World journal of emergency medicine最新文献

{"title":"Duplicated gallbladder with acute cholecystitis: a case of unusual presentation and diagnostic challenges.","authors":"Eren Ogut, Fatos Belgin Yildirim, Osman Memis","doi":"10.5847/wjem.j.1920-8642.2024.021","DOIUrl":"10.5847/wjem.j.1920-8642.2024.021","url":null,"abstract":"","PeriodicalId":23685,"journal":{"name":"World journal of emergency medicine","volume":"15 2","pages":"156-158"},"PeriodicalIF":2.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10925538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140111518","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":"Evaluation of disease burden and symptom scores in patients with acute atrial fibrillation in the emergency department.","authors":"Nikola Schütz, Dominik Roth, Michael Prinz, Filippo Cacioppo, Sebastian Schnaubelt, Alexander O Spiel, Hans Domanovits, Harald Herkner","doi":"10.5847/wjem.j.1920-8642.2024.075","DOIUrl":"https://doi.org/10.5847/wjem.j.1920-8642.2024.075","url":null,"abstract":"","PeriodicalId":23685,"journal":{"name":"World journal of emergency medicine","volume":"15 5","pages":"397-400"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11402876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296701","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":"Comparing 11 early warning scores and three shock indices in early sepsis prediction in the emergency department.","authors":"Rex Pui Kin Lam, Zonglin Dai, Eric Ho Yin Lau, Carrie Yuen Ting Ip, Ho Ching Chan, Lingyun Zhao, Tat Chi Tsang, Matthew Sik Hon Tsui, Timothy Hudson Rainer","doi":"10.5847/wjem.j.1920-8642.2024.052","DOIUrl":"https://doi.org/10.5847/wjem.j.1920-8642.2024.052","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the discriminatory performance of 11 vital sign-based early warning scores (EWSs) and three shock indices in early sepsis prediction in the emergency department (ED).</p><p><strong>Methods: </strong>We performed a retrospective study on consecutive adult patients with an infection over 3 months in a public ED in Hong Kong. The primary outcome was sepsis (Sepsis-3 definition) within 48 h of ED presentation. Using c-statistics and the DeLong test, we compared 11 EWSs, including the National Early Warning Score 2 (NEWS2), Modified Early Warning Score, and Worthing Physiological Scoring System (WPS), etc., and three shock indices (the shock index [SI], modified shock index [MSI], and diastolic shock index [DSI]), with Systemic Inflammatory Response Syndrome (SIRS) and quick Sequential Organ Failure Assessment (qSOFA) in predicting the primary outcome, intensive care unit admission, and mortality at different time points.</p><p><strong>Results: </strong>We analyzed 601 patients, of whom 166 (27.6%) developed sepsis. NEWS2 had the highest point estimate (area under the receiver operating characteristic curve [AUROC] 0.75, 95%<i>CI</i> 0.70-0.79) and was significantly better than SIRS, qSOFA, other EWSs and shock indices, except WPS, at predicting the primary outcome. However, the pooled sensitivity and specificity of NEWS2 ≥ 5 for the prediction of sepsis were 0.45 (95%<i>CI</i> 0.37-0.52) and 0.88 (95%<i>CI</i> 0.85-0.91), respectively. The discriminatory performance of all EWSs and shock indices declined when used to predict mortality at a more remote time point.</p><p><strong>Conclusion: </strong>NEWS2 compared favorably with other EWSs and shock indices in early sepsis prediction but its low sensitivity at the usual cut-off point requires further modification for sepsis screening.</p>","PeriodicalId":23685,"journal":{"name":"World journal of emergency medicine","volume":"15 4","pages":"273-282"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11265628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141761275","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":"Epidemiological characteristics of traumatic spinal cord injuries in the intensive care unit from 2018 to 2023: a retrospective hospital-based study.","authors":"Weiting Chen, Haopeng Wu, Jiafei Yu, Lanxing Cao, Gensheng Zhang","doi":"10.5847/wjem.j.1920-8642.2024.085","DOIUrl":"10.5847/wjem.j.1920-8642.2024.085","url":null,"abstract":"<p><strong>Background: </strong>The objective of this retrospective hospital-based study was to describe the epidemiological features of traumatic spinal cord injury (TSCI) in the intensive care unit (ICU) and assess the incidence and possible risk factors for venous thromboembolism (VTE) following TSCI.