Emergency Medicine International最新文献

{"title":"The Age-Modified Shock Index: Predicting Massive Transfusion and Mortality in Traumatic Injury Patients.","authors":"Soo Bin Choi, Suck Ju Cho, Seok-Ran Yeom, Sung-Wook Park, Young Mo Cho, Up Huh, Yeaeun Kim, Dongman Ryu, Chanhee Song, Won Ung Tae, Il Jae Wang","doi":"10.1155/emmi/8754824","DOIUrl":"10.1155/emmi/8754824","url":null,"abstract":"<p><p><b>Background and Purpose:</b> Previous studies have demonstrated that the shock index (SI), age-adjusted shock index (ASI), and modified shock index (MSI) are useful for predicting massive transfusion (MT) and mortality in patients with traumatic injuries. However, studies have not been conducted on the use of the age-modified shock index (AMSI) to indicate the prognosis of patients with traumatic injuries. This study aimed to evaluate the predictive power of AMSI for MT and mortality. We hypothesized that AMSI would be superior to other indices in predicting outcomes in patients with traumatic injuries. <b>Methods:</b> This retrospective, single-center study was conducted at a level 1 trauma center and included consecutive patients who visited the trauma center between January 2016 and December 2022. The predictive value of AMSI for MT, in-hospital mortality, and 24 h mortality was assessed using receiver operating characteristic (ROC) analysis. We compared the area under the ROC curve (AUROC) of AMSI with those of SI, ASI, and MSI. <b>Results:</b> In total, 6591 patients were included in the study, of whom 479 received MT. The in-hospital and 24 h mortality rates were 8.7% and 5.3%, respectively. The SI, ASI, MSI, and AMSI all showed better predictive performance for MT (AUC > 0.7) than that for in-hospital (AUC: 0.50, 0.61, 0.50, and 0.62) and 24 h mortality (AUC: 0.54, 0.56, 0.54, and 0.56). However, AMSI did not demonstrate superior performance compared with the other indices (SI, ASI, and MSI) in predicting both MT and 24 h mortality. AMSI demonstrated significantly better predictive performance for in-hospital mortality than the other indices; however, the difference from ASI was not substantial. This is likely because age has a significant impact on in-hospital mortality. <b>Conclusion:</b> Indices other than AMSI that are easier to compute may be more useful for the prognostic evaluation of patients with traumatic injuries.</p>","PeriodicalId":11528,"journal":{"name":"Emergency Medicine International","volume":"2025 ","pages":"8754824"},"PeriodicalIF":1.2,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12158586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender-Based Clinical Differences in Hymenoptera Venom Poisoning: A Retrospective Study From Taiwan (April 2021 to March 2023).","authors":"Ching-Hsiang Yu, Sheng-Teck Tan, Hsiu-Wu Yang, Yen-Chun Lai, Yu-Jang Su","doi":"10.1155/emmi/8893175","DOIUrl":"10.1155/emmi/8893175","url":null,"abstract":"<p><p><b>Background:</b> Hymenoptera stings are a common cause of emergency visits. <b>Objective:</b> This study aims to assess potential gender disparities in clinical presentation and outcomes of Hymenoptera stings. <b>Methods:</b> Medical records were collected from a single medical center in Northern Taiwan, covering the period from April 1, 2021, to March 31, 2023. A total of 87 patients with confirmed Hymenoptera sting incidents were identified. Data on gender, sting location, clinical presentation, diagnostic evaluation, complications, treatment, and clinical outcomes were analyzed. <b>Results:</b> Among the 87 patients, 47.1% were male and 52.9% were female, showing a nearly balanced distribution of cases. Females experienced a higher rate of stings during holidays. Males, however, were more likely to suffer from severe systemic reactions and had a higher average number of stings compared to females (1.3 vs. 1.0, <i>p</i>=0.049). <b>Conclusion:</b> Males are at higher risk for multiple stings and severe systemic reactions from Hymenoptera stings. Additionally, females tend to experience more stings during spring and autumn compared to males.</p>","PeriodicalId":11528,"journal":{"name":"Emergency Medicine International","volume":"2025 ","pages":"8893175"},"PeriodicalIF":1.2,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Maternal Prepregnancy Nutritional Status on Pregnancy Outcomes.","authors":"Yejuan Jiang, Xue Wang, Lilong Wu, Xiaoge Huang, Xingru Cao","doi":"10.1155/emmi/1502902","DOIUrl":"10.1155/emmi/1502902","url":null,"abstract":"<p><p><b>Background:</b> The influence of prepregnancy body mass index (BMI) and dietary patterns on pregnancy outcomes remains unclear. This study examines the sociodemographic factors affecting the prepregnancy BMI and dietary health, as well as their impact on maternal and neonatal complications. <b>Methods:</b> A total of 1064 women were enrolled at the Jinan Maternal and Child Health Hospital (Shandong, China) from January 2021 