Yonsei Medical Journal最新文献

{"title":"Elevated Soluble Suppressor of Tumorigenicity 2 Levels in Gout Patients and Its Association with Cardiovascular Disease Risk Indicators.","authors":"Jiyoung Agatha Kim, Ji Eun Lee, Kunhyung Bae, Sung Soo Ahn","doi":"10.3349/ymj.2024.0001","DOIUrl":"10.3349/ymj.2024.0001","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the association between soluble suppressor of tumorigenicity 2 (sST2) levels and cardiovascular disease predictors in patients with gout.</p><p><strong>Materials and methods: </strong>We retrospectively reviewed the medical records of patients with gout who were tested for sST2 but did not receive uric acid-lowering therapy. These patients were classified into elevated and normal sST2 groups using a cut-off of >49.6 ng/mL and >35.4 ng/mL in males and females, respectively. Correlations between clinical and laboratory variables, sST2 levels, and elevated sST2 level predictors were assessed using linear and logistic regression analyses.</p><p><strong>Results: </strong>Notably, 27 (11.3%) and 211 (88.7%) of the 238 identified patients had elevated and normal sST2 levels, respectively. Linear regression analysis revealed that male sex (β=-0.190, <i>p</i>=0.002), body mass index (BMI) (β=-0.184, <i>p</i>=0.002), white blood cell count (β=0.231, <i>p</i><0.001), C-reactive protein (β=0.135, <i>p</i>=0.031), and fasting blood glucose (β=0.210, <i>p</i><0.001) were independently associated with sST2 levels. In multivariate logistic regression analysis, male sex [odds ratio (OR) 0.112, <i>p</i>=0.001], BMI (OR 0.836, <i>p</i>=0.008), creatinine (OR 5.730, <i>p</i>=0.024), and fasting blood glucose (OR 1.042, <i>p</i>=0.002) predicted elevated sST2 levels. Patients with increased sST2 levels had a significantly higher atherosclerotic cardiovascular disease risk score and a greater proportion of high-risk Framingham Risk Score compared to the normal sST2 group (<i>p</i>=0.002 and <i>p</i><0.001).</p><p><strong>Conclusion: </strong>Patients with gout and elevated sST2 levels have a higher risk of future cardiovascular disorders, which may provide insights into risk stratification and the implementation of intervention strategies.</p>","PeriodicalId":23765,"journal":{"name":"Yonsei Medical Journal","volume":"66 3","pages":"151-159"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11865869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143504535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differences in Treatment Outcomes Depending on the Adjuvant Treatment Modality in Craniopharyngioma.","authors":"Byung Min Lee, Jaeho Cho, Dong-Seok Kim, Jong Hee Chang, Seok-Gu Kang, Eui-Hyun Kim, Ju Hyung Moon, Sung Soo Ahn, Yae Won Park, Chang-Ok Suh, Hong In Yoon","doi":"10.3349/ymj.2023.0566","DOIUrl":"10.3349/ymj.2023.0566","url":null,"abstract":"<p><strong>Purpose: </strong>Adjuvant treatment for craniopharyngioma after surgery is controversial. Adjuvant external beam radiation therapy (EBRT) can increase the risk of long-term sequelae. Stereotactic radiosurgery (SRS) is used to reduce treatment-related toxicity. In this study, we compared the treatment outcomes and toxicities of adjuvant therapies for craniopharyngioma.</p><p><strong>Materials and methods: </strong>We analyzed patients who underwent craniopharyngioma tumor removal between 2000 and 2017. Of the 153 patients, 27 and 20 received adjuvant fractionated EBRT and SRS, respectively. We compared the local control (LC), progression-free survival (PFS), and overall survival between groups that received adjuvant fractionated EBRT, SRS, and surveillance.</p><p><strong>Results: </strong>The median follow-up period was 77.7 months. For SRS and surveillance, the 10-year LC was 57.2% and 57.4%, respectively. No local progression was observed after adjuvant fractionated EBRT. One patient in the adjuvant fractionated EBRT group died owing to glioma 94 months after receiving radiotherapy (10-year PFS: 80%). The 10-year PFS was 43.6% and 50.7% in the SRS and surveillance groups, respectively. The treatment outcomes significantly differed according to adjuvant treatment in non-gross total resection (GTR) patients. Additional treatment-related toxicity was comparable in the adjuvant fractionated EBRT and other groups.