Internal and Emergency Medicine最新文献_第9页

Demographic and regional trends in systemic and cardiovascular amyloidosis-related mortality among older adults in the United States from 1999 to 2020. 1999年至2020年美国老年人系统性和心血管淀粉样变性相关死亡率的人口统计学和区域趋势

IF 3.2 3区医学

Internal and Emergency Medicine Pub Date : 2025-06-01 Epub Date: 2025-02-20 DOI: 10.1007/s11739-025-03893-8

Jasninder Singh Dhaliwal, Fatima Hussain, Hamza Ahmed, Abeer T M A Khan, Abdullah Aslam Khan, Maha Asghar Memon, Maha Arshad, Sayed Maisum Mehdi, Anum Touseef Hussain, Ayesha Ali Rind, Syeda Umbreen Munir, Bilal Ali, Kashaf Nadeem, Ahmed Mustafa Rashid

{"title":"Demographic and regional trends in systemic and cardiovascular amyloidosis-related mortality among older adults in the United States from 1999 to 2020.","authors":"Jasninder Singh Dhaliwal, Fatima Hussain, Hamza Ahmed, Abeer T M A Khan, Abdullah Aslam Khan, Maha Asghar Memon, Maha Arshad, Sayed Maisum Mehdi, Anum Touseef Hussain, Ayesha Ali Rind, Syeda Umbreen Munir, Bilal Ali, Kashaf Nadeem, Ahmed Mustafa Rashid","doi":"10.1007/s11739-025-03893-8","DOIUrl":"10.1007/s11739-025-03893-8","url":null,"abstract":"Despite therapy advancements, amyloidosis mortality rates for older adults (aged ≥ 65) are rising. This study analyzes trends in amyloidosis-related mortality among older adults in the U.S. We conducted a cross-sectional analysis of death certificates from the CDC WONDER database for amyloidosis-related deaths from 1999 to 2020. Age-adjusted mortality rates (AAMRs) per 100,000 persons and annual percent change (APC) were calculated by age, race/ethnicity, urban-rural classification, and region. From 1999 to 2020, AAMR for amyloidosis in older adults (aged ≥ 65) in the U.S. increased from 2.7 to 5.6. Men consistently had higher AAMRs than women (men: 3.7 vs. women: 2.2 in 1999; men: 8.5 vs. women: 3.5 in 2020). In 2020, Non-Hispanic Blacks had the highest AAMR at 11.8, with an APC of 19.8 (95% CI 10.5-25.5). Regional differences were notable, with AAMRs highest in the Northeast (6.9) and lowest in the South (4.2). Large metropolitan areas had a higher AAMR (6.3) than non-metropolitan areas (4.6). Cardiac amyloidosis accounted for 68.8% of deaths, with AAMR rising from 1.7 to 4.2. There has been a significant increase in AAMRs for amyloidosis in the U.S. from 1999 to 2020, particularly among males, Non-Hispanic Blacks, and those in large metropolitan and Northeast areas. These findings stress the need for enhanced prevention and treatment strategies for older adults.","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":"1003-1012"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467987","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

Association between post-arrest 12-lead electrocardiographic features and neurologically intact survival for patients of in-hospital cardiac arrest. 院内心脏骤停患者骤停后12导联心电图特征与神经系统完整生存的关系

IF 3.2 3区医学

Internal and Emergency Medicine Pub Date : 2025-06-01 Epub Date: 2025-04-02 DOI: 10.1007/s11739-025-03936-0

Chih-Hung Wang, Cheng-Yi Wu, Joyce Tay, Meng-Che Wu, Li-Ting Ho, Wei-Han Lin, Jr-Jiun Lin, Huang-Fu Yeh, Chu-Lin Tsai, Chien-Hua Huang, Wen-Jone Chen

