Irish Journal of Medical Science最新文献

{"title":"Impact of percutaneous cholecystostomy timing on clinical outcomes in moderate-to-severe acute cholecystitis.","authors":"Sinan Karatoprak, Mustafa Bilgili, Oğuz Aslan, Gamze Türk, Nur Betül Karatoprak, Uğur Aydemir","doi":"10.1007/s11845-026-04430-y","DOIUrl":"https://doi.org/10.1007/s11845-026-04430-y","url":null,"abstract":"<p><strong>Objectives: </strong>The optimal timing of percutaneous cholecystostomy (PC) in moderate-to-severe acute cholecystitis remains uncertain. This study evaluated the relationship between PC timing and clinical outcomes, particularly hospital length of stay (LOS), in patients with Tokyo Grade II-III acute cholecystitis.</p><p><strong>Methods: </strong>This retrospective single-center study included 102 patients with Tokyo Grade II-III acute cholecystitis who underwent PC between January 2022 and January 2025. Patients were classified as early (≤24 h), intermediate (25-48 h), or delayed (≥49 h) according to the timing of drainage. Clinical outcomes included LOS, recurrence, in-hospital mortality, hepatopancreatobiliary complications, catheter-related complications, and interval cholecystectomy. Multivariable linear regression analyses using separate ASA-based and Charlson Comorbidity Index (CCI)-based models were performed to identify independent predictors of LOS.</p><p><strong>Results: </strong>The mean age was 72.8 years. Sixty-six patients (64.7%) had Tokyo Grade III disease. Mean LOS was 8.76 ± 6.71 days in the early group, 9.45 ± 4.91 days in the intermediate group, and 13.33 ± 9.66 days in delayed group (p = 0.030), with similar findings in both Tokyo Grade II and III subgroups. In multivariable regression analyses, procedural timing remained an independent predictor of LOS in both ASA-based and CCI-based models. Hemoglobin showed a borderline negative association, whereas albumin, Tokyo grade, ASA score, and CCI were not independently associated with LOS. Earlier intervention was also associated with greater white blood cell reduction (p = 0.024).</p><p><strong>Conclusion: </strong>Earlier PC was associated with shorter hospitalization and greater early inflammatory improvement. Procedural timing was the most consistent independent predictor of LOS.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856237","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":"Utility of the 4-meter backward walking speed test in older adults with neurodegenerative diseases.","authors":"Kubra Altunkalem Seydi, Derya Kaya, Idil Yavuz, Alev Cam Mahser, Feyza Mutlay, Fatma Sena Dost, Ahmet Turan Isik","doi":"10.1007/s11845-026-04424-w","DOIUrl":"https://doi.org/10.1007/s11845-026-04424-w","url":null,"abstract":"<p><strong>Background and aim: </strong>Less is known about backward walking speed (BWS) in older adults. This study aims to establish a cutoff value for BWS to distinguish cognitively impaired individuals from healthy controls and to assess the association between backward walking slowing and risk of neurodegenerative diseases.</p><p><strong>Methods: </strong>389 older patients, grouped into cognitively healthy (CH), amnestic mild cognitive impairment (aMCI), Alzheimer's disease (AD), Parkinson's disease (PD), and non-AD groups. BWS was measured using a standardized 4-meter protocol. Cognitive and functional status were evaluated via the comprehensive geriatric assessment. ROC analysis was used to determine the diagnostic threshold for BWS, and multinomial logistic regression was used to assess the associations.</p><p><strong>Results: </strong>A BWS cutoff of 0.395 m/s effectively distinguished CH individuals from those with neurodegenerative diseases (AUC=0.723). After adjusting for age, each 0.1 m/s decrease in BWS was associated with 22% increased odds of having aMCI, 37% increased odds of AD, 28% increased odds of PD, and 59% increased odds of having non-AD dementia. BWS showed a positive association with global cognitive scores in patients with CH and aMCI (p< 0.05) and with semantic verbal fluency scores in those with AD and aMCI (p< 0.05).</p><p><strong>Conclusion: </strong>BWS is associated with an increased risk of neurodegenerative diseases, which can cause cognitive impairment, and may help indicate individuals at risk of cognitive decline.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837883","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":"Neutrophil-to-lymphocyte ratio as a risk factor for prolonged hospital stay in stroke: The Peru-Casimiro study.","authors":"Milagros Del Rosario Xiomi Rojas-Catacora, Marcio José Concepción-Zavaleta, Jenyfer María Fuentes-Mendoza, Miguel A Vences, Julia Coronado-Arroyo, Ruth Elena Catacora Hilasaca, Luis Concepción-Urteaga, Juan Eduardo Quiroz-Aldave, Cristian David Armas-Flórez","doi":"10.1007/s11845-026-04421-z","DOIUrl":"https://doi.org/10.1007/s11845-026-04421-z","url":null,"abstract":"<p><strong>Background: </strong>The neutrophil-to-lymphocyte ratio (NLR) is an accessible biomarker of systemic inflammation with potential prognostic utility in cerebrovascular disease (CVD). Its relationship with prolonged hospitalization in stroke remains insufficiently explored in Peruvian populations.