Journal of Korean Medical Science最新文献

{"title":"Letter to the Editor: Disclosure of Generative AI Usage in Biomedical Academic Writings Should Be Mandatory and Comprehensive.","authors":"Bor Luen Tang","doi":"10.3346/jkms.2026.41.e312","DOIUrl":"10.3346/jkms.2026.41.e312","url":null,"abstract":"","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"41 29","pages":"e312"},"PeriodicalIF":3.2,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13406947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148604266","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}

{"title":"Comprehensive Consideration of Ethics in AI-assisted Scientific Writing and Peer Review.","authors":"Jin-Hong Yoo","doi":"10.3346/jkms.2026.41.e281","DOIUrl":"10.3346/jkms.2026.41.e281","url":null,"abstract":"<p><p>The emergence of large language models and generative artificial intelligence (AI) is driving fundamental transformations in the ecosystem of scholarly publishing and peer review. As manuscript production enters an era of sophisticated technological assistance, it has become imperative to transition from traditional approaches focused on misconduct prevention toward a more proactive ethical framework. We propose a new standard centered on transparency, accountability, and confidentiality, presenting a clear solution to challenges associated with integrating AI into academic discourse. Regarding authorship, AI cannot be credited as an author; the final accountability for academic integrity lies only with human authors. Transparency is maintained through a tiered disclosure framework that mandates reporting based on the extent of artificial intelligence utilization. In the context of peer review, while the potential of artificial intelligence to optimize efficiency is recognized, its application must be restricted to a closed security system to safeguard against data breaches. Furthermore, this review highlights new risk factors such as algorithmic sycophancy and prompt injection attacks, emphasizing that a final verification through human expertise is essential to ensuring the integrity of the peer review process. In conclusion, we present a comprehensive regulatory revision roadmap integrating the authors' obligations for transparent information disclosures, reviewers' commitment to confidentiality and security, and editors' ethical oversight. This framework does not regard AI as an object of absolute prohibition but rather positions it as an advanced scholarly aid rooted in human intellectual accountability. The perspectives in this <i>Special Issue</i> will provide a practical framework to maintain academic rigor and enhance institutional trust in the era of AI.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"41 29","pages":"e281"},"PeriodicalIF":3.2,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13406946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148604270","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}

{"title":"Association Between Health Literacy and Outpatient Expenditure in Korea.","authors":"Seokjun Moon, Junghun Yoo, Jaehun Jung, Dun-Sol Go","doi":"10.3346/jkms.2026.41.e65","DOIUrl":"10.3346/jkms.2026.41.e65","url":null,"abstract":"<p><strong>Background: </strong>Health literacy (HL) is increasingly recognized as a crucial determinant of healthcare utilization and costs. Despite its importance, empirical evidence on the relationship between HL and healthcare expenditures in South Korea is limited. This issue is particularly timely and relevant given the country's rapidly rising outpatient expenditure.</p><p><strong>Methods: </strong>This study analyzed data from the Korea Health Panel Survey conducted in 2021 (n = 8,630) to examine the association between HL and outpatient healthcare costs. HL was measured using the Korean version of the Health Literacy Survey European Questionnaire 16 (range: 0-16) and categorized as high (≥ 13) or low (≤ 12). Outpatient expenditure was defined as the sum of insurance-covered payments, out-of-pocket spending, and non-covered services, excluding pharmaceutical costs. Expenditure data were log-transformed and analyzed using multivariable linear regression. Subgroup analyses by age group were conducted under the assumption that healthcare utilization patterns vary across age categories.</p><p><strong>Results: </strong>The results showed that individuals with high HL spent 8.6% less on outpatient care than those with low HL. Subgroup analyses further revealed that this association was statistically significant only among adults aged 65 years and older.</p><p><strong>Conclusion: </strong>These findings provide evidence that higher HL is associated with reduced outpatient expenditures in South Korea, particularly in older populations. Therefore, promoting HL among older adults may represent an effective strategy for improving healthcare efficiency and mitigating the burden of rising outpatient costs.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"41 28","pages":"e65"},"PeriodicalIF":3.2,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387848/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148536109","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}