{"title":"Association between post-arrest 12-lead electrocardiographic features and neurologically intact survival for patients of in-hospital cardiac arrest.","authors":"Chih-Hung Wang, Cheng-Yi Wu, Joyce Tay, Meng-Che Wu, Li-Ting Ho, Wei-Han Lin, Jr-Jiun Lin, Huang-Fu Yeh, Chu-Lin Tsai, Chien-Hua Huang, Wen-Jone Chen","doi":"10.1007/s11739-025-03936-0","DOIUrl":"10.1007/s11739-025-03936-0","url":null,"abstract":"Twelve-lead electrocardiogram (ECG) may provide prognostic information for in-hospital cardiac arrest (IHCA). This study aimed to identify post-arrest ECG features and their temporal changes associated with IHCA outcomes. This single-center retrospective study included patients experiencing IHCA between 2005 and 2022. Post-arrest ECGs were obtained within 48 h after an IHCA, admission ECGs upon hospital admission, and pre-arrest ECGs within 72 h before an IHCA. Multivariable logistic regression analyses were conducted to identify ECG features associated with neurologically intact survival. A total of 708 patients were included, with 131 (18.5%) achieving neurologically intact survival. The median age was 70.4 years (interquartile range: 59.2-82.6), and 362 (62.7%) patients were male. Four post-arrest ECG features were associated with survival: sinus rhythm (odds ratio [OR]: 1.81, 95% confidence interval [CI]: 1.11-2.93), QRS duration between 80 and 120 ms (OR: 1.91, 95% CI 1.19-3.08), low QRS voltage (OR: 0.50, 95% CI 0.25-0.99), and prolonged QTc (OR: 1.89, 95% CI 1.08-3.28). Comparing with admission ECGs, new-onset right bundle branch block (OR: 0.39, 95% CI 0.16-0.95) and increases in the number of leads with ST depression (OR: 0.85, 95% CI 0.77-0.94) on post-arrest ECGs were inversely associated with survival. Compared with pre-arrest ECGs, increases in the number of leads with ST depression (OR: 0.91, 95% CI 0.88-0.96) on post-arrest ECGs were also inversely associated with survival. Post-arrest ECGs may serve as a valuable prognostic tool for IHCA. Further exploration is warranted to determine whether incorporating these ECG features can enhance the performance of prediction models for IHCA outcomes.","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":"1107-1118"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763748","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 effect of SGLT2 inhibitors on hepatic steatosis detected by MRI-PDFF in patients with type 2 Diabetes mellitus and metabolic-associated steatotic liver disease. MRI-PDFF检测SGLT2抑制剂对2型糖尿病合并代谢相关脂肪变性肝病患者肝脂肪变性的影响

IF 3.2 3区医学

Internal and Emergency Medicine Pub Date : 2025-06-01 Epub Date: 2025-03-14 DOI: 10.1007/s11739-025-03902-w

Mona Ahmed Amin, Noha Adly Sadik, Hala Ahmed Saad, Mohammed Fawzy, Hend Abdallah Elsheimy