</p><p><strong>Aims: </strong>To evaluate whether the NLR at admission is associated with prolonged hospital stay (≥ 9 days) in patients with ischemic and hemorrhagic CVD treated at Hospital de Emergencias José Casimiro Ulloa (2022-2024) METHODS: A retrospective observational study was performed including 227 adults with confirmed CVD. Clinical, demographic, and laboratory data were retrieved from medical records. Optimal NLR cut-offs were determined using RO1C curve analysis. Logistic regression models-stratified by stroke subtype-assessed associations between NLR and prolonged hospitalization, adjusting for relevant clinical variables and collinearity.</p><p><strong>Results: </strong>Among 227 patients, 61.7% had ischemic and 38.3% hemorrhagic CVD. Prolonged stay occurred in 21.4% of ischemic and 54.0% of hemorrhagic cases. ROC analysis identified optimal NLR cut-offs of 3.16 (ischemic; AUC = 0.738) and 3.18 (hemorrhagic; AUC = 0.616). In ischemic CVD, NLR was the only independent predictor of prolonged stay (adjusted OR = 1.173; p = 0.005). No variable, including NLR, independently predicted prolonged hospitalization in hemorrhagic CVD.</p><p><strong>Conclusions: </strong>Admission NLR may be an independent predictor of prolonged hospital stay in ischemic but not hemorrhagic stroke. NLR may support early risk stratification in resource-limited emergency settings. Prospective studies incorporating standardized stroke severity measures are needed.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837753","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 predictors of persistence in IgE-mediated cow's milk allergy in children with multiple food allergies.","authors":"Ercan Yılmaz, Erdem Topal","doi":"10.1007/s11845-026-04417-9","DOIUrl":"https://doi.org/10.1007/s11845-026-04417-9","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to identify independent clinical predictors of failure to develop tolerance to IgE-mediated cow's milk allergy in children with multiple food allergies.</p><p><strong>Method: </strong>This retrospective cohort study included 134 children diagnosed with IgE-mediated cow's milk allergy with multiple food allergies. Patients were divided into two groups based on tolerance development: those who developed tolerance and those who did not. Demographic characteristics, clinical findings after food intake, and laboratory parameters were compared between groups. To identify independent clinical risk factors associated with the lack of tolerance development, clinical variables found to be statistically significant (p < 0.05) in univariate analyses were included in multivariate logistic regression analysis.</p><p><strong>Results: </strong>Ninety-six patients (71.6%) were male, with a median age of 84 months (range: 33-146 months). The median age at symptom onset was 5 months (range: 1-36 months), and the median follow-up duration was 79 months (range: 1-93 months). Atopic eczema was present in 42.5% of patients, and a history of recurrent wheezing or asthma was present in 14.2%. Among concomitant food allergies, egg allergy was the most common (50.7%). While cutaneous findings were most frequently observed in initial reactions, wheezing (18.7%) was the most common respiratory symptom. Anaphylaxis was diagnosed in 24.6% of patients. In the multivariate logistic regression analysis performed to determine the clinical risk factors associated with the failure to develop tolerance to IgE-mediated cow's milk allergy in patients, the following factors were identified: as the initial reaction after cow's milk intake are anaphylaxis [OR: 4.95 (1.82-13.5), p = 0.002], hypotension [OR: 3.97 (1.19-13.2), p = 0.025)], wheezing [OR: 2.86 (1.11-7.36), p = 0.029] and lethargy [OR: 3.53 (1.23-10.1), p = 0.019)] were identified as independent risk factors.</p><p><strong>Conclusion: </strong>Severe clinical reactions initially presenting with systemic and respiratory involvement are independent clinical predictors of failure to develop tolerance to IgE-mediated cow's milk allergy in children with multiple food allergies.