International Journal of Emergency Medicine最新文献

{"title":"Strengthening hospital resilience to earthquakes: a public health review of seismic risk reduction programs in the Middle East.","authors":"Yasir Almukhlifi, Maher Alsulami, Abdullah Alharbi, Tafe Howsawi, Amal Hussain, Reema Alfageeh, Aseel Alzahrani, Eatedal Alshareef, Amal Salah, Rani Radey, Mohammed Sultan","doi":"10.1186/s12245-025-01000-4","DOIUrl":"https://doi.org/10.1186/s12245-025-01000-4","url":null,"abstract":"<p><strong>Introduction: </strong>Maintaining hospital functionality during and after earthquakes is essential for effective disaster response in seismically active regions. In the Middle East, hospital resilience is challenged by limited infrastructure investment, variable enforcement of safety regulations, and inconsistent preparedness planning.</p><p><strong>Methods: </strong>A systematic literature review was conducted across nine databases (2009-2024), including EBSCO, Cochrane, PsycINFO, Scopus, Web of Science, PubMed, Medline, EconLit, and Google Scholar. Studies were included if they assessed hospitals in the Middle East with comprehensive or partial seismic risk reduction programs. Three independent reviewers performed data extraction and quality appraisal using validated tools appropriate to study design.</p><p><strong>Results: </strong>Five studies met the inclusion criteria. Hospitals with comprehensive seismic risk reduction programs, including structural retrofitting, disaster drills, surge capacity plans, and emergency communication protocols, demonstrated higher levels of functional continuity following earthquakes. In contrast, facilities lacking such measures reported structural damage, service disruptions, and patient evacuations. Mobile hospitals were identified as a promising adaptive strategy for mitigating overload in high-risk, resource-limited settings.</p><p><strong>Conclusion: </strong>Comprehensive seismic preparedness programs enhance hospital functionality in earthquake-prone regions. These findings underscore the importance of integrated risk reduction strategies, cross-sector coordination, and sustained investment. Further research is needed to evaluate the comparative impact of preparedness levels using standardized functionality indicators, and to explore scalable innovations such as mobile and modular healthcare units to strengthen regional disaster resilience.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"203"},"PeriodicalIF":2.0,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145291899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Domain validation of the CRASH prognostic model for predicting 14-day mortality among patients and traumatic brain injury and intracranial hemorrhage in a Thai emergency department.","authors":"Welawat Tienpratarn, Phichayut Phinyo, Chaiyaporn Yuksen, Sirote Wongwaisayawan, Jiraporn Khorana, Jayanton Patumanond","doi":"10.1186/s12245-025-01008-w","DOIUrl":"https://doi.org/10.1186/s12245-025-01008-w","url":null,"abstract":"<p><strong>Background: </strong>Traumatic brain injury (TBI) is a significant health concern, with intracranial haemorrhage (ICH) being a common complication following injury. The CRASH prediction model plays a crucial role in clinical prognostication and decision-making within this patient group. However, external validation is critical to ensure the model's validity and applicability across different populations and settings beyond those in which it was originally developed. This study aimed to validate the CRASH prediction model for 14-day mortality among TBI patients with ICH presenting to a Thai emergency department.</p><p><strong>Methods: </strong>This retrospective study included adult TBI patients with ICH who visited the emergency department (ED) at Ramathibodi Hospital, Thailand, between 2020 and 2022. The Basic model, which incorporates age, Glasgow Coma Scale (GCS) score (3-15), pupillary reaction, and major extracranial injury, and the CT model, which extends the Basic model by including CT findings, were evaluated for their discriminative ability and calibration.</p><p><strong>Results: </strong>A total of 232 patients were included in the validation dataset. Significant differences in clinical characteristics were observed between the datasets, including older age, predominance of mild TBI, subarachnoid hemorrhage, and non-evacuated hematoma in the validation dataset. The observed 14-day mortality rate in this cohort was 9.1%, compared to 20.7% in the development dataset. The area under the receiver operating characteristics curve (AuROC) was 0.92 (95% CI: 0.84, 1.00) for the Basic model and 0.93 (95% CI: 0.86, 1.00) for the CT model. However, the calibration for both models was fair. Recalibration achieved better predictive accuracy and reduced overestimation in high-risk groups.