Frontiers in Medicine最新文献

{"title":"Soluble MHC class I chain-related protein A is a specific biomarker for the early detection of graft-versus-host disease.","authors":"Alexander Kupis, Nina Buchtele, Philipp Wohlfarth, Werner Rabitsch, Katarina D Kovacevic Miljevic, Marion Mussbacher, Bernd Jilma, Christian Schoergenhofer","doi":"10.3389/fmed.2025.1580452","DOIUrl":"10.3389/fmed.2025.1580452","url":null,"abstract":"<p><strong>Introduction: </strong>MHC class I chain-related protein A (MICA) acts as a marker of cellular stress and its expression is a destruction-signal for NKG2D-expressing cytotoxic cells. Soluble MICA (sMICA) concentrations after allogeneic hematopoietic stem cell transplantation (HSCT) were associated with worse outcomes and graft-versus-host disease (GVHD). We hypothesized that (i) sMICA could be a prognostic biomarker for the development of GVHD and (ii) may act as an acute phase reactant.</p><p><strong>Methods: </strong>In this prospective study we included 48 patients undergoing HSCT and drew blood samples before conditioning (baseline), during engraftment and 100 days after HSCT. The follow-up period was 1 year for each patient. Soluble MICA and established acute phase reactants (C-reactive Protein, von Willebrand Factor) were measured by enzyme-linked immunoassay (ELISA).</p><p><strong>Results: </strong>Of the 44 patients in the final analysis, 30 (68%) developed GVHD (16 acute GVHD, 8 chronic GVHD, 6 acute and chronic GVHD). Soluble MICA concentrations at baseline and during engraftment were significantly higher in patients who developed acute or chronic GVHD (<i>p</i> = 0.017). Receiver operating characteristic (ROC) curve analysis for the baseline values showed an area under the curve of 0.78 (<i>p</i> < 0.001; 95% confidence intervals 0.64-0.91) for diagnosis of acute or chronic GVHD. Soluble MICA concentrations above 93.5 pg/mL had a specificity of 93% for the diagnosis of GVHD, while the sensitivity was only 47%.</p><p><strong>Discussion: </strong>Soluble MICA did not correlate with other acute phase reactants and remained stable during engraftment. Soluble MICA may potentially serve as a biomarker with high specificity for the prediction of GVHD.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1580452"},"PeriodicalIF":3.1,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of pyroptosis-associated genes in endometrial cancer utilizing a 101-combination machine learning framework and multi-omics data.","authors":"Li Juan Huang, Chen Liu, Lin Chen, Min Tang, Shi Tong Zhan, Feng Chen, An Yi Teng, Li Na Zhou, Wei Lin Sang, Ye Yang","doi":"10.3389/fmed.2025.1590405","DOIUrl":"10.3389/fmed.2025.1590405","url":null,"abstract":"<p><strong>Background: </strong>Endometrial cancer (EC) is a common and increasingly prevalent gynecological malignancy. Pyroptosis, a pro-inflammatory form of programmed cell death, plays dual roles in cancer but remains poorly understood in the context of EC and its immune microenvironment.</p><p><strong>Methods: </strong>We identified pyroptosis-associated genes (PAGs) and applied a 101-combination machine learning framework to construct and validate a robust prognostic model using TCGA bulk RNA-seq and single-cell transcriptomic data. Immune infiltration was assessed using CIBERSORT and Tumor Immune Dysfunction and Exclusion (TIDE), while CellChat was employed to investigate pyroptosis-related cell-cell communication. Drug sensitivity was predicted with OncoPredict.</p><p><strong>Results: </strong>A seven-gene prognostic model demonstrated robust predictive performance with concordance index (<i>C</i>-index) values exceeding 0.70 in both training and validation cohorts. The model stratified EC patients into high- and low-risk groups with distinct immune infiltration profiles and differential responses to programmed cell death protein 1 (PD-1) blockade. Drug sensitivity analysis revealed several therapeutic agents with potential efficacy in high-risk and low-risk subgroups.</p><p><strong>Conclusion: </strong>This study highlights the clinical and immunological relevance of pyroptosis in EC and introduces a PAG-based model with strong predictive and therapeutic potential. These findings provide a foundation for developing pyroptosis-guided precision immunotherapy strategies in EC.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1590405"},"PeriodicalIF":3.1,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lid wiper epitheliopathy: an early sign of dry eye diagnosis.","authors":"Yuan Gao, Meiting Huang, Wenjing Song, Yingsi Li, Xiaoming Yan","doi":"10.3389/fmed.2025.1593430","DOIUrl":"10.3389/fmed.2025.1593430","url":null,"abstract":"<p><strong>Objectives: </strong>The purpose of this study was to investigate the relationship between the severity of lid wiper epitheliopathy (LWE) and ocular surface features and evaluate the potential of LWE as an early diagnosis indicator of dry eye.