Irish Journal of Medical Science最新文献

{"title":"Optimal surgical timing for anterior cruciate ligament reconstruction to minimize osteoarthritis incidence: A systematic review.","authors":"Fabriccio J Visconti-Lopez, Diego J Aparcana-Granda, Edwin F Mio-Rodriguez, Amir F Orihuela-Orrego, Diego Alejandro Maticorena Quevedo, Akram Hernández-Vásquez","doi":"10.1007/s11845-026-04650-2","DOIUrl":"https://doi.org/10.1007/s11845-026-04650-2","url":null,"abstract":"<p><strong>Background: </strong>Anterior cruciate ligament (ACL) injury is a common cause of knee instability and may contribute to the development of osteoarthritis (OA). Whether the timing of ACL reconstruction influences the subsequent risk of OA remains uncertain.</p><p><strong>Objective: </strong>To compare the incidence of OA and secondary knee complications following early versus delayed ACL reconstruction.</p><p><strong>Methods: </strong>A systematic search was conducted in PubMed, the Cochrane Library, Embase, Web of Science, and Scopus. The review was reported according to the PRISMA 2020 guidelines. Randomized controlled trials and cohort studies comparing OA incidence after early versus delayed ACL reconstruction were eligible. Methodological quality and risk of bias were assessed using the Newcastle-Ottawa Scale and the RoB 2 tool, as appropriate.</p><p><strong>Results: </strong>Five studies involving 1,659 patients were included. Definitions of early and delayed ACL reconstruction varied across studies. Follow-up ranged from 5 to 17.5 years, and the reported incidence of OA ranged from 2% to 49%, with heterogeneous assessment methods, including radiographic grading and patient-reported outcome measures. Delayed reconstruction was associated with a higher incidence of secondary meniscal injuries and subsequent meniscectomies. Total knee arthroplasty rates were also higher in delayed reconstruction groups, reaching 10.9%, compared with up to 0.2% in early reconstruction groups.</p><p><strong>Conclusions: </strong>Early ACL reconstruction may be associated with fewer secondary knee complications, particularly meniscal injuries, meniscectomies, and subsequent knee arthroplasty. However, substantial heterogeneity in the definitions of surgical timing, OA assessment methods, and follow-up duration limits the certainty of these findings. Further studies using standardized definitions and outcome measures are needed to determine the optimal timing of ACL reconstruction for reducing long-term OA risk.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of a structured healthcare professional-supported kangaroo care model on clinical outcomes in preterm neonates: A retrospective quasi-experimental cohort study.","authors":"Ayşe Çuvadar, Yeter Çuvadar Baş, Nurten Özçalkap, Nargizahon Erkaboeva","doi":"10.1007/s11845-026-04670-y","DOIUrl":"https://doi.org/10.1007/s11845-026-04670-y","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effects of a structured healthcare professional-supported kangaroo mother care (KMC) model on physiological stability and clinical outcomes in preterm neonates hospitalized in a neonatal intensive care unit (NICU).</p><p><strong>Methods: </strong>This retrospective quasi-experimental before-after cohort study included 64 preterm neonates (intervention: n = 33; comparison: n = 31) admitted to a tertiary-level NICU. During the comparison period, conventional KMC was provided once daily by mothers. Following implementation of a structured NICU protocol on 1 March 2025, KMC was administered eight times daily at three-hour intervals by both mothers and midwives/nurses. Primary outcomes included length of hospital stay and physiological parameters measured before and after KMC sessions.</p><p><strong>Results: </strong>Neonates in the intervention group had a significantly shorter hospital stay than those in the comparison group (p < 0.001). After adjustment for gestational age, birth weight, and sex, comparison-group neonates had an adjusted hospital stay 9.88 days longer than intervention-group neonates (B = 9.884, 95% CI: 5.280-14.487, p < 0.001; R² = 0.769). Post-KMC heart and respiratory rates were significantly lower and oxygen saturation was significantly higher in the intervention group (p < 0.001). Within-group analyses also showed significant improvements in physiological parameters following KMC, with larger effect sizes in the intervention group.