Internal and Emergency Medicine最新文献_第10页

Hyperamylasemia in COVID-19 patients: pancreatic involvement or secondary epiphenomenon? COVID-19患者的高淀粉酶血症：累及胰腺还是继发性附带现象？

IF 3.8 3区医学

Internal and Emergency Medicine Pub Date : 2025-08-20 DOI: 10.1007/s11739-025-04087-y

Marcello Candelli, Roberta Calce, Giulia Pignataro, Simona Racco, Mariella Fuorlo, Fabiana Barone, Andrea Piccioni, Giuseppe Merra, Veronica Ojetti, Antonio Gasbarrini, Francesco Franceschi

{"title":"Hyperamylasemia in COVID-19 patients: pancreatic involvement or secondary epiphenomenon?","authors":"Marcello Candelli, Roberta Calce, Giulia Pignataro, Simona Racco, Mariella Fuorlo, Fabiana Barone, Andrea Piccioni, Giuseppe Merra, Veronica Ojetti, Antonio Gasbarrini, Francesco Franceschi","doi":"10.1007/s11739-025-04087-y","DOIUrl":"https://doi.org/10.1007/s11739-025-04087-y","url":null,"abstract":"Elevated serum amylase has been frequently observed in COVID-19 patients, but whether hyperamylasemia results from a direct or indirect pancreatic effect or other mechanisms remains debated. Our study aimed to investigate the association between hyperamylasemia, pancreatitis, and COVID-19 severity. We retrospectively analyzed 1858 patients who visited the emergency department of Fondazione Policlinico Gemelli-IRCCS in Rome during the first two years of the pandemic. All had a confirmed COVID-19 diagnosis and underwent serum amylase evaluation. Clinical and laboratory data, including oxygen therapy requirements, intensive care unit (ICU) admission, and mortality, were extracted from electronic medical records. Univariate analysis revealed a correlation between hyperamylasemia and blood urea nitrogen, ICU admission, multiple comorbidities, and D-dimer levels. Multivariable logistic regression, adjusted for age, sex, comorbidities, and blood urea nitrogen, confirmed that ICU admission-but not in-hospital mortality-was independently associated with hyperamylasemia. Acute pancreatitis was diagnosed in only four patients. Elevated serum amylase levels appear more related to disease severity than direct pancreatic involvement. Emergency physicians should recognize that hyperamylasemia detected upon emergency department admission in COVID-19 patients may indicate an increased risk of ICU admission rather than acute pancreatitis, warranting closer evaluation and management.","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144953050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Oral anticoagulants-related bleeding: what happens in the emergency room? The Galeno study. 口服抗凝剂相关出血：在急诊室会发生什么？Galeno研究。

IF 3.8 3区医学

Internal and Emergency Medicine Pub Date : 2025-08-19 DOI: 10.1007/s11739-025-04078-z

Doris Barcellona, Giada Melis, Antonio Bussu, Monica Orrù, Maria Laura Caddeo, Emilia Antonucci, Antonella Mameli, Francesco Marongiu

{"title":"Oral anticoagulants-related bleeding: what happens in the emergency room? The Galeno study.","authors":"Doris Barcellona, Giada Melis, Antonio Bussu, Monica Orrù, Maria Laura Caddeo, Emilia Antonucci, Antonella Mameli, Francesco Marongiu","doi":"10.1007/s11739-025-04078-z","DOIUrl":"10.1007/s11739-025-04078-z","url":null,"abstract":"There are no real-world data on the modalities and outcomes of managing major or life-threatening bleeding related to oral anticoagulants in the emergency room (ER). The primary endpoint of this prospective observational study was to evaluate the therapeutic regimen ER physicians started to manage bleeding and 30-day mortality. The secondary endpoint was to evaluate the appropriateness of DOACs prescription and hospital admissions. Data were collected using RedCap. Patient's general characteristics, laboratory test results, therapy started in the ER to manage bleeding, patient transfer to another hospital department or discharge home, and 30-day mortality were recorded. A total of 526 consecutive patients were enrolled, 67% treated with DOACs and 33% with VKAs. Reversal of oral anticoagulants was successfully performed in a minority of patients, while in a percentage ranging from 30.5% for dabigatran to 60.2% for VKAs, patients did not receive any treatment, even if necessary. Thirty-day mortality was 11% and 17% for patients treated with DOACs and VKAs, respectively. Major bleeding conferred a higher risk of death (OR = 2.95, 1.42-6.16). Compared with VKAs, DOACs therapy reduced the risk of death by 57% (OR = 0.43, 0.26-0.72). Excessive doses were administered to 10.8%, 13%, 18%, and 19% of patients treated with rivaroxaban, edoxaban, apixaban, and dabigatran, respectively. In these patients, major bleeding occurred in a percentage ranging from 66.7% to 94.7% depending on the drug administered. Overall, 25.8% of patients, treated primarily with DOACs, were discharged. The management of oral anticoagulant-related major or life-threatening bleeding in the ER appears poor.","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