</p><p><strong>Methods: </strong>We retrospectively reviewed the medical records of 370 patients with TSCI who were admitted between January 2018 and March 2023. The following parameters were collected: age, sex, body mass index, occupation, underlying diseases, smoking history, education level, etiology of injury, injury segments, American Spinal Injury Association (ASIA) Impairment Scale score, severity of injury, injury severity score (ISS), VTE risk score (Caprini score), treatment, VTE prophylaxis, ICU length of stay, length of hospital stay, concomitant injuries, and complications. Descriptive statistics were used to summarize the demographic and clinical characteristics of the study participants. Logistic regression analysis was used to determine the risk factors for VTE.</p><p><strong>Results: </strong>The mean age of patients with TSCI was 55.5 ± 13.4 years, with a male-to-female ratio of 6.5:1. The leading cause of TSCI was falls from height (46.5%), followed by traffic accidents (36.5%). The cervical spinal cord was the most affected segment, followed by the thoracolumbar region. Among all the patients, 362 (97.8%) had concomitant injuries. Complications were observed in 255 patients (68.9%) during hospitalization. The incidence rate of VTE was 25.1%. Logistic regression analysis revealed that age (<i>OR</i>=1.721, 95%<i>CI</i>: 1.207-2.454, <i>P</i>=0.003), mechanical ventilation (<i>OR</i>=3.427, 95%<i>CI</i>: 1.873-6.271, <i>P</i><0.001), and non-use of chemical prophylaxis (<i>OR</i>=2.986, 95%<i>CI</i>: 1.749-5.099, <i>P</i><0.001) were risk factors for VTE.</p><p><strong>Conclusion: </strong>Falls from height and traffic accidents were the main causes of TSCIs in the ICU, especially for male patients with cervical spinal cord injuries. VTE is a frequent complication in patients with TSCI in the ICU. Age, mechanical ventilation, and non-use of chemical prophylaxis were found to be independent risk factors for VTE following TSCI.</p>","PeriodicalId":23685,"journal":{"name":"World journal of emergency medicine","volume":"15 6","pages":"455-464"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11586151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142732393","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":"Infective native aortic aneurysm primarily presenting as gastrointestinal bleeding: a case report.","authors":"Xinyu Zhang, Yuhong Mi","doi":"10.5847/wjem.j.1920-8642.2024.097","DOIUrl":"10.5847/wjem.j.1920-8642.2024.097","url":null,"abstract":"","PeriodicalId":23685,"journal":{"name":"World journal of emergency medicine","volume":"15 6","pages":"514-516"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11586143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142732622","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":"Analysis of risk factors for trauma-induced coagulopathy in elderly major trauma patients.","authors":"Yangbo Kang, Qi Yang, Hongbo Ding, Yufeng Hu, Jiasheng Shen, Feng Ruan, Bojin Chen, Yiping Feng, Yuchen Jin, Shanxiang Xu, Libing Jiang, Guirong Wang, Yong'an Xu","doi":"10.5847/wjem.j.1920-8642.2024.093","DOIUrl":"10.5847/wjem.j.1920-8642.2024.093","url":null,"abstract":"<p><strong>Background: </strong>Trauma-induced coagulopathy (TIC) due to serious injuries significantly leads to increased mortality and morbidity among elderly patients. However, the risk factors of TIC are not well elucidated. This study aimed to explore the risk factors of TIC in elderly patients who have major trauma.</p><p><strong>Methods: </strong>In this retrospective study, the risk factors for TIC in elderly trauma patients at a single trauma center were investigated between January 2015 and September 2020. The demographic information including gender, age, trauma parts, injury severity, use of blood products, use of vasopressors, need of emergency surgery, duration of mechanical ventilation, length of stay in the intensive care unit (ICU) and hospital, and clinical outcomes were extracted from electric medical records. Multivariate logistic regression analysis was performed to differentiate risk factors, and the performance of the model was evaluated using receiver operating characteristics (ROC) curves.