Journal of Critical Care Medicine最新文献

{"title":"Age-related differences in sepsis outcomes: A comparative analysis of elderly and very elderly ICU patients.","authors":"Ozgur Kilic, Enver Demircan","doi":"10.2478/jccm-2025-0034","DOIUrl":"10.2478/jccm-2025-0034","url":null,"abstract":"<p><strong>Background: </strong>The rapid aging of the global population has amplified the clinical and economic burden of sepsis, a leading cause of morbidity and mortality in the elderly. Within this demographic, the \"very elderly\" (≥80 years) represent a particularly vulnerable subgroup. This study evaluates and compares the outcomes and prognostic factors of elderly (65-79 years) and very elderly ICU patients with sepsis or septic shock.</p><p><strong>Methods: </strong>A retrospective observational study was conducted in a single-center ICU, including 251 patients aged ≥65 years diagnosed with sepsis or septic shock. Patients were categorized as elderly (65-79 years, N=162) or very elderly (≥80 years, N=89). Data on demographics, comorbidities, laboratory results, infection sources, treatments, and outcomes were collected. Prognostic factors for mortality were analyzed using binary logistic regression.</p><p><strong>Results: </strong>The very elderly group exhibited higher rates of dementia, immobility, and fungal infections, while malignancy was more prevalent in the elderly group. ICU length of stay was longer in the very elderly group (median 8 vs. 6 days, P=0.027). ICU mortality was lower in the very elderly group, showing a trend toward significance but not reaching statistical significance (70.8% vs. 82.1%, P=0.056). Shared predictors of mortality included higher SOFA scores, malignancy, hospital-acquired sepsis, invasive mechanical ventilation, and acute kidney injury.</p><p><strong>Conclusion: </strong>This study highlights differences in sepsis outcomes between elderly and very elderly patients. The findings underscore the importance of developing and implementing age-specific management strategies to improve outcomes in these high-risk populations. These insights contribute to a more tailored and effective approach to geriatric critical care.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"11 4","pages":"337-346"},"PeriodicalIF":1.7,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12592921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145483218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of protein intervention timings on critically ill patients: A systematic review and meta- analysis.","authors":"Pranav Kumar Sharma, Sanjiya Arora, Tirth Bhavsar, Mamta Kamboj, Rahul Kamboj, Varnika Gupta, Anitha Sigamani Ramamurthi, Kumari Uthayakumar, Ajay Singh, Sachin Mahendrakumar Chaudhary, Arghadip Das, Arianisa Bajrami, Sumesh Singh, Devendra Tripathi","doi":"10.2478/jccm-2025-0047","DOIUrl":"10.2478/jccm-2025-0047","url":null,"abstract":"<p><strong>Background: </strong>Critically ill patients experience metabolic alterations that promote muscle atrophy and protein catabolism, increasing morbidity and mortality. While adequate protein provision is essential, the optimal timing remains controversial. Guidelines recommend higher protein targets, but evidence from randomized controlled trials is limited and inconsistent.</p><p><strong>Aim: </strong>To evaluate the effects of early versus late protein supplementation on mortality, complications, and clinical outcomes in critically ill patients.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted using PubMed, Embase, Cochrane Library, and Google Scholar (January 2010-December 2022). Studies comparing early and late protein administration in adult ICU patients were included. Primary outcomes were mortality, infectious complications, overall complications, pneumonia, ICU/hospital length of stay, and mechanical ventilation duration.</p><p><strong>Results: </strong>Thirteen studies (8 RCTs, 3 retrospective, 2 prospective cohorts) involving 10,672 patients were analyzed. Mortality (RR = 0.87, 95% CI: 0.74-1.04, p = 0.11; I² = 36%), overall complications (RR = 0.87, 95% CI: 0.74-1.02, p = 0.08; I² = 26%), infectious complications (RR = 0.86, 95% CI: 0.58-1.27, p = 0.37; I² = 65%), and pneumonia (RR = 0.78, 95% CI: 0.41-1.48, p = 0.34; I² = 0%) showed no significant differences between early protein (EP) and late protein (LP) groups. EP significantly reduced ICU length of stay (MD = -0.28 days, 95% CI: -0.33 to -0.23, p < 0.00001; I² = 99%) and mechanical ventilation duration (MD = -0.66 days, 95% CI: -0.90 to -0.41, p < 0.00001; I² = 85%), but was associated with a longer hospital stay (MD = 0.47 days, 95% CI: 0.31-0.63, p < 0.00001; I² = 98%).</p><p><strong>Conclusion: </strong>Early protein supplementation does not significantly affect mortality or major complications but may shorten ICU stay and ventilation duration. High heterogeneity for some outcomes warrants cautious interpretation.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"11 4","pages":"323-336"},"PeriodicalIF":1.7,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12592978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145483234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complication patterns and postoperative outcomes in surgical patients admitted to intensive care units.","authors":"Caroline Tolentino Sanches, Silvia Paulino Ribeiro Albanese, Monique Elen Robuste, Gabriela Gomes da Silva, Marcos Toshiyuki Tanita, Cintia Grion","doi":"10.2478/jccm-2025-0044","DOIUrl":"10.2478/jccm-2025-0044","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the frequency and types of postoperative complications and risk factors for in-hospital mortality.</p><p><strong>Methods: </strong>This retrospective longitudinal study included adult patients who underwent surgical procedures and were admitted to the intensive care unit of a university hospital between March and July 2022. Study variables included sociodemographic, clinical, and epidemiological data; postoperative complications and hospital outcomes. The significance level was set at 5%.