World journal of emergency medicine最新文献

{"title":"Long-term cardiovascular outcomes and risk factors in adult sepsis survivors: a systematic review and meta-analysis.","authors":"Zesheng Wu, Fanghui Chen, Chen Xiao, Xue Zhao, Yuansheng Xu, Jinyan Fang, Yinyan Shao","doi":"10.5847/wjem.j.1920-8642.2025.098","DOIUrl":"10.5847/wjem.j.1920-8642.2025.098","url":null,"abstract":"<p><strong>Background: </strong>Sepsis may increase the risk of long-term cardiovascular outcomes. This study aims to investigate association between sepsis survivorship and cardiovascular outcomes and to identify risk factors.</p><p><strong>Methods: </strong>We conducted a comprehensive systematic search of MEDLINE, EMBASE, the Cochrane Library, Wanfang, and CNKI from database inception through May 2025, without language restrictions. The primary outcome was a composite of myocardial infarction, stroke, congestive heart failure, or cardiovascular death. To evaluate the association between sepsis survivors and cardiovascular outcomes, we calculated cumulative incidence rates and hazard ratios (<i>HR</i>s) with corresponding 95% confidence intervals (95% <i>CI</i>s).</p><p><strong>Results: </strong>Twenty-five observational studies comprising 7,525,271 participants were included. The pooled cumulative incidence of major cardiovascular events was 9.0% (95% <i>CI</i>: 6.1%-11.9%), myocardial infarction 2.4% (95% <i>CI</i>: 1.6%-3.1%), stroke 4.9% (95% <i>CI</i>: 3.8%-6.1%), and congestive heart failure 8.6% (95% <i>CI</i>: 4.6%-12.6%). Compared with non-sepsis controls, sepsis survivors had a significantly higher risk of major cardiovascular events (<i>HR</i>: 1.54; 95% <i>CI</i>: 1.32-1.79), myocardial infarction (<i>HR</i>: 1.41; 95% <i>CI</i>: 1.29-1.54), stroke (<i>HR</i>: 1.45; 95% <i>CI</i>: 1.32-1.60), and congestive heart failure (<i>HR</i>: 1.51; 95% <i>CI</i>: 1.46-1.56). Risk factors associated with increased cardiovascular events in sepsis survivors included age ≤ 45 years, male, hyperlipidemia, and multiple comorbidities.</p><p><strong>Conclusion: </strong>Adult sepsis survivors may face significantly increased risks of long-term cardiovascular outcomes. Both common cardiovascular risk factors and sepsis-related pathophysiological changes contribute to this association.</p>","PeriodicalId":23685,"journal":{"name":"World journal of emergency medicine","volume":"16 5","pages":"423-430"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114045","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":"An approach for the emergency diagnosis and treatment of sepsis-associated encephalopathy in elderly individuals: a literature review.","authors":"Wei Gu, Jie Zhong, Chuanzhu Lyu, Guoqiang Zhang, Miaorong Xie, Yuefeng Ma, Wei Guo","doi":"10.5847/wjem.j.1920-8642.2025.0101","DOIUrl":"10.5847/wjem.j.1920-8642.2025.0101","url":null,"abstract":"<p><strong>Background: </strong>Sepsis-associated encephalopathy (SAE) is a diffuse dysfunction of the nervous system resulting from sepsis originating outside the central nervous system. Elderly individuals (≥65 years of age) constitute a particularly vulnerable population comprised by a high burden of underlying diseases and complications, which frequently leads to underdiagnosis or misdiagnosis. These patients are at increased risk of long-term or permanent central nervous system impairment, making rapid and accurate diagnosis and treatment especially critical. The review is expected to promote improvements in the diagnosis and treatment of SAE in elderly patients, ultimately achieving more standardized and efficient SAE management.</p><p><strong>Methods: </strong>We performed a literature search in four databases-PubMed, Embase, China National Knowledge Infrastructure (CNKI), and Wanfang-from inception to April 2025 using bilinguals (Chinese and English).</p><p><strong>Results: </strong>The diagnostic criteria for SAE in elderly individuals include the following: (1) sepsis; (2) new-onset neurological dysfunction; and (3) exclusion of other causes of neurological dysfunction. Physicians should develop tailored empiric anti-infective plans for elderly SAE patients, considering comorbidities, organ function, infection site, local bacterial spectrum, and resistance. The treatment protocol can be adjusted once the pathogen is identified. Stabilizing hemodynamics and ensuring cerebral perfusion are two fluid resuscitation strategies used in elderly SAE patients. An individualized approach to fluid resuscitation using restrictive fluid volumes should be employed. Supportive treatment for elderly SAE patients focuses on improving tissue perfusion/oxygenation, controlling blood glucose levels, and correcting internal imbalances. Early rehabilitation, nutritional support, cognitive training, and family-based emotional support are important components of comprehensive care.