</p><p><strong>Methods: </strong>Eighty-eight patients diagnosed with dry eye by TFOS DEWS II were divided into two groups based on the Korb grading: the mild group and the moderate-severe group. Ocular assessments included examination of LWE, tear-film lipid layer thickness (LLT) measurement, partial blinking rate (PBR) calculation, fluorescein tear breakup time (FTBUT) measurement, determining corneal fluorescein staining score, eyelid margin score, and meiboscore.</p><p><strong>Results: </strong>In patients with upper LWE, the PBR and ocular surface disease index (OSDI) score were higher and LLT was lower in the moderate-severe LWE group (<i>p</i> < 0.05). In patients with lower LWE, the PBR and lower eyelid margin score were significantly higher in the moderate-severe LWE group (<i>p</i> < 0.05). The upper LWE staining score was moderately and significantly associated with the lower LWE staining score. Compared with LWE, if the FTBUT was used as the diagnostic indicator according to TFOS DEWS II, China, or ADES, the missed diagnosis rate fluctuated from 5.7 to 54.5%.</p><p><strong>Conclusion: </strong>The severity of LWE is related to dry eye indicators such as the PBR, FTBUT, eyelid margin score, OSDI, and meiboscore. Both upper and lower LWE can be used as diagnostic criteria for dry eye. Moreover, compared with FTBUT, LWE is more suitable as an early sign of dry eye diagnosis.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1593430"},"PeriodicalIF":3.1,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Povidone-iodine nasal spray (Nasodine^®) for the common cold: a randomized, controlled, double-blind, Phase III clinical trial.","authors":"Thomas M Polasek, Peter L Friedland","doi":"10.3389/fmed.2025.1565069","DOIUrl":"10.3389/fmed.2025.1565069","url":null,"abstract":"<p><strong>Aim: </strong>To determine the safety and efficacy of a 0.5% povidone-iodine nasal spray (Nasodine) as a treatment for the common cold (ACTRN12619000764134).</p><p><strong>Methods: </strong>A multi-center, randomized, controlled, double-blind Phase III study was conducted to assess the impact of Nasodine on the common cold. Two hundred and sixty (260) euthyroid adults with qualifying cold symptoms and meeting inclusion/exclusion criteria were randomized 2:1 to Nasodine or matching saline nasal spray (SNS), each applied 4 times daily for 5 days. Cold severity was reported using the WURSS-21 survey. The primary endpoint was impact on nasal symptoms (4-item scale), with the validated 19-item Global Severity Score (GSS) as the key secondary endpoint.</p><p><strong>Results: </strong>All cold severity outcomes pointed in favor of Nasodine over SNS. In the ITT (<i>n</i> = 260), the Nasodine benefit over SNS on nasal symptoms was 8.4% (<i>p</i> = 0.217). For GSS, the benefit was 12.6% (<i>p</i> = 0.054) in the ITT population. <i>Post hoc</i> subset analyses showed markedly improved benefits of Nasodine: In subjects with stronger symptoms at enrollment (ES), the GSS benefit was 17.1% (<i>p</i> = 0.023); for those with confirmed viral infection (VES), GSS benefit was 23.0% (<i>p</i> = 0.048); and for those enrolled within 24 h of symptom onset (24S), GSS benefit was 39.7% (<i>p</i> = 0.024). In terms of functional impairment, the Nasodine benefit was greater in all subsets, with 16.1% (<i>p</i> = 0.041) benefit in ITT, 22.2% in ES (<i>p</i> = 0.012), 32.1% in VES (<i>p</i> = 0.023) and 37.1% in 24S (<i>p</i> = 0.093). Nasodine was well tolerated, with mild transient nasopharyngeal discomfort being a common adverse effect.</p><p><strong>Conclusion: </strong>Nasodine treatment had a consistently positive and clinically meaningful benefit on overall cold severity when compared with saline nasal spray. Early treatment after symptom onset is an important efficacy factor.</p><p><strong>Clinical trial registration: </strong>https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377353&isReview=true, identifier ACTRN12619000764134.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1565069"},"PeriodicalIF":3.1,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial: Clinical management of older persons with cancer: current status and future directions.","authors":"Aziz Karaoglu, Gülistan Bahat","doi":"10.3389/fmed.2025.1631044","DOIUrl":"10.3389/fmed.2025.1631044","url":null,"abstract":"","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1631044"},"PeriodicalIF":3.1,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive value of preoperative inflammatory response markers on short-term postoperative complications following colorectal surgery: a secondary analysis of a randomized clinical trial.","authors":"Ning Bu, Chang Liu, Zhidong Kong, Wei Gao, Yaomin Zhu","doi":"10.3389/fmed.2025.1536807","DOIUrl":"10.3389/fmed.2025.1536807","url":null,"abstract":"<p><strong>Background: </strong>Numerous inflammatory biomarkers have been identified to possess a positive prognostic value in relation to the clinical outcomes of patients with various cancers. Despite this, there is a paucity of comprehensive studies that compare the prognostic value of commonly used inflammatory parameters specifically within colorectal cancer (CRC) populations. These parameters include the peripheral blood neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune inflammation index (SII), albumin-to-globulin ratio (AGR), and prognostic nutritional index (PNI). Thus, the objective of this research was to conduct a thorough comparison of the predictive potential value of preoperative commonly used inflammatory response markers in CRC patients.