Western Journal of Emergency Medicine最新文献

{"title":"Randomized Controlled Trial of Atorvastatin in Acute Influenza in the Emergency Department.","authors":"Maureen Chase, Michael N Cocchi, Anne V Grossestreuer, Xiaowen Liu, Jacob Vine, Ari L Moskowitz, Michael W Donnino","doi":"10.5811/westjem.33580","DOIUrl":"10.5811/westjem.33580","url":null,"abstract":"<p><strong>Objectives: </strong>We sought to determine whether atorvastatin administration attenuates the inflammatory response and improves clinical outcomes in acute influenza.</p><p><strong>Methods: </strong>We conducted a randomized double-blind trial administering atorvastatin 40 milligrams or placebo to adults with confirmed influenza for five days between December 2013-May 2018. Patients were primarily enrolled in the emergency department (ED) at an urban, tertiary-care center. Serum was obtained at enrollment and 72 hours for the primary outcome, change in interleukin (IL-6). Patients reported severity of influenza symptoms over 10 days. We used linear mixed-effects models for the primary comparisons.</p><p><strong>Results: </strong>Of the 116 enrolled patients, 59 received atorvastatin and 57 received placebo. Groups were well-matched including baseline influenza symptom scores and receipt of an antiviral medication. There was no difference between groups in the change in interleukin-6 (IL-6) levels (P=0.468). However, there were significant differences in the overall influenza symptom scores, favoring faster resolution in the atorvastatin group (P=0.05). For patients presenting within 48 hours of symptom onset, resolution was faster for the overall score (P <0.001) and for the fever (P=0.001), sore throat (P=0.005) and headache (P=0.006) components. No safety concerns were identified.</p><p><strong>Conclusion: </strong>Atorvastatin administration in acute influenza appears safe. We did not find attenuation of IL-6 with atorvastatin. Patients receiving atorvastatin reported improvement in their clinical symptoms at a faster rate than those in the placebo group, particularly in patients presenting within 48 hours of symptom onset. This trial is registered at ClinicalTrials.gov, Identifier: NCT02056340.</p>","PeriodicalId":23682,"journal":{"name":"Western Journal of Emergency Medicine","volume":"26 3","pages":"600-608"},"PeriodicalIF":1.8,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498146","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":"Emergency Physician Assessment of Productivity and Supervision Practices.","authors":"Kraftin Schreyer, Diane Kuhn, Vicki Norton","doi":"10.5811/westjem.19417","DOIUrl":"10.5811/westjem.19417","url":null,"abstract":"<p><strong>Introduction: </strong>Despite a lack of data guiding safe standards for physician productivity and supervision of non-physician practitioners (NPP), legislation dictating supervision ratios for emergency physicians (EP) has been enacted in Florida and elsewhere across the country. To inform future legislation, we aim to identify current productivity and supervision practices among practicing EPs as well as those physicians' safety assessments of their current practices.</p><p><strong>Methods: </strong>We conducted a cross-sectional observational study regarding EPs' perspectives on safe staffing and supervision models. A survey, consisting of 14 questions examining different variables affecting supervision and productivity, was used to determine physicians' opinions on the safety of productivity and supervision models across a range of annual volumes, employers, and years of experience. We coded safety assessments as binary (yes/no) and measured productivity by patients treated per hour. Ratios of physician to supervisee (either resident physician or or NPP) were given as number of supervisees: EP.</p><p><strong>Results: </strong>The survey response rate was 4.8% (196/4,004). On average, most EPs treated 2.6 patients per hour, regardless of years of experience, employment model, or supervision model. More than 80% of EPs felt that their current patients-per- hour practice was safe. Direct supervision represented 59% of total visits and the majority in all employment models except for community contract-management groups (CMG). A minimum of 80% of physicians felt that their current supervision practices were safe across employment models, with the notable exception of community CMGs. Most felt that a safe ratio for direct supervision of NPPs was 1:1. Over 30% reported there was no safe staffing ratio for indirect supervision.</p><p><strong>Conclusion: </strong>With the exception of those employed by community contract-management groups, EPs felt that their current productivity and supervision practices were safe; however, average productivity and supervision ratios are much lower than prior estimates and in current legislation governing emergency department practice. Standards of care for both productivity and supervision that take into account current practices and safety assessments should be established and considered when future policies and legislation are developed.</p>","PeriodicalId":23682,"journal":{"name":"Western Journal of Emergency Medicine","volume":"26 3","pages":"500-506"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498177","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":"Epidemiology of 911 Calls for Opioid Overdose in Nogales, Arizona.","authors":"Melody Glenn, Darien Stratton, Keith Primeau, Amber Rice","doi":"10.5811/westjem.18597","DOIUrl":"10.5811/westjem.18597","url":null,"abstract":"<p><strong>Objective: </strong>Drug overdose is the leading cause of unintentional death in the United States, and individuals identifying as BIPOC (Black, indigenous and people of color) and those of low socioeconomic status are over-represented in this statistic. The US-Mexico border faces several unique challenges when it comes to healthcare and the drug overdose crisis, due in large part to health inequities. Although the US Centers for Disease Control and Prevention recommends that overdose prevention programs address health inequities, little is known about opioid overdoses in this rural, primarily Spanish-speaking region. As emergency medical services (EMS) records collect countywide data, they represent a high-quality source for epidemiologic surveillance.</p><p><strong>Methods: </strong>We conducted a retrospective chart review based on a local quality assurance program in which two years of EMS records were reviewed with the primary objective of characterizing patients receiving prehospital care for opioid overdoses in a rural, borderland community, and the secondary objective of characterizing EMS's fidelity to a naloxone distribution protocol. We included electronic patient care records for analysis if they included the EMS clinician's impression of overdose, opiate abuse, or opiate-related disorder from November 1, 2020-October 31,2022. The following data points were abstracted: date; patient initials/gender/age; police presence; response location; bystanders on scene; naloxone administration prior to EMS arrival; distribution of naloxone kit (yes/no); substance reported; and disposition. We analyzed descriptive statistics.</p><p><strong>Results: </strong>A total of 74 cases met inclusion criteria over two years with the majority of cases involving men (82%) with a median age of 28. Almost half of overdoses occurred at private residences (46%), and slightly more than half (57%) reported fentanyl use prior to overdose. Family or friends were usually (64%) on scene, and law enforcement was often (77%) the first 911 to arrive. Naloxone was administered on scene in almost all cases (91%), usually by EMS (44%) or law enforcement (43%). The EMS clinicians distributed naloxone kits at 61% of calls.</p><p><strong>Conclusion: </strong>Opioid overdoses along the US-Mexico border occurred primarily among young men using illicit fentanyl in private residences. Although family/friends were often present, they rarely administered naloxone. Law enforcement was often the first 911 responder to arrive. Emergency medical services is a suitable setting for naloxone distribution programs.</p>","PeriodicalId":23682,"journal":{"name":"Western Journal of Emergency Medicine","volume":"26 3","pages":"528-534"},"PeriodicalIF":1.8,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498179","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":"Social Determinants of Health and Health Literacy in Emergency Patients with Diabetic Ketoacidosis.","authors":"Daniel F Suarez, Ryan M Schneider, Margo Girardi, Gina LaRossa, Julianne Yeary, Taylor Kaser, Rachel Ancona, Paulina Cruz Bravo, Richard T Griffey","doi":"10.5811/westjem.35262","DOIUrl":"10.5811/westjem.35262","url":null,"abstract":"<p><strong>Introduction: </strong>Social determinants of health (SDoH) and health literacy have been demonstrated to significantly impact health outcomes. As part of a study of diabetic ketoacidosis (DKA) treatment from the emergency department (ED), we assessed the burden of SDoH and health literacy among patients with DKA to identify potentially modifiable risk factors in the development of DKA.</p><p><strong>Methods: </strong>This was an exploratory, prospective, cross-sectional study of adult patients with DKA in a large urban academic ED from March 2023-March 2024. We administered the Centers for Medicare & Medicaid Services Accountable Health Communities Health-Related Social Needs Screening Tool (SNST) and the Brief Health Literacy Screen (BHLS).</p><p><strong>Results: </strong>Of 126 identified ED patients with confirmed DKA, 57 completed the SNST and 72 completed the BHLS. Nearly all patients (56 patients, 98%) reported at least one unmet SDoH need, and 32 (56%) patients reported five or more. The most frequently reported SDoH needs were physical activity (77%), mental health (63%), financial strain (60%), substance use (54%), and food insecurity (51%). Seventy-two patients completed the BHLS, which demonstrated high levels of health literacy, with median responses ranging from 4-5 on a Likert scale with 5 corresponding to highest health literacy.</p><p><strong>Conclusion: </strong>Social determinants of health needs are prominent among patients who develop DKA, highlighting an opportunity for ED-based interventions to address specific SDoH factors to prevent the development of this disease. Self-reported health literacy scores were high in this patient population.</p>","PeriodicalId":23682,"journal":{"name":"Western Journal of Emergency Medicine","volume":"26 3","pages":"381-386"},"PeriodicalIF":1.8,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498170","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":"Case Study of How Alleviating \"Pebbles in the Shoe\" Improves Operations in the Emergency Department.","authors":"Diana Savitzky, Yash Chavda, Suchismita Datta, Alexandra Reens, Elizabeth Conklin, Matthew Scott, Christopher Caspers","doi":"10.5811/westjem.24990","DOIUrl":"10.5811/westjem.24990","url":null,"abstract":"<p><strong>Objectives: </strong>Addressing minor yet significant frustrations, or \"pebbles,\" in the workplace can reduce physician burnout, as noted by the American Medical Association. These \"pebbles\" are small workflow issues that are relatively easy to fix but can significantly improve the workday when resolved. This quality improvement project aimed to enhance clinician well-being in an emergency department (ED) affiliated with an academic institution through human-centered design by actively engaging clinicians to identify these \"pebbles\" and for a dedicated team to address them.</p><p><strong>Methods: </strong>A task force comprised of three emergency physicians collaborating with emergency medicine leadership was established. After educating clinicians about \"pebbles,\" clinicians were able to anonymously submit pebbles based on recall of frustrations in a baseline survey at the start of the project, as well as submit pebbles in real time by a QR code that was placed in easily noticeable areas. The task force met bimonthly to categorize, prioritize, and assign ownership of the pebbles. Progress was communicated to staff via a monthly \"stop light\" report. An anonymous survey assessed the impact on clinician well-being among 68 emergency clinicians within seven months of starting the project.</p><p><strong>Results: </strong>Over seven months, 284 pebbles were submitted (approximately 40 per month). The feasibility of addressing pebbles was characterized by a color scale: green (easy to fix): 149 (53%); yellow (more complex): 111 (39%); and red (not feasible, \"boulder\"): 24 (8%). Categories of pebbles included the following: equipment/supply: 115 (40%); nursing/clinical: 86 (30%); process: 64 (23%); and information technology/technology: 19 (7%). A total of 214 pebbles (75%) were completed. Among 51 respondents (75% response rate), the self-reported impact on well-being of having pebbles addressed was as follows: extremely effective: 16 (31%); very effective: 25 (49%); moderately effective: 8 (16%); slightly effective: 2 (4%); and not effective 0 (0%).</p><p><strong>Conclusion: </strong>In addition to improving personal resilience, improving well-being in the ED involves addressing efficiency of practice. This project highlights the positive impact of resolving small, feasible issues identified by clinicians, which resulted in 80% of respondents rating the project as very to extremely effective in improving their well-being. Most pebbles were related to equipment and easily fixed, while issues involving human interactions (eg, communications between consultants and EM) were more challenging. Regular meetings and accountability facilitated progress. This approach is replicable across medical specialties and practice settings, offering a low-cost method to enhance clinician work environments and well-being.</p>","PeriodicalId":23682,"journal":{"name":"Western Journal of Emergency Medicine","volume":"26 3","pages":"523-527"},"PeriodicalIF":1.8,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498156","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":"Effects of Emergency Department Training on Buprenorphine Prescribing and Opioid Use Disorder-Associated ED Revisits: Retrospective Cohort Study.","authors":"Anna Torchiano, Brian Roberts, Rachel Haroz, Christopher Milburn, Kaitlan Baston, Jessica Heil, Valerie Ganetsky, Matthew Salzman","doi":"10.5811/westjem.35589","DOIUrl":"10.5811/westjem.35589","url":null,"abstract":"<p><strong>Introduction: </strong>Prescribing patients buprenorphine from the emergency department (ED) is recommended by multiple organizations. However, it is unclear how best to encourage physicians to prescribe buprenorphine from the ED. Our objectives in this study were to examine the effects of a departmental-wide training initiative for emergency physicians to prescribe buprenorphine, increase buprenorphine prescribing, and decrease ED re-utilization for opioid use disorder (OUD) complications.</p><p><strong>Methods: </strong>We performed this retrospective cohort study at an academic medical center. Beginning May 1, 2018, the ED started a buprenorphine-education initiative and tracked the proportion of clinicians who obtained buprenorphine-prescribing certification over the following 16 months. We identified adult patients referred to an addiction clinic from the ED during this period. Our primary outcome was the proportion of patients who received a buprenorphine prescription from the ED. Secondary outcomes included ED re-utilization for OUD complications and buprenorphine refills, as well as follow-up in the bridge clinic within 30 days.</p><p><strong>Results: </strong>The proportion of physicians eligible to prescribe buprenorphine increased from 37% to 88% over the study period, and 430 patients were referred to an addiction clinic. The proportion of patients referred to a bridge program who received a buprenorphine prescription increased from 50% during the first month compared to 92% during month 16 (odds ratio 1.14, 95% confidence interval 1.08-1.21 per month). There were no statistically significant changes in any secondary outcomes.</p><p><strong>Conclusion: </strong>Our intervention increased buprenorphine prescribing by emergency physicians. It did not decrease ED reutilization for complications related to opioid use disorder.</p>","PeriodicalId":23682,"journal":{"name":"Western Journal of Emergency Medicine","volume":"26 3","pages":"580-587"},"PeriodicalIF":1.8,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208081/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498167","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":"Incidence and Characteristics of Alcohol-Based Hand Sanitizer Ingestion in Florida before and during the Coronavirus Pandemic.","authors":"Justin Arnold, Amira Athanasios, Diep Nguyen, Rahul Mhaskar","doi":"10.5811/westjem.20814","DOIUrl":"10.5811/westjem.20814","url":null,"abstract":"<p><strong>Introduction: </strong>Hand sanitizer use and media coverage increased throughout the coronavirus-2019 pandemic. In this study our goal was to examine and compare the incidence, demographics, and clinical outcomes of exposures to alcohol-based hand sanitizers (ABHS) before and during the COVID-19 pandemic in the state of Florida.</p><p><strong>Methods: </strong>We analyzed statewide data on all ABHS exposures in adults collected by the Florida Poison Information Network from March 1, 2015-February 28, 2020 (\"pre-COVID-19\" cohort) and during the COVID-19 pandemic from March 1, 2020-May 5, 2023 (\"COVID-19\" cohort). We performed descriptive, univariable, and multivariable analyses to assess changes in sex, age, medical outcome, and intentionality of the exposure in the pre-COVID-19 vs COVID-19 study periods, and we examined the factors associated with medical outcomes.</p><p><strong>Results: </strong>We identified 876 single-substance ingestions of ABHS, 414 in the pre-COVID-19 cohort and 462 in the COVID-19 cohort. The proportions of ABHS ingestions increased significantly during the COVID-19 pandemic in all age groups except the 25-50 age group, where it decreased. Individuals 18-24 of age and those ≥51 years showed a relative increase in both intentional and unintentional ingestions during the COVID-19 period compared to the 25-50 age group. The significant risk factors associated with more severe outcomes in exposed individuals were intentional exposures and younger age.</p><p><strong>Conclusion: </strong>Unintentional ingestions of alcohol-based hand sanitizers showed a relative increase during the COVID-19 pandemic, particularly in individuals 18-25 years of age and those ≥51. Both intentional ingestions and younger age increased the likelihood of moderate or severe outcomes. Harm reduction strategies targeted toward younger individuals and those with intentional ingestions should be considered during future pandemics.</p>","PeriodicalId":23682,"journal":{"name":"Western Journal of Emergency Medicine","volume":"26 3","pages":"643-649"},"PeriodicalIF":1.8,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498137","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":"Legislating Fear: How Immigration Status Mandates Threaten Public Health.","authors":"Peter Sangeyup Yun, Lindsey Williams, Janice Blanchard","doi":"10.5811/westjem.42065","DOIUrl":"10.5811/westjem.42065","url":null,"abstract":"","PeriodicalId":23682,"journal":{"name":"Western Journal of Emergency Medicine","volume":"26 3","pages":"413-414"},"PeriodicalIF":1.8,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498138","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":"Caught Unprepared: The Urgent Need for Reproductive Health Training in Emergency Medicine.","authors":"Peter Sangeyup Yun, Monica Saxena","doi":"10.5811/westjem.42064","DOIUrl":"10.5811/westjem.42064","url":null,"abstract":"","PeriodicalId":23682,"journal":{"name":"Western Journal of Emergency Medicine","volume":"26 3","pages":"758-759"},"PeriodicalIF":1.8,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498157","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":"Predictive Factors and Nomogram for 30-Day Mortality in Heatstroke Patients: A Retrospective Cohort Study.","authors":"Anxin Li, Yuchen Zhang, Xiaoshi Zhang, Zixiao Duan, Yan Chen, Xiaoyan Jiang, Wuquan Deng","doi":"10.5811/westjem.23666","DOIUrl":"10.5811/westjem.23666","url":null,"abstract":"<p><strong>Objective: </strong>Heatstroke (HS) is a severe condition associated with significant morbidity and mortality. In this study we aimed to identify early risk factors that impacted the 30-day mortality of HS patients and establish a predictive model to assist clinicians in identifying the risk of death.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study, analyzing the clinical data of 203 HS patients between May 2016-September 2024. The patients were divided into two groups: those who had died within 30 days of symptom onset; and those who had survived. We analyzed the risk factors affecting 30-day mortality. A nomogram was drawn to visualize the clinical model. We used the receiver operating characteristic (ROC) curve and calibration curve to verify the accuracy of the nomogram. A decision curve analysis was also performed to evaluate the clinical usefulness of the nomogram.</p><p><strong>Results: </strong>Within a 30-day period, 57 patients (28.08%) died. The APACHE II score, the ratio of lactate-to-albumin (LAR), and the core temperature at 30 minutes after admission were independent risk factors for death of HS patients at 30 days. The area under the ROC curve (AUC) for predicting mortality based on the APACHE II score was 0.867, with a sensitivity of 96.5% and a specificity of 61.6%. Moreover, the AUC for predicting mortality based on the LAR was 0.874, with a sensitivity of 93.0% and a specificity of 77.4%. The AUC based on the core temperature at 30 minutes after admission was 0.774, with a sensitivity of 70.2% and a specificity of 78.8%. Finally, the AUC for predicting death due to HS using the combination of these three factors was 0.928, with a sensitivity of 82.5% and a specificity of 91.8%. The calibration curve and the decision-curve analysis showed that the new nomogram had better accuracy and potential application value in predicting the prognosis of HS patients.</p><p><strong>Conclusion: </strong>A nomogram with these three indicators in combination-APACHE II score, lactate-to-albumin ratio, and core temperature at 30 minutes after admission-can be used to predict 30-day mortality of heatstroke patients.</p>","PeriodicalId":23682,"journal":{"name":"Western Journal of Emergency Medicine","volume":"26 3","pages":"657-666"},"PeriodicalIF":1.8,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498145","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}