{"title":"The effect of SGLT2 inhibitors on hepatic steatosis detected by MRI-PDFF in patients with type 2 Diabetes mellitus and metabolic-associated steatotic liver disease.","authors":"Mona Ahmed Amin, Noha Adly Sadik, Hala Ahmed Saad, Mohammed Fawzy, Hend Abdallah Elsheimy","doi":"10.1007/s11739-025-03902-w","DOIUrl":"10.1007/s11739-025-03902-w","url":null,"abstract":"Sodium-glucose co-transporter type-2 (SGLT2) inhibitors have been identified to have a crucial hepatoprotective role in patients with type 2 diabetes (T2DM) and metabolic-associated steatotic liver disease (MASLD). Thus, we aimed to assess the effect of SGLT2 inhibitors on hepatic steatosis in patients with T2DM and MASLD added to the standard of care (SOC) treatment. Our study was a single-arm clinical trial with trial no ISRCTN85961860. Thirty T2DM patients with MASLD were recruited from the outpatient endocrinology and diabetes clinic of the Internal Medicine Department at Kasr Al-Aini Hospital, Cairo University, Egypt. Our Patients received Empagliflozin 10 mg daily which was added to SOC treatment and followed up for 24 weeks. Magnetic resonance imaging proton density fat fraction (MRI-PDFF) was done at baseline and after 24 weeks to assess the percentage change in hepatic fat mass. Also changes in Fib-4 and NAFLD fibrosis scores were calculated. Our study showed a statistically significant decrease in the mean MRI-PDFF measurement of hepatic steatosis after 24 weeks of adding empagliflozin to SOC treatment (13.297 ± 7.15) compared to the mean at baseline (15.288 ± 8.72), P = 0.006 with overall percentage decrease about 13.16% of liver steatosis. There were significant decreases in BMI, fasting blood glucose, and Alanine transaminase, (P < 0.001, 0.03, 0.01) respectively. There were no significant differences in Fib-4 or NAFLD fibrosis scores. Adding empagliflozin 10 mg to the standard treatment in patients with diabetes and MASLD could reduce hepatic fat mass significantly after 24 weeks of treatment. Thus, adding SGLT2 inhibitors to the clinical practice guidelines could be a therapeutic agent for patients with MASLD and T2DM.","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":"1025-1033"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630388","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}

引用次数: 0

Clinical characterization of aortitis and periaortitis: study of 134 patients from a single university hospital. 主动脉炎和动脉周炎的临床特征：对某大学医院134例患者的研究

IF 3.2 3区医学

Internal and Emergency Medicine Pub Date : 2025-06-01 Epub Date: 2025-03-04 DOI: 10.1007/s11739-025-03908-4

Carmen Secada-Gómez, Javier Loricera, Adrián Martín-Gutiérrez, Fernando López-Gutiérrez, Lucía García-Alcalde, María Núñez-Sayar, Ander Ucelay-Aristi, Isabel Martínez-Rodríguez, Santos Castañeda, Ricardo Blanco

{"title":"Clinical characterization of aortitis and periaortitis: study of 134 patients from a single university hospital.","authors":"Carmen Secada-Gómez, Javier Loricera, Adrián Martín-Gutiérrez, Fernando López-Gutiérrez, Lucía García-Alcalde, María Núñez-Sayar, Ander Ucelay-Aristi, Isabel Martínez-Rodríguez, Santos Castañeda, Ricardo Blanco","doi":"10.1007/s11739-025-03908-4","DOIUrl":"10.1007/s11739-025-03908-4","url":null,"abstract":"Aortitis and periaortitis refer to the inflammation of the aortic wall and the surrounding tissues. Both conditions are associated with various diseases and express nonspecific manifestations. Early diagnosis and treatment are crucial to improve the prognosis of the disease. This study aimed to assess the causes and main clinical features of aortitis and periaortitis in patients from a single centre in Spain. Observational, retrospective study of patients diagnosed with aortitis or periaortitis at a Spanish referral center over the last decade. 134 patients (87 female; mean age of 55.1 ± 9.1 years) were recruited, 132 of which had aortitis and two periaortitis. Aortitis was associated with giant cell arteritis (n = 102), Takayasu's arteritis (n = 6), IgG4-related disease (n = 6), infectious diseases (n = 3), malignancy (n = 1), drugs (n = 1), isolated aortitis (n = 1), and other immune-mediated inflammatory diseases (IMIDs) (n = 12). IMIDs included were Sjögren's syndrome (n = 2), sarcoidosis (n = 2), rheumatoid arthritis (n = 2), axial spondyloarthritis (n = 2), inflammatory bowel disease (n = 1), primary biliary cirrhosis (n = 1), idiopathic pulmonary fibrosis (n = 1), and polyarteritis nodosa (n = 1). Periaortitis was due to idiopathic retroperitoneal fibrosis in both cases. Imaging techniques used for diagnosis included 18F-FDG PET/CT scan (n = 133), CT-angiography (n = 44), and/or MRI-angiography (n = 33). Polymyalgia rheumatica (52.2%) and asthenia (53.7%) were the most common manifestations, followed by limb claudication (23.9%) and inflammatory back pain (26.9%). Acute-phase reactants were typically increased. Aortitis is a common condition and may be associated with multiple non-infectious diseases. Its clinical presentation is often unspecific, requiring a high level of suspicion to get an early diagnosis and treatment.","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":"1045-1057"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556670","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