{"title":"Statistical Competence and Editorial Policies in Biomedical Publications.","authors":"Olena Zimba, Aizhan Oralbek, Maidan Mukhamediyarov, Marlen Yessirkepov, Burhan Fatih Kocyigit","doi":"10.3346/jkms.2026.41.e286","DOIUrl":"10.3346/jkms.2026.41.e286","url":null,"abstract":"<p><p>Misuse of statistical methods in biomedical research remains widespread, undermining scientific integrity and public health. Flawed analyses can lead to misleading clinical guidelines, unnecessary treatments, or concealment of true treatment effects. Statistical errors often result from a structural training gap that affects the research process from study design to reporting, rather than from individual incompetence. Authors should be able to select appropriate measures of central tendency based on the data distribution, apply parametric and nonparametric tests correctly, use regression analyses with attention to statistical power and collinearity, and interpret <i>P</i> values in the context of confidence intervals. The growing number of retractions in statistics and the continued citation of retracted articles highlight the limitations of current peer-review processes. Statistical Package for the Social Sciences is the most widely used statistical software in health sciences research, while R/RStudio is gaining increasing adoption due to its open-source nature, analytical flexibility, and capacity for fully reproducible and transparent analyses. Software selection can significantly influence analytical outcomes due to differences in default algorithms. Therefore, full disclosure of software versions and procedures is essential for reproducibility. Integrating artificial intelligence-based tools into statistical workflows introduces risks, including output hallucination, a lack of algorithmic transparency, and unresolved accountability. These tools should not be used without internationally accepted validation guidelines. At the publisher level, employing statistical editors, enforcing open data-sharing policies, and adopting contributor role taxonomies such as Contributor Roles Taxonomy are the most effective structural interventions. Enhancing the statistical quality of biomedical literature requires coordinated, sustained efforts from all stakeholders in scientific communication.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"41 28","pages":"e286"},"PeriodicalIF":3.2,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148536148","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}

{"title":"Post-Acute Sequelae of COVID-19 Across 15 Major Health Domains and 67 Diseases in Individuals With Depressive Disorder: A Korean Nationwide Cohort Study.","authors":"Jaehyeong Cho, Selin Woo, Jaeyu Park, Yejun Son, Hyesu Jo, Hayeon Lee, Ho Geol Woo, Hanseul Cho, Guillaume Fond, Laurent Boyer, Yerin Hwang, Dong Keon Yon","doi":"10.3346/jkms.2026.41.e181","DOIUrl":"10.3346/jkms.2026.41.e181","url":null,"abstract":"<p><strong>Background: </strong>Individuals with depressive disorder often face barriers in accessing healthcare; however, research on the acute and post-acute sequelae of coronavirus disease 2019 (COVID-19) (PASC) in this population remains limited. We aimed to investigate the risk of PASC in individuals with depressive disorder.</p><p><strong>Methods: </strong>We used a longitudinal, large-scale, population-based cohort from South Korea, including individuals aged ≥ 20 years with depressive disorder and confirmed severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection between January 1, 2020 and December 31, 2022. Individuals were followed from the date of COVID-19 diagnosis (index date) until the occurrence of each outcome, which included 15 major health domains and 67 specific diseases defined based on the International Classification of Diseases, 10th edition (ICD-10) codes. To reduce bias, we applied 1:1 propensity score matching and estimated the adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) using Cox proportional hazards regression. Subgroup analyses were conducted based on COVID-19 severity (mild vs. moderate-to-severe), vaccination status, and time-dependent risk patterns (< 3, 3-6, 6-12, and ≥ 12 months).</p><p><strong>Results: </strong>The study included 722,088 individuals with depressive disorder (mean age, 44.10 [standard deviation, 11.80] years; 61.65% female). In individuals with depressive disorder, SARS-CoV-2 infection was associated with an elevated risk of postacute sequelae across 14 of 15 major health domains, including infections (aHR, 1.27; 95% CI, 1.24-1.30), respiratory disorders (aHR, 1.54; 95% CI, 1.49-1.59), and circulatory/respiratory symptoms (aHR, 1.34; 95% CI, 1.31-1.37). Among 67 specific conditions, 35 showed significantly elevated risks, including malnutrition (aHR, 1.31; 1.13-1.53), chronic obstructive pulmonary disease (aHR, 1.54; 95% CI, 1.49-1.59), asthma (aHR, 1.61; 95% CI, 1.54-1.68), and vascular intestinal disorders (aHR, 1.38; 95% CI, 1.03-1.85). The risks peaked within the first 3 months postinfection and gradually declined over time. Severe COVID-19 was associated with increased risks compared to mild cases, particularly for blood disorders (aHR, 3.14; 95% CI, 2.84-3.48), and self-harm (aHR, 14.83; 95% CI, 6.52-33.71).</p><p><strong>Conclusion: </strong>In individuals with depressive disorder, SARS-CoV-2 infection is associated with a higher risk of developing post-acute sequelae across nearly all health domains and more than half of the specific conditions. Targeted surveillance and tailored intervention strategies are needed to mitigate long-term health consequences.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"41 28","pages":"e181"},"PeriodicalIF":3.2,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148536180","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}