</p><p><strong>Conclusion: </strong>Adjuvant fractionated EBRT could be effective in controlling local failure, especially in patients with non-GTR, while maintaining acceptable treatment-related toxicity.</p>","PeriodicalId":23765,"journal":{"name":"Yonsei Medical Journal","volume":"66 3","pages":"141-150"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11865873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143504524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Model for Projecting the Number of Doctors in South Korea.","authors":"Se-Jik Kim","doi":"10.3349/ymj.2024.0400","DOIUrl":"10.3349/ymj.2024.0400","url":null,"abstract":"<p><p>This paper develops a new model for forecasting potential shortfalls in the healthcare sector, providing an economically grounded framework for projections. The model is applied to assess potential doctor shortages in South Korea over the next decade under reasonable economic scenarios. Our analysis indicates that demand for healthcare, driven by aging-related factors, is projected to grow at an annual rate of 1.3% to 1.9%. In contrast, the supply of healthcare-bolstered by technological advancements, improved medical equipment, and natural growth in the doctor workforce-is expected to increase by 3.2% annually. These findings suggest that South Korea's healthcare system is likely to meet future demand without necessitating an expansion of medical school admissions.</p>","PeriodicalId":23765,"journal":{"name":"Yonsei Medical Journal","volume":"66 3","pages":"195-201"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11865876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143504620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Application of New Risk-Adjustment Models to Improve the Current Model for Hospital Standardized Mortality Ratio in South Korea.","authors":"Hyeki Park, Ji-Sook Choi, Min Sun Shin, Soomin Kim, Hyekyoung Kim, Nahyeong Im, Soon Joo Park, Donggyo Shin, Youngmi Song, Yunjung Cho, Hyunmi Joo, Hyeryeon Hong, Yong-Hwa Hwang, Choon-Seon Park","doi":"10.3349/ymj.2023.0545","DOIUrl":"10.3349/ymj.2023.0545","url":null,"abstract":"<p><strong>Purpose: </strong>This study assessed the validity of the hospital standardized mortality ratio (HSMR) risk-adjusted model by comparing models that include clinical information and the current model based on administrative information in South Korea.</p><p><strong>Materials and methods: </strong>The data of 53976 inpatients were analyzed. The current HSMR risk-adjusted model (Model 1) adjusts for sex, age, health coverage, emergency hospitalization status, main diagnosis, surgery status, and Charlson Comorbidity Index (CCI) using administrative data. As candidate variables, among clinical information, the American Society of Anesthesiologists score, Acute Physiology and Chronic Health Evaluation (APACHE) II, Simplified Acute Physiology Score (SAPS) 3, present on admission CCI, and cancer stage were collected. Surgery status, intensive care in the intensive care unit, and CCI were selected as proxy variables among administrative data. In-hospital death was defined as the dependent variable, and a logistic regression analysis was performed. The statistical performance of each model was compared using C-index values.</p><p><strong>Results: </strong>There was a strong correlation between variables in the administrative data and those in the medical records. The C-index of the existing model (Model 1) was 0.785; Model 2, which included all clinical data, had a higher C-index of 0.857. In Model 4, in which APACHE II and SAPS 3 were replaced with variables recorded in the administrative data from Model 2, the C-index further increased to 0.863.</p><p><strong>Conclusion: </strong>The HSMR assessment model improved when clinical data were adjusted. Simultaneously, the validity of the evaluation method could be secured even if some of the clinical information was replaced with the information in the administrative data.</p>","PeriodicalId":23765,"journal":{"name":"Yonsei Medical Journal","volume":"66 3","pages":"179-186"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11865872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143504622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of a Machine Learning Classifier for Predicting Post-Induction Hypotension in Non-Cardiac Surgery.","authors":"Insun Park, Jae Hyon Park, Young Hyun Koo, Chang-Hoon Koo, Bon-Wook Koo, Jin-Hee Kim, Ah-Young Oh","doi":"10.3349/ymj.2024.0020","DOIUrl":"10.3349/ymj.2024.0020","url":null,"abstract":"<p><strong>Purpose: </strong>To develop a machine learning (ML) classifier for predicting post-induction hypotension (PIH) in non-cardiac surgeries.