</p><p><strong>Results: </strong>Among the 371 elderly trauma patients, 248 (66.8%) were male, with the age of 72.5 ± 6.8 years, median injury severity score (ISS) of 24 (IQR: 17-29), and Glasgow coma score (GCS) of 14 (IQR: 7-15). Of these patients, 129 (34.8%) were diagnosed with TIC, whereas 242 (65.2%) were diagnosed with non-TIC. The severity scores such as ISS (25 [20-34] vs. 21 [16-29], <i>P</i><0.001) and shock index (SI), (0.90±0.66 vs. 0.58 ± 0.18, <i>P</i><0.001) was significantly higher in the TIC group than in the non-TIC group. Serum calcium levels (1.97±0.19 mmol/L vs. 2.15±0.16 mmol/L, <i>P</i><0.001), fibrinogen levels (1.7±0.8 g/L vs. 2.8±0.9 g/L, <i>P</i><0.001), and base excess (BE, -4.9±4.6 mmol/L vs. -1.2 ± 3.1 mmol/L, <i>P</i><0.001) were significantly lower in the TIC group than in the non-TIC group. Multivariate logistic regression analysis revealed that ISS>16 (<i>OR</i>: 3.404, 95%<i>CI</i>: 1.471-7.880; <i>P=</i>0.004), SI>1 (<i>OR</i>: 5.641, 95%<i>CI</i>: 1.700-18.719; <i>P</i>=0.005), low BE (<i>OR</i>: 0.868, 95%<i>CI</i>: 0.760-0.991; <i>P</i>=0.037), hypocalcemia (<i>OR</i>: 0.060, 95%<i>CI</i>: 0.009-0.392; <i>P</i>=0.003), and hypofibrinogenemia (<i>OR</i>: 0.266, 95%<i>CI</i>: 0.168-0.419; <i>P</i><0.001) were independent risk factors for TIC in elderly trauma patients. The AUC of the prediction model included all these risk factors was 0.887 (95%<i>CI</i>: 0.851-0.923) with a sensitivity and specificity of 83.6% and 82.6%, respectively.</p><p><strong>Conclusion: </strong>Higher ISS (more than 16), higher SI (more than 1), acidosis, hypocalcemia, and hypofibrinogenemia emerged as independent risk factors for TIC in elderly trauma patients.</p>","PeriodicalId":23685,"journal":{"name":"World journal of emergency medicine","volume":"15 6","pages":"475-480"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11586144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142733098","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":"Assessment of rehabilitation treatment for patients with acute poisoning-induced toxic encephalopathy.","authors":"Hao Wu, Yu Zhou, Baogen Xu, Wen Liu, Jinquan Li, Chuhan Zhou, Hao Sun, Yu Zheng","doi":"10.5847/wjem.j.1920-8642.2024.095","DOIUrl":"10.5847/wjem.j.1920-8642.2024.095","url":null,"abstract":"<p><strong>Background: </strong>Poisoned patients often suffer damage to multiple systems, and those experiencing central nervous system disorders present more severe conditions, prolonged hospital stays, and increased mortality rates. We aimed to assess the efficacy of rehabilitation interventions for patients with toxic encephalopathy.</p><p><strong>Methods: </strong>This retrospective, observational, comparative cohort study was performed at the teaching hospital affiliated of Nanjing Medical University, from October 2020 to December 2022. Patients who met the diagnostic criteria for toxic encephalopathy and exclusion criteria were included, and patients were divided into three subgroups according to Glasgow Coma Scale (GCS). Demographic and clinical characteristics were collected. The effect of the rehabilitation intervention on patients were assessed in the improvement of consciousness status (Glasgow Coma Scale [GCS] score), muscle strength and movement and swallowing function (Fugl-Meyer Assessment [FMA] scale, Water Swallow Test [WST], and Standardized Swallowing Assessment [SSA]). Subgroup analysis was based on different toxic species.</p><p><strong>Results: </strong>Out of the 464 patients with toxic encephalopathy, 184 cases received rehabilitation treatments. For the severe toxic encephalopathy patients, patients without rehabilitation intervention have a 2.21 times higher risk of death compared to patients with rehabilitation intervention (Hazard ratio [<i>HR</i>]=2.21). Subgroup analysis revealed that rehabilitation intervention significantly increased the survival rate of patients with pesticide poisoning (<i>P</i>=0.02), while no significant improvement was observed in patients with drug/biological agent poisoning (<i>P</i>=0.44). After rehabilitation intervention, significant improvement in GCS and FMA were observed in severe patients with toxic encephalopathy (<i>P</i><0.01).