{"title":"Long-Term Trends of Distal Radius Fractures in Adults Aged ≥ 50 Years in Korea Using Nationwide Claims Database (2006-2022).","authors":"Jae-Hwi Nho, Seong-Jun Kim, Tae-Young Kim, Kyungjun Lim, Jaiyong Kim, Jihye Kim, Hoyeon Jang, Yong-Chan Ha","doi":"10.3346/jkms.2026.41.e194","DOIUrl":"10.3346/jkms.2026.41.e194","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the long-term trends in the incidence, mortality, and subsequent fractures following distal radius fractures among South Koreans aged ≥ 50 years based on a nationwide claims database from 2006 to 2022.</p><p><strong>Methods: </strong>Using the National Health Insurance database, we identified individuals aged ≥ 50 years who received treatment for distal radius fractures from 2006 to 2022. Distal radius fractures were defined using diagnostic codes (S525 and S526) and treatment codes (N1601, N1611, N1603, N1613, N0996, N0998, N0983, N0643). Annual incidence rates, 1-year mortality rates, and rates of subsequent fractures were estimated after adjustment for age and sex.</p><p><strong>Results: </strong>Over the 16-year study period, the total number of distal radius fractures increased steadily (from 51,152 cases in 2006 to 100,729 in 2022). The incidence rate increased slightly from 426 per 100,000 in 2006 to 442 per 100,000 in 2022. The 1-year mortality rates after a distal radius fracture declined from 2.73% in 2006 to 1.79% in 2021 (incidence rate ratio per year, 0.985; <i>P</i> < 0.001), representing an annual decrease of 1.52%. The 1-year mortality rate in 2021 for men (3.41%) was higher than that for women (1.32%) (incidence rate ratio, 2.740; <i>P</i> < 0.001). The rate of subsequent distal radius fractures within 1 year following a distal radius fracture rose from 0.82% in 2007 to 7.44% in 2021 (annual increase of 17.21% [incidence rate ratio, 1.172; 95% confidence interval, 1.152-1.192; <i>P</i> < 0.001]). The rate of subsequent osteoporotic fractures within 1 year after a distal radius fracture also increased from 2.33% in 2007 to 8.96% in 2021, with an annual increase of 10.81% (incidence rate ratio, 1.108; <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>The long-term trends in this study-an increased number and incidence rate but decreased mortality after distal radius fractures in South Korea-highlight the need to initiate preventive strategies for subsequent osteoporotic fractures to reduce the associated socioeconomic burden.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"41 28","pages":"e194"},"PeriodicalIF":3.2,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148536043","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}

