2025

Oxygen Prescriptions for Gynaecology Inpatients (2025)

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Type of publication:

Service improvement case study

Author(s):

*William Roberts

Citation:

SaTH Improvement Hub, December 2025

SMART Aim:

Trust policy for all inpatients to have a target oxygen saturation identified on admission. Widespread issue with poor oxygen prescription compliance across the country. 47% (n = 15) of gynae inpatients had no oxygen prescribed. Incorrect/absent prescriptions have the potential to cause harm. Target compliance 80%

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Next-of-Kin (NOK) Communication Bundle – Second Cycle (2025)

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Type of publication:

Service improvement case study

Author(s):

*Yasmin Ahmadi, *Giulia Abdel Latif

Citation:

SaTH Improvement Hub, December 2025

SMART Aim:

To evaluate the awareness, use, and perceived helpfulness of the NOK communication sticker among ward staff following its implementation in Cycle 1 by 31st October 2025 as evidenced by staff feedback survey results.

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Intravenous fluid mismanagement: time for national stewardship and quality improvement (2025)

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Type of publication:

Journal article

Author(s):

Breen, Andrew; *Miller, Ashley; Timmins, Alan; Barton, Greg; Kirk-Bayley, Justin; Peck, Marcus John Edwards; Davis, Huw John; Wilkinson, Jonathan.

Citation:

BMJ Open Quality. 14(4), 2025 Dec 14.

DOI: 10.1136/bmjoq-2025-003503

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The Impact of Smoking on Outcomes Following Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-Analysis (2025)

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Type of publication:

Systematic Review

Author(s):

*Ibrahim, Abdelrahman; Al-Musabi, Musab; Kabariti, Rakan; Kempe-Gowda, Swarna; Wade, Roger.

Citation:

Cureus. 17(11):e96765, 2025 Nov.

Abstract:

The influence of smoking on postoperative outcomes following anterior cruciate ligament (ACL) reconstruction is a topic of ongoing scientific discussion and uncertainty. We aimed to conduct a systematic review and meta-analysis to compare the outcomes between smokers and non-smokers undergoing this procedure. We conducted a systematic search of electronic information sources, including MEDLINE, EMBASE, CINAHL, CENTRAL, ClinicalTrials.gov, and bibliographic reference lists. We applied a combination of free-text search and controlled vocabulary search adapted to thesaurus headings, search operators, and limits in each of the above-mentioned databases. Primary outcome parameters included surgical site infections, ACL graft rupture, revision rates, and patient-reported outcome measures (PROMs). We identified 24 comparative studies, including a total of 672,241 patients, of whom 69,113 were in the smoker group and 603,128 were in the non-smoker group. The analysis revealed that smoking was associated with a significantly higher risk of surgical site infections (OR 1.40, P=0.01). Smokers also reported significantly worse PROMs on the International Knee Documentation Committee (IKDC) score (MD -5.38, P<0.00001) and multiple Knee Injury and Osteoarthritis Outcome
Score (KOOS) subscales. There was no statistically significant difference between the two cohorts for ACL graft rupture or all-cause revision rates. Smoking appears to be associated with a higher risk of surgical site infections following ACL reconstruction and is linked to significantly poorer functional PROMs.

DOI: 10.7759/cureus.96765

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Utilising research management technology to streamline and integrate pharmacy clinical trial processes within a multi-disciplinary research team: a service evaluation (2025)

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Type of publication:

Conference abstract

Author(s):

*Essra Y.; *Angela Y.; *Rachel R.;

Citation:

International Journal of Pharmacy Practice. Conference: Royal Pharmaceutical Society Annual Conference, RPS 2025. London United Kingdom. 33(Supplement 1) (pp i17), 2025. Date of Publication: 01 Nov 2025

Abstract:

Introduction: Clinical trials are the gold standard for testing pharmacological, behavioural and policy interventions [1]. In hospital settings, trial setup can be complex, requiring coordination across multiple teams, specialties, and environments. For trials involving InvestigationalMedicinal Products (IMPs), pharmacy departments must align their processes with other research teams in a transparent, efficient, and standardised manner [2]. One approach to achieving this is using a research management system. Aim(s): To evaluate the implementation of a digital research management system (EDGE) in streamlining and standardising the setup of clinical trials involving pharmacy and other departments. Methodology: As this was a service evaluation, ethical approval was not required. Retrospective quantitative data from between 01 May 2022- 28 May 2025 were extracted from the research management system at a single NHS hospital trust. Data were analysed to assess the number of pharmacy workflows set up, turnaround times and the range of clinical trials supported. Qualitative stakeholder feedback on experiences of implementation were also sought from research nurse colleagues and the trust governance and quality assurance lead. Result(s): Between 2022-2025, four pharmacy-specific workflows were developed and implemented. These were: Expression of interest/feasibility; Amendment implementation; Pharmacy site file audit and Trial closure and archiving. A total of 161 workflows were completed across 62 different clinical trials. Notably 67% of pharmacy workflows were completed ahead of their target timelines. Feedback from research nurses and the trust research and governance lead was positive. The implementation of the pharmacy workflows provided greater transparency for pharmacy set-up and management of clinical trials facilitating better collaborative relationships between the team. Use of the workflows also lead to reduction in e-mail correspondence with better ability to track progress with different tasks and provide visibility to obstacles and blockers. Discussion(s): The implementation of a research management system significantly improved the efficiency, transparency, and coordination of pharmacy workflows in clinical trial setup and management. Positive stakeholder feedback and early completion of most workflows suggest that digital tools can enhance interdisciplinary collaboration in research settings. A key limitation is this evaluation was limited to a single NHS trust and relied on retrospective data and informal stakeholder feedback, which may not fully capture the broader impact or generalisability of the findings.

DOI: 10.1093/ijpp/riaf093.092

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Double jeopardy: Escalating mortality trends and disparities in lung cancer patients with sepsis - A retrospective epidemiological study (2025)

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Type of publication:

Conference abstract

Author(s):

Hemida M.F.; Sarfraz M.R.; Khan T.; Mushtaq I.; Ibrahim A.A.; Chandak V.; Al-Saadi M.; Sharhiar Z.; *Ali A.

Citation:

Thorax. Conference: British Thoracic Society Winter Meeting 2025. Westminster . 80(Supplement 2) (pp A249-A250), 2025. Date of Publication: 01 Nov 2025

Abstract:

Background Lung cancer (LC) remains the leading cause of cancer-related mortality globally. Studies indicate LC patients with sepsis have significantly lower survival rates, yet the temporal trends and disparities in mortality remain unexplored. We examined mortality trends and disparities of LC complicated by sepsis across different sociodemographic strata. Methods This retrospective study analysed death certificate data from the Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research database from 1999-2023, for individuals >=25 years with multiple causes of death listed as lung/bronchus cancer (ICD-10: C34) with sepsis. Age-adjusted mortality rates (AAMRs) per 100,000 population were calculated and stratified by sex, race/ethnicity, and geographic region, with Joinpoint regression analysis to determine the change in mortality trends. Results From 1999-2023, 103,907 deaths were attributed to LC with co-existing sepsis, demonstrating increasing mortality trends throughout the study period. AAMRs rose significantly from 1.61 in 1999 to 2.07 in 2023 (AAPC: 1.32%; p<0.000001). Sex-stratified analysis revealed men had consistently higher overall AAMRs (2.32/100,000) with an AAPC of 0.49% (95% CI: -0.12 to 1.12; p=0.12) compared to women (1.37/100,000) with an AAPC of 1.94% (95% CI: 1.74 to 2.14; p<0.000001). Patients aged >=65 years exhibited the highest mortality rates (6.59%). Racially, non-Hispanic (NH) Black individuals had the highest overall AAMRs with increasing mortality patterns (AAMRs: 2.57/100,000; AAPC: 0.32%; 95% CI: 0.045 to 0.599; p=0.02), while Hispanic populations recorded the lowest AAMR (1.01/100,000; AAPC: 0.61%; 95% CI: 0.156 to 1.068; p=0.01). Regionally, the South demonstrated the highest mortality (AAMRs: 2.04), followed by the Northeast (AAMRs: 1.78), Midwest (AAMRs: 1.75), and West (AAMRs: 1.42). Most deaths occurred in inpatient medical facilities (90,425 deaths; 87%). Conclusion Mortality rates increased significantly over the study period with a significant increase during recent years. Notable disparities across sex, race/ethnicity, and geographic regions were observed, with NH Black populations and Southern states showed highest mortality rates. These findings highlight the urgent need for targeted sepsis prevention protocols in LC patients, enhanced surveillance systems for high-risk demographics, and comprehensive region-specific interventions to address underlying healthcare disparities and improve clinical outcomes across all populations.

DOI: 10.1136/thorax-2025-BTSabstracts.358

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Epidemiology of cystic fibrosis-related deaths in the united states, 1999-2023: A CDC WONDER-based study (2025)

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Type of publication:

Conference abstract

Author(s):

Mushtaq I.; Sarfraz M.R.; Hemida M.F.; *Ali A.; Ibrahim A.A.; Patel K.; Saghir M.; Sharhiar Z.; Ahmad H.M.; Chaudhry Z.J.

Citation:

Thorax. Conference: British Thoracic Society Winter Meeting 2025. Westminster . 80(Supplement 2) (pp A55-A56), 2025. Date of Publication: 01 Nov 2025.