</p><p><strong>Materials and methods: </strong>Preoperative data and early vital signs were obtained from 3669 cases in the VitalDB database, an open-source registry. PIH was defined as sustained mean arterial pressure (MAP) <65 mm Hg within 20 minutes since induction or from induction to incision. Six different ML algorithms were used to create binary classifiers to predict PIH. The primary outcome was the area under the receiver operating characteristic curve (AUROC) of ML classifiers.</p><p><strong>Results: </strong>A total of 2321 (63.3%) cases exhibited PIH. Among ML classifiers, the random forest regressor and extremely gradient boosting regressor showed the highest AUROC, both recording a value of 0.772. Excluding these models, the light gradient boosting machine regressor showed the second highest AUROC [0.769; 95% confidence interval (CI), 0.767-0.771], followed by the gradient boosting regressor (0.768; 95% CI, 0.763-0.772), AdaBoost regressor (0.752; 95% CI, 0.743-0.761), and automatic relevance determination regression (0.685; 95% CI, 0.669-0.701). The top three important features were mean diastolic blood pressure (DBP), minimum MAP, and minimum DBP from anesthetic induction to tracheal intubation, and these features were lower in cases with PIH (all <i>p</i><0.001).</p><p><strong>Conclusion: </strong>ML classifiers exhibited moderate performance in predicting PIH, and have the potential for real-time prediction.</p>","PeriodicalId":23765,"journal":{"name":"Yonsei Medical Journal","volume":"66 3","pages":"160-171"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11865874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143504567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence-Based Early Prediction of Acute Respiratory Failure in the Emergency Department Using Biosignal and Clinical Data.","authors":"Changho Han, Yun Jung Jung, Ji Eun Park, Wou Young Chung, Dukyong Yoon","doi":"10.3349/ymj.2024.0126","DOIUrl":"10.3349/ymj.2024.0126","url":null,"abstract":"<p><strong>Purpose: </strong>Early identification of patients at risk for acute respiratory failure (ARF) could help clinicians devise preventive strategies. Analyzing biosignals with artificial intelligence (AI) can uncover hidden information and variability within time series. We aimed to develop and validate AI models to predict ARF within 72 h after emergency department admission, primarily using high-resolution biosignals collected within 4 h of arrival.</p><p><strong>Materials and methods: </strong>Our AI model, built on convolutional recurrent neural networks, combines biosignal feature extraction and sequence modeling. The model was developed and internally validated with data from 5284 admissions [1085 (20.5%) positive for ARF], and externally validated using data from 144 admissions [7 (4.9%) positive for ARF] from another institution. We defined ARF as the application of advanced respiratory support devices.</p><p><strong>Results: </strong>Our AI model performed well in predicting ARF, achieving area under the receiver operating characteristic curve (AUROC) of 0.840 and 0.743 in internal and external validations, respectively. It outperformed the Modified Early Warning Score (MEWS) and XGBoost models built only with clinical variables. High predictive ability for mortality was observed, with AUROC up to 0.809. A 10% increase in AI prediction scores was associated with 1.44-fold and 1.42-fold increases in ARF risk and mortality risk, respectively, even after adjusting for MEWS and demographic variables.</p><p><strong>Conclusion: </strong>Our AI model demonstrates high predictive accuracy and significant associations with clinical outcomes. Our AI model has the potential to promptly aid in triage decisions. Our study shows that using AI to analyze biosignals advances disease detection and prediction.