{"title":"Developing Regionally Coordinated Infection Control Strategies for Carbapenem-Resistant and Carbapenemase-Producing Enterobacterales in Acute and Long-Term Care Hospitals: A Delphi Study.","authors":"Naae Lee, Songhui Lee, Eunmi Kim, Seung Soon Lee, Won Sup Oh, Young Keun Kim, Eun Hee Song, Seungmin Jeong","doi":"10.3346/jkms.2026.41.e179","DOIUrl":"10.3346/jkms.2026.41.e179","url":null,"abstract":"<p><strong>Background: </strong>Carbapenem-resistant Enterobacterales (CRE), particularly carbapenemase-producing Enterobacterales (CPE), remain a major global public health concern. In Korea, reports from acute care hospitals (ACHs) have increased in absolute numbers, while those from long-term care hospitals (LTCHs) have risen both in numbers and in proportion. This Delphi study aimed to develop expert consensus to inform national CPE infection control policy by identifying key challenges, essential program components in ACHs and LTCHs, and strategies for regional coordination between healthcare facilities.</p><p><strong>Methods: </strong>A three-round Delphi study was conducted between October 2024 and February 2025 with 19 experts, including infectious disease physicians and infection control nurse leaders. The first round consisted of open-ended and multiple-choice questions to assess expert responses on the current practices and areas for improvement. Based on these responses, 85 items were rated on a 10-point Likert scale in the second and third rounds. Consensus was determined using content validity ratio, degree of convergence, and degree of consensus. Final strategies were then proposed by prioritizing items with the highest agreement and adapting them to the Korean healthcare context.</p><p><strong>Results: </strong>Of 85 items evaluated, 56 achieved consensus. In ACHs, the highest priorities focused on strengthening surveillance activities for high-risk patients with CRE/CPE, antimicrobial stewardship, and healthcare-associated infection surveillance, supported by sufficient financial and workforce resources. In LTCHs, the top priorities included admission screening and testing for CRE/CPE supported by national reimbursement and effective communication within and between healthcare facilities to ensure timely information transfer. Experts prioritized implementing standardized transfer records to indicate whether patients are CRE/CPE carriers or belong to high-risk groups, and expanding national reimbursement for screening, testing, and related infection control activities as key measures to enhance information sharing and regional collaboration.</p><p><strong>Conclusion: </strong>The Delphi consensus identified key priorities to strengthen CRE/CPE surveillance and antimicrobial stewardship in ACHs, expand reimbursed screening testing in LTCHs, and establish standardized interfacility transfer communication. These findings support regionally coordinated policies to enhance CRE/CPE infection control in Korea provide evidence for national policy development.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"41 28","pages":"e179"},"PeriodicalIF":3.2,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148536100","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}

{"title":"Sex Differences in Long-term Outcomes Following Coronary Artery Bypass Grafting: A Nationwide Population-Based Propensity Score-Matched Cohort Study.","authors":"Suk Kyung Lim, Yong Ho Jeong, Yun Jin Kim, Yongil Cho, Hyo Jun Jang, Yang Hyun Cho, Kiick Sung, Wook Sung Kim, Joon Bum Kim, Hee Jung Kim, Jun Ho Lee","doi":"10.3346/jkms.2026.41.e161","DOIUrl":"10.3346/jkms.2026.41.e161","url":null,"abstract":"<p><strong>Background: </strong>The relationship between sex differences and clinical outcomes following coronary artery bypass grafting (CABG) has been highlighted in several studies. However, these studies were mostly based on single- or multi-center data, and only a few meta-analyses examined long-term outcomes. To address this limitation, we conducted a nationwide population-based cohort study in Korea.</p><p><strong>Methods: </strong>A total of 48,206 adult patients who underwent first-time isolated CABG between January 2005 and December 2021 were enrolled. To address potential confounding, propensity score (PS) matching was conducted. The primary outcome was overall mortality.</p><p><strong>Results: </strong>Among the enrolled patients, 12,270 (25.5%) were female. The median age of the overall cohort was 66.0 years (interquartile range [IQR], 59.0-72.0), with female patients (median, 69.0; IQR, 63.0-75.0) being significantly older than male patients (<i>P</i> < 0.001). In the PS-matched cohort, in-hospital mortality did not differ significantly between female and male groups (odds ratio, 1.13; 95% confidence interval [CI], 0.78-1.64). However, the female group was a significant predictor of better overall survival (hazard ratio [HR], 0.83; 95% CI, 0.77-0.90) compared to the male group. Cardiac-related mortality was comparable between the two groups (HR, 0.89; 95% CI, 0.65-1.22). The median duration of the follow-up period was 7.8 (IQR, 4.0-12.6) years.</p><p><strong>Conclusion: </strong>In this nationwide population-based PS-matched cohort study, female patients who underwent isolated CABG exhibited significantly lower overall mortality compared to male patients during long-term follow-up, whereas no significant difference was observed in cardiac-related mortality.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"41 28","pages":"e161"},"PeriodicalIF":3.2,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148536132","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}