</p><p><strong>Conclusion: </strong>The original CRASH prediction model demonstrates strong discriminative ability for predicting 14-day mortality in TBI patients; however, significant miscalibration was observed. Recalibration was therefore undertaken to improve the model's generalisability to local populations. Nonetheless, further studies are warranted to confirm the consistency and applicability of the recalibrated models.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"202"},"PeriodicalIF":2.0,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145291896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI-enhanced crowdsourcing for disaster management: strengthening community resilience through social media.","authors":"Sheikh Kamran Abid, Ruhizal Roosli, Umber Nazir, Nur Shazwani Kamarudin","doi":"10.1186/s12245-025-01009-9","DOIUrl":"10.1186/s12245-025-01009-9","url":null,"abstract":"<p><p>As disasters become more frequent and complex, the integration of artificial intelligence (AI) with crowdsourced data from social media is emerging as a powerful approach to enhance disaster management and community resilience. This study investigates the potential of AI-enhanced crowdsourcing to improve emergency preparedness and response. A systematic review was conducted using both qualitative and quantitative methodologies, guided by the PRISMA framework, to identify and evaluate relevant literature. The findings reveal that AI systems can effectively process real-time social media data to deliver timely alerts, coordinate emergency actions, and engage communities. Key themes explored include the effectiveness of community participation, AI's capacity to manage large-scale information flows, and the challenges posed by misinformation, data privacy, and infrastructural limitations. The results suggest that when strategically implemented, AI-enhanced crowdsourcing can play a critical role in building adaptive and sustainable disaster management frameworks. The paper concludes with practical and policy-level recommendations for integrating these technologies into Pakistan's disaster management systems.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"201"},"PeriodicalIF":2.0,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12516865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145286266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors contributing to bleeding and perforated peptic ulcers in Syria: findings from a multicenter cohort study.","authors":"Jamal Ataya, Yaman Haj Hasan, Rawan Daboul, Hamdah Hanifa, Nour Bannoud, Nour Alhuda Abd Alnabi, Masa Watfa, Mohammed Jomaa, Hamoud Hamed, Ahmad Alhaj","doi":"10.1186/s12245-025-01024-w","DOIUrl":"10.1186/s12245-025-01024-w","url":null,"abstract":"<p><strong>Background: </strong>Peptic ulcer disease (PUD) is a common gastrointestinal disorder characterized by the formation of open lesions in the stomach or duodenum, leading to potentially life-threatening complications such as bleeding, perforation, and obstruction. Despite advances in understanding its pathophysiology and management, PUD continues to present significant health challenges, particularly in conflict-affected regions like Syria. This study investigates clinical presentation, demographic factors, and risk profiles associated with bleeding and perforated ulcers, aiming to contribute to evidence-based strategies for improving diagnosis and management in resource-limited settings.</p><p><strong>Methods: </strong>A multicenter cohort study was conducted across five major hospitals in Syria from 2018 to 2023, enrolling 242 patients diagnosed with bleeding or perforated ulcers. Demographic data, clinical histories, lifestyle factors, and medical interventions were collected from hospital records. Statistical analyses, including Chi-square tests, t-tests, and logistic regression, were performed to identify associations between ulcer types, demographic variables, and clinical outcomes.</p><p><strong>Results: </strong>Significant demographic differences were found between patients with bleeding and perforated ulcers. The bleeding group was older (mean age = 60.4 ± 18.7 years) compared to the perforation group (mean age = 49.4 ± 16.9 years), with rural residents more likely to experience bleeding ulcers (57.3%). Patients with a past history of peptic ulcer disease, gastritis, or other upper‑GI disorders were more likely to develop perforated ulcers, while those with multiple comorbidities were predisposed to bleeding ulcers. Lifestyle factors, such as occupation and smoking status, also influence ulcer type, with retired individuals more likely to develop bleeding ulcers and heavy smokers more often diagnosed with perforation. Clinical outcomes varied, with interventions predominantly consisting of open surgeries for perforated ulcers and laparoscopic approaches for bleeding ulcers.</p><p><strong>Conclusion: </strong>This study highlights the complex interplay of demographic, clinical, and lifestyle factors in the presentation of bleeding and perforated peptic ulcers in Syria. The findings underscore the need for tailored, context-specific approaches in the management of PUD, particularly in conflict zones with limited healthcare access. This research provides valuable insights into predictors of ulcer type and complications, offering a foundation for evidence-based guidelines aimed at improving patient outcomes in resource-constrained settings.