Emergency Medicine International最新文献

{"title":"Predictors of Massive Transfusion in Patients With Hollow Organ Injury After Blunt Multiple Trauma: A Cohort of Blunt Bowel Mesenteric Injury.","authors":"Ting-Min Hsieh, Po-Chun Chuang, Chun-Ting Liu, Bei-Yu Wu, Ching-Hua Hsieh, Fu-Jen Cheng","doi":"10.1155/emmi/5286788","DOIUrl":"https://doi.org/10.1155/emmi/5286788","url":null,"abstract":"<p><strong>Background: </strong>Massive transfusion (MT) is life-saving for patients with exsanguination, especially after blunt abdominopelvic trauma, due to subtle manifestations. Blunt bowel mesenteric injuries (BBMIs), besides their potential risk of peritonitis, are still one of the few indications for emergency laparotomy for hemorrhagic shock in the era of nonoperative management. Early prediction of the need for MT defined as using ≥ 10 units of packed red blood cells (PRBCs) in 24 h and activation of the MT protocol (MTP) is a critical aspect in resuscitation. Current scoring systems predicting MT are usually laboratory data or hemodynamic status-dependent, which are limited by the time-consuming and dynamic characteristics of trauma; thus, they seem to lack objectivity in patients with BBMI due to dramatic clinical deterioration. The present study aimed to determine the predictors of associated injuries contributing to the requirement for MT in patients who underwent surgical BBMI.</p><p><strong>Methods: </strong>This retrospective study reviewed the data of hospitalized patients with trauma between 2009 and 2022. The patients were divided based on the presence or absence of MT before emergency laparotomy. Associated injury parameters and bowel mesenteric injury characteristics were used in multivariate regression analysis to identify independent predictors of MT.</p><p><strong>Results: </strong>A total of 163 adult patients with surgically proven BBMI were enrolled in the study. The overall patients with MT were 30.6% (50/163). Compared to the MT (-) group, BBMI patients receiving MT had worse clinical injury severity, vital signs, and prognosis; patients receiving MT had significant a lower initial hemoglobin level and higher percentages of receiving PRBC (11.15 mg/dL vs. 13.10 mg/dL, <i>p</i> < 0.001 and 47% vs. 42%, <i>p</i> < 0.001) and required more volume of PRBC at emergency department (ED) (5.5 units vs. 0 units, <i>p</i> < 0.001) as compared to the MT (-) group. Besides, patients with MT administered more amounts of PRBC within 24 h and at operation room in comparison with patients without MT (16 units vs. 2 units, <i>p</i> < 0.001 and 8 units vs. 0 units, <i>p</i> < 0.001). Patients with MT involved with more isolated mesenteric injury or combined injury and had both higher complications and overall mortality rates (94% vs. 55.8%, <i>p</i> < 0.001 and 32% vs. 4.4%, <i>p</i> < 0.001). In multivariate analysis, the presence of traumatic brain injury (TBI) (odds ratio [OR] = 6.7, 95% confidence intervals [CIs]: 1.66-27.02) and pelvic fracture (OR = 6.01, 95% CIs = 1.45-24.89) was identified as an independent predictor of MT after adjusting for confounding factors.</p><p><strong>Conclusions: </strong>For patients with BBMI, one-third require MT prior to laparotomy, necessitating early activation of the MTP. When BBMI patients present with hemodynamic instability or higher injury severity, particularly in the presence of concomita","PeriodicalId":11528,"journal":{"name":"Emergency Medicine International","volume":"2026 ","pages":"5286788"},"PeriodicalIF":0.8,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13071859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147688871","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 the Lactate-to-Albumin Ratio and ICU/In-Hospital Mortality in Critically Ill Patients With Comorbid Type 2 Diabetes Mellitus : A Cohort Study Utilizing the MIMIC-IV Database.","authors":"Zhuo-Ting Cheng, Jia-Liang Wang, Yan-Bo Zhao, Zheng-Ming Zhao, Zhi-Jun Li, Yang Liu","doi":"10.1155/emmi/2751114","DOIUrl":"https://doi.org/10.1155/emmi/2751114","url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetes mellitus (T2DM) accounts for over 90% of diabetes cases worldwide, and its rising prevalence poses a substantial public health challenge. The lactate-to-albumin ratio (LAR) is a novel biomarker that reflects both metabolic stress and nutritional-inflammatory status, and it has demonstrated independent prognostic value in various critical illnesses. However, its association with mortality in critically ill patients with T2DM remains unclear. This study aims to evaluate the predictive value of LAR for prognosis in this specific patient population through a retrospective analysis.