millions of people globally. Identification of potential risk factors to better understand who is at risk of developing PCC is important because it would allow for early and appropriate clinical support. OBJECTIVE: To evaluate the demographic characteristics and comorbidities that have been found to be associated with an increased risk of developing PCC. DATA SOURCES: Medline and Embase databases were systematically searched from inception to December 5, 2022...

IMPORTANCE: Post-COVID-19 condition (PCC), also known as long COVID, affects many individuals. Prevention of PCC is an urgent public health priority. OBJECTIVE: To examine whether treatment with nirmatrelvir in the acute phase of COVID-19 is associated with reduced risk of PCC. DESIGN, SETTING, AND PARTICIPANTS: This cohort study used the health care databases of the US Department of Veterans Affairs (VA) to identify patients who had a SARS-CoV-2 positive test result between January 3, 2022, and December 31, 2022, who were not hospitalized on the day of the positive test result, who had at least 1 risk factor for progression to severe COVID-19 illness, and who had survived the first 30 days after SARS-CoV-2 diagnosis...

IMPORTANCE: Given the high risk of thrombosis and anticoagulation-related bleeding in patients with hypoxemic COVID-19 pneumonia, identifying the lowest effective dose of anticoagulation therapy for these patients is imperative. OBJECTIVES: To determine whether therapeutic anticoagulation (TA) or high-dose prophylactic anticoagulation (HD-PA) decreases mortality and/or disease duration compared with standard-dose prophylactic anticoagulation (SD-PA), and whether TA outperforms HD-PA; and to compare the net clinical outcomes among the 3 strategies...

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IMPORTANCE: The study results suggest that delirium is the most common postoperative complication in older adults and is associated with poor outcomes, including long-term cognitive decline and incident dementia. OBJECTIVE: To examine the patterns and pace of cognitive decline up to 72 months (6 years) in a cohort of older adults following delirium. DESIGN, SETTING, AND PARTICIPANTS: This was a prospective, observational cohort study with long-term follow-up including 560 community-dwelling older adults (older than 70 years) in the ongoing Successful Aging after Elective Surgery study that began in 2010...

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