</p><p><strong>Methods: </strong>This is a retrospective, single-center cohort analysis. We performed a secondary analysis of 392 individuals with CRC who fulfilled our inclusion criteria and were admitted to the First Affiliated Hospital of Xi'an Jiaotong University between June 2018 and August 2019. Initially, the clinical data including baseline demographics, laboratory indices, type of surgery, type of anesthesia, and postoperative complications were collected. Then, the prognostic efficacy and threshold values of preoperative inflammatory biomarkers were ascertained through the employment of receiver operating characteristic (ROC) curves. Finally, both univariate and multivariate analyses were conducted to discern the risk factors contributing to postoperative complications with CRC patients.</p><p><strong>Results: </strong>In the present study, 54 (13.78%) patients experienced surgical complications. According to ROC curve analysis, PNI possessed the strongest predictive ability for surgical complications (AUC = 0.706, 95% CI = 0.642-0.770; <i>p</i> = 0.001). Concurrently, the cut-off value of PNI was 48.78 based on the highest Youden index. Multivariate analysis demonstrated that PNI ≤ 48.78 (OR = 0.904, 95% CI = 0.844-0.967, <i>p</i> = 0.003) and laparotomy (OR = 1.863, 95% CI = 1.017-3.415, <i>p</i> = 0.044) emerged as independent risk factors for short-term postoperative complications. Lastly, the PNI ≤ 48.78 group exhibited an increased likelihood of requiring intraoperative blood transfusions and experienced extended duration of hospitalization.</p><p><strong>Conclusion: </strong>Preoperative PNI possesses superior ability and serves as an independent predictor of clinical complications following colorectal resection surgery. Multidisciplinary teams should focus on addressing patients' immunonutrition status before surgery.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1536807"},"PeriodicalIF":3.1,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: A rare case of hemoptysis: multiple vascular variations.","authors":"Beining Zhang, Jiangye Wang, Ninggang Zheng","doi":"10.3389/fmed.2025.1585686","DOIUrl":"10.3389/fmed.2025.1585686","url":null,"abstract":"<p><p>Bronchial artery embolization (BAE) is an effective treatment for hemoptysis, with potential complications including pain and spinal ischemia. We report a rare case in which the right bronchial artery communicated with the right intercostal arteries, and the right intercostal artery had an anastomosis with the right vertebral artery. Additionally, the left bronchial artery was found to have a connection with the left vertebral artery.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1585686"},"PeriodicalIF":3.1,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12178182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in surgery and anesthesia practices during the COVID-19 pandemic: a nationwide analysis from South Korea's Health Insurance Database.","authors":"EunJin Ahn, Hyo Jin Kim, Si Ra Bang","doi":"10.3389/fmed.2025.1548043","DOIUrl":"10.3389/fmed.2025.1548043","url":null,"abstract":"<p><strong>Introduction: </strong>The coronavirus disease 2019 (COVID-19) pandemic has led to significant changes to global healthcare systems, particularly affecting surgical and anesthetic practices. This study investigated nationwide trend in anesthesia and surgery before and during the pandemic.</p><p><strong>Methods: </strong>This retrospective, population-based study analyzed confirmed COVID-19 cases in the Korean National Health Information Database from 2019 to 2021. Anesthesia procedures were categorized into general anesthesia, regional anesthesia, and monitored anesthesia care (MAC). COVID-19 positive patients were defined as those with a confirmed diagnosis within 30 days before and after surgery. We analyzed anesthesia modality, patient characteristics, hospital type and COVID-19 trends.</p><p><strong>Results: </strong>A total of 6,878,556 anesthesia procedures were recorded. The number of procedures decreased slightly in 2020 but increased in 2021. General anesthesia accounted for the majority of procedures. Regional anesthesia, especially brachial plexus block (BPB), and MAC showed an increasing trend. There was a positive correlation between monthly COVID-19 case counts and surgical volume. Most COVID-19 positive patients underwent surgery in general hospitals and received general anesthesia.