</p><p><strong>Conclusion: </strong>The diagnosis and management of SAE in elderly patients support early recognition and timely intervention.</p>","PeriodicalId":23685,"journal":{"name":"World journal of emergency medicine","volume":"16 5","pages":"415-422"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114068","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":"Defining optimal volume of inflation for partial resuscitative endovascular balloon occlusion of the aorta in swine hemorrhagic shock model.","authors":"Shin Ae Lee, Jongwon Ha, Ye Rim Chang","doi":"10.5847/wjem.j.1920-8642.2025.096","DOIUrl":"10.5847/wjem.j.1920-8642.2025.096","url":null,"abstract":"<p><strong>Background: </strong>Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a minimally invasive technique used to control non-compressible torso hemorrhage. However, the optimal degree of partial occlusion that offers maximum therapeutic benefit remains unclear. This study aimed to identify the optimal partial inflation volume for REBOA.</p><p><strong>Methods: </strong>In a swine model of hemorrhagic shock, nine healthy female pigs were randomly assigned to three groups based on balloon inflation volume: 30% (R30), 60% (R60), and 100% (R100) of the volume required to eliminate the contralateral femoral arterial waveform. Hemodynamic variables, fluid and vasopressor requirements, and biochemical markers were evaluated during balloon occlusion and resuscitation following 40% blood volume-controlled hemorrhage.</p><p><strong>Results: </strong>The R30 group showed higher mean arterial pressure during resuscitation and required less fluid and norepinephrine than those of the R100 group. The mean heart rate significantly differed over time among the groups, with more gradual changes in the R30 group. Markers of ischemia-reperfusion injury (lactate, pH, blood urea nitrogen, and creatinine) similarly exhibited significant temporal differences. Post hoc analysis revealed significant pH differences between the groups. The plasma lactate and creatinine levels were significantly lower in the R30 group than those in the other two groups.</p><p><strong>Conclusion: </strong>In this swine hemorrhagic shock model, partial REBOA with 30% balloon inflation maintained hemodynamic stability while reducing metabolic derangement compared with higher ballon volumes of 60% and 100% inflation. A strategy involving partial inflation targeting approximately 30%, followed by monitoring the blood pressure trend while using a vasoconstrictor, if necessary, may have potential clinical utility.</p>","PeriodicalId":23685,"journal":{"name":"World journal of emergency medicine","volume":"16 5","pages":"431-437"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114099","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":"Treatment of cardiac arrest secondary to acute myocardial infarction: combination of emergency half-dose thrombolysis with extracorporeal cardiopulmonary resuscitation.","authors":"Conglong Hu, Hao Hu, Yan Cao, Xiaotong Han","doi":"10.5847/wjem.j.1920-8642.2025.089","DOIUrl":"10.5847/wjem.j.1920-8642.2025.089","url":null,"abstract":"","PeriodicalId":23685,"journal":{"name":"World journal of emergency medicine","volume":"16 5","pages":"505-507"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114103","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":"Accuracy of machine electrocardiogram interpretation and implementation of a de-prioritization protocol in the emergency department.","authors":"Adam K Stanley, Isobel Sonksen, Henry Morgan, Nicola Hilton, Sukhbir Bhullar","doi":"10.5847/wjem.j.1920-8642.2025.087","DOIUrl":"10.5847/wjem.j.1920-8642.2025.087","url":null,"abstract":"","PeriodicalId":23685,"journal":{"name":"World journal of emergency medicine","volume":"16 5","pages":"486-487"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114054","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":"No genetic causal relationship between smoking and acute respiratory distress syndrome: insights from Mendelian randomization