Clarkson disease in critically and non-critically ill patients: insights from the Italian IRIS-CLS registry. 克拉克森病在危重症和非危重症患者中的应用：来自意大利IRIS-CLS登记的见解

IF 3.2 3区医学

Internal and Emergency Medicine Pub Date : 2025-06-01 Epub Date: 2025-03-08 DOI: 10.1007/s11739-025-03890-x

Riccardo Colombo, Jonathan Montomoli, Teresa Lanzi, Antonella Tosoni, Claudia Agabiti Rosei, Giuseppe Visani, Franco Verlicchi, Chiara Cogliati, Manuela Nebuloni, Maddalena Alessandra Wu

{"title":"Clarkson disease in critically and non-critically ill patients: insights from the Italian IRIS-CLS registry.","authors":"Riccardo Colombo, Jonathan Montomoli, Teresa Lanzi, Antonella Tosoni, Claudia Agabiti Rosei, Giuseppe Visani, Franco Verlicchi, Chiara Cogliati, Manuela Nebuloni, Maddalena Alessandra Wu","doi":"10.1007/s11739-025-03890-x","DOIUrl":"10.1007/s11739-025-03890-x","url":null,"abstract":"Idiopathic Systemic Capillary Leak Syndrome (ISCLS) is a poorly understood paroxysmal permeability disorder. This study aimed to characterize the clinical features and severity markers of ISCLS in critically and non-critically ill patients. We analyzed prospectively and retrospectively collected data on ISCLS cases from the Italian IRIS-CLS Registry (January 1995-December 2023). A total of 124 acute episodes were identified in 32 patients; 61 episodes in 26 patients having complete records were included in the analysis. Monoclonal gammopathy was found in 20/23 adults but was absent in all three pediatric patients, who exhibited IgA deficiency instead. At admission, patients presented with hypotension (systolic arterial pressure 87 mmHg [80-105]), tachycardia (110 bpm [96-130]), and hemoconcentration (hematocrit 57% [48-62.7]). ICU admission was required in 70.5%, and cardiac involvement occurred in 49.2% of episodes. Fluid volume infused correlated positively with rhabdomyolysis severity, and the need for renal replacement therapy was more frequent in patients receiving ≥ 3 L. No pharmacologic treatment was effective during the crises. Mortality was 9.8% per episode, and the day-1 Sequential Organ Failure Assessment score was a predictor of death (p = 0.0181). Immunoglobulin prophylaxis reduced attack frequency from 0.67 (0.4-1.07) to 0.4 (0.1-0.52) per year (p = 0.033). Two adults (8.7%) developed multiple myeloma during follow-up. This study provides a comprehensive overview of ISCLS in both critically and non-critically ill patients. We highlight clinical-biochemical-instrumental red-flags and emphasize the need for increased awareness and early recognition since effective treatments for acute shock remain elusive.","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":"991-1001"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12130070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585755","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}

引用次数: 0

Musculoskeletal manifestations in a cohort of Behçet's disease patients and their impact on health-related quality of life. 一组behaperet病患者的肌肉骨骼表现及其对健康相关生活质量的影响

IF 3.2 3区医学

Internal and Emergency Medicine Pub Date : 2025-06-01 Epub Date: 2025-03-07 DOI: 10.1007/s11739-025-03903-9