</p><p><strong>Methods: </strong>This retrospective observational cohort study utilized data from the Medical Information Mart for Intensive Care IV (MIMIC-IV) v3.0 database, which includes complete medical records of patients admitted to the intensive care unit (ICU) of a U.S. medical center between 2008 and 2022. Subjects were categorized into three groups based on LAR tertiles. The study assessed ICU mortality and in-hospital mortality as primary outcomes; 30-day, 90-day, and 365-day mortality after ICU admission served as secondary outcomes. Machine learning identified key variables related to LAR and outcomes. The association between LAR and primary outcomes was analyzed using multivariate logistic regression and restricted cubic spline (RCS) regression. Cumulative mortality was analyzed using Kaplan-Meier curves. Threshold effects were evaluated using generalized additive models to enhance clinical applicability. Sensitivity and subgroup analyses were used to validate the robustness of the results and the interactions within subgroups.</p><p><strong>Result: </strong>The study included 5463 critically ill T2DM patients. Using Boruta and SHapley Additive exPlanations (SHAP) algorithms, 14 key variables were identified. RCS analysis revealed a nonlinear relationship between LAR and in-hospital mortality (<i>p</i> for nonlinearity = 0.001). Threshold effect analysis identified a critical LAR threshold of 2.10. Kaplan-Meier survival curves showed that higher LAR values were correlated with increased mortality (<i>p</i> < 0.001). Subgroup analyses revealed significant interactions in gender subgroups for ICU mortality (<i>p</i> for interaction = 0.043) and in hyperlipidemia (HLD) subgroups for in-hospital mortality (<i>p</i> for interaction = 0.049). Sensitivity analyses confirmed robust associations between LAR and ICU mortality (OR 1.32, 95% CI: 1.20-1.45, <i>p</i> < 0.001) and in-hospital mortality (OR 1.37, 95% CI: 1.26-1.50, <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>This study identified a significant correlation between elevated LAR and adverse ICU outcomes in critically ill patients with T2DM.</p>","PeriodicalId":11528,"journal":{"name":"Emergency Medicine International","volume":"2026 ","pages":"2751114"},"PeriodicalIF":0.8,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13072064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147688894","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":"National Assessment of Emergency, Intensive Care, and Anesthesia Physician Distribution in Saudi Arabia, 2023: Implications for Emergency Care Access.","authors":"Waleed M Kattan","doi":"10.1155/emmi/9606167","DOIUrl":"https://doi.org/10.1155/emmi/9606167","url":null,"abstract":"<p><strong>Background: </strong>In line with Saudi Arabia's Vision 2030, transforming the health workforce has become a central priority, particularly to address persistent geographic and sectoral inequities and imbalances in national workforce participation within critical specialties such as emergency medicine, intensive care, and anesthesia. Despite national workforce expansion, no comprehensive assessment has quantified the distribution of these physicians across regions and sectors.</p><p><strong>Objectives: </strong>This study aims to examine the distribution and density of emergency, intensive care, and anesthesia physicians across Saudi Arabia's 20 health regions, assess disparities by sector and nationality, and quantify inequality using Gini coefficients.</p><p><strong>Methods: </strong>This cross-sectional study utilized secondary data sourced from the Ministry of Health's 2023 Statistical Yearbook. Physician counts were categorized by sector: the Ministry of Health, other governmental entities, and the private sector. Regional physician-to-population ratios were calculated, and inequality was assessed using Lorenz curves and the Gini coefficient.</p><p><strong>Results: </strong>In 2023, Saudi Arabia had 4999 emergency physicians, 4559 anesthesiologists, and 3185 intensivists, with approximately 65% employed by the Ministry of Health. Saudi workforce participation varied substantially, reaching 46% in emergency medicine but remaining lower in intensive care (37%) and anesthesia (22%). From 2019 to 2023, physician densities increased across all three specialties to 14.8 per 100,000 for emergency medicine, 13.5 for anesthesia, and 9.4 for intensive care, levels favorable relative to international benchmarks. Despite this growth, marked geographic disparities persisted: Riyadh and Jeddah had the largest absolute numbers but lower population-adjusted densities, whereas smaller regions showed higher per-capita ratios despite limited infrastructure. Geographic inequality was moderate across specialties, with Gini coefficients of 0.52 for anesthesia, 0.49 for intensive care, and 0.45 for emergency medicine.</p><p><strong>Conclusion: </strong>Despite overall workforce growth, Saudi Arabia's acute care physicians remain unevenly distributed: urban centers house most staff but have lower per-capita coverage, whereas peripheral regions have higher ratios but limited capacity. Addressing national workforce participation and optimizing regional deployment are essential for equitable care.