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837773","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":"A comparison of patient self-referrals and general practitioner referrals to the emergency department in Ireland during the COVID-19 pandemic: secondary data analysis of the \"Better Data, Better Planning\" study.","authors":"Muhammad Shan, Rose Galvin, Louise A Barry, Collette Devlin, Gillian Corey, Fergal Cummins, Damien Ryan, Niamh M Cummins","doi":"10.1007/s11845-026-04320-3","DOIUrl":"https://doi.org/10.1007/s11845-026-04320-3","url":null,"abstract":"<p><strong>Background: </strong>Internationally crowding in Emergency Departments (ED) has become a public health issue. In Ireland, primary care is centred around General Practitioners who can refer patients with acute illnesses or injuries to the ED. Patients can also choose to go directly to the ED if they require emergency care and self-referrals to the ED have been rising in recent years.</p><p><strong>Aim: </strong>The study aims to describe the demographic and clinical characteristics of patients who self-referred compared to patients referred by GPs in Irish EDs during the COVID-19 pandemic.</p><p><strong>Methods: </strong>This was a secondary data analysis of a cross-sectional, multi-centre study describing Irish ED utilisation; the Better Data, Better Planning (BDBP) Study. Descriptive comparisons were made between GP referrals to the ED and self-referrals in relation to; demographics, clinical data, healthcare utilisation, service awareness and other factors, with data being analysed in SPSS.</p><p><strong>Results: </strong>Demographic differences were minimal however significant differences were observed between GP referrals and self-referrals for; types of clinical presentations (p < 0.05), duration of complaint (p < 0.001), awareness of other services (p < 0.05), need for reassurance (p < 0.001), acquiring a second opinion (p < 0.05) and utilisation of GPs over the year (p < 0.05).</p><p><strong>Conclusion: </strong>Demographics were similar between GP referrals and self-referrals to the ED however significant behavioural and clinical differences were observed across groups. Awareness of these factors could be useful for policymakers in service planning for ED crowding generally and also more specifically in the event of a future pandemic.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837847","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":"Beyond light's criteria: pleural lactate predicts need for tube thoracostomy in complicated parapneumonic effusions.","authors":"Mahmut Ozbey, Ibrahim Can Kürkçüoğlu","doi":"10.1007/s11845-026-04435-7","DOIUrl":"https://doi.org/10.1007/s11845-026-04435-7","url":null,"abstract":"<p><strong>Background: </strong>Differentiation of pleural effusions and identification of complicated parapneumonic effusions remain important challenges in clinical practice. Although Light's criteria are routinely applied, additional pleural fluid parameters may provide complementary information in selected patients.</p><p><strong>Aims: </strong>To evaluate the diagnostic performance of pleural fluid lactate and the pleural fluid-to-blood lactate ratio in pleural effusions and to examine their association with complicated parapneumonic effusions and drainage approach.</p><p><strong>Methods: </strong>This study included 110 patients who underwent pleural drainage. Paired pleural fluid and venous blood samples were obtained prior to drainage, and lactate levels were measured using a blood gas analyser. Pleural effusions were classified according to Light's criteria. Diagnostic performance was assessed using receiver operating characteristic analysis.</p><p><strong>Results: </strong>Of the 110 patients, 90 (81.8%) had exudative and 20 (18.2%) transudative effusions. Pleural fluid lactate and the pleural fluid-to-blood lactate ratio showed good discrimination between exudative and transudative effusions (AUC 0.912 and 0.883, p < 0.001), while blood lactate alone had limited diagnostic value. No significant correlation was observed between pleural and blood lactate levels. In patients with complicated parapneumonic effusions, higher pleural fluid lactate levels were associated with complicated effusions (cut-off 5.45 mmol/L; AUC 0.883). Elevated pleural fluid lactate values were also more frequently observed in patients who required tube thoracostomy (cut-off 4.05 mmol/L; AUC 0.920).</p><p><strong>Conclusions: </strong>Pleural fluid lactate may serve as a useful adjunct to standard pleural fluid analysis. Its measurement could assist in the assessment of disease severity and drainage requirements in parapneumonic effusions; however, further prospective studies are warranted.