</p><p><strong>Results: </strong>We analyzed 202 patients, with a median age of 67 years (IQR 55-74) and a predominance of males (62.4%). Inhospital mortality was 26.2%. Postoperative complications occurred in 84.7% of patients, with cardiovascular (53.4%), infectious (49.5%), and gastrointestinal (48.5%) complications being the most frequent. Early postoperative feeding was initiated in 34.2% of cases, and a delay was associated with a higher risk of complications. Nausea and vomiting prophylaxis were administered to most patients-intraoperatively in 61.9% and postoperatively in 96%. In logistic regression analysis, female sex, urgent surgery, and higher SAPS 3 scores were identified as independent risk factors for death.</p><p><strong>Conclusions: </strong>Postoperative complications were highly prevalent and associated with an increased risk of death. Intra-operative nausea and vomiting prophylaxis and early postoperative feeding were associated with a lower frequency of complications. Identified risk factors for mortality included female sex, higher SAPS 3 scores, and urgent surgeries.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"11 4","pages":"367-375"},"PeriodicalIF":1.7,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12592923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145483280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of the implementation of a selective digestive decontamination protocol in an intensive care unit.","authors":"Rosario Fernández-Fernández, Eugenia Yuste-Ossorio, Natalia Chueca-García, Purificación Fernández-Morales, Rocio Morón-Romero, Manuel Colmenero","doi":"10.2478/jccm-2025-0025","DOIUrl":"10.2478/jccm-2025-0025","url":null,"abstract":"<p><strong>Introduction: </strong>The use of selective digestive decontamination (SDD) in critically ill patients remains controversial. The impact of antimicrobial resistance varies according to multiple factors attributed to the type of patient and the characteristics of intensive care units (ICU).</p><p><strong>Aim of the study: </strong>to describe the effect of the implementation of a selective digestive decontamination protocol on the incidence of nosocomial infections and colonization of multidrug-resistant organisms (MDRO) in an intensive care unit.</p><p><strong>Materials and methods: </strong>Prospective observational study in a general ICU of a University Hospital. All patients admitted for 2 years (divided into 1-year periods) before and after the implementation of the SDD were included. This intervention was performed in all patients who received invasive mechanical ventilation in the second period. Incidence density rates were determined for all nosocomial infections (per days of stay) and device-associated infections (per days of use), and risk ratio (RR) were calculated with 95% confidence intervals. Microbiological surveillance of the colonization status of patients was performed on admission and on a weekly basis. A univariate analysis was performed for comparison between groups. A p<0.05 was considered significant.</p><p><strong>Results: </strong>A total of 1532 patients were included in the pre-intervention period (pre-SDD) and 1734 in the post-intervention period (post-SDD). The incidence of all infections decreased [9.21 vs 6.54 per days of stay; RR: 0,71 (0,428 - 1,172), p=0,16], although not significantly. Both catheter-related bacteremias and all catheter-related bacteremias together (primary and secondary) were significantly reduced [4.49 vs 0.71 per 1000 days of use; RR: 0,157 (0,017 - 0,723), p=0,006]. The colonization rates by MDRO also decreased (3.26% vs 2.36%), but not significantly.</p><p><strong>Conclusions: </strong>Implementation of SDD significantly decreased the number of catheter-related bacteraemias, without an increase in MDRO colonization.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"11 4","pages":"357-366"},"PeriodicalIF":1.7,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12592849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145483207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe acute respiratory distress syndrome in a woman infected with Ascaris lumbricoides.","authors":"Alexandra Elena Lazar, Mihai Claudiu Pui","doi":"10.2478/jccm-2025-0039","DOIUrl":"10.2478/jccm-2025-0039","url":null,"abstract":"<p><p>Acute Respiratory Distress Syndrome [ARDS] is a critical condition characterized by severe respiratory failure due to widespread lung inflammation, which can arise from various causes including trauma, infections, and systemic diseases. Among the rare causes is infection with Ascaris lumbricoides, a helminth typically affecting the gastrointestinal tract but capable of causing severe respiratory complications. We present the case of a 41-year-old woman with acute respiratory distress and negative viral and bacterial tests, who was ultimately diagnosed with Ascaris lumbricoides-induced ARDS. Her management included mechanical ventilation, antimicrobial therapy, corticosteroids, and eventually anthelmintic treatment after discovering the parasite. Despite initial deterioration and severe hypoxemia, the patient improved significantly following anthelmintic therapy, allowing extubation on day 8 and ICU discharge on day 12. Helminth-induced ARDS, though rare, should be considered in critically ill patients, especially in endemic regions. Early identification and appropriate therapy can dramatically improve outcomes.