to December 2023. The China pregnancy healthy diet index (CHDI-P) was used to assess dietary health. Regression analyses were conducted to evaluate the relationship between sociodemographic characteristics, the BMI, CHDI-P scores, and adverse pregnancy outcomes. <b>Results:</b> Higher education and moderate income were protective factors for maintaining a normal BMI, while older maternal age was linked to dietary patterns. Prepregnancy obesity significantly increased the risk of gestational diabetes and hypertension, while overweight and obesity were associated with a lower risk of small-for-gestational-age (SGA) births. Additionally, suboptimal dietary patterns were linked to a higher risk of large-for-gestational-age (LGA) infants and macrosomia. <b>Conclusion:</b> Prepregnancy overweight, obesity, and unhealthy dietary patterns contribute to adverse pregnancy outcomes, including gestational diabetes, hypertension, LGA, and macrosomia. These findings highlight the importance of weight management and nutritional guidance before and during pregnancy, particularly for women with lower educational attainment.</p>","PeriodicalId":11528,"journal":{"name":"Emergency Medicine International","volume":"2025 ","pages":"1502902"},"PeriodicalIF":1.2,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12143946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differences in Characteristics of Trauma Between General Trauma and Suicidal Trauma-Trauma Mechanism, Injury Site, and Severity: A Single-Center Study.","authors":"Ji Young Hyun, Yae Jun Son, SuHyun Kim, Keum Seok Bae, Jae Sik Chung, Il Hwan Park, Young Un Choi","doi":"10.1155/emmi/6058288","DOIUrl":"10.1155/emmi/6058288","url":null,"abstract":"<p><p><b>Background:</b> Among patients with trauma, those with self-harm exhibit different characteristics than those who experience general accidents. Unstable vital signs following a severe injury often limit accurate imaging and injury assessment during initial treatment, rendering decision-making challenging for definitive care. Identifying correlations between damage area and severity can improve predictions and treatment decisions. We identify differences in characteristics of trauma between patients who experienced general accidents and those who attempted suicide. <b>Methods:</b> This study investigates differences in trauma characteristics between accidental and self-harm injuries in a single-center cohort of 10,180 patients (2015-2023). We analyzed age, sex, trauma mechanism, intention of suicide, Abbreviated Injury Scale (AIS) score, injury severity score (ISS), and height for falls. We divided intentionality into accident and self-harm and analyzed and compared their characteristics. <b>Results:</b> The self-harm group was significantly younger (mean: 10 years younger, <i>p</i> < 0.05) and had a higher proportion of falls (41.0%) and stab injuries (48.9%). Self-harm falls were more severe, with a mean fall height of 10.8m (vs. 4.14m in the accidental group, <i>p</i> < 0.001), resulting in a higher ISS (18.6 vs. 15.5, <i>p</i> < 0.05). In the self-harm group, fall attempts were common among teenagers and those in their 20s, while knife injuries were common in individuals in their 40s and 50s. <b>Conclusion:</b> This study confirmed the relationship between the injury mechanism and AIS in patients with trauma. The damaged area and degree of damage differed between the self-harm and accident groups, even with the same mechanism. Understanding these patterns can enhance initial ER assessments and reduce missed injuries in high-risk patients.</p>","PeriodicalId":11528,"journal":{"name":"Emergency Medicine International","volume":"2025 ","pages":"6058288"},"PeriodicalIF":1.2,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Efficacy of the Marburg Heart Score to Triage Patients Presenting With Chest Pain in an Emergency Department: A Prospective, Multicenter, Observational Study.","authors":"Loïc Druilhe, Lucie Creusier, Jérémy Pasco, Julie Eloi, Virginie Furet, Eric Roupie, Richard Macrez","doi":"10.1155/emmi/6085679","DOIUrl":"10.1155/emmi/6085679","url":null,"abstract":"<p><p><b>Objective:</b> Chest pain is a common complaint in emergency departments. Although most patients are admitted to emergency department intensive care, only 12% have acute coronary syndrome. An accurate, efficient score is needed to improve triage and prevent unnecessary referrals to emergency department intensive care. The Marburg Heart Score, validated to rule out acute coronary syndrome in primary care, is quick to administer and does not require test results. This study aims to assess whether the Marburg Heart Score is effective in a triage setting for patients presenting with chest pain in emergency departments. <b>Method:</b> This prospective, observational, multicenter study was conducted with triage nurses in four hospitals in France between July 15, 