</p>","PeriodicalId":23765,"journal":{"name":"Yonsei Medical Journal","volume":"66 2","pages":"121-130"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11790410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vitamin D Attenuates Non-Alcoholic Fatty Liver Disease in High-Fat Diet-Induced Obesity Murine Model.","authors":"Sook In Chung, Lin Liang, Heejae Han, Kyung Hee Park, Jae-Hyun Lee, Jung-Won Park","doi":"10.3349/ymj.2024.0038","DOIUrl":"10.3349/ymj.2024.0038","url":null,"abstract":"<p><strong>Purpose: </strong>Obesity and metabolic syndrome are acknowledged as key factors contributing to the development of non-alcoholic fatty liver disease (NAFLD). Vitamin D (VitD) is a multifaceted secosteroid hormone known for its anti-fibrotic and anti-inflammatory properties, with its deficiency often linked to obesity. Our study aimed to investigate whether VitD supplementation could mitigate the liver pathology associated with NAFLD.</p><p><strong>Materials and methods: </strong>The NAFLD model was developed by subjecting male C57BL/6 mice to a high-fat diet (HFD) for 14 weeks. These mice were supplemented with VitD through intraperitoneal injection at a dosage of 7 µg/kg, administered three times per week for 7 weeks.</p><p><strong>Results: </strong>HFD resulted in VitD deficiency, insulin resistance, and increased liver weight. It elevated serum levels of liver aminotransferases and triglyceride, ultimately leading to steatohepatitis with fibrosis. This model exhibited increased levels of transforming growth factor (TGF)-β1, pro-inflammatory cytokines, HNF4α transcription factors, reactive oxygen species (ROS), renin-angiotensin system activity, and epithelial-mesenchymal transitions (EMT) within the liver. Supplementation with VitD resulted in the recovery of liver weight, improvement in histologic features associated with steatohepatitis, and reduction in alanine aminotransferases and triglyceride levels induced by the HFD. Additionally, it mitigated the HFD-induced over-expressions of TGF-β1 and fibrosis-related genes, along with pro-inflammatory cytokines and ROS. Notably, no adverse effect was found due to VitD supplementation in this model.</p><p><strong>Conclusion: </strong>VitD ameliorates steatohepatitis within obesity-induced NAFLD through its multifaceted pathways. VitD supplementation emerges as a potentially safe, cost-effective, and direct treatment approach for NAFLD patients dealing with obesity or metabolic dysfunction.</p>","PeriodicalId":23765,"journal":{"name":"Yonsei Medical Journal","volume":"66 2","pages":"75-86"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11790407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Elderly Patients with Chronic Kidney Disease.","authors":"Yohan Park, Won Min Hwang","doi":"10.3349/ymj.2024.0178","DOIUrl":"10.3349/ymj.2024.0178","url":null,"abstract":"<p><p>Chronic kidney disease (CKD) is highly prevalent among elderly patients, and as the global population ages, the number of elderly patients with CKD is increasing. Elderly patients require additional considerations beyond those required for their younger counterparts, such as comorbidities, frailty, and geriatric syndromes. In this review, we primarily focus on these additional considerations specific to elderly patients and discuss the assessment of CKD and its management strategies, including blood pressure and glycemic control; dyslipidemia, anemia, and electrolyte and metabolic acidosis management; and medication dosage, among others, as well as polypharmacy and nonpharmacological management. Furthermore, the concept of conservative kidney management and the practical recommendations of the Korean Society of Geriatric Nephrology for elderly patients with end-stage kidney disease requiring dialysis therapy are discussed. In particular, the aging rate in Korea is exceptionally high; therefore, it is crucial to pay more attention to the increase in elderly patients with CKD. A more palliative approach, rather than intensive treatment strategies, may be necessary for these patients. In a world with an abundance of information, shared decision-making with patients is of great importance, and it is essential to keep in mind that this holds true for elderly patients as well.