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"200"},"PeriodicalIF":2.0,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12516891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145286298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abrupt formation and spontaneous resolution of a mobile right atrial thrombus following intraoperative cardiopulmonary resuscitation during da Vinci robotic-assisted surgery: a case report.","authors":"Yunfeng Jiang, Wenqing Ruan, Yangyang Xia, Chenlong Xie, Wei Yuan, Jiangang Song, Jian Wang","doi":"10.1186/s12245-025-01006-y","DOIUrl":"10.1186/s12245-025-01006-y","url":null,"abstract":"","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"199"},"PeriodicalIF":2.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12512525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145274585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Intestinal fistula following concentrated hydrochloric acid ingestion: a rare case report.","authors":"Xiaoxi Zhu, Yunchao Chen, Zejin Ou, Ruichang Zhang, Zhi Wang","doi":"10.1186/s12245-025-00997-y","DOIUrl":"https://doi.org/10.1186/s12245-025-00997-y","url":null,"abstract":"","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"198"},"PeriodicalIF":2.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12513084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145274565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes and guideline adherence for emergency department thoracotomy: a single-center experience in Saudi Arabia.","authors":"Mohammed Alageel, Tareq Al-Salamah, Latifa Alshabib, Yara Al-Digi","doi":"10.1186/s12245-025-00992-3","DOIUrl":"10.1186/s12245-025-00992-3","url":null,"abstract":"<p><strong>Background: </strong>Emergency department thoracotomy (EDT) is a high-risk, salvage procedure performed during the resuscitation of critically injured patients who are in extremis or experience cardiac arrest immediately before or after arrival at the emergency department (ED) following trauma. Despite its potential to improve outcomes in selected patients, its indications and ideal clinical applications remain controversial due to significant risks of morbidity and mortality. In Saudi Arabia, trauma is responsible for approximately 20% of fatalities and is the leading cause of disability-adjusted life-years lost among males. However, there is limited research on EDT outcomes in this region.</p><p><strong>Methods: </strong>This retrospective cohort study was conducted at a tertiary academic trauma center in Riyadh with dedicated trauma and surgical services. Medical records from 2015 to 2023 were reviewed to identify adult patients who underwent EDT, using trauma team activations as a screening criterion. Data collected included demographics, mechanisms of injury, procedure indications, and timing.</p><p><strong>Results: </strong>During the study period, the center averaged 151 trauma activations per year, identifying 11 patients who underwent EDT. All were male, with a mean age of 35.64 ± 8.89 years. Blunt trauma was the cause in 64.6% of cases. Of these, 45.4% met the Eastern Association for the Surgery of Trauma (EAST) guideline recommendations for EDT, while 18.2% had contraindications. Traumatic arrest in the ED or prehospital settings was the most common indication 72.7%. Mean time between ED arrival to procedure initiation was 25.45 ± 15.85 min. One patient survived to discharge. Among 45 traumatic arrests screened, 4.44% lacked documentation for withholding EDT despite conditional guideline recommendations.</p><p><strong>Conclusions: </strong>Given the limited data available on EDT in the MENA region, our study offers important perspectives from a high-volume trauma center in KSA, where the rate of EDT was found to be very low. This low rate is likely due to the predominant injury patterns observed, presenting few candidates who might benefit from the procedure. At the same time, most patients who may have benefited based on guideline recommendations did undergo the procedure. These findings emphasize the need for heightened clinician awareness and systematic decision-making regarding EDT in trauma care. To enhance the generalizability of our findings and assess EDT's utility in regional settings, further research involving larger multicenter registries is necessary in the country and the region.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"197"},"PeriodicalIF":2.0,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12512718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Visualizing the landscape of ocular melanoma research: a bibliometric analysis.","authors":"Maya Lee, Ethan Nichols, Vindhya N Reddy, Latha Ganti","doi":"10.1186/s12245-025-01018-8","DOIUrl":"10.1186/s12245-025-01018-8","url":null,"abstract":"<p><strong>Introduction: </strong>Ocular melanoma is a type of malignancy affecting the eye. Symptoms can include dark spots near or around the iris or the mucous membrane of the eyes. Treatments include radiation, laser therapy, and enucleation or evisceration of the eye.