2018, and May 31, 2019. The primary endpoint was the negative predictive value of the Marburg Heart Score ≤ 2 for ruling out acute coronary syndrome. Acute coronary syndrome diagnosis was made using medical record data combined with a diagnosis from the physician in charge. <b>Results:</b> A total of 1045 patients were included. For a cutoff score of ≤ 2, the negative predictive value for suspected acute coronary syndrome was 95.6% (95% CI [94.0-97.2]) and the area under the curve was 0.603 (95% CI [0.521-0.685]). There were 28 false negatives, two of which were due to the score being completed incorrectly. <b>Conclusion:</b> This study reveals that the Marburg Heart Score is an efficient tool to direct patients presenting with chest pain and MHS < 2 to a conventional ED bed. This could potentially optimize triage in the emergency department to prevent overloading the emergency department intensive care.</p>","PeriodicalId":11528,"journal":{"name":"Emergency Medicine International","volume":"2025 ","pages":"6085679"},"PeriodicalIF":1.2,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12116132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification and Experimental Validation of Biomarkers Associated With Mitochondria and Macrophage Polarization in Sepsis.","authors":"Liping She, Xiaojing Deng, Yeping Bian, Hui Cheng, Jian Xu","doi":"10.1155/emmi/8755175","DOIUrl":"10.1155/emmi/8755175","url":null,"abstract":"<p><p><b>Background:</b> Sepsis is a common and serious condition, where mitochondria and macrophage polarization play a crucial role. Therefore, this study aimed to identify and validate biomarkers for sepsis associated with mitochondria-related genes (MCRGs) and macrophage polarization-related genes (MPRGs), providing new targets and strategies for therapeutic intervention. <b>Methods:</b> This study utilized the GSE95233 and GSE28750 datasets. Initially, intersection genes were identified by overlapping MCRGs and the results from differential expression analysis and weighted gene co-expression network analysis (WGCNA). Biomarkers were identified through machine learning and gene expression analysis. A nomogram was developed and evaluated based on these biomarkers. Finally, functional enrichment, immune infiltration, and reverse transcription quantitative polymerase chain reaction (RT-qPCR) analyses were conducted to further elucidate the biological mechanisms underlying sepsis. <b>Results:</b> The study identified YME1L1, ECHDC3, THEM4, and COQ10A as biomarkers for sepsis. Among them, YME1L1, THEM4, and COQ10A showed significantly lower expression levels in sepsis samples, while ECHDC3 exhibited markedly higher expression. Notably, RT-qPCR analysis confirmed that YME1L1, THEM4, and COQ10A exhibited significantly lower expression levels in sepsis samples. A nomogram based on these biomarkers was developed and validated, effectively predicting sepsis risk. Enrichment analysis indicated that the biomarkers were co-enriched in the oxidative phosphorylation pathway. Additionally, 13 significantly different immune cell types were identified between sepsis and control samples. Biomarker association analysis revealed that CD8 T cells had the strongest positive correlation with YME1L1 (cor = 0.84, <i>p</i> < 0.05) and the strongest negative correlation with ECHDC3 (cor = -0.76, <i>p</i> < 0.05), suggesting their potential role in the disease mechanism. <b>Conclusion:</b> In this study, YME1L1, ECHDC3, THEM4, and COQ10A were identified as biomarkers for sepsis, with their expression levels validated in clinical samples. These findings provided a promising theoretical foundation for the development of targeted treatments for sepsis.</p>","PeriodicalId":11528,"journal":{"name":"Emergency Medicine International","volume":"2025 ","pages":"8755175"},"PeriodicalIF":1.2,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of Revised Simplified Geneva Score in Triage Nurse Evaluation for Patients With Suspected Pulmonary Embolism: A Retrospective Chart Review.","authors":"Nicola Osti, Alberto Maino, Giulia Moreschini, Cristina Marinconz, Nicola Susca, Cristina Contu, Vito Racanelli, Anna Brugnolli","doi":"10.1155/emmi/2807776","DOIUrl":"10.1155/emmi/2807776","url":null,"abstract":"<p><p><b>Background:</b> Pulmonary embolism (PE) is a clinical condition frequently encountered in the emergency department (ED), with a high and early mortality rate. ED triage determines the priority of further evaluation of care at the time of patient arrival. Very little is known about the specific role of ED triage in PE. We aimed to evaluate (1) whether the current five-level triage (5LT) system can identify patients with PE and differently prioritize them for medical evaluation and (2) the discriminatory capacity of simplified revised Geneva score (SRGS) toward PE diagnosis when calculated by triage nurses. <b>Methods:</b> A retrospective chart review