</p><p><strong>Conclusion: </strong>Despite the pandemic, overall surgical volume in South Korea remained relatively stable compared to global trends. The shift toward regional techniques like BPB suggests adaptation to reduce aerosol-generating procedures. These findings highlight the need for strategic allocation of resources and preparedness planning in future pandemics.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1548043"},"PeriodicalIF":3.1,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of intravoxel incoherent motion imaging in the diagnosis of polycystic ovary syndrome.","authors":"Keying Wang, Qian Song, Anrong Zeng, Ying Li, Jinwei Qiang","doi":"10.3389/fmed.2025.1513710","DOIUrl":"10.3389/fmed.2025.1513710","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the diagnostic efficacy of intravoxel incoherent motion (IVIM) parameters in ovarian stroma changes in polycystic ovary syndrome (PCOS) patients.</p><p><strong>Methods: </strong>This prospective study included 58 PCOS patients and 60 healthy controls. Both groups underwent conventional magnetic resonance imaging (MRI) and IVIM scans. The diagnostic efficacy of IVIM parameters and conventional MRI was investigated and compared by using area under the curves (AUC). Binary logistic regression analysis, integrated discrimination improvement (IDI), and net reclassification improvement (NRI) were also used to assess the improvement in diagnosis of PCOS when combining IVIM parameters with conventional MRI features.</p><p><strong>Results: </strong>The apparent diffusion coefficient (ADC) and D values were significantly lower, while the D* and <i>f</i> values were significantly higher than the controls in the ovarian stroma in PCOS patients. The follicle number (FN) counted on the MRI showed an AUC of 0.90 (95%CI: 0.84-0.96) for differentiating PCOS from the controls, with a cutoff value of 23. The ADC value yielded the highest AUC of 0.83 (95%CI: 0.76-0.90) among the IVIM parameters, with a cutoff value of 1.04 × 10^-3 mm²/s. The diagnostic performance was significantly by combining ADC and FN with an AUC of 0.94 (95%CI: 0.90-0.98). The IDI and NRI also showed improved diagnostic performance than FN alone.</p><p><strong>Conclusion: </strong>The D* and <i>f</i> values of the ovarian stroma in PCOS patients are significantly increased, while the ADC and D values are significantly reduced. The combination of ADC and FN can improve the diagnostic efficacy for PCOS.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1513710"},"PeriodicalIF":3.1,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation between lactate/albumin ratio and 28-day mortality in sepsis-associated acute kidney injury patients.","authors":"Susu He, Yongkang Wang, Shiyu Wei, Shifeng Yang","doi":"10.3389/fmed.2025.1546112","DOIUrl":"10.3389/fmed.2025.1546112","url":null,"abstract":"<p><strong>Background: </strong>The lactate/albumin ratio (LAR) was related to adverse outcomes in heart failure, myocardial infarction, and acute pancreatitis. However, it remains unevaluated whether LAR has prognosis significance in sepsis-associated acute kidney injury (SA-AKI) patients. Therefore, this research was performed to clarify the potential predictive utility of LAR for 28-day mortality in SA-AKI patients.</p><p><strong>Methods: </strong>Participants diagnosed with SA-AKI were selected from the Medical Information Mart for Intensive Care (MIMIC-IV) database and then placed into four groups in accordance with LAR quartiles. The endpoint was all-cause mortality within 28 days. The Kaplan-Meier curves were conducted to estimate the cumulative survival rates in the four groups. The correlation between LAR and the endpoint was elucidated by constructing Cox proportional hazards analysis, restricted cubic splines (RCS), and subgroup analysis.</p><p><strong>Results: </strong>Of the 3,895 patients with SA-AKI, 58.59% were men. The mortality rate from all causes within 28 days was 28.55%. The Kaplan-Meier curves showed that participants having elevated LAR exhibited significantly decreased survival rates. Cox proportional hazards models showed that higher LAR was related to higher 28-day death rate in SA-AKI patients (HR: 1.224, 95% CI: 1.160-1.291, <i>p</i> < 0.001). In addition, RCS analyses revealed that LAR was non-linearly correlated with the risk of 28-day death.</p><p><strong>Conclusion: </strong>LAR was independently related to an elevated risk of mortality within 28 days in SA-AKI patients. More prospective research studies are necessitated for further confirmation of these findings.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1546112"},"PeriodicalIF":3.1,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}