</p>","PeriodicalId":11528,"journal":{"name":"Emergency Medicine International","volume":"2026 ","pages":"9606167"},"PeriodicalIF":0.8,"publicationDate":"2026-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13069181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147671366","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":"First-Aid Practices and Knowledge Regarding Snake and Scorpion Bites Among Patients Attending Onandjokwe State Hospital, Namibia: A Hospital-Based Cross-Sectional Study.","authors":"Petrus Uushona, Albertina M N Shatri","doi":"10.1155/emmi/6658174","DOIUrl":"https://doi.org/10.1155/emmi/6658174","url":null,"abstract":"<p><strong>Background: </strong>Snake and scorpion bites pose a significant public health burden, with an estimated global annual morbidity rate of 5.4 million and 1.2 million, respectively. Various first-aid methods are commonly practiced in communities, aiming to improve the chances of survival after bites. This study evaluated community practices for first aid on snake and scorpion bites and examined the alignment of these practices with WHO recommendations. This will determine the need for targeted educational interventions to promote evidence-based and safe first-aid practices.</p><p><strong>Methods: </strong>A cross-sectional study was conducted amongst patients served by the Onandjokwe State Hospital from November to December 2024, with a total of 103 participants included in the study. The study assessed practices on occasions of bites, the perceived need for intervention, health-seeking behaviors, and barriers to healthcare access when bites occur.</p><p><strong>Results: </strong>A total of 103 participants were included in the study, with 36.9% of participants having personal experiences with bites and 74.8% knowing someone who has been bitten. Only 0.97% of participants have received formal first-aid training for bites, and 91.26% indicated that their communities would benefit from educational campaigns aimed at imparting knowledge on appropriate first-aid practices. Only 12.6% of participants reported recommended first-aid practices. Potentially harmful practices mentioned included the application of tourniquets, making incisions at bite sites, suctioning venom from wounds, and consuming various substances such as urine, <i>Colophospermum mopane</i> leaves, and other unspecified traditional remedies. Participants exhibited positive health-seeking behavior, with 98.1% stating they would go to the hospital after bites. This is important as it demonstrates continued public trust in the healthcare system, with individuals presenting to hospitals in cases of bites, where appropriate treatment, such as antivenoms, can be provided to them. However, several barriers, such as distance, finances, and transportation, were identified by participants as reasons that delay timely hospital presentation after bites.</p><p><strong>Conclusion: </strong>Communities would benefit from targeted educational campaigns on proper practices, and many would welcome such initiatives.</p>","PeriodicalId":11528,"journal":{"name":"Emergency Medicine International","volume":"2026 ","pages":"6658174"},"PeriodicalIF":0.8,"publicationDate":"2026-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13069967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147671398","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":"Usability Testing of a Hair Apposition Device for Scalp Laceration: A Manikin Simulation Study.","authors":"Hyun Soo Kim, Dongbum Suh, Dae Kon Kim, Jin Hee Lee, Hyuksool Kwon, Chulmin Ha, Hyoung Ju Lee","doi":"10.1155/emmi/5559198","DOIUrl":"https://doi.org/10.1155/emmi/5559198","url":null,"abstract":"<p><strong>Objectives: </strong>The hair apposition technique (HAT) is a method for closing scalp lacerations by twisting adjacent hair strands, which may require more than one operator. The hair apposition device (HADev), a prototype, was developed to enable single-operator use by integrating a comb, hair clips, and an anchoring system. Accordingly, the objective of this study was to evaluate the usability of HADev.</p><p><strong>Methods: </strong>Study participants were medical professionals with prior experience in HAT. Following a 30-min lecture and practice session, participants performed HAT using HADev on manikins with short (8 cm) and long (20 cm) hair. Each participant completed two procedures for each hair type. Participants were randomized according to the sequence of hair length. The success rate and procedure time were recorded. Questionnaires were administered to assess the perceived difficulty and satisfaction.