on ED patients who underwent computed tomography pulmonary angiography (CTPA) in 2023. Based on the CTPA report, patients were categorized into two subgroups: CTPA PE-negative and CTPA PE-positive. We then searched for correlations between PE diagnosis and triage priority level, time from triage to medical evaluation, SRGS, and National Early Warning Score 2 (NEWS2). <b>Results:</b> Of the 196 patients included in the analysis (age 71.1 ± 16.9), 45 (23.0%) were CTPA PE-positive (26 proximal PE and 19 distal PE). There was no correlation between the assigned triage color code and the CTPA results. Although we found a statistically significant difference in the prevalence of CTPA-confirmed PE according to the results of the SRGS (<i>p</i> = 0.014), the SRGS calculated at the time of triage showed a poor prediction accuracy for subsequent PE diagnosis (area under curve [AUC] 0.608). NEWS2 was significantly associated with the triage-assigned priority level (<i>p</i> < 0.001). <b>Conclusions:</b> The current 5LT was unable to differently prioritize patients with or without PE, and it seems unlikely that implementation of SRGS in the triage nurse evaluation will significantly improve the prioritization of patients with suspected PE for medical evaluation. Nonetheless, application of SRGS in triage evaluation may improve the appropriateness of the subsequent clinical pathway for PE diagnosis and risk stratification.</p>","PeriodicalId":11528,"journal":{"name":"Emergency Medicine International","volume":"2025 ","pages":"2807776"},"PeriodicalIF":1.2,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Noradrenaline Administration Dosage on the Occurrence of Peripheral Intravenous Catheter-Related Venous Phlebitis in Critically Ill Patients Using a Time-Dependent Multilevel Cox Regression Model.","authors":"Hideto Yasuda, Claire M Rickard, Jessica A Schults, Nicole Marsh, Masahiro Kashiura, Yuki Kishihara, Yutaro Shinzato, Shunsuke Amagasa, Takashi Moriya, Yuki Kotani, Natsuki Kondo, Kosuke Sekine, Nobuaki Shime, Keita Morikane, Takayuki Abe","doi":"10.1155/emmi/4457109","DOIUrl":"10.1155/emmi/4457109","url":null,"abstract":"<p><p><b>Purpose:</b> Peripheral intravenous catheter (PIVC)-administered noradrenaline offers faster treatment for septic shock but risks complications like phlebitis. We aimed to investigate the relationship between the total noradrenaline dose administered via PIVCs and the development of phlebitis by considering the influence of noradrenaline as a time-dependent covariate. <b>Methods:</b> A post hoc analysis was conducted on prospective multicenter cohort data from 23 intensive care units in Japan. The total noradrenaline dose was included as a time-dependent variable in a multilevel Cox regression model, and smoothing splines assessed nonlinear relationships. The primary endpoint was phlebitis. Directed acyclic graphs were used to define confounding factors for the analysis. <b>Results:</b> The analysis included 3410 PIVCs from 1351 patients, with noradrenaline administered to 70 patients (5.2%) with 91 PIVCs (2.6%). The median dwell time and interquartile range of PIVCs was 46.2 h (21.3-82.9). No significant association was observed between the total noradrenaline dose and the occurrence of phlebitis through analysis using the multilevel Cox regression model with time-dependent covariate, which assumed the linear relationship between phlebitis occurrence and the total noradrenaline dose (hazard ratio 1.06, 95% confidence interval [CI] 0.93-1.20). Spline curve analysis suggested a nonlinear relationship between the total noradrenaline dose and phlebitis, and the risk of phlebitis increased when the total administered dose of noradrenaline exceeded 6 mg as the lower limit of the 95% CI exceeded the significant threshold of 1.0. Sensitivity analyses, including additional potential risk factors, showed consistent results compared with those of the primary analysis. <b>Conclusions:</b> Administering noradrenaline within a total dose not exceeding 6 mg reduces the risk of phlebitis, potentially allowing safer administration through PIVCs. <b>Trial Registration:</b> UMIN Clinical Trials Registry (UMIN-CTR): UMIN000028019.