Background: Low serum magnesium (sMg) is associated with cardiovascular risk factors and atherosclerotic disease. Objective: To evaluate the association between sMg levels on admission and clinical outcomes in hospitalized non-ST-elevation myocardial infarction (NSTEMI) patients. Methods: A retrospective analysis of all patients admitted to a single tertiary center with a primary diagnosis of NSTEMI. Patients with advanced chronic kidney disease were excluded. Clinical data were collected and compared between lower sMg quartile patients (Q1; sMg < 1.9 mg/dL) and all other patients (Q2–Q4; sMg ≥ 1.9 mg/dL). Results: The study cohort included 4552 patients (70% male, median age 69 [IQR 59–79]) who were followed for a median of 4.4 (IQR 2.4–6.6) years. The median sMg level in the low sMg group was 1.7 (1.6–1.8) and 2.0 (2.0–2.2) mg/dL in the normal/high sMg group. The low sMg group was older (mean of 72 vs. 67 years), less likely to be male (64% vs. 72%), and had higher rates of comorbidities, including diabetes, hypertension, and atrial fibrillation (59% vs. 29%, 92% vs. 85%, and 6% vs. 5%; p < 0.05 for all). Kaplan–Meier survival analysis demonstrated significantly higher cumulative death probability at 4 years in the low sMg group (34% vs. 22%; p log rank <0.001). In a multivariable analysis model adjusted for sex, significant comorbidities, coronary interventions during the hospitalization, and renal function, the low sMg group exhibited an independent 24% increased risk of death during follow up (95% CI 1.11–1.39; p < 0.001). Conclusions: Low sMg is independently associated with higher risk of long-term mortality among patients recovering from an NSTEMI event.

Background: Clostridioides difficile (CD) is the main cause of nosocomial diarrhea, resulting in increased morbidity and mortality, and is thought to be greatly affected by strict hygiene. In this study, we assessed changes in CD infection prevalence and outcomes pre- and during the COVID-19 pandemic (CP). Methods: This was an observational cohort performed at a tertiary medical center (MC) and a geriatric hospital (GH). Patients from both hospitals diagnosed with CD were included, and the period of one year prior to the pandemic to one year after was compared. Data was extracted from electronic medical records (EMR). Results: A total of 145 CD-associated diarrhea (CDAD) cases were diagnosed in the MC and 54 in the GH. There was no change in CDAD prevalence or mortality between the study periods in either hospital. Disease duration, measured as days with diarrhea (DWD), was shorter during the CP in the GH (10.6 days vs. 8.1 days, p < 0.01). CDAD was more prevalent in the GH during both periods; however, the disease was milder, with only three mortality cases and a significantly shorter disease duration (3.19 DWD vs. 10.67 in the MC before CP; 3.11 vs. 8.1 during CP, p < 0.01). In a survival analysis for MC patients, no significant differences were found between periods before and after adjustment for age, gender and period. Conclusions: The CP affected the duration but not the prevalence of CDAD. The milder course of CDAD in the GH may have been due to the quality of treatment provided in an academic GH and the subsequent faster diagnosis and treatment.

Background and Objectives: Older nursing-care patients are a clinically complex population with marked functional dependence, cognitive impairment, nutritional vulnerability, and multimorbidity. Although nursing-home residents are often considered at higher risk for adverse outcomes, many highly dependent older adults receive nursing care at home. Materials and Methods: This single-center retrospective cohort study included 501 nursing-care patients hospitalized between December 2022 and December 2023, of whom 334 were admitted from home and 167 from nursing homes. The primary outcome was in-hospital mortality; secondary outcomes included length of hospital stay, discharge destination, and 90-day post-discharge mortality among patients discharged alive. Longer-term survival analyses were exploratory. Demographic, clinical, functional, nutritional, laboratory, hospitalization, and mortality data were evaluated. Results: The median age was 85 years (IQR, 11), and 63.1% of patients were women. Patients admitted from home were older than those admitted from nursing homes (median 86 vs. 84 years; p = 0.036). Nursing-home patients more frequently presented with fever and infection-related diagnoses and had a higher prevalence of dementia (85.0% vs. 58.1%; p < 0.001), greater pressure-ulcer risk according to the Norton scale (p < 0.001), and greater nutritional vulnerability according to the MNA-mini (p = 0.007). Median length of stay did not differ significantly between groups (p = 0.755). In-hospital mortality was 23.7% in patients admitted from home and 18.6% in those admitted from nursing homes (p = 0.194). Among patients discharged alive, 90-day post-discharge mortality was 24.3% and 28.7%, respectively (p = 0.348). In the extended Cox model for 90-day post-discharge mortality, neither source of admission nor its time-dependent interaction was significantly associated with mortality (source of admission: HR, 0.831; 95% CI, 0.097–7.096; p = 0.865; time-dependent interaction: HR, 1.036; 95% CI, 0.573–1.873; p = 0.907). Conclusions: No statistically significant difference in in-hospital mortality was detected according to source of admission. Nursing-home patients had greater cognitive, nutritional, pressure-ulcer-risk, and infection-related vulnerability. These findings do not establish equivalence between groups and should be interpreted together with individual clinical characteristics.