</p><p><strong>Results: </strong>Twenty participants (13 physicians and 7 residents) completed 40 procedures using HADev, with 20 performed on short-haired manikins and 20 on long-haired manikins. For short hair, physicians and residents achieved success rates of 100% and 85.7%, with median procedure times of 55.1 and 52.8 s, respectively. For long hair, physicians and residents achieved success rates of 92.3% and 100%, with median times of 63.0 and 62.1 s, respectively. The median perceived difficulty scores (1 = very easy, 5 = very difficult) were 2 for HAT and 1 for HADev. The median satisfaction scores (1 = excellent, 5 = very poor) were 2 for physicians and 3 for residents with HAT and 1 for both groups with HADev.</p><p><strong>Conclusion: </strong>HADev demonstrated feasibility for single-operator use in a simulated environment, with a 95% success rate and procedure time of approximately 1 min for both hair conditions. However, further studies are needed to improve its usability and assess its clinical applicability.</p>","PeriodicalId":11528,"journal":{"name":"Emergency Medicine International","volume":"2026 ","pages":"5559198"},"PeriodicalIF":0.8,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13122727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147766116","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":"Surgical Pleth Index as a Potentially Useful and Noninvasive Tool for Assessing Tracheal Intubation Conditions in Female Patients During Neuromuscular Blockade-Free Anesthesia.","authors":"Jiale Chen, Zhihao Pan, Jinwei Zheng","doi":"10.1155/emmi/7863986","DOIUrl":"https://doi.org/10.1155/emmi/7863986","url":null,"abstract":"<p><strong>Background: </strong>Neuromuscular blocking agents (NMBAs) are commonly used during tracheal intubation to ensure smoother procedural conditions, but they are associated with the risk of prolonged paralysis and respiratory complications. This study explores the relationship between the surgical pleth index (SPI) measured immediately before intubation and tracheal intubation conditions in patients who did not receive neuromuscular blockers, along with the predictive value of the SPI in these conditions.</p><p><strong>Methods: </strong>A total of 100 surgical patients (excluded 17 patients who did not meet the eligibility criteria) undergoing elective surgery under general anesthesia at The Affiliated Lihuili Hospital of Ningbo University between November 2021 and June 2022 were included, and key parameters, including systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), and SPI, were measured at different time points (T0 to T5).</p><p><strong>Results: </strong>At T2, significant reductions in SBP, DBP, HR, and SPI were observed compared to baseline (T0, after the completion of 6 mL/kg of lactate Ringer's solution infusion) and preintubation values (T1, at the time of loss of consciousness) (<i>p</i> < 0.05). Postintubation, both SBP and DBP significantly increased at T5 (3 min after intubation) compared to T2 (immediately before intubation) (<i>p</i> < 0.05). The patients were classified into \"excellent\" and \"good\" groups based on their intubation conditions. SPI values at T3 (immediately after intubation), T4 (1 min after intubation), and T5 were significantly higher in the \"good\" group compared to the \"excellent\" group (<i>p</i> < 0.05). Post hoc sex-stratified receiver operating characteristic (ROC) analysis showed an area under the curve (AUC) of 0.713 (<i>p</i> = 0.037) and 95% confidence interval (CI) (0.539-0.887), indicating moderate predictive value for the SPI in assessing tracheal intubation conditions.</p><p><strong>Conclusions: </strong>The SPI proves to be a potentially useful and noninvasive tool for evaluating tracheal intubation conditions in female patients without the use of NMBAs.</p>","PeriodicalId":11528,"journal":{"name":"Emergency Medicine International","volume":"2026 ","pages":"7863986"},"PeriodicalIF":0.8,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12968434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147431607","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":"The Associations Between Fibrinogen and Septic Shock in Critically Ill Patients With Sepsis: A Retrospective Cohort Study.","authors":"Jianqin Huang, Murong Lu, Yu Zhai, Jiexuan Xu, Pengcheng Duan, Shuting Liu, Xuemei Liu, Hongjing Yu","doi":"10.1155/emmi/8849147","DOIUrl":"https://doi.org/10.1155/emmi/8849147","url":null,"abstract":"<p><strong>Background: </strong>Fibrinogen has been used as a prognostic indicator for sepsis. However, the associations of fibrinogen and septic shock in septic patients remain unclear. This study aimed to explore the relationship between fibrinogen levels and the occurrence of septic shock in patients with sepsis.