</p><p><strong>Method: </strong>A bibliometric analysis was conducted using the database Web of Science. VosViewer version 1.6.20 was utilized to import tab-delimited files and visualize the data from Web of Science.</p><p><strong>Results: </strong>Data was collected from 1990 to 2024, with 2021 being the highest publication year (258). The U.S. (1,950), Germany (405), and England (205) released the greatest number of publications. From those countries, Thomas Jefferson University and Leiden University released the largest number of articles written about ocular melanoma.</p><p><strong>Conclusion: </strong>Ocular melanoma is a rare type of cancer affecting people worldwide. As medicinal research advances over time, the ability to prevent and treat ocular melanoma steadily improves. Over the past years (1990-2024), there has been a general increase in the number of publications regarding ocular melanoma. There have been gaps in the research in South Asian and African demographics, showing that these communities have not brought enough attention to this disease.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"195"},"PeriodicalIF":2.0,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12505995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IFEM model framework for the accreditation of training sites for emergency medicine specialists.","authors":"Andrew Singer, Simon Chu, Anantharaman Venkataraman, Nicholas Jouriles, Arif Alper Cevik, James Kwan","doi":"10.1186/s12245-025-01001-3","DOIUrl":"10.1186/s12245-025-01001-3","url":null,"abstract":"<p><p>The International Federation for Emergency Medicine (IFEM) has developed model curricula for undergraduate education, graduate education and continuing professional development in Emergency Medicine. Graduate education is delivered in various settings, including training sites based in a clinical Emergency Department. In order to ensure the quality of the training that is delivered at these sites, mature training systems have a system that accredits these sites for training purposes. This paper presents a model framework for this accreditation process that may be used by national societies to develop their own process. This paper also includes a comparison of this framework with the accreditation standards of established programs in IFEM member societies.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"196"},"PeriodicalIF":2.0,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12505791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the pentraxin-3 as a prognostic biomarker in paraquat poisoning: a systematic-narrative hybrid review.","authors":"Deepu Mathew, Ambika Prasad Patra","doi":"10.1186/s12245-025-01003-1","DOIUrl":"10.1186/s12245-025-01003-1","url":null,"abstract":"<p><strong>Purpose: </strong>Paraquat is a commonly used pesticide that is highly toxic to humans and leads to fatal lung fibrosis upon consumption. Due to its rapid clearance from the bloodstream, there are no reliable biomarkers for the diagnosis and prognosis of paraquat intoxication. Pentraxin 3 (PTX3), an acute-phase inflammatory mediator, has emerged as a potential biomarker, particularly in the context of lung injury and fibrosis. This review aimed to assess the prognostic value of the level of PTX3 in predicting clinical outcomes in patients with paraquat poisoning and to evaluate the correlation between PTX3 levels and the severity of poisoning.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted using PubMed, MEDLINE (Ovid), EMBASE (Ovid), Web of Science, Scopus, CROSSREF, and Google Scholar. The included studies were observational (cohort or case-control), involving human subjects with confirmed paraquat poisoning, and reported PTX3 levels related to clinical outcomes. Data on PTX3 expression, disease severity, and prognostic correlations were extracted.</p><p><strong>Results: </strong>Two primary studies were performed. PTX3 levels were significantly elevated in non-survivors compared to survivors and were positively correlated with serum paraquat levels and disease severity. PTX3 levels peaked between 12 and 24 h post-ingestion and maintained a prognostic value over subsequent days. A PTX3 cut-off of 8.9 ng/mL was associated with higher mortality, with moderate sensitivity and specificity.</p><p><strong>Conclusion: </strong>PTX3 is a promising prognostic biomarker for paraquat poisoning, particularly in cases where traditional markers are unreliable. Due to the limited sample size, a multicenter study is recommended to validate the role of PTX3 in clinical and forensic settings.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"193"},"PeriodicalIF":2.0,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12502491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}