</p><p><strong>Conclusion: </strong>A structured healthcare professional-supported KMC model was associated with improved physiological stability and shorter hospitalization, supporting the integration of midwives and nurses to sustain KMC in NICU settings.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ireland's Mental Health Act 2026: rights, rhetoric, and regressive realities.","authors":"Brendan D Kelly","doi":"10.1007/s11845-026-04690-8","DOIUrl":"https://doi.org/10.1007/s11845-026-04690-8","url":null,"abstract":"<p><strong>Background: </strong>Ireland's Mental Health Act 2026, which has yet to be commenced, represents the most significant revision of mental health legislation since the Mental Health Act 2001.</p><p><strong>Aims: </strong>To examine the 2026 Act, identify key implications for mental healthcare and human rights, and propose amendments before commencement.</p><p><strong>Methods: </strong>Review of the Mental Health Act 2026 and related legislation and literature.</p><p><strong>Results: </strong>The 2026 Act contains several welcome reforms, including updated definitions and clearer provisions concerning specific restrictive practices. Substantial problems remain. The 'risk' criterion for involuntary admission should be removed; criteria for involuntary admission and involuntary treatment should be aligned and should include lack of relevant decision-making capacity; and legislation should not facilitate involuntary treatment of people who retain capacity to refuse treatment. The proposed combination of mental health review boards, mandatory Circuit Court applications under the Assisted Decision-Making (Capacity) Act 2015, and possible High Court proceedings creates an unnecessarily complex three-layered legal structure. The Mental Health Commission and Decision Support Service should be incorporated into the Health Information and Quality Authority; existing statutory regulatory powers should be fully used; and excessive legislative prescription of individual care planning should be avoided.</p><p><strong>Conclusions: </strong>The 2026 Act contains some useful reforms but requires substantial amendment before commencement. Mental health law should protect liberty and autonomy while ensuring timely, effective, and proportionate treatment for people with severe mental illness who lack decision-making capacity. As presently drafted, the Act simply increases legal and regulatory complexity without identifiable gains in rights protection or clinical care.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergency clinicians' knowledge and perceptions of training, education, and resources in eating disorders.","authors":"Parinita Arora, Aljawharah Albanumay, Pauline Boyle, Mary Byrne, Aileen McCabe","doi":"10.1007/s11845-026-04657-9","DOIUrl":"https://doi.org/10.1007/s11845-026-04657-9","url":null,"abstract":"<p><strong>Background: </strong>Emergency clinicians have an important role in the recognition, assessment, and emergency management of patients with eating disorders. International studies suggest emergency clinicians receive limited training in eating disorders; however, Irish data are lacking. This study aimed to evaluate emergency clinicians' perceptions of education, training, and available resources.</p><p><strong>Methods: </strong>A single-centre cross-sectional survey study was conducted in an Irish Emergency Department (ED). Investigator-developed surveys were distributed to emergency medicine physicians and emergency nursing staff. Surveys assessed undergraduate and postgraduate education, awareness of clinical guidelines, perceived training adequacy, and educational needs relating to eating disorders.</p><p><strong>Results: </strong>Twenty-three emergency medicine physicians and twenty-six emergency nurses participated, representing response rates of 60.5% and 27.4%, respectively. Most physicians (n = 22, 95.7%) reported undergraduate training in eating disorders compared with 57.7% of nurses (n = 15); however, only eleven (47.8%) of physicians and eight (30.8%) of nurses considered this training adequate. Postgraduate training was reported by seven (30.4%) of physicians and seven (26.9%) of nurses. Awareness of key clinical guidelines among physicians was limited, with nine (39.1%) familiar with the Royal College of Psychiatrists' Medical Emergencies in Eating Disorders (MEED) guidance. Emergency clinicians supported additional education on eating disorders.