</p><p><strong>Conclusion: </strong>Active rehabilitation intervention for patients exposed to poisons that can potentially cause toxic encephalopathy may improve the prognosis and reduce the mortality rate in clinical practice.</p>","PeriodicalId":23685,"journal":{"name":"World journal of emergency medicine","volume":"15 6","pages":"441-447"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11586154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142733099","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":"Effect of sphygmomanometer cuff pressure on the differentiation of veins from arteries on ultrasound imaging: an observational cross-sectional study.","authors":"Marechika Tsubouchi, Ryohei Matsui, Mami Tsubota, Yota Yamagishi, Yuka Miyazaki, Hideki Murakami, Tomonori Hattori, Hiroshi Sasano","doi":"10.5847/wjem.j.1920-8642.2024.073","DOIUrl":"10.5847/wjem.j.1920-8642.2024.073","url":null,"abstract":"<p><strong>Background: </strong>Ultrasound guidance is commonly used for accessing difficult peripheral veins. For successful access, a tourniquet is required for venodilation. Tourniquets decrease the compressibility and increase the diameter of veins; they also obfuscate artery-vein differentiation on ultrasound. We aimed to establish the upper limit of sphygmomanometer cuff pressure that facilitates artery-vein differentiation during ultrasound-guided peripheral intravenous access.</p><p><strong>Methods: </strong>We employed the sphygmomanometer cuff as a tourniquet for venodilation and tested it on seven participants at six different levels as follows: 0 mmHg, DBP/2, DBP, (DBP+SBP)/2, SBP, and SBP+20 mmHg. We used an ultrasound probe attached to a pressure-measuring instrument to record cross-sectional images of the cubital artery and vein. During ultrasonography, compression was applied to the blood vessels through the skin. The following day, we measured the wrist pulse pressure and observed the oximeter pulse wave at six different tourniquet pressure levels. Repeated-measures analysis of variance (ANOVA) on ranks and Tukey's post-hoc analysis were used for multiple comparisons.</p><p><strong>Results: </strong>Arterial pulsation was maintained at tourniquet pressures between 0 mmHg and (DBP+SBP)/2. However, arterial pulsation decreased or disappeared when the tourniquet pressure reached or exceeded the SBP. Moreover, at this pressure level, the superior compressibility of veins compared to that of arteries was no longer observed. Compression of the artery to 75% and 50% of its original diameter increased arterial pulsation.</p><p><strong>Conclusion: </strong>Arterial pulsation and the superior compressibility are useful indicators for differentiating veins from arteries until the tourniquet pressure reaches (DBP+SBP)/2. However, these indicators are not reliable once the tourniquet pressure exceeds the SBP.</p>","PeriodicalId":23685,"journal":{"name":"World journal of emergency medicine","volume":"15 6","pages":"448-454"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11586153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142732346","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":"Mutual promotion of mitochondrial fission and oxidative stress contributes to mitochondrial-DNA-mediated inflammation and epithelial-mesenchymal transition in paraquat-induced pulmonary fibrosis.","authors":"Jie Zhang,&nbsp;Wen-Jing Li,&nbsp;Shi-Qiang Chen,&nbsp;Ze Chen,&nbsp;Chen Zhang,&nbsp;Ran Ying,&nbsp;Hong-Bing Liu,&nbsp;Long-Wang Chen,&nbsp;Ya-Hui Tang,&nbsp;Zhong-Qiu Lu,&nbsp;Guang-Ju Zhao","doi":"10.5847/wjem.j.1920-8642.2023.057","DOIUrl":"https://doi.org/10.5847/wjem.j.1920-8642.2023.057","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary fibrosis (PF) is one of the main causes of death in patients with paraquat (PQ) poisoning. This study aimed to evaluate the relationship between mitochondrial fission and oxidative stress in PQ-induced epithelial-mesenchymal transition (EMT) and PF.