FIB-4, a surrogate marker of liver fibrosis, predicts mortality and adverse events after acute myocardial ınfarction. FIB-4是肝纤维化的替代标志物，可预测急性心肌梗死后的死亡率和不良事件ınfarction。

IF 3.8 3区医学

Internal and Emergency Medicine Pub Date : 2025-08-19 DOI: 10.1007/s11739-025-04094-z

Mehmet Gorur, Salim Satar, Selen Acehan, Muge Gulen, Kadir Nigiz, Sarper Sevdımbas

{"title":"FIB-4, a surrogate marker of liver fibrosis, predicts mortality and adverse events after acute myocardial ınfarction.","authors":"Mehmet Gorur, Salim Satar, Selen Acehan, Muge Gulen, Kadir Nigiz, Sarper Sevdımbas","doi":"10.1007/s11739-025-04094-z","DOIUrl":"10.1007/s11739-025-04094-z","url":null,"abstract":"The Fibrosis-4 (FIB-4) score is a simple, non-invasive index originally developed to assess liver fibrosis. Recently, it has gained attention as a potential prognostic marker in cardiovascular diseases. This study aimed to evaluate whether the FIB-4 score, independent of its role in liver assessment, can predict short-term mortality and major adverse cardiovascular events (MACE) in patients with acute myocardial infarction (AMI) undergoing coronary angiography (CAG) in the emergency department (ED). In this prospective observational study, 1017 patients diagnosed with AMI and treated with CAG between May 1, 2023, and February 29, 2024, were included. Patients were stratified into three groups based on FIB-4 score: low (< 1.45), intermediate (1.45-3.25), and high (> 3.25). Clinical and laboratory data, HEART scores, angiographic findings, in-hospital and 30-day outcomes were compared across groups. Patients with FIB-4 > 3.25 exhibited significantly higher rates of ST-elevation myocardial infarction (60.2%), hypertension (64%), diabetes mellitus (47.5%), atrial fibrillation (11%), and ventricular tachycardia (2.1%) (all p < 0.01). In-hospital mortality (14.4%), 30-day mortality (19.9%), and MACE (24.8%) were significantly elevated in this group (p < 0.001). Multivariate analysis identified FIB-4 > 3.25 (OR 3.816; p = 0.001), HEART score (OR 1.161; p = 0.013), and hemoglobin (OR 0.873; p = 0.038) as independent predictors of mortality. ROC analysis revealed moderate discriminative performance for FIB-4 (AUC: 0.693) and HEART score (AUC: 0.766). Elevated FIB-4 scores are independently associated with increased short-term mortality and adverse cardiovascular outcomes in AMI patients undergoing CAG. Beyond its traditional role in liver disease, the FIB-4 score may serve as a practical, non-invasive biomarker for early cardiovascular risk stratification in patients presenting to the ED with acute myocardial infarction.","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Intermediate care units: an effective alternative to reduce intensive care unit admissions-a prospective cohort study. 中级监护病房：减少重症监护病房入院的有效选择——一项前瞻性队列研究。

IF 3.8 3区医学

Internal and Emergency Medicine Pub Date : 2025-08-19 DOI: 10.1007/s11739-025-04083-2

Gianni Turcato, Arian Zaboli, Alessandro Cipriano, Paolo Ferretto, Fabrizio Lucente, Lucia Filippi, Michael Maggi, Massimo Marchetti, Christian Josef Wiedermann, Lorenzo Ghiadoni