</p><p><strong>Conclusion: </strong>Emergency clinicians reported substantial gaps in education and awareness relating to eating disorders and expressed a perceived need for additional training. Enhanced undergraduate and postgraduate education, guideline dissemination, and strengthened multidisciplinary resources may improve clinicians' preparedness to recognise and manage eating disorders in emergency care.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and functional predictors of delayed return to sport after first-time patellar dislocation in adolescents: A prospective cohort study.","authors":"Muhammad Nauman Shahid, Abdullah Waheed Dar, Moin Haider, Mohsin Asghar, Sultan Bakht Afroz, Muhammad Ibraheem Yousaf, Jahangir Iqbal Khan, Hareem Khalid, Ahmad Khalil, Muhammad Arslan Sajid, H M Humza Naim Nizami, Omer Javed Khan, Ammar Muzammil, Arslan Shuja","doi":"10.1007/s11845-026-04695-3","DOIUrl":"https://doi.org/10.1007/s11845-026-04695-3","url":null,"abstract":"<p><strong>Background: </strong>First-time lateral patellar dislocation is common in adolescent athletes and may cause persistent functional impairment despite nonoperative treatment. Early predictors of delayed return to sport remain incompletely defined.</p><p><strong>Objective: </strong>To identify early clinical and functional factors associated with delayed return to unrestricted preinjury-level sport after first-time lateral patellar dislocation in adolescents.</p><p><strong>Methods: </strong>This prospective cohort study included 160 adolescents aged 12-18 years (97 females, 63 males) with first-time traumatic lateral patellar dislocation managed nonoperatively. Participants underwent standardized rehabilitation and were followed for 12 months. At 3 months, quadriceps limb-symmetry index (LSI), single-leg hop performance, Y-Balance asymmetry, patellar apprehension, Banff Patellofemoral Instability Instrument 2.0 (BPII 2.0), and Pediatric International Knee Documentation Committee scores were assessed. Delayed return to sport was defined as failure to resume unrestricted preinjury-level sport within 6 months. Associations were evaluated using multivariable logistic regression.</p><p><strong>Results: </strong>Seventy-six participants (47.5%) experienced delayed return to sport. Compared with timely returners, they had lower quadriceps LSI, poorer hop performance, greater Y-Balance asymmetry, more frequent patellar apprehension, and worse patient-reported function. Independent predictors were each 10-percentage-point decrease in quadriceps LSI (adjusted odds ratio [aOR] 1.82, 95% CI 1.29-2.57), persistent patellar apprehension (aOR 2.71, 95% CI 1.31-5.62), and each 10-point decrease in BPII 2.0 score (aOR 1.51, 95% CI 1.13-2.02). The model showed good discrimination (AUC 0.80, 95% CI 0.73-0.86).</p><p><strong>Conclusion: </strong>Reduced quadriceps symmetry, persistent apprehension, and poorer instability-specific function were independently associated with delayed return to sport, supporting multidimensional, criterion-based rehabilitation in adolescents.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between the estimated small dense low-density lipoprotein cholesterol and multimorbidity: a national longitudinal study.","authors":"Juan Peng, Li Chen, Zishun Zhan, Bin Yi, Dan Li, Aimei Li","doi":"10.1007/s11845-026-04664-w","DOIUrl":"https://doi.org/10.1007/s11845-026-04664-w","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the relationship between E-sdLDL-C and the risk of multimorbidity and to explore whether E-sdLDL-C is a stronger predictor of multimorbidity than the traditional lipid profiles.</p><p><strong>Methods: </strong>This study included 10,763 participants in the cross-sectional analysis and 7,321 in the longitudinal analysis from the China Health and Retirement Longitudinal Study, all of whom were aged over 45 years. E-sdLDL-C was calculated using the formula: E-sdLDL-C (mg/dL) = LDL-C -(1.43 × LDL-C -(0.14 × (ln (TG) × LDL-C)) - 8.99). Multimorbidity was defined as the coexistence of at least two chronic diseases. Logistic regression and Cox proportional hazards models were used to evaluate the cross-sectional and longitudinal relationships between E-sdLDL-C and traditional lipid profiles and multimorbidity, respectively. Additionally, cumulative E-sdLDL-C (CumE-sdLDL-C) exposure was analyzed to assess its long-term impact on multimorbidity development.