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"11 4","pages":"435-441"},"PeriodicalIF":1.7,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12593364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145483300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nurses' attitudes and knowledge about organ donation and transplantation in closed hospital wards.","authors":"Anastasios Tzenalis, Elpida Kontesidou, George Kipourgos, Evangelia Andreopoulou, Angelikh Gkotsi, Eleni Albani","doi":"10.2478/jccm-2025-0041","DOIUrl":"10.2478/jccm-2025-0041","url":null,"abstract":"<p><strong>Objective: </strong>Nurses in closed hospital wards, such as Intensive Care and isolation units, play a pivotal role in identifying potential donors and supporting families during sensitive decision-making moments. However, gaps in knowledge or negative attitudes among nurses can hinder donation efforts. This study aims to explore the knowledge and attitudes of closed-ward nurses regarding organ donation and transplantation, providing insights to enhance education, advocacy, and clinical practices in these critical settings.</p><p><strong>Methods: </strong>Modern analysis was performed on the data collected from questionnaires distributed to nurses of … General Hospital. The study involved 108 nurses. The questionnaire used to collect the data was provided by the Department of Social Work of the … University and distributed in electronic form to hospital nurses.</p><p><strong>Results: </strong>After analyzing the nurses' responses, it emerged that 85.19% of nurses are positive about the idea of organ donation and declare themselves willing to become donors, motivated by their will to really help their fellow human beings. In contrast, 5.56% said they would not be willing to donate. The main cause of their refusal seems to be fear and the prejudices they have, but also the fact that there is no trust in the organizations responsible for transplants. Finally, regarding the knowledge of the nurses who participated in the survey, the average knowledge score on the scale 0-100 is 72.</p><p><strong>Conclusions: </strong>There is a clear need for specialized training for nurses managing organ donation. The emotional burden and responsibilities they face are significant. Enhanced training supports their well-being and ensures a more compassionate, efficient process for donors and families, ultimately improving the experience for all involved.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"11 4","pages":"409-416"},"PeriodicalIF":1.7,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12592922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145483286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiological insights into carbapenem resistant infections in critical care settings: A molecular and clinical investigation.","authors":"Camelia Vintila, Razvan Lucian Coseriu, Alexandru Andrei Ujlaki Nagi, Adrian Man","doi":"10.2478/jccm-2025-0048","DOIUrl":"10.2478/jccm-2025-0048","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the prevalence and genetic relatedness of multidrug-resistant Gram-negative bacilli, particularly those resistant to carbapenems, in patients admitted to intensive care units. It also sought to explore associations between bacterial colonization or infection and clinical outcomes, including comorbidities, treatment regimens, and mortality.</p><p><strong>Methods: </strong>Between November 2022 and December 2023, screening and pathological samples were collected from patients at a tertiary hospital. Screening samples included rectal and pharyngeal swabs, while pathological samples comprised respiratory tract secretions. Bacterial identification and antibiotic susceptibility testing were performed using standard microbiological methods. Genetic similarity among isolates was assessed using a molecular fingerprinting technique to detect potential clonal spread.</p><p><strong>Results: </strong>A total of 62 carbapenem-resistant strains were identified, with Acinetobacter baumannii and Klebsiella pneumoniae being the most prevalent. Pathological isolates exhibited higher resistance levels than screening isolates. Most patients had multiple comorbidities, with cardiac, renal, and pulmonary conditions being the most common. A significant association was found between prolonged intensive care unit stay and increased mortality. However, no significant correlation was observed between the number of comorbidities or antibiotic classes used and mortality. Molecular analysis revealed clonal clusters of Acinetobacter and Klebsiella strains, suggesting nosocomial transmission.</p><p><strong>Conclusions: </strong>The findings underscore the importance of early screening, molecular surveillance, and stringent infection control measures in intensive care settings.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"11 4","pages":"347-356"},"PeriodicalIF":1.7,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12592977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145483292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative analysis of COVID-19 critically ill patients across four pandemic waves in Greece.","authors":"Stelios Kokkoris, Aikaterini Goufa, Dimitrios Tsilivarakis, Fotios Kavallieratos, Georgia Minatsi, Despoina Papadaki, Aikaterini Pranti, Spyros Zakynthinos, Anastasia Kotanidou, Christina Routsi","doi":"10.2478/jccm-2025-0036","DOIUrl":"10.2478/jccm-2025-0036","url":null,"abstract":"<p><strong>Introduction: </strong>There is limited information about trends in mortality of intensive care unit (ICU) patients with Coronavirus Disease-2019 (COVID-19) throughout the entire pandemic period.</p><p><strong>Aim: </strong>We compared the ICU mortality among the four consecutive waves of the pandemic, according to the virus variant predominance.</p><p><strong>Methods: </strong>This is a retrospective study of prospectively collected data extracted from our COVID-19 clinical database. All adult patients with confirmed SARS-CoV-2 infection, consecutively admitted to our ICU from March 2020 through April 2022, were included. For the analysis we used the dates of the four periods of the pandemic, according to the predominance of different SARS-CoV-2 variants in Greece. Kaplan-Meier and Cox proportional hazards analyses were used.</