</p>","PeriodicalId":23765,"journal":{"name":"Yonsei Medical Journal","volume":"66 2","pages":"63-74"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11790406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conventional versus Instillation Negative-Pressure Wound Therapy for Severe Soft Tissue Injury in Open Pelvic Fractures: A Retrospective Review.","authors":"Donghwan Choi, Won Tae Cho, Hyung Keun Song, Junsik Kwon, Byung Hee Kang, Hohyung Jung, Min Ji Kim, Kyoungwon Jung","doi":"10.3349/ymj.2023.0473","DOIUrl":"10.3349/ymj.2023.0473","url":null,"abstract":"<p><strong>Purpose: </strong>We investigated the clinical features, current negative-pressure wound therapy (NPWT) management strategies, and outcomes of pelvic-perineal soft tissue infection after open pelvic fractures.</p><p><strong>Materials and methods: </strong>We analyzed the data of patients admitted to our trauma center with pelvic-perineal soft tissue after open pelvic fractures over a 7-year period. We investigated the injury severity score (ISS), medical costs, number of NPWTs, time required to reach definite wound coverage, complications, fracture classifications, transfusion requirements, interventions, length of stay (LOS) in hospital and intensive care unit (ICU), and prognosis.</p><p><strong>Results: </strong>Twenty patients with open pelvic fractures were treated with NPWT, and one patient who underwent NPWT died of pelvic sepsis during ICU treatment. The median LOS in hospital and medical costs were 98 [56-164] days and 106400 [65600-171100] USD, respectively. Patients treated with instillation NPWT (iNPWT, n=10) had a shorter NPWT duration (24 [13-39] vs. 46 [42-91] days, <i>p</i>=0.023), time to definite wound coverage (30 [21-43] vs. 49 [42-93] days, <i>p</i>=0.026), and hospital LOS (56 [43-72] vs. 158 [101-192] days, <i>p</i>=0.001), as well as lower medical costs (67800 [42500-102500] vs. 144200 [110400-236000] USD, <i>p</i>=0.009) compared to those treated with conventional NPWT.</p><p><strong>Conclusion: </strong>NPWT is a feasible method for treating pelvic soft tissue infections in patients with open pelvic fractures. iNPWT can reduce the duration of NPWT, hospital LOS, and medical costs.</p>","PeriodicalId":23765,"journal":{"name":"Yonsei Medical Journal","volume":"66 2","pages":"94-102"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11790408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Distal Fusion Level on Sacroiliac Joint Degenerative Change Following Adolescent Idiopathic Scoliosis Surgery.","authors":"Sang-Ho Kim, Jae-Won Shin, Seong-Hwan Moon, Kyung-Soo Suk, Si-Young Park, Byung-Ho Lee, Ji-Won Kwon, Joong Won Ha, Yung Park, Hak-Sun Kim","doi":"10.3349/ymj.2023.0634","DOIUrl":"10.3349/ymj.2023.0634","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the relationship between distal fusion level in correction and fusion surgery for adolescent idiopathic scoliosis (AIS) and radiologic changes in the sacroiliac (SI) joint.</p><p><strong>Materials and methods: </strong>This retrospective cohort study evaluated patients who underwent correction and fusion for AIS between 2005 and 2017 with at least 5 years of follow-up. We categorized patients into two groups: Group 1 (distal fusion above L2, 74 patients) and Group 2 (distal fusion at L3 and below, 52 patients). Radiologic parameters and SI joint changes were evaluated on plain radiographs obtained from preoperative to 5 years postoperatively. We also investigated other risk factors for SI joint change.</p><p><strong>Results: </strong>Analysis of demographic factors revealed no significant difference between the two groups. There was a significant difference in the incidence of SI joint change between Group 1 (5 patients, 6.75%) and Group 2 (18 patients, 34.61%), with Group 2 showing a faster increase in incidence according to the Kaplan-Meier method (<i>p</i><0.0001). Preoperative lumbar lordosis (LL) and ΔLL had a significant relationship with SI joint changes [preoperative LL, hazard ratio (HR)=0.77, 95% confidence interval (CI)=0.64-0.93, <i>p</i>=0.008; ΔLL, HR=0.79, 95% CI=0.67-0.95, <i>p</i>=0.01).</p><p><strong>Conclusion: </strong>After AIS surgery, patients who had fusion to the lower lumbar vertebrae (L3 or L4) experienced a higher incidence and faster progression of degenerative changes in the SI joint. Low preoperative LL and inadequate correction of LL during the operation were also risk factors for SI joint degeneration.</p>","PeriodicalId":23765,"journal":{"name":"Yonsei Medical Journal","volume":"66 2","pages":"103-110"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11790409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}