Abstract:

Background Cystic fibrosis (CF) is a hereditary multisystem disorder predominantly affecting the respiratory system, contributing significantly to morbidity and mortality in the developed nations, despite advancement in treatments. Characterizing mortality patterns across demographic and geographic populations is essential for developing targeted prevention and management strategies. Therefore, we analyzed temporal mortality trends in cystic fibrosis across diverse populations in the United States from 1999-2023. Methods Data were extracted from the CDC WONDER database (1999-2023) to identify mortality rates among individuals aged >=1 year with CF listed as the underlying cause of death (ICD-10: E84.0, E84.1, E84.8, E84.9). Age-adjusted mortality rates (AAMRs) per 100,000 population were calculated and stratified by sex, age group, race/ethnicity, geographic region, and place of death. Temporal trends were analyzed using Joinpoint regression to estimate average annual percent change (AAPC). Results From 1999-2023, 11,997 deaths were reported among individuals with CF across all age groups (<1 to >=65 years). The AAMR decreased significantly from 0.19 in 1999 to 0.09 in 2023 (AAPC: -3.1%; p<0.000001), with accelerated decline in recent years. Both sexes demonstrated comparable average AAMRs (0.15), though with different rates of decline: men (AAPC: -2.7%; 95% CI: -4.17 to -1.29; p=0.0002) and women (AAPC: -2.9%; 95% CI: -4.19 to -1.66; p=0.000008). By race/ethnicity, non-Hispanic populations exhibited higher overall AAMRs compared to Hispanics (0.18 vs. 0.06), with incongruent trends observed among non-white races and Hispanic populations. Regionally, the Midwest recorded the highest AAMR (0.17), followed by the South (0.16), Northeast (0.15), and West (0.13). Age-stratified analysis revealed peak mortality in the 15-34 years group (0.32/100,000), followed by the 35-64 years group (0.12/100,000). Most deaths occurred in inpatient medical facilities (8,260 deaths; 68.8%). Conclusion CF mortality rates declined significantly over two decades, with comparable reductions in both sexes. However, substantial disparities persist, with young adults (15-34 years) experiencing high mortality rates and notable racial/ethnic differences. Regional disparities were evident across geographic areas. While these findings suggest improved CF management and care, they underscore the critical need for targeted interventions addressing persistent demographic and geographic disparities to ensure equitable outcomes across all populations.

DOI: 10.1136/thorax-2025-BTSabstracts.79

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Eosinophilic phenotype and bacterial load in hospitalised patients with exacerbations of COPD (2025)

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Type of publication:

Conference abstract

Author(s):

*Thumbe A.; *Ahmad N.

Citation:

Thorax. Conference: British Thoracic Society Winter Meeting 2025. Westminster . 80(Supplement 2) (pp A122), 2025. Date of Publication: 01 Nov 2025.

Abstract:

Background COPD is a heterogenous disease, and the eosinophilic phenotype is now well recognised as a treatable trait. However, it is less well known as to what extent bacterial infections affect this group of patients.1 Aim Our primary aim was to look at the incidence of bacterial growth in eosinophilic and the non-eosinophilic phenotype within our cohort of patients with COPD. Method A retrospective analysis was conducted on patients coded has having been admitted to our Trust with COPD exacerbations from October 2020 to April 2021. Historic sputum culture results were collected from our web-based patient portal. Patients were included in the analysis if they had a sputum culture showing bacterial growth at any time. Eosinophilic phenotypes (EP) were defined as having a blood eosinophil count >=0.3×109/L and non-eosinophilic phenotypes (NEP) as having a blood eosinophil count<0.3×109/L. Results In the study period, 337 unique patients were admitted with COPD exacerbations. They had a mean age (SD) of 73 (9) years, 49.6% (167/337) were female and 64.1% (216/337) were EP. 47% (n=157/337) patients had at least one positive sputum culture. Of these, 68.8% (n=108/157) were classified as EP. 72%(n=108/150) of EP had a positive sputum culture compared to 70% (n=49/70) of NEP; Odds Ratio 1.10 (95% CI 0.59-2.06); Chi-Square 0.021; p=0.88. When compared, NEP had higher burden of H. Influenzae, Strep Pneumoniae and Moraxella (59%, 20% and 20% vs 55%, 19% and 15%, respectively) whereas EP had a higher burden of Coliforms, Pseudomonas sp and S.aureus (32%, 30% and 15% v 25%, 25% and 8%, respectively). Conclusion Our findings suggest that in COPD patients requiring hospital admission, there is no significant difference between the bacterial burden of EP and NEP. Hence, future treatments of EP should not only include biologics but also focus on the role of bacteria in preventing exacerbations.

DOI: 10.1136/thorax-2025-BTSabstracts.179

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