</p><p><strong>Methods: </strong>Data were retrospectively analyzed from the Medical Information Mart for Intensive Care IV (MIMIC-IV v3.1) database. The Boruta algorithm and random forest model were used for feature selection to ensure the important variables affecting results. Multivariate logistic regression assessed the association between fibrinogen and septic shock. Subgroup analysis was conducted to evaluate the impact of additional variables on the results.</p><p><strong>Results: </strong>The study included 3302 septic patients. Fibrinogen was significantly associated with septic shock (odds ratio [OR] = 1.46; 95% confidence interval [CI], 1.35-1.56), and the risk of septic shock increased with higher fibrinogen levels (all <i>p</i> values for trend < 0.001). The ROC curve demonstrated the predictive accuracy of fibrinogen for septic shock in sepsis patients. After adjustment for demographics and laboratory, fibrinogen had a higher area under curve (AUC) value (0.78; 95% CI, 0.76-0.79) than SOFA (AUC, 0.58; 95% CI, 0.56-0.61), SASP II (AUC, 0.67; 95% CI, 0.65-0.69), and APS II (AUC, 0.69; 95% CI, 0.68-0.71).</p><p><strong>Conclusion: </strong>A linear relationship was found between fibrinogen levels and septic shock. Elevated fibrinogen levels were linked to a higher risk of septic shock in septic patients.</p>","PeriodicalId":11528,"journal":{"name":"Emergency Medicine International","volume":"2026 ","pages":"8849147"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12951003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147347370","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":"Left-Side Versus Right-Side Lateral Tilt During Maternal CPR: Effects on Compression Quality and Rescuer Fatigue.","authors":"Chia-Lung Kao, Jui-Yi Tsou, Ming-Yuan Hong, Chih-Jan Chang, Fong-Chin Su, Chih-Hsien Chi","doi":"10.1155/emmi/3607809","DOIUrl":"https://doi.org/10.1155/emmi/3607809","url":null,"abstract":"<p><strong>Background: </strong>Maternal cardiac arrest presents unique challenges due to physiological changes in pregnancy. Left lateral tilt (LLT) is commonly recommended to relieve aortocaval compression, but its impact on chest compression quality remains unclear.</p><p><strong>Objectives: </strong>This study evaluates chest compressions performed in the LLT position from both the right and left sides to determine if they meet high quality cardiopulmonary resuscitation standards.</p><p><strong>Methods: </strong>This randomized crossover study included 44 healthcare providers performing two-minute chest compressions' sessions on a manikin in the LLT position from both right and left sides. Compression depth, rate, recoil, force distribution, rescuer fatigue, and physiological parameters were analyzed.</p><p><strong>Results: </strong>Both approaches maintained adequate compression rates, but left-side LLT chest compressions achieved better depth (41.23 ± 9.11 mm vs. 35.50 ± 9.54 mm, <i>p</i> < 0.001) and complete recoil (67.05 ± 39.05% vs. 38.39 ± 34.23%, <i>p</i> < 0.001). Left-side LLT chest compressions also generated higher peak force and lower residual release force. Right-side LLT chest compressions were associated with greater rescuer fatigue and instability.</p><p><strong>Conclusion: </strong>Left-side LLT chest compression provides superior compression depth and recoil compared with right-side LLT chest compression. However, neither method consistently meets high quality cardiopulmonary resuscitation standards. These findings support the 2015 AHA guideline preference for manual uterine displacement over LLT chest compression. Further research is needed to optimize maternal cardiac arrest management.</p>","PeriodicalId":11528,"journal":{"name":"Emergency Medicine International","volume":"2026 ","pages":"3607809"},"PeriodicalIF":0.8,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12936698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147324602","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":"Prognostic Value of Hemoglobin, Albumin, Lymphocyte, and Platelet Score in Predicting Mortality in Patients With Aortic Dissection: A Retrospective Single-Center Study Based on ROC Curve Analysis.","authors":"Canan Şahin, Yahya Şahin","doi":"10.1155/emmi/6996031","DOIUrl":"https://doi.org/10.1155/emmi/6996031","url":null,"abstract":"<p><strong>Background: </strong>Aortic dissection (AD) is a life-threatening cardiovascular emergency associated with high mortality. Early risk stratification through reliable biomarkers is critical for guiding clinical decisions. The hemoglobin, albumin, lymphocyte, and platelet (HALP) score is a novel composite index reflecting inflammation, nutritional status, and hematologic balance. Although it has shown prognostic relevance in several disease states, its utility in predicting mortality in AD remains unknown. This study aimed to investigate the prognostic value of the HALP score and other hematologic markers in patients with AD.