La pacient d'urgències ara està pitjor que aquest matí.

In Catalan, pacient is commonly the same form for both masculine and feminine:

• el pacient = the male patient
• la pacient = the female patient

So the gender is shown by the article, not by changing the noun itself. That is why the sentence has la pacient.

Here d'urgències means something like from the emergency department or the ER patient.

So:

• la pacient d'urgències = the emergency-room patient / the patient from the ER

Literally, de means of/from, but in hospital language this phrase works as a modifier of pacient.

In Catalan, the hospital department is normally called urgències, in the plural.

So even though English often says the emergency room or emergency, Catalan usually says:

• anar a urgències = to go to the ER
• treballar a urgències = to work in the emergency department

That plural form is just the standard Catalan usage.

Because de becomes d' before a vowel.

So:

• de + urgències → d'urgències

This is a normal Catalan contraction/apostrophe rule, similar to:

• l'hospital
• d'aigua
• m'agrada

Because this sentence talks about the patient's current condition or state, and Catalan normally uses estar for that.

• està pitjor = she is worse / she is in a worse condition now

This is one of the most important uses of estar: physical condition, health, and temporary state.

Using és here would sound wrong or very unnatural, because the sentence is not describing an essential characteristic of the patient; it is describing how she is at the moment.

Yes. Pitjor is the normal Catalan word for worse.

It is an irregular comparative, like English bad → worse.

You will often see:

• bo / bona → millor = better
• dolent / dolenta → pitjor = worse

In sentences about health or condition, pitjor is the natural choice:

• està millor = is better
• està pitjor = is worse

A more literal form like més dolenta is usually less natural here.

Here que means than.

So the structure is:

• pitjor que... = worse than...

This is the normal Catalan comparative pattern:

• millor que = better than
• pitjor que = worse than
• més gran que = bigger than

So:

• està pitjor que aquest matí = she is worse than this morning

Because matí is a masculine noun in Catalan.

So:

• aquest matí = this morning
• aquest vespre = this evening
• aquesta tarda = this afternoon

The demonstrative has to agree with the noun:

• masculine singular: aquest
• feminine singular: aquesta

Yes, you can think of the sentence as slightly shortened.

The full idea is:

• She is worse now than she was this morning.

Catalan, like English, often leaves out the repeated part when it is obvious from context. So que aquest matí is understood as than this morning / than she was this morning.

That makes the sentence sound natural and efficient.

No. Catalan word order is somewhat flexible.

This sentence says:

• La pacient d'urgències ara està pitjor que aquest matí.

But you could also hear:

• Ara la pacient d'urgències està pitjor que aquest matí.
• La pacient d'urgències està ara pitjor que aquest matí.

The version with ara before està is perfectly natural and highlights the contrast with an earlier time: now she is worse.