{"title":"Assessing the Relationship Between Work-Related Factors and Mental Health in Public Health Doctors During National Health Emergencies.","authors":"Ji-Ae Yun, JinYoung Lee, Hyein Song, Sejin Choi, Sangyoon Han, Kyeong-Sook Choi","doi":"10.3346/jkms.2026.41.e191","DOIUrl":"10.3346/jkms.2026.41.e191","url":null,"abstract":"<p><strong>Background: </strong>South Korean public health doctors (PHDs) serve as frontline responders in underserved regions during national health crises, such as the COVID-19 pandemic. However, the system has not adapted to evolving healthcare needs and despite the essential roles of PHDs, little is known about the unique occupational stressors they face. We examined how work-related factors, especially national guidelines and policies, impact the mental health of PHDs during public health emergency deployments, providing evidence to inform policy and support systems for this workforce.</p><p><strong>Methods: </strong>An online cross-sectional survey of all PHDs serving between July and August 2021 was used to collect data on demographics, work-related stress, and mental health outcomes using validated questionnaires. Associations between work factors and mental health (depressive symptoms, embitterment, burnout) were analyzed using logistic regression.</p><p><strong>Results: </strong>Among 269 PHDs (mean age 29.7 years), 27.1% reported depressive symptoms, 9.3% embitterment, and 45.4% burnout. Dissatisfaction with financial compensation was associated with higher risks of depressive symptoms (adjusted odds ratio [aOR], 2.481), embitterment (aOR, 3.695), and burnout (aOR, 2.997). Deployment of 3-6 months increased embitterment (aOR, 3.770) and burnout (aOR, 2.469). Job demands predicted all outcomes (aOR, 1.033-1.040). National guidelines/policies and concerns related to work and environment were associated with depressive symptoms (aOR, 1.138, 1.056) and burnout (aOR, 1.105, 1.042).</p><p><strong>Conclusion: </strong>This study highlights the need for adequate compensation, manageable deployment duration, and strong organizational support, including clear national guidelines and policies to mitigate mental health risks, among PHDs during public health emergency deployments.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"41 28","pages":"e191"},"PeriodicalIF":3.2,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148536107","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}

{"title":"Systemic Inflammatory Indexes as Predictors of Delirium, Thromboembolic Events, and Mortality After Hip Fracture and Major Orthopedic Surgery: A Meta-Analysis.","authors":"Suyeon Park, Ki Tae Park, Naye Kang, Eunseo Joung, Nah Yon Kim, Byung-Ho Yoon","doi":"10.3346/jkms.2026.41.e180","DOIUrl":"10.3346/jkms.2026.41.e180","url":null,"abstract":"<p><strong>Background: </strong>Hip fractures and other orthopedic surgeries are often associated with poor post-operative outcomes, including thrombus formation, delirium, and mortality. Systemic inflammatory markers, such as the systemic immune-inflammatory index (SII) and systemic inflammation response index (SIRI), have shown potential for predicting adverse outcomes in cancer and cardiovascular diseases. This meta-analysis evaluates the predictive value of SII and SIRI for complications following orthopedic surgeries, aiming to establish them as practical tools for risk stratification to assist the surgeons' decision for optimal treatments.</p><p><strong>Methods: </strong>A systematic search was conducted in PubMed, Embase, and Web of Science through January 2025, adhering to PRISMA guidelines. Cohort studies reporting the relationship between pre-operative SII/SIRI and post-operative complications were included. Outcomes included thrombus formation, delirium, and mortality. Random-effects models were used for meta-analyses, and heterogeneity was assessed with I² statistics. Sensitivity analyses were performed to mitigate the heterogeneity.</p><p><strong>Results: </strong>Nineteen studies with 8,315 patients published up to January 2025 were included. High pre-operative SII was associated with post-operative delirium (standardized mean difference, 1.28; 95% confidence intervals, 0.25-2.32; I² = 96.5%; <i>P</i> = 0.015). Based on two studies, elevated pre-operative SIRI showed a trend toward higher delirium risk (pooled odds ratios, 3.07; 95% confidence intervals, 2.66-3.48; no heterogeneity; <i>P</i> < 0.001). Sensitivity analysis suggested a potential association, but statistical significance was not achieved.</p><p><strong>Conclusion: </strong>SII and SIRI show promise as predictors for post-operative delirium but have limited evidence for thrombus formation or mortality. Future research should focus on prospective studies with standardized cut-offs to validate their clinical utility.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"41 27","pages":"e180"},"PeriodicalIF":3.2,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13365169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148436590","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}