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837770","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":"Comparison of the benefit of primary prophylactic implantable cardioverter-defibrillator on patients with ischemic cardiomyopathy and idiopathic dilated cardiomyopathy.","authors":"Jing Zhuang, Gaoqin Wen","doi":"10.1007/s11845-026-04427-7","DOIUrl":"https://doi.org/10.1007/s11845-026-04427-7","url":null,"abstract":"<p><strong>Background: </strong>Ischemic cardiomyopathy (ICM) and idiopathic dilated cardiomyopathy (DCM) shared common structural alterations with a high mortality from sudden cardiac death (SCD) and pump failure. Implantable cardioverter-defibrillator (ICD) has been confirmed both beneficial and cost-effective for primary prevention of SCD in patients with ischemic or non-ischemic heart diseases. The management of heart failure has improved due to the of implantation of ICD and cardiac resynchronization therapy-defibrillator (CRT-D). It remains unclear whether there is a difference in clinical effectiveness of primary prophylactic ICD implantation between patients with ICM and DCM.</p><p><strong>Methods: </strong>We conducted a retrospective, single-center study, which enrolled 53 DCM patients and 25 ICM patients with guideline indications for primary prophylactic ICD or CRT-D treatment. Primary endpoint was all-cause mortality and secondary outcomes included cardiovascular death.</p><p><strong>Results: </strong>During a median follow-up of 38.5 months, all-cause death occurred in 8 patients (32%) in the ICM group and 5 patients (9.43%) in the DCM group (P = 0.012). Cardiovascular death occurred in 5 patients (20%) in the ICM group and 3 patients (5.66%) in the DCM group (P = 0.052). Multivariable Cox regression analysis showed that cardiogenic mortality in the ICM group is higher than that in the DCM group (hazard ratio [HR] 0.119, 95% confidence interval (CI) 0.016 to 0.860, P = 0.035).</p><p><strong>Conclusions: </strong>Among patients who received ICD implantation for the primary prevention of SCD, there is no statistical difference in benefits between DCM and ICM patients. However, compared with DCM patients, ICM patients have a higher cardiovascular mortality, due to more exposure to risk factors.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837505","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":"A new perspective on predicting latency period in preterm premature rupture of membranes: the role of cervical area measurement.","authors":"Yücel Kaya, Emrah Dagdeviren, İlteriş Yaman, Can Tercan, Ali Selçuk Yeniocak, Verda Alpay","doi":"10.1007/s11845-026-04418-8","DOIUrl":"https://doi.org/10.1007/s11845-026-04418-8","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the relationship between cervical area (CA) measured by two-dimensional (2D) transvaginal ultrasonography (TVUS) and the latency period in pregnancies complicated by preterm premature rupture of membranes (PPROM), and to compare its predictive performance with that of cervical length (CL).</p><p><strong>Methods: </strong>This retrospective cohort study included 164 singleton pregnancies with PPROM (24 + 0-32 + 3 weeks). Archived TVUS images obtained within 24 h of admission were reanalyzed in a blinded manner. CA (cm²), CL (mm), and cervical funneling were recorded. The latency period was defined as the time from membrane rupture to delivery and categorized as short (≤ 10 days) or long (> 10 days). Group comparisons, correlation analyses, receiver operating characteristic (ROC) curves, and multivariable logistic regression were performed to identify independent predictors.</p><p><strong>Results: </strong>Seventy-eight pregnancies had a short latency period. Both CL and CA were significantly lower in the short-latency group. Although the area under the curve (AUC) for CA was higher than that for CL (0.763 vs. 0.678), pairwise comparison using the DeLong test did not show a statistically significant difference (p = 0.064). In the multivariable analysis, cervical funneling (adjusted OR 10.777, 95% CI 4.456-26.063; p < 0.001) and CA (adjusted OR 0.701, 95% CI 0.598-0.822; p < 0.001) remained independent predictors of a short latency, whereas CL lost significance (p = 0.383). CA and CL showed a positive correlation with the latency period (p < 0.001).</p><p><strong>Conclusions: </strong>CA measured by 2D-TVUS is an independent predictor of the latency period in PPROM and shows comparable discriminative ability to CL. Incorporating CA assessment may improve risk stratification and aid in timely perinatal management decisions in PPROM pregnancies.