</p><p><strong>Methods: </strong>C57BL/6 mice and MLE-12 cells were exposed to PQ to construct a PF model <i>in vivo</i> and <i>in vitro</i>. Histological changes in the lungs were examined by hematoxylin and eosin (H&E) staining. Mitochondrial morphology was detected by MitoTracker^® Deep Red FM or transmission electron microscopy (TEM). Western blotting and immunofluorescence were used to determine the expression of protein. The migration ability of the cells was detected by the cell scratch test. Mitochondrial DNA (mtDNA) levels were assessed by real-time polymerase chain reaction (PCR). Enzyme-linked immunosorbent assay (ELISA) was applied to detect cytokine levels. Superoxide dismutase (SOD) activity and the levels of glutathione (GSH) and malondialdehyde (MDA) were detected by chemichromatometry.</p><p><strong>Results: </strong>PQ exposure caused EMT and PF <i>in vivo</i> and <i>in vitro</i>. PQ destroyed mitochondrial structure and enhanced the expression of dynamin-related protein 1 (Drp1), which were accompanied by oxidative stress. Inhibiting mitochondrial fission using mitochondrial division inhibitor-1 (Mdivi-1), a selective inhibitor of Drp1, attenuated PQ-induced EMT and oxidative damage. Treatment with N-acetyl-L-cysteine (NAC), an antioxidant, reduced Drp1 expression, attenuated mitochondrial structure damage and inhibited PQ-induced EMT and PF. Both Mdivi-1 and NAC treatment markedly suppressed mtDNA release, the expression of Toll-like receptor 9 (TLR9) and phosphorylation (P)-NF-κB p65 as well as cytokines (interleukin 6 [IL-6], interleukin-1β [IL-1β], and tumor necrosis factor-α [TNF-α]) production.</p><p><strong>Conclusion: </strong>Mutual promotion of mitochondrial fission and oxidative stress contributes to EMT in PQ-induced PF, which is associated with the mtDNA/TLR9/NF-κB pathway.</p>","PeriodicalId":23685,"journal":{"name":"World journal of emergency medicine","volume":"14 3","pages":"209-216"},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10156520/pdf/WJEM-14-209.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9423546","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":"Effect of post-rewarming fever after targeted temperature management in cardiac arrest patients: a systematic review and meta-analysis.","authors":"Guang-Qi Guo,&nbsp;Yan-Nan Ma,&nbsp;Shuang Xu,&nbsp;Hong-Rong Zhang,&nbsp;Peng Sun","doi":"10.5847/wjem.j.1920-8642.2023.056","DOIUrl":"https://doi.org/10.5847/wjem.j.1920-8642.2023.056","url":null,"abstract":"<p><strong>Background: </strong>Targeted temperature management (TTM), as a therapeutic temperature control strategy for cardiac arrest (CA), is recommended by guidelines. However, the relationship between post-rewarming fever (PRF) and the prognosis of CA patients is unclear. Therefore, we aim to summarize the studies regarding the influence of PRF on patients with CA.</p><p><strong>Methods: </strong>EMBASE, PubMed, and Cochrane Central databases were searched from inception to March 13, 2022. Randomized clinical trials (RCTs) and cohort studies on PRF in CA patients were included. According to the heterogeneity, the meta-analysis was performed using a random effects model or fixed effects model to calculate the pooled odds ratios (<i>ORs</i>) and corresponding 95% confidence intervals (<i>CI</i> s). The outcome data were unfavorable neurological outcome and mortality.</p><p><strong>Results: </strong>The meta-analysis included 11 observational studies involving 3,246 patients. The results of the meta-analysis show that PRF (body temperature >38.0 °C) has no effect on the neurological outcome of CA patients (<i>OR</i> 0.71, 95% <i>CI</i> 0.43-1.17, <i>I</i> ² 82%) and has a significant relationship with lower mortality (<i>OR</i> 0.63; 95% <i>CI</i> 0.49-0.80, <i>I</i> ² 39%). However, PRF with a stricter definition (body temperature >38.5 °C ) was associated with worse neurological outcome (<i>OR</i> 1.44, 95% <i>CI</i> 1.08-1.92, <i>I</i> ² 45%) and higher mortality (<i>OR</i> 1.71, 95% <i>CI</i> 1.25-2.35, <i>I</i> ² 47%).</p><p><strong>Conclusion: </strong>This study suggests that PRF >38.0 °C may not affect the neurological outcome and have a lower mortality in CA patients who completed TTM. However, PRF >38.5 °C is a potential prognostic factor for worse outcomes in CA patients.</p>","PeriodicalId":23685,"journal":{"name":"World journal of emergency medicine","volume":"14 3","pages":"217-223"},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10156532/pdf/WJEM-14-217.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9430660","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}