</p><p><strong>Results: </strong>Compared to individuals with lower E-sdLDL-C levels, those with higher E-sdLDL-C levels had a significantly increased risk of multimorbidity in both cross-sectional (odds ratio [OR] 1.223, 95% confidence interval [CI] 1.095-1.366) and cohort analyses (hazard ratio [HR] 1.278, 95% CI 1.163-1.404). Discordantly high E‑sdLDL‑C had a higher risk of multimorbidity in discordance analyses with triglycerides (HR 1.251, 95% CI 1.094-1.429) as compared with the respective concordantly low groups. Furthermore, higher CumE-sdLDL-C exposure was associated with an increased risk of incident multimorbidity (HR 1.335, 95% CI 1.098-1.623).</p><p><strong>Conclusions: </strong>Elevated E-sdLDL-C levels were associated with an increased risk of multimorbidity in middle‑aged and older adults, both at baseline and over time.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autosomal recessive axonal neuropathy with neuromyotonia in a paediatric patient - a case based review.","authors":"Maria Gianina Balea, Roxana Milea, Cristina Tecar, Dafin Fior Mureșanu","doi":"10.1007/s11845-026-04696-2","DOIUrl":"https://doi.org/10.1007/s11845-026-04696-2","url":null,"abstract":"<p><strong>Background: </strong>Autosomal recessive axonal neuropathy with neuromyotonia (ARAN-NM) is a distinct clinical and genetic entity within the hereditary peripheral neuropathies (HPN), caused by recessive loss-of-function mutations in the histidine triad nucleotide binding protein 1 (HINT1) gene.</p><p><strong>Case presentation: </strong>We report the case of a 13-year-old girl presenting with gait impairment and progressive motor weakness starting at the age of 6, with delayed muscle relaxation after a strong voluntary contraction, which developed later in the course. Electrophysiological studies showed axonal motor polyneuropathy and neuromyotonic discharges. Molecular analysis revealed a homozygous, pathogenic variant, c.110G > C (p.Arg37Pro) in HINT1.</p><p><strong>Conclusions: </strong>This case emphasises the elusive nature of ARAN-NM in children, whose clinical presentation is not distinctly characteristic at onset.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The functional burden of chronic urticaria: Sleep quality, activity impairment and work productivity.","authors":"Mustafa Tosun, Gülnur İlgün","doi":"10.1007/s11845-026-04687-3","DOIUrl":"https://doi.org/10.1007/s11845-026-04687-3","url":null,"abstract":"<p><strong>Background: </strong>Chronic urticaria (CU) is associated with a substantial disease burden extending beyond cutaneous manifestations. It may impair psychological well-being, sleep quality, daily functioning, and work productivity, although these domains have rarely been evaluated simultaneously.</p><p><strong>Aim: </strong>To investigate sleep quality, psychological status, activity impairment, and work productivity in patients with chronic urticaria and identify factors independently associated with the disease.</p><p><strong>Methods: </strong>This cross-sectional case-control study included 108 patients with chronic urticaria and 95 healthy controls. Sleep quality, psychological status, and work productivity were assessed using the Pittsburgh Sleep Quality Index (PSQI), Depression Anxiety Stress Scale-21 (DASS-21), and Work Productivity and Activity Impairment Questionnaire (WPAI). Multivariable logistic regression analysis was performed to identify factors independently associated with chronic urticaria.</p><p><strong>Results: </strong>Patients with chronic urticaria had significantly poorer sleep quality, higher depression and anxiety scores, and greater activity impairment than controls (all p < 0.05). In multivariable analysis, higher PSQI, depression, stress, and activity impairment scores were independently associated with chronic urticaria (all p < 0.05). Among employed participants, absenteeism, presenteeism, and overall work productivity impairment were significantly greater in patients (all p < 0.001).</p><p><strong>Conclusion: </strong>Chronic urticaria is associated with impaired sleep quality, psychological distress, activity impairment, and reduced work productivity. These findings highlight the multidimensional burden of the disease and support a holistic, patient-centred approach to its management.