Samar Tharwat, Nasim Jaber, Hamza Aljubaeh, Omar Abumunshar

{"title":"Musculoskeletal manifestations in a cohort of Behçet's disease patients and their impact on health-related quality of life.","authors":"Samar Tharwat, Nasim Jaber, Hamza Aljubaeh, Omar Abumunshar","doi":"10.1007/s11739-025-03903-9","DOIUrl":"10.1007/s11739-025-03903-9","url":null,"abstract":"Behçet's disease (BD) is a multifaceted disorder of undetermined etiology. Distinct clinical manifestations exhibit varying prevalences, with mucocutaneous and ocular presentations being the most prevalent in the BD population. The aim of this study was to assess musculoskeletal (MSK) manifestations and their effect on health-related quality of life (HRQoL) of life in individuals with BD. We asked patients with BD to complete an online survey. The survey had many questions focused on demographic, clinical, and therapeutic data, as well as the Nordic musculoskeletal questionnaire and the short form-36 (SF-36). There was a total of 185 BD patients, mostly females (54.6%), with a mean age of 33.81 years. The most prevalent clinical manifestation was recurrent oral aphthosis (95.1%), followed by ocular involvement (72.4%). Most of the study patients (85.4%) reported MSK manifestations in the last 6 months. These manifestations included mainly the lower back (69%) and neck (67%), followed by the left and right knees (62% and 60%, respectively), while the least affected areas of the body were the right elbow (37%), and the right ankle and foot (7%). The age at disease onset (p = 0.007) showed a statistically significant difference between those with MSK manifestations and those without. Patients exhibiting MSK manifestations demonstrated statistically significant lower scores of all SF-36 domains compared to those without such manifestations. MSK manifestations are prevalent and adversely affect HRQoL among BD patients. Therefore, early identification and treatment are strongly recommended.","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":"1035-1044"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585759","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}

引用次数: 0

Echocardiographic clues of the "atrial pump mechanism" during cardiopulmonary resuscitation. 心肺复苏过程中 "心房泵机制 "的超声心动图线索。

IF 3.2 3区医学

Internal and Emergency Medicine Pub Date : 2025-06-01 Epub Date: 2024-09-06 DOI: 10.1007/s11739-024-03762-w

Emanuele Catena, Alessandra Volontè, Tommaso Fossali, Elisa Ballone, Paola Bergomi, Martina Locatelli, Beatrice Borghi, Davide Ottolina, Roberto Rech, Antonio Castelli, Riccardo Colombo

{"title":"Echocardiographic clues of the \"atrial pump mechanism\" during cardiopulmonary resuscitation.","authors":"Emanuele Catena, Alessandra Volontè, Tommaso Fossali, Elisa Ballone, Paola Bergomi, Martina Locatelli, Beatrice Borghi, Davide Ottolina, Roberto Rech, Antonio Castelli, Riccardo Colombo","doi":"10.1007/s11739-024-03762-w","DOIUrl":"10.1007/s11739-024-03762-w","url":null,"abstract":"Instead of the ventricles, atria may be the cardiac structures mainly compressed during cardiopulmonary resuscitation (CPR). This study aimed to assess the prevalence and the mechanical characteristics of atrial compression, named the \"atrial pump mechanism\", in patients undergoing CPR. A retrospective cohort study was conducted on patients with witnessed refractory out-of-hospital cardiac arrest who were admitted to a tertiary referral center for extracorporeal CPR. The area of maximal compression (AMC) by chest compressions was assessed by transesophageal echocardiography. Right atrial wall excursion (RAWE), left atrial fractional shortening (LAFS), right ventricular fractional area change (RVFAC), and left ventricular fractional shortening (LVFS) were measured. Common carotid and middle cerebral artery peak velocities were assessed using color-Doppler imaging as markers of cardiac outflow and cerebral perfusion. Forty patients were included in the study. Five (12.5%) had AMC over the atria. The atrial pump pattern was characterized by marked atrial compression with higher RAWE and LAFS values compared to the other patients (p < 0.001). Common carotid Doppler and transcranial Doppler-velocity patterns were detectable in all patients with open left ventricular outflow tract, without differences between patients. CPR was successful in four patients (80%) with atrial pump compared to 14 (40%) with no atrial pump mechanism (p = 0.155). In this series of selected patients with witnessed cardiac arrest, the prevalence of the atrial pump mechanism was not negligible. It may contribute to forward blood flow and the maintenance of cerebral perfusion during prolonged cardiopulmonary resuscitation.","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":"1215-1223"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142145592","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