{"title":"Intermediate care units: an effective alternative to reduce intensive care unit admissions-a prospective cohort study.","authors":"Gianni Turcato, Arian Zaboli, Alessandro Cipriano, Paolo Ferretto, Fabrizio Lucente, Lucia Filippi, Michael Maggi, Massimo Marchetti, Christian Josef Wiedermann, Lorenzo Ghiadoni","doi":"10.1007/s11739-025-04083-2","DOIUrl":"10.1007/s11739-025-04083-2","url":null,"abstract":"Background: Critically ill medical patients from the Emergency Department (ED) are admitted either to general wards or the Intensive Care Unit (ICU). This binary allocation may lead to suboptimal management of non-intensive critical patients, increasing ICU overcrowding. Intermediate Care Units (IMCUs) could be an effective alternative, but their ability to reduce avoidable ICU admissions remains unclear.Aim: To evaluate whether an IMCU could effectively manage acutely ill patients with potential ICU treatment needs and to assess its role in reducing avoidable ICU admissions while maintaining patient outcomes.Methods: This prospective observational study (January-December 2024) was conducted at the IMCU of Alto Vicentino Hospital, Santorso, Italy. All acute patients admitted to the IMCU were included, excluding step-down ICU transfers. Clinical characteristics, disease severity, and organ dysfunction were recorded. Patients were classified based on their potential ICU treatment need, and ICU exclusion criteria were documented. Primary outcomes were ICU transfer due to IMCU failure and 30-day mortality.Results: Among 678 patients, 40.4% (274/678) had potential ICU treatment needs. Overall, 92.6% had organ failure, and 41.3% had multiple organ dysfunctions. IMCU management avoided ICU admission in 203 of 274 patients (79.9%). ICU transfer rate was 6.9% (47/678), and 30-day mortality was 12.8% (87/678). Among ICU-potential patients, mortality was 16.4% (45/274), decreasing to 11.4% (27/236) in those without ICU exclusion criteria.Conclusions: These findings suggest that IMCUs may serve as an effective alternative for managing critically ill non-intensive care patients, reducing avoidable ICU admissions while maintaining clinical outcomes.","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The potential of smoke-free products to reduce harm for smokers: what does the toxicological evidence say? 无烟产品减少对吸烟者危害的潜力：毒理学证据怎么说？

IF 3.8 3区医学

Internal and Emergency Medicine Pub Date : 2025-08-19 DOI: 10.1007/s11739-025-04093-0

Reinhard Niessner

{"title":"The potential of smoke-free products to reduce harm for smokers: what does the toxicological evidence say?","authors":"Reinhard Niessner","doi":"10.1007/s11739-025-04093-0","DOIUrl":"10.1007/s11739-025-04093-0","url":null,"abstract":"There continues to be a high prevalence of smoking in many European countries. In Germany, for example, there are over 20 million smokers, most of whom exhibit little desire to quit. In other countries, the adoption of smoke-free products (SFPs), including e-cigarettes (ECs), heated tobacco products (HTPs), and oral nicotine pouches (NPs), is helping smokers to transition away from cigarettes. In Germany, debate about SFPs primarily focuses on their potential harms to non-smokers, particularly the underage population. This debate seems one-sided: raising concerns alone does not sufficiently inform the 20 million smokers about the comparative health risks of cigarettes and SFPs, an issue increasingly echoed by practitioners and researchers. Instead, the current discourse is dominated by misconceptions, as evidenced by surveys on smokers' perceptions of the relative health risks of cigarettes and SFPs. Considering the gravity of the topic, it is essential to revisit the scientific facts. The growing evidence shows that SFPs, including ECs, HTPs, and NPs, expose users to significantly fewer numbers and lower concentrations of toxicants relative to combustible cigarettes. In vitro studies and biomarkers of harm in SFP users suggest that these lower emissions translate to reduced risks of harm. It is the nature of science that the evidence will never be complete, but the totality of data should be considered when discussing the correct handling of SFPs. At present, these data suggest that SFPs can play a useful role in curbing the individual and societal risks associated with smoking.","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Fever of unknown origin (FUO) FADOI-SIMIT Italian registry: can demographics, comorbidities, and clinical variables predict the etiology of classic FUO?-a prospective Italian study. FADOI-SIMIT意大利注册：人口统计学、合并症和临床变量能否预测经典FUO的病因？一项意大利前瞻性研究。

IF 3.8 3区医学

Internal and Emergency Medicine Pub Date : 2025-08-19 DOI: 10.1007/s11739-025-04084-1