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum apelin levels in established pulmonary arterial hypertension: A cross-sectional case-control study.","authors":"Mehmet Taha Özkan, Hilal Erken, Alperen Taş, Çağatay Tunca, Ayşenur Özkaya İbiş, Nadire Işık Erol Algül, Gürkan İş, Saadet Demirtaş İnci","doi":"10.1007/s11845-026-04691-7","DOIUrl":"https://doi.org/10.1007/s11845-026-04691-7","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary arterial hypertension (PAH) is a progressive condition involving pulmonary vasoconstriction, vascular remodeling, abnormal angiogenesis, and right ventricular dysfunction. Apelin, an endogenous peptide acting via the APJ receptor, modulates vascular tone, enhances nitric oxide-mediated vasodilation, and counteracts the renin-angiotensin system, suggesting relevance to PAH.</p><p><strong>Aims: </strong>To compare serum apelin levels between patients with established PAH and healthy controls and to examine their relationship with cross-sectional measures of disease severity.</p><p><strong>Methods: </strong>In this prospective cross-sectional study, 40 patients with established Group 1 PAH receiving PAH-specific therapy and 40 age- and sex-matched healthy controls were enrolled. All participants underwent echocardiographic evaluation, a six-minute walk test, and serum apelin measurement. PAH patients were additionally classified using the 2022 ESC/ERS four-strata risk model and WHO functional class.</p><p><strong>Results: </strong>Serum apelin levels were significantly higher in PAH patients than in controls (1006.20 ± 312.99 pg/mL vs. 812.46 ± 245.80 pg/mL; p = 0.003). Apelin levels did not differ significantly across PAH etiologies (p = 0.16), ESC/ERS risk strata (p = 0.84), or WHO functional classes (p = 0.06). In multivariable logistic regression, apelin remained independently associated with PAH status (OR 1.345 per 100 pg/mL; 95% CI 1.084-1.669; p = 0.007).</p><p><strong>Conclusions: </strong>Serum apelin levels were higher in patients with established PAH than in healthy controls and were independently associated with PAH status, whereas no significant association with the evaluated cross-sectional severity measures was demonstrated. Any potential diagnostic role of apelin requires validation in newly diagnosed, treatment-naïve patients and clinically relevant comparator groups.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149193786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of a clinical specialist physiotherapy service working in advanced practice in an emergency department setting.","authors":"Sophia Willgress, Enda McCarthy, Louiso duPisane, Elaine Barker, Aileen McCabe","doi":"10.1007/s11845-026-04668-6","DOIUrl":"https://doi.org/10.1007/s11845-026-04668-6","url":null,"abstract":"<p><strong>Background: </strong>Clinical Specialist Physiotherapists (CSPs) with an advanced scope of practice have been introduced internationally to Emergency Departments (EDs).</p><p><strong>Aims: </strong>To evaluate the activity, patient characteristics, clinical outcomes and emergency department process measures associated with an Irish ED CSP with an advanced scope of practice service.</p><p><strong>Methods: </strong>A retrospective service evaluation was undertaken of all patients managed by the ED CSP with an advanced scope of practice between 1 April 2023 and 31 August 2024 and 1 March 2025 and 15 March 2026. Demographic, clinical and operational data were extracted from the ED information system.</p><p><strong>Results: </strong>1,633 ED patients were managed by the CSP with an advanced scope of practice. The mean patient age was 43.6 (SD 16.2) years and 54.2% were male. Back pain (46.6%) and limb problems (42.3%) were the most common presenting complaints. Soft tissue injury (61.5%) and back pain (23.1%) were the commonest discharge diagnoses. Most patients were discharged with physiotherapy follow-up (58.6%) while only 60 patients (3.7%) required hospital admission. Fourteen admitted patients underwent urgent discectomy and decompression, and one case of cauda equina syndrome was identified. Mean ED length of stay was significantly shorter for CSP-managed patients than for the overall ED population (312.1 vs. 664.5 min, p < 0.05). Hospital admission rates were also significantly lower (3.7% vs. 28.5%, p < 0.05).</p><p><strong>Conclusion: </strong>An ED CSP service was associated with reduced length of stay, low admission rates and appropriate identification of serious pathology, supporting the expansion of advanced physiotherapy roles within Irish emergency care.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149193798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}