Linezolid-induced neuropathy in Nocardia pneumonia. 利奈唑胺致诺卡菌肺炎的神经病变。

IF 3.2 3区医学

Internal and Emergency Medicine Pub Date : 2025-06-01 Epub Date: 2025-02-10 DOI: 10.1007/s11739-025-03886-7

Yiwei Wang, Miao Dai

引用次数: 0

Rapid response system and mortality in intensive care unit: a nationwide cohort study in South Korea. 重症监护室快速反应系统与死亡率：韩国全国范围内的队列研究。

IF 3.2 3区医学

Internal and Emergency Medicine Pub Date : 2025-06-01 Epub Date: 2024-09-25 DOI: 10.1007/s11739-024-03780-8

Tak Kyu Oh, In-Ae Song

{"title":"Rapid response system and mortality in intensive care unit: a nationwide cohort study in South Korea.","authors":"Tak Kyu Oh, In-Ae Song","doi":"10.1007/s11739-024-03780-8","DOIUrl":"10.1007/s11739-024-03780-8","url":null,"abstract":"The beneficial effects of a rapid response system (RRS) on clinical outcomes in patients admitted to a ward have been established. However, the relationship between RRS implementation and clinical outcomes in patients in the intensive care unit (ICU) has not yet been established. Therefore, we aimed to investigate whether the RRS affects clinical outcomes in critically ill patients admitted to the ICU. As a nationwide, population-based cohort study, all adult patients who were admitted to the ICU from 1 January 2019 to 31 December 2021 in South Korea were included. Patients in hospitals with an RRS formed the RRS group; those in hospitals lacking an RRS constituted the non-RRS group. In total, 900,606 patients admitted to the ICU were included in the final analysis. Among them, 365,305 (40.6%) were assigned to the RRS group, and 535,301 (59.4%) were assigned to the non-RRS group. After propensity score (PS) matching, a total of 454,748 patients (227,374 in each group) were included in the final analysis. In the PS-matched cohort, the RRS group showed 8% (odds ratio [OR]: 0.92, 95% confidence interval [CI]: 0.91, 0.94; P < 0.001) and 11% (hazard ratio: 0.89, 95% CI: 0.88, 0.90; P < 0.001) lower in-hospital mortality rates and 1-year all-cause mortality rates than the non-RRS group, respectively. In addition, ICU readmission rates and the occurrence rate for adverse events during hospitalization in the RRS group were 3% (OR: 0.97, 95% CI: 0.95, 0.98; P < 0.001) and 21% (OR: 0.79, 95% CI: 0.78, 0.80; P < 0.001) lower than those in the non-RRS group, respectively. RRS deployment was linked to lower in-hospital and 1-year all-cause mortality rates, ICU readmission rates, and the occurrence of adverse events during hospitalization among ICU patients. The findings indicate that using the RRS could assist not only patients in the ward but also critically ill patients in the ICU.","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":"1235-1243"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345999","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

Predicting COPD readmissions: a novel 2e index with traditional regression and machine-learning approaches. 预测慢性阻塞性肺病的再入院情况：采用传统回归和机器学习方法的新型 2e 指数。

IF 3.2 3区医学

Internal and Emergency Medicine Pub Date : 2025-06-01 Epub Date: 2024-11-09 DOI: 10.1007/s11739-024-03816-z

Chiat Qiao Liew, Yen-Pin Chen, Jun-Wan Gao, Chia-Hsin Ko, Chu-Lin Tsai

引用次数: 0