</p><p><strong>Methods: </strong>This retrospective study included 51 patients diagnosed with AD between January 2020 and December 2024 using contrast-enhanced thoracoabdominal computed tomography. Patients were grouped as survivors or nonsurvivors. Hematologic parameters (hemoglobin, hematocrit, red blood cell, platelet count, and mean platelet volume) and inflammatory indices (neutrophil-to-lymphocyte ratio [NLR], platelet-to-lymphocyte ratio [PLR], systemic immune-inflammation index [SII], and HALP score) were recorded. The Shapiro-Wilk test assessed normality; Student's <i>t</i>-test or the Mann-Whitney <i>U</i> test was applied accordingly. ROC analysis was performed to evaluate the predictive power of each parameter. Statistical significance was defined as <i>p</i> < 0.05. The primary outcome was in-hospital mortality.</p><p><strong>Results: </strong>Overall mortality was 33.3%. Nonsurvivors were older and had significantly lower levels of hemoglobin, hematocrit, RBC, and platelet count (<i>p</i> < 0.001). The HALP score was lower in the exitus group, though not statistically significant in direct comparison (<i>p</i> = 0.549). ROC analysis revealed that the HALP score had an AUC of 0.715 (95% CI: 0.572-0.857, <i>p</i> = 0.003), with 55.9% sensitivity and 82.4% specificity at a cutoff of 4.05. Classical parameters such as RBC (AUC = 0.824), Hgb (AUC = 0.802), and Htc (AUC = 0.811) demonstrated stronger predictive capacity. The in-hospital mortality rate was 33.3%.</p><p><strong>Conclusions: </strong>The HALP score demonstrated high specificity and moderate sensitivity in predicting mortality in AD, suggesting its potential as a complementary biomarker. Its ease of use and accessibility make it suitable for emergency clinical settings. Prospective multicenter studies are needed to confirm its prognostic validity and routine application in AD management.</p>","PeriodicalId":11528,"journal":{"name":"Emergency Medicine International","volume":"2026 ","pages":"6996031"},"PeriodicalIF":0.8,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12930098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147303558","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":"Presentations Due to Priapism in an Urban Hospital in Switzerland.","authors":"Julian Dionigi Uhl, Lukas Koneval, Laila Schneidewind, Manuel Haschke, Aristomenis Exadaktylos, Evangelia Liakoni","doi":"10.1155/emmi/9996341","DOIUrl":"https://doi.org/10.1155/emmi/9996341","url":null,"abstract":"<p><strong>Objective: </strong>Priapism, a persisting erection not associated with sexual stimulation, can be ischaemic, with the risk of permanent erectile dysfunction, or nonischaemic. Drugs-e.g., injection therapies for erectile dysfunction, as well as neuroleptics, antidepressants and various other medicines-can also cause priapism. This study aimed to describe presentations due to priapism and provide insights into specific causes, clinical presentations, diagnostic strategies and emergency management.</p><p><strong>Methods: </strong>A single-centre, retrospective, observational study of patients (≥ 16 years old) presenting to the University Hospital of Bern, Switzerland, between January 2010 and June 2023 due to priapism. The cases were retrieved from the electronic health records using full-text search.</p><p><strong>Results: </strong>During the study period, 40 cases corresponding to 32 patients were included. The mean ± SD age was 48 ± 15 years, and pain was present in 21 cases (53%) on presentation. Median time of erection was 15 h (range: 1-80, <i>n</i> = 23). A penile blood gas analysis was performed in 32 cases (80%), and 29 of these (91%) were of the low-flow type. Most commonly suspected causes were idiopathic (<i>n</i> = 25, 63%) and drug-induced (<i>n</i> = 10, 25%). Suspected agents in the drug-induced cases were corpus cavernosum autoinjection therapy (<i>n</i> = 4), trazodone (<i>n</i> = 3), sildenafil (<i>n</i> = 2) and urapidil (<i>n</i> = 1). Puncture of the corpus cavernosum and injection of noradrenalin and adrenalin were the therapeutic measure in 35 cases (88%). In 13 cases, there was at least one recurrence, including 10 within one week. Drugs given as recurrence prophylaxis included tadalafil (<i>n</i> = 9) and diazepam (<i>n</i> = 4).</p><p><strong>Conclusion: </strong>Presentations due to priapism appear to be rare, but the majority of the cases presented with ischaemic priapism, which is a medical emergency. The findings can be used to identify areas requiring further research (e.g., drugs used as recurrence prophylaxis) and raise awareness of this potentially severe complication-which patients are often ashamed to report.</p>","PeriodicalId":11528,"journal":{"name":"Emergency Medicine International","volume":"2026 ","pages":"9996341"},"PeriodicalIF":0.8,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12917415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147269973","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}