</p>","PeriodicalId":11528,"journal":{"name":"Emergency Medicine International","volume":"2025 ","pages":"4457109"},"PeriodicalIF":1.2,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12074845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single-Substance SSRI Intoxication: A Clinical and Outcome Profile Presentation in a Poisoning Referal Center.","authors":"Rokhsareh Meamar, Zahra Rabiei, Awat Feizi, Melika Namvar, Nastaran Eizadi-Mood","doi":"10.1155/emmi/4727543","DOIUrl":"https://doi.org/10.1155/emmi/4727543","url":null,"abstract":"<p><p><b>Background:</b> Due to the increasing concern about selective serotonin reuptake inhibitors (SSRIs) poisoning, specifically the risk of serotonin syndrome (SS), and the QT-prolonging effects of certain SSRIs, we evaluated the clinical presentations and outcomes of patients who overdosed on single SSRIs. <b>Methods:</b> We carried out a cross-sectional study at a Poisoning Emergency referal center in Isfahan, Iran, involving 101 patients who had taken a single SSRI drug and were hospitalized between January 2021 and January 2024. Information on demographics, toxicological features, clinical symptoms, electrocardiogram (ECG) findings, and outcomes was gathered. <b>Results:</b> The average age of the patients was 26.98 ± 10.57 years. Females outnumbered males (male to female ratio was 1:3.8). Sertraline was the most frequently ingested SSRI (43.6%), followed by fluoxetine (18.8%). Gastrointestinal symptoms (nausea and vomiting) were the most common clinical signs (<i>n</i> = 30, 29.7%). Six patients (5.9%) were diagnosed with SS. Only one patient experienced a brief, self-limiting seizure after consuming 4 g of sertraline. ECG showed QT interval prolongation (QT prolongation) in 32 patients (31.6%). One patient developed a first-degree AV block after taking 600 mg of citalopram. There was no significant difference in QT prolongation or SS based on the type of SSRI used. All patients survived without complications. <b>Conclusion:</b> This study indicates that overdosing on a single SSRI typically results in mild to moderate clinical manifestations. Cardiac issues, such as QT prolongation, were relatively common among our patients.</p>","PeriodicalId":11528,"journal":{"name":"Emergency Medicine International","volume":"2025 ","pages":"4727543"},"PeriodicalIF":1.2,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12065973/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Enhanced Hydration Therapy and Improved Prognosis in Patients With Acute Ischemic Stroke Who Were Treated With Thrombolytics: A Preliminary Study.","authors":"Leng Chieh Lin, Chen-June Seak, Yen Chu Huang, Yuan Hsiung Tsai, Jen Tsung Yang, Kai-Hsiang Wu, Chia-Peng Chang, Yen Yun Tsai","doi":"10.1155/emmi/1220736","DOIUrl":"https://doi.org/10.1155/emmi/1220736","url":null,"abstract":"<p><p><b>Introduction:</b> Hypovolemia affects the clinical outcomes and efficacy of thrombolytic therapies such as recombinant tissue plasminogen activator (rt-PA). Hence, it plays an essential role in stroke management. Blood urea nitrogen-to-creatinine ratio (BCR) is an indicator of hypovolemia and is a promising area of further investigation. <b>Methods:</b> This study assessed the efficacy of enhanced hydration therapy in patients with acute ischemic stroke (AIS) who had an elevated BCR and were receiving rt-PA treatment. The outcomes between patients with AIS who received enhanced hydration therapy (the study group) and those with AIS who received standard hydration therapy (the historical control group) were compared. Eligible patients received 0.9% NaCl intravenous infusion at a volume of 20 mL/kg body weight. Then, a bolus injection of one-third of the total volume was administered, and the remaining two-third was continuously infused over 8 h. Next, a maintenance infusion of 40-80 mL/h was administered within 16 h. The primary outcomes were 3-month functional recovery and early neurological deterioration. <b>Results:</b> This analysis included 20 patients with AIS and 170 historical controls. The study and historical control groups did not significantly differ in terms of demographic characteristics, baseline stroke severity, and biochemical parameters. However, the study group had a higher prevalence of hypertension than the historical control group. Further, the study group had significantly better 3-month functional outcomes than the historical control group (<i>p</i>=0.018). In particular, 45.0% of patients in the study group and 21.2% in the control group achieved a modified Rankin Scale score of ≤ 2. Based on a subgroup analysis, patients with a lower stroke severity (National Institutes of Health Stroke Scale [NIHSS] scores of 4-10) in the study group exhibited significant improvements in functional outcomes. Meanwhile, patients with a higher stroke severity (NIHSS scores of 11-24) did not present with comparable benefits. The high stroke severity group had a higher complication rate than the low stroke severity group. However, the results did not significantly differ. Importantly, none of the patients who received enhanced hydration therapy developed adverse events. <b>Conclusion:</b> Enhanced hydration therapy can improve outcomes in patients with stroke who had an elevated BCR and who received rt-PA treatment. Further, it is not associated with significant complications.</p>","PeriodicalId":11528,"journal":{"name":"Emergency Medicine International","volume":"2025 ","pages":"1220736"},"PeriodicalIF":1.2,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12041639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}