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837792","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":"Functional gastrointestinal disorders in adults with epilepsy: associations with psychological symptoms, chronotype, and seizure burden.","authors":"Gizem Nur Solak Khan, Ferda Ilgen Uslu","doi":"10.1007/s11845-026-04396-x","DOIUrl":"https://doi.org/10.1007/s11845-026-04396-x","url":null,"abstract":"<p><strong>Background: </strong>Epilepsy is frequently accompanied by psychiatric comorbidities, whereas functional gastrointestinal disorders are often overlooked. This study investigated the prevalence of functional gastrointestinal disorders in adult patients with epilepsy (PWE) and their associations with psychological symptoms, chronotype, and seizure characteristics.</p><p><strong>Methods: </strong>In this cross-sectional case-control study, 100 adult PWE and 100 age- and sex-matched healthy controls (HC) were evaluated. Functional gastrointestinal disorders were assessed using Rome IV criteria and stool form with the Bristol Stool Form Scale. Depression and anxiety were measured with the Beck inventories, and chronotype with the Morningness-Eveningness Questionnaire. Clinical epilepsy variables and antiseizure medication profiles were recorded.</p><p><strong>Results: </strong>Functional gastrointestinal disorders were significantly more prevalent in PWE than in HCs. Irritable bowel syndrome and functional constipation occurred more frequently in the PWE, and constipation-predominant stool patterns were markedly increased. Patients with epilepsy showed higher rates of moderate-to-severe depression and anxiety and a predominance of intermediate chronotype. Within the PWE, functional gastrointestinal disorders and constipation-predominant stool patterns were associated with higher psychological symptom burden, polytherapy, and ongoing seizures, but not with epilepsy subtype, electroencephalography, or magnetic resonance imaging findings.</p><p><strong>Conclusion: </strong>Adults with epilepsy exhibit a substantially increased burden of functional gastrointestinal disorders accompanied by elevated psychological symptoms and altered chronotype distribution. Gastrointestinal symptoms were largely unreported clinically, despite their association with greater disease complexity. Systematic screening for functional gastrointestinal disorders, mood symptoms, and chronotype may facilitate a more comprehensive and integrated approach to epilepsy care. These findings underscore the need for multidisciplinary assessment in practice.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837798","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":"Occupational and lifestyle factors associated with SCORE-2 cardiovascular risk among emergency healthcare workers.","authors":"Murat Doğan, Anıl Özüdoğru","doi":"10.1007/s11845-026-04429-5","DOIUrl":"https://doi.org/10.1007/s11845-026-04429-5","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to examine the associations between occupational characteristics, lifestyle behaviors, sleep quality, and 10-year cardiovascular risk estimated using SCORE-2 algorithm among ambulance emergency medical services (EMS) and emergency department healthcare workers.</p><p><strong>Methods: </strong>This cross-sectional study included 300 healthcare workers employed in ambulance EMS (n = 122) and emergency departments (n = 178). Sociodemographic variables, occupational characteristics, lifestyle behaviors, and clinical data were collected using a structured questionnaire. Sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI), and cardiovascular risk was estimated using SCORE-2. Group comparisons were performed using the Mann-Whitney U and chi-square tests. Associations were evaluated with Spearman correlation, and independent predictors of SCORE-2 were identified using multivariable linear regression analysis.</p><p><strong>Results: </strong>The median SCORE-2 value was 2.8% (IQR: 1.6-4.7), with no significant difference between ambulance EMS and emergency department workers (p = 0.855). Participants aged ≥ 50 years had significantly higher SCORE-2 values compared with those aged 40-49 years (p < 0.001). Alcohol consumption was associated with higher SCORE-2 levels (p < 0.001) and remained an independent predictor in multivariable analysis (B = 1.41, 95% CI: 0.60-2.22). Age and sex were also independently associated with SCORE-2. Although sleep quality showed a weak positive correlation with SCORE-2 (r = 0.166, p = 0.004), this association was not significant after adjustment.</p><p><strong>Conclusion: </strong>In emergency healthcare workers, SCORE-2-estimated cardiovascular risk is mainly driven by age, sex, and alcohol consumption rather than work setting or shift characteristics. These findings suggest that incorporating occupational and lifestyle factors alongside SCORE-2 may improve cardiovascular risk assessment in shift-working healthcare professionals.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837929","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}