Roberto Luzzati, Verena Zerbato, Luciano Attard, Giulio Virgili, Alessandro Cilli, Ada Zanier, Marco Libanore, Daniela Segala, Andrea Tedesco, Maria Elena Bortolotti, Emanuele Pontali, Marcello Feasi, Azzurra Re, Igor Giarretta, Fulvio Pomero, Elisa Zagarrì, Ercole Concia, Francesco Dentali, Dario Manfellotto, Mauro Campanini

{"title":"Fever of unknown origin (FUO) FADOI-SIMIT Italian registry: can demographics, comorbidities, and clinical variables predict the etiology of classic FUO?-a prospective Italian study.","authors":"Roberto Luzzati, Verena Zerbato, Luciano Attard, Giulio Virgili, Alessandro Cilli, Ada Zanier, Marco Libanore, Daniela Segala, Andrea Tedesco, Maria Elena Bortolotti, Emanuele Pontali, Marcello Feasi, Azzurra Re, Igor Giarretta, Fulvio Pomero, Elisa Zagarrì, Ercole Concia, Francesco Dentali, Dario Manfellotto, Mauro Campanini","doi":"10.1007/s11739-025-04084-1","DOIUrl":"10.1007/s11739-025-04084-1","url":null,"abstract":"Fever of Unknown Origin (FUO) remains a diagnostic challenge, defined by prolonged fever lasting for more than three weeks without a clear cause despite a minimum of three days of hospital investigations or three outpatient visits at least. This study aims to explore the etiologies and potential predictive factors for classic FUO in Italy, updating prior data from earlier studies. Conducted from October 2019 to June 2023, this prospective, multi-center registry enrolled 188 patients from 25 Italian hospitals, assessing demographics, comorbidities, and clinical characteristics in relation to FUO causes. Results indicated that 72.1% of cases reached a final diagnosis, with etiologies primarily in non-infectious inflammatory (31.8%), infectious (25.7%), and neoplastic (8.4%) categories, while 27.9% remained undiagnosed. Younger patients (under 55 years) were more likely to lack a definitive diagnosis, suggesting that advanced investigations might benefit early this patient population. Comorbid conditions like chronic obstructive pulmonary disease and cardiovascular symptoms were associated with infectious causes, whereas musculoskeletal and dermatologic signs suggested a non-infectious inflammatory origin. The overall mortality rate was 2.8% at a 6-month follow-up. This study highlights the need for improved diagnostic tools to address the substantial number of undiagnosed FUO cases. Trial registration: NCT05254522 ClinicalTrials.gov identifier.","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Missed diagnosis rate of portal venous system thrombosis in cirrhosis on contrast-enhanced CT scans: Review of radiology reports from a tertiary hospital. 肝硬化门静脉系统血栓CT增强扫描的漏诊率：某三级医院影像学报告回顾。

IF 3.8 3区医学

Internal and Emergency Medicine Pub Date : 2025-08-18 DOI: 10.1007/s11739-025-04076-1

Siqi Jia, Huiyuan Lu, Ting Wang, Wenhui Huo, Zhuang Liu, Yueying Shi, Libo Zhang, Xingshun Qi

{"title":"Missed diagnosis rate of portal venous system thrombosis in cirrhosis on contrast-enhanced CT scans: Review of radiology reports from a tertiary hospital.","authors":"Siqi Jia, Huiyuan Lu, Ting Wang, Wenhui Huo, Zhuang Liu, Yueying Shi, Libo Zhang, Xingshun Qi","doi":"10.1007/s11739-025-04076-1","DOIUrl":"10.1007/s11739-025-04076-1","url":null,"abstract":"Portal venous system thrombosis (PVST) negatively influences the outcomes of cirrhotic patients. Its accurate diagnosis is essential for treatment selection and prognostic assessment, but it is usually missed in clinical practice. Overall, 684 contrast-enhanced computed tomography (CE-CT) scans were performed in cirrhotic patients who were consecutively admitted from January 2015 to June 2023, and were retrospectively reviewed by two independent researchers. Weighted-kappa was calculated to estimate the consistency of the two researchers in the diagnosis of PVST. If their conclusions were inconsistent, a senior researcher would be invited to make a final diagnosis. Clinically significant PVST (CSPVST) was further identified. By comparing the researchers' diagnosis with the radiology reports, the missed diagnosis rate of PVST was calculated. The Kappa coefficient was 0.85, indicating almost perfect consistency in the diagnosis of PVST between the two researchers. In total, PVST was diagnosed by the researchers on 278 (40.64%) of the 684 scans; and among them, a diagnosis of PVST was not recorded in 168 radiology reports. Thus, the missed diagnosis rate of PVST was 60.43% (168/278). CSPVST was diagnosed by the researchers on 87 (12.72%) scans; and among them, a diagnosis of PVST was not recorded in 38 radiology reports. Thus, the missed diagnosis rate of CSPVST was 43.68% (38/87). If a diagnosis of PVST was made only according to the radiology reports, a very high proportion of PVST would be missed. Considering a high rate of PVST detection in cirrhosis, the radiologists should pay more attention to the diagnosis of PVST, especially CSPVST.","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The impact of COVID-19 pandemic on hospitalization rate, clinical impairment and mortality of cirrhotic patients: comment. 新冠肺炎疫情对肝硬化患者住院率、临床损害及死亡率的影响

IF 3.8 3区医学

Internal and Emergency Medicine Pub Date : 2025-08-18 DOI: 10.1007/s11739-025-04068-1

Yunlong Song, Bo Yu, Yan Li

引用次数: 0

Mechanical dispersion predicts survival of dialysis-dependent patients with preserved left ventricular ejection fraction. 机械弥散预测左心室射血分数保留的透析依赖患者的生存。

IF 3.8 3区医学

Internal and Emergency Medicine Pub Date : 2025-08-13 DOI: 10.1007/s11739-025-04073-4

Milica Scepanovic, Ivan Stankovic, Tamara Jemcov, Ivona Vranic, Aleksandra Maksimovic, Rodoljub Markovic, Nadezda Zec, Jovana Kusic Milicevic, Aleksandar N Neskovic

{"title":"Mechanical dispersion predicts survival of dialysis-dependent patients with preserved left ventricular ejection fraction.","authors":"Milica Scepanovic, Ivan Stankovic, Tamara Jemcov, Ivona Vranic, Aleksandra Maksimovic, Rodoljub Markovic, Nadezda Zec, Jovana Kusic Milicevic, Aleksandar N Neskovic","doi":"10.1007/s11739-025-04073-4","DOIUrl":"https://doi.org/10.1007/s11739-025-04073-4","url":null,"abstract":"Cardiovascular disease is a leading cause of mortality in chronic kidney disease patients undergoing renal replacement therapy (RRT). Echocardiographic risk assessment, especially in patients with preserved left ventricular ejection fraction (LVEF), may help identifying at-risk individuals. This study evaluates the prognostic significance of left ventricular (LV) mass global longitudinal strain (GLS) and mechanical dispersion in RRT patients with preserved LVEF. We prospectively followed 78 RRT patients with LVEF ≥ 50% over 55 ± 6 months to assess all-cause mortality. LV mass was determined using linear measurements and indexed to body surface area to obtain LV mass index (LVMI). GLS was calculated as the average of 18 segmental peak systolic strain values while mechanical dispersion was calculated from time intervals measured from the ECG R-wave to peak longitudinal strain across 18 LV segments. LV hypertrophy was observed in 58% of patients. Over a median follow-up of 55 ± 6 months, 29 patients (37%) died. Univariate Cox regression analysis identified age, diabetes mellitus, LVMI, GLS, and mechanical dispersion as predictors of all-cause mortality. Multivariate analysis confirmed that age [hazard ratio (HR) 1.04, 95% confidence interval (CI) 1.01-1.07, p = 0.014], LVMI (HR 1.02, 95% CI 1.01-1.03, p = 0.001), GLS (HR 0.77, 95%CI 0.66-0.88, p = 0.014) and mechanical dispersion (HR 2.16, 95% CI 1.03-4.52, p = 0.042) were independent mortality predictors. In dialysis-dependent patients with preserved LVEF, increased mechanical dispersion is associated with worse survival. This parameter, when combined with LVMI and GLS, could serve as an additional tool for risk stratification in this vulnerable patient population.","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144834986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Traube's pulse: key concepts of this old and concerning sign in the era of ultrasound assisted physical examination. 特劳伯脉搏：超声辅助体检时代这一古老而令人担忧的标志的关键概念。

IF 3.8 3区医学

Internal and Emergency Medicine Pub Date : 2025-08-11 DOI: 10.1007/s11739-025-04082-3

Paolo Pellegrini, Veronica Boccioletti, Luca Conte, Ilaria Nicoletti, Andrea Pacchioni

引用次数: 0