Journal of Korean Medical Science最新文献

{"title":"Comparison of Trauma Mortality Prediction Models With Updated Survival Risk Ratios in Korea.","authors":"Juyoung Kim, Yun Jung Heo, Yoon Kim","doi":"10.3346/jkms.2025.40.e51","DOIUrl":"https://doi.org/10.3346/jkms.2025.40.e51","url":null,"abstract":"<p><strong>Background: </strong>Despite the considerable disease burden due to trauma injury, sufficient effort has not been made for the assessment of nationwide trauma care status in Korea. We explored the feasibility of a diagnosis code-based injury severity measuring method in light of its real-world usage.</p><p><strong>Methods: </strong>We used datasets from the National Emergency Department Information System to calculate the survival risk ratios (SRRs) and the Korean Trauma Data Bank to predict models, respectively. The target cohort was split into training and validation datasets using stratified random sampling in an 8:2 ratio. We established six major mortality prediction models depending on the included parameters: 1) the Trauma and Injury Severity Score (TRISS) (age, sex, original Revised Trauma Score [RTS], Injury Severity Score [ISS]), 2) extended International Classification of Diseases-based Injury Severity Score (ICISS) 1 (age, sex, original RTS, ICISS using international SRRs), 3) extended ICISS 2 (age, sex, original RTS, ICISS using Korean SRRs based on 4-digit diagnosis codes), 4) extended ICISS 3 (age, sex, original RTS, ICISS using Korean SRRs based on full-digit diagnosis codes), 5) extended ICISS 4 (age, sex, modified RTS, and ICISS using Korean SRRs based on 4-digit diagnosis codes), 6) extended ICISS 5 (age, sex, modified RTS, and ICISS using Korean SRRs based on full-digit diagnosis codes). We estimated the model using training datasets and fitted it to the validation datasets. We measured the area under the receiver operating characteristic curve (AUC) for discriminative ability. Overall performance was also evaluated using the Brier score.</p><p><strong>Results: </strong>We observed the feasibility of the extended ICISS models, though their performance was slightly lower than the TRISS model (training cohort, AUC 0.936-0.938 vs. 0.949). Regarding SRR calculation methods, we did not find statistically significant differences. The alternative use of the Alert, Voice, Pain, Unresponsive Scale instead of the Glasgow Coma Scale in the RTS calculation did not degrade model performance.</p><p><strong>Conclusion: </strong>The availability of the practical ICISS model was observed based on the model performance. We expect our ICISS model to contribute to strengthening the Korean Trauma Care System by utilizing mortality prediction and severity classification.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 15","pages":"e51"},"PeriodicalIF":3.0,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12011615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970182","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":"Group B <i>Streptococcus</i> Detection Rate and Clindamycin Resistance Among Reproductive-Age Women in Korea During 2003-2022.","authors":"Areum Shin, Doo Ri Kim, Ji-Hee Sung, Jinyoung Yang, Suk-Joo Choi, Cheong-Rae Roh, Tae Yeul Kim, Hee Jae Huh, Nam Yong Lee, Soo-Young Oh, Yae-Jean Kim","doi":"10.3346/jkms.2025.40.e29","DOIUrl":"https://doi.org/10.3346/jkms.2025.40.e29","url":null,"abstract":"<p><strong>Background: </strong>Group B <i>Streptococcus</i> (GBS) is one of the leading causes of neonatal early-onset sepsis, resulting in high mortality and significant comorbidity. Intrapartum penicillin prophylaxis is recommended for pregnant women with GBS colonization to prevent vertical transmission. For pregnant women at high risk of anaphylaxis to penicillin, clindamycin is recommended only if the susceptibility of GBS isolates has been identified. We retrospectively examined the GBS detection rate and clindamycin resistance among Korean women of reproductive age over the last 20 years.</p><p><strong>Methods: </strong>Microbiologic studies using vaginal, vaginal-rectal or vaginal-perianal swabs from female patients 15-49 years of age during 2003-2022 were reviewed. Annual GBS detection rates and clindamycin resistance rates were calculated. The study period was divided into two periods (period 1, 2003-2015; period 2, 2016-2022) based on the introduction of universal culture-based GBS screening in our center in 2016. GBS detection rates and clindamycin resistance rates were compared between the periods using χ² tests.</p><p><strong>Results: </strong>A total of 14,571 women were tested 16,879 times and GBS was isolated in 1,054 tests (6.2%), with 423 clindamycin-resistant isolates (40.1%). The GBS detection rate increased from 3.4% (301/8,869) in period 1 to 9.4% (2,753/8,010) in period 2 (<i>P</i> < 0.001). Even during period 1, the GBS detection rate was higher in 2009-2015 compared to 2003-2008 (<i>P</i> < 0.001). Clindamycin resistance rates have remained at similar levels since 2009, which were 39.5% (199/301) in period 1 and 40.2% (303/753) in period 2 (<i>P</i> = 0.833).</p><p><strong>Conclusion: </strong>This study demonstrated that GBS detection rates in Korean women of reproductive age significantly increased almost three times during the twenty years of the study period, with a persistently high clindamycin resistance rate of up to 40%.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 15","pages":"e29"},"PeriodicalIF":3.0,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12011610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969425","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":"Physician-Scientist Training System and Development Strategies in Korea.","authors":"Gwang Hyeon Eom, Jungmin Kim, Jong-Il Kim, Hyo Yi Choi, Dong Hyeon Lee","doi":"10.3346/jkms.2025.40.e140","DOIUrl":"https://doi.org/10.3346/jkms.2025.40.e140","url":null,"abstract":"<p><p>Physician-scientists play a pivotal role in bridging clinical practice and biomedical research, advancing medical science, and tackling complex healthcare challenges. In South Korea, the declining number of medical doctors engaging in basic medical sciences has prompted the implementation of various training initiatives since the 2000s. Notable initiatives, such as the Integrated Physician-Scientist Training Program (2019) and the Global Physician-Scientist Training Program (2024), aim to cultivate multidisciplinary physician-scientists capable of addressing unmet medical needs. This study offers a comprehensive overview of the current training systems, funding mechanisms, and strategic approaches for physician-scientists in South Korea, compares them with international best practices, and proposes actionable policy recommendations to enhance their effectiveness and long-term sustainability.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 15","pages":"e140"},"PeriodicalIF":3.0,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12011614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022474","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":"Roots of the Large-Scale Household Humidifier Disinfectant Poisoning Tragedy: Regulatory and Surveillance Shortcomings in Korea.","authors":"Dong-Uk Park, Kyung Ehi Zoh, Dae Hwan Cho, Soyoung Park, Jeonghwa Hwang, Cheong-Hak Choi, Dong-Hee Koh, Yeyong Choi, Jinyoung Park","doi":"10.3346/jkms.2025.40.e144","DOIUrl":"https://doi.org/10.3346/jkms.2025.40.e144","url":null,"abstract":"<p><p>The multi-decade household humidifier disinfectant poisoning tragedy (HHDT) in South Korea highlights the importance of investigating government failures. This study aims to identify and discuss key failures and shortcomings in the South Korean authorities' approach to regulating humidifier disinfectants (HDs) and monitoring cases of chemical poisoning. We reviewed both the HD risk prevention measures that the South Korean Ministry of Environment (KME) should have implemented under the Toxic Chemicals Control Act (TCCA) (1991-2013). Polyhexamethylene guanidine phosphate (PHMG), a new chemical, was approved for use as a disinfectant under the TCCA. KME declared PHMG non-hazardous based solely on pre-production documentation provided by the industry. In addition, the Korea Disease Control and Prevention Agency (KDCPA) failed to detect the HHDT that had accumulated each year for more than a decade. KME's neglect of its responsibilities, coupled with KDCPA's lack of chemical poisoning surveillance systems, led to the accumulation of widespread HHDT.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 15","pages":"e144"},"PeriodicalIF":3.0,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12011611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985935","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":"The Older the Patients, the More Aggressive the Prostate Cancer Detected Even Among Those With a Prostate-Specific Antigen Level Below the Low-Risk Threshold: Analysis Using Nationwide Korean Data.","authors":"Jong Hyun Pyun, Young Hwii Ko, Sang Won Kim, Sung Gu Kang, Nak-Hoon Son","doi":"10.3346/jkms.2025.40.e57","DOIUrl":"https://doi.org/10.3346/jkms.2025.40.e57","url":null,"abstract":"<p><strong>Background: </strong>To investigate the clinicopathologic pattern of prostate cancer (PCa) in elderly patients compared with their younger counterparts with a prostate-specific antigen (PSA) level below the low-risk threshold (< 10 ng/mL), which is often a deciding factor for biopsy.</p><p><strong>Methods: </strong>A nationwide database of PCa at the time of biopsy from 2010 to 2020 was constructed from 39 hospitals. Patients were categorized into age groups of < 64 years, 65-69 years, 70-74 years, and ≥ 75 years considering guidelines that recommend PSA testing only for those aged 55-69 years during the study period, the average age of Korean PCa registrants of 70.3 years (2010-2020), and the average life expectancy of Korean males of 80.3 years (2020).</p><p><strong>Results: </strong>The mean ± standard deviation age was 70.3 ± 8.2 years, which was normally distributed (kurtosis = 0.095). Among 14,548 subjects, 54.1%, 39.5%, and 6.4% of them had high-risk disease, intermediate-risk disease, and low-risk disease, respectively. Based on three risk parameters, a marked increase in high-risk cancer was observed in the oldest age group (linear combination, <i>P</i> < 0.001). The same pattern was observed among patients with low-risk disease (PSA < 10 ng/mL), who were divided into PSA tiers as follows: 4-5 ng/mL (<i>P</i> < 0.001), 5-6 ng/mL (<i>P</i> < 0.001), 6-7 ng/mL (<i>P</i> < 0.001), 7-8 ng/mL (<i>P</i> < 0.001), 8-9 ng/mL (<i>P</i> = 0.009), and 9-10 ng/mL (<i>P</i> < 0.001). In all PSA tiers between 4 and 10 ng/mL, multivariate analysis demonstrated a significantly higher prevalence of high-risk cancer in the oldest age group than in the youngest age group. In the lowest tier (4-5 ng/mL), 35.2% of those aged over 75 years had high-risk PCa.</p><p><strong>Conclusion: </strong>The older the patient, the more aggressive the PCa. Moreover, there was an increase in high-risk PCa in older males compared with younger males even with a PSA level below the low-risk threshold of 10 ng/mL, suggesting the need to strengthen cancer screening policies in the older population.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 15","pages":"e57"},"PeriodicalIF":3.0,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12011613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024663","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":"Quality of Life in Women With Gestational Diabetes Mellitus and Treatment Satisfaction Upon Intermittently Scanned Continuous Glucose Monitoring.","authors":"Sookyung Won, Hyeon Ji Kim, Jee Yoon Park, Kyung Joon Oh, Sung Hee Choi, Hak Chul Jang, Joon Ho Moon","doi":"10.3346/jkms.2025.40.e46","DOIUrl":"https://doi.org/10.3346/jkms.2025.40.e46","url":null,"abstract":"<p><strong>Background: </strong>To assess the quality of life (QoL) and treatment satisfaction with intermittently-scanned continuous glucose monitoring (isCGM) in women with gestational diabetes mellitus (GDM).</p><p><strong>Methods: </strong>This prospective observational study included 189 women with GDM who completed the Korean version of the Audit of Diabetes-Dependent Quality of Life Questionnaire (K-ADDQoL). Among them, 25 women who utilized isCGM between gestational weeks 30 and 34 completed the Korean version of the Diabetes Treatment Satisfaction Questionnaire change version (K-DTSQc) to evaluate their satisfaction with isCGM during pregnancy.</p><p><strong>Results: </strong>GDM had a negative impact on the perceived QoL in 89.4% of the women. All 19 domains of the K-ADDQoL were adversely influenced by GDM, with the most significant impact on the freedom to eat (weighted impact score, -6.98 ± 2.49, <i>P</i> < 0.001) and the least impact on the sex life (-0.25 ± 0.80, <i>P</i> = 0.008). Younger women and those treated with insulin perceived themselves as being more affected in their QoL due to GDM. Women perceived to have less effect on their QoL attributed to GDM exhibited higher ΔHbA1c one year after delivery (ΔHbA1c, 0.3 ± 0.4% vs. 0.0 ± 0.4% in less affected vs. more affected women). The utilization of isCGM improved treatment satisfaction (overall satisfaction score, 10.36 ± 9.21, <i>P</i> < 0.001), independent of glycemic control during pregnancy.</p><p><strong>Conclusion: </strong>Although GDM negatively affects the perceived QoL during pregnancy, attentiveness to GDM management may have a positive impact on long-term glycemic control. Moreover, employing isCGM can enhance treatment satisfaction in women with GDM.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 15","pages":"e46"},"PeriodicalIF":3.0,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12011612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025074","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":"Ten-Year Trends of Fluorescein Angiography in Korea Using Data From the Health Insurance Review and Assessment Service.","authors":"Dong Woo Kim, Min Seok Kim","doi":"10.3346/jkms.2025.40.e39","DOIUrl":"https://doi.org/10.3346/jkms.2025.40.e39","url":null,"abstract":"<p><strong>Background: </strong>Fluorescein angiography (FA) is a diagnostic procedure that is crucial for conditions such as age-related macular degeneration and diabetic retinopathy, and due to its importance, the use of conventional and wide-angle FA (wide FA) is on the rise. This study aimed to analyze the annual trends of conventional and wide FA and the trends of healthcare institutions performing these examinations in Korea.</p><p><strong>Methods: </strong>This retrospective study examined data from the Health Insurance Review and Assessment Service's Health and Medical Big Data Open Portal. We investigated the number of patients who underwent conventional and wide FA procedures performed in Korea from 2014 to 2023, categorized by age group and type of healthcare facility. Additionally, trends in healthcare expenditures were analyzed.</p><p><strong>Results: </strong>The number of patients undergoing conventional FA consistently declined, while those receiving wide FA increased steadily, keeping the overall patient count relatively stable. Healthcare costs related to conventional FA gradually decreased, whereas expenses for wide FA rose steadily, contributing to an increase in total medical expenses. Analysis of ten-year age intervals revealed that patients in their 60s were the most frequent recipients of wide FA in every year, except for 2014. The prevalence of wide FA at primary healthcare facilities has been steadily increasing.</p><p><strong>Conclusion: </strong>The use of wide FA has been steadily increasing, gradually replacing conventional FA, particularly in primary healthcare settings. Overall, medical expenses continue to rise. The findings of this study provide valuable evidence for the efficient allocation of medical resources in the future.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 14","pages":"e39"},"PeriodicalIF":3.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11995198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997511","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":"The Impact of Self-Compassion on Enhancing the Professional Quality of Life for Healthcare Workers.","authors":"Eulji Jung, Young-Eun Jung","doi":"10.3346/jkms.2025.40.e141","DOIUrl":"https://doi.org/10.3346/jkms.2025.40.e141","url":null,"abstract":"<p><p>Emphasizing the importance of psychological experiences in professional roles, this study explored the relationship between self-compassion and professional quality of life (ProQOL) among healthcare workers (HCWs). Sociodemographic characteristics, depressive symptoms, self-compassion, and ProQOL were assessed by conducting an online survey with 371 HCWs on coronavirus disease 2019 dedicated teams. Our findings indicate that self-compassion contributes to a better ProQOL, enhancing compassion satisfaction while reducing burnout and secondary traumatic stress, even when controlling depressive symptoms. These results have important implications fostering self-compassion interventions for a better ProQOL in HCWs.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 14","pages":"e141"},"PeriodicalIF":3.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11995194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015481","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":"Comparative Efficacy of High-Dose Rosuvastatin and Atorvastatin in Preventing Cystatin C-Oriented Contrast-Induced Nephropathy in Patients With Acute Myocardial Infarction: RACCOON-AMI Registry.","authors":"Ji Hye Kim, Hyunah Kim, Seung-Hyuk Choi, Woo Jeong Chun, Joon Hyung Doh, Jong-Young Lee, Seung-Jae Lee, Byung Jin Kim","doi":"10.3346/jkms.2025.40.e50","DOIUrl":"https://doi.org/10.3346/jkms.2025.40.e50","url":null,"abstract":"<p><strong>Background: </strong>Prevention of contrast-induced nephropathy (CIN) is crucial in acute myocardial infarction (AMI) patients undergoing coronary interventions. Previous studies suggest that high-dose statins may aid in CIN prevention, yet comparative studies among different statin types using cystatin C (cysC) as a biomarker for CIN are absent. This study evaluated the effectiveness of high-dose rosuvastatin versus atorvastatin in preventing cysC-based CIN (cysC-CIN) in AMI patients.</p><p><strong>Methods: </strong>This multicenter registry included 431 patients (rosuvastatin 20 mg: n = 231, atorvastatin 40 mg: n = 200). The primary endpoint was cysC-CIN incidence within 48 hours post contrast; the secondary endpoints were creatinine-based CIN (cr-CIN) incidence within 72 hours post contrast and post 30 days adverse events.</p><p><strong>Results: </strong>The incidences of cysC-CIN (12.1% vs. 7.5%, <i>P</i> = 0.103) and cr-CIN (6.2% vs. 3.5%, <i>P</i> = 0.103) were higher in the atorvastatin group without significant statistical differences. Multivariable regression analysis, which was adjusted for CIN risk factors and the variables with univariate association, showed no increased odds ratio (OR) (OR, 2.185; 95% confidence interval [CI], 0.899, 5.315; <i>P</i> = 0.085) for cysC-CIN in the atorvastatin group compared to the rosuvastatin group. However, statin-naïve atorvastatin subgroup had significantly increased odds of cysC-CIN compared to the rosuvastatin group (OR, 2.977; 95% CI, 1.057, 8.378; <i>P</i> = 0.039). At post 30 days renal, cardiovascular, and mortality event rates were both low and similar between the two groups.</p><p><strong>Conclusion: </strong>No significant difference in cysC-CIN incidence was found between the high-dose rosuvastatin and atorvastatin groups in AMI patients and cysC was more sensitive to the early detection of CIN than creatinine.</p><p><strong>Trial registration: </strong>Clinical Research Information Service Identifier: KCT0003703.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 14","pages":"e50"},"PeriodicalIF":3.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11995196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008423","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":"Administration of Calcium and Magnesium in Acute Intracerebral Hemorrhage Patients: Assessing Safety and Feasibility.","authors":"Moinay Kim, Wonhyoung Park, Jun Ha Hwang, Jae Hyun Kim, Yeongu Chung, Si Un Lee, Joonho Byun, Jung Cheol Park, Jae Sung Ahn, Seungjoo Lee","doi":"10.3346/jkms.2025.40.e45","DOIUrl":"https://doi.org/10.3346/jkms.2025.40.e45","url":null,"abstract":"<p><strong>Background: </strong>Serum calcium and magnesium levels are a key factor of the coagulation cascade and may potentially contribute to the pathophysiology of intracerebral hemorrhage (ICH) expansion. The aim of this study was to attain and sustain target levels of serum calcium and magnesium for three days following admission.</p><p><strong>Methods: </strong>A single-blind, prospective, multicenter randomized study was conducted from 2019 to 2022 years, enrolling acute ICH patients aged 18-80 years, with radiological diagnosis and without surgical intervention. Participants were randomly assigned in a 1:1 ratio to either the study group or the control group. In the study group, the target serum levels of calcium (9-10.2 mg/dL) and magnesium (2-3 mg/dL) were actively achieved and maintained for a duration of 3 days following admission. The primary outcome was the expansion of ICH volume within the first 3 days between the study group and the control groups.</p><p><strong>Results: </strong>After implementing inclusion/exclusion criteria, 105 of 354 patients remained in the study. There were no significant differences in ICH volume on hospital days 2 and 3 between the groups. Admission factors including Glasgow coma scale score, hemoglobin level, ICH volume, and spot sign showed significant correlations in multivariate analysis. On the third day of hospitalization, admission serum magnesium levels showed a significant correlation with ICH expansion, whereas calcium levels did not.</p><p><strong>Conclusion: </strong>Admission serum magnesium levels were found to correlate with hematoma expansion in patients with acute ICH. While magnesium itself may not be a direct therapeutic target, it could serve as a valuable indicator for identifying potential therapeutic strategies aimed at preventing ICH volume increase.</p><p><strong>Trial registration: </strong>Clinical Research Information Service Identifier: KCT0004427.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 14","pages":"e45"},"PeriodicalIF":3.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11995200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022472","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}