and transcriptomics.","authors":"Yan Zhang, Xiaotong Han, Maiying Fan, Siyu Lu, Yuteng Zeng, Zhitong Zhou, Xueyu Xu, Yimin Zhu, Xiquan Yan","doi":"10.5847/wjem.j.1920-8642.2025.076","DOIUrl":"10.5847/wjem.j.1920-8642.2025.076","url":null,"abstract":"","PeriodicalId":23685,"journal":{"name":"World journal of emergency medicine","volume":"16 5","pages":"494-496"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114043","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":"Ventricular aneurysm formation after successful intensive hemoperfusion in chlorfenapyr poisoning: a case report.","authors":"Ruiqiao Zhao, Cuifei Luo, Ping Wang, Yuanqiang Lu","doi":"10.5847/wjem.j.1920-8642.2025.092","DOIUrl":"10.5847/wjem.j.1920-8642.2025.092","url":null,"abstract":"","PeriodicalId":23685,"journal":{"name":"World journal of emergency medicine","volume":"16 5","pages":"511-513"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444229/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114061","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":"A case of colorectal cancer with urinary tract infection induced by bayberry pits.","authors":"Simin Yang, Haoran Li, Yan Xiao","doi":"10.5847/wjem.j.1920-8642.2025.075","DOIUrl":"10.5847/wjem.j.1920-8642.2025.075","url":null,"abstract":"","PeriodicalId":23685,"journal":{"name":"World journal of emergency medicine","volume":"16 5","pages":"514-515"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114076","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 pulse indicated continuous cardiac output monitoring on outcomes of intensive care unit patients with shock: a propensity score matching analysis.","authors":"Danyang Li, Yi Xia, Yangmin Hu, Linlin Du, Tiancha Huang, Chengyang Chen, Yufei Xiao, Leiqing Li, Yang Yu, Shujun Dai, Wei Cui, Huahao Shen","doi":"10.5847/wjem.j.1920-8642.2025.0100","DOIUrl":"10.5847/wjem.j.1920-8642.2025.0100","url":null,"abstract":"<p><strong>Background: </strong>Pulse indicated continuous cardiac output (PiCCO) has largely replaced Swan-Ganz catheterization in shock patients. However, whether PiCCO monitoring can improve outcomes of shock patients, such as mortality, length of hospital stay, duration of mechanical ventilation, or laboratory parameters, remains unknown.</p><p><strong>Methods: </strong>This retrospective cohort study included patients with shock in the intensive care unit (ICU) from January 2013 to January 2020. Patients were divided into PiCCO group and non-PiCCO group based on treatment with PiCCO monitoring or not. Demographic characteristics, Acute Physiology and Chronic Health Evaluation (APACHE) II scores, quick Sequential Organ Failure Assessment (qSOFA) scores, 14-day mortality, and N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels at 0, 1, 3 and 7 days after onset of shock, duration of mechanical ventilation, length of hospital stay and hospitalization costs were compiled and analyzed using propensity score matching (PSM).</p><p><strong>Results: </strong>Real-world analysis of 1,583 ICU patients suffering shock after propensity score matching revealed that 14-day mortality did not differ between PiCCO and non-PiCCO groups (36.2% vs. 32.6%, <i>P</i>=0.343). Duration of mechanical ventilation, hospital stay, and hospitalization costs were also similar between the two groups (<i>P</i>>0.05). No differences in changes of NT-proBNP levels on days 0, 1, 3, and 7 as compared to baseline were noted between the two groups (<i>P</i>>0.05).</p><p><strong>Conclusions: </strong>The results of our real-world indicate that PiCCO monitoring may not shorten the duration of mechanical ventilation, length of hospital stay, or reduce hospitalization costs, nor will it bring survival benefits to ICU patients suffering shock.</p>","PeriodicalId":23685,"journal":{"name":"World journal of emergency medicine","volume":"16 5","pages":"469-474"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114125","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":"Disseminated mucormycosis originating from the stomach.","authors":"Yongli Han, Mengting Liu, Weiping Huang, Hongke Zeng","doi":"10.5847/wjem.j.1920-8642.2025.088","DOIUrl":"10.5847/wjem.j.1920-8642.2025.088","url":null,"abstract":"","PeriodicalId":23685,"journal":{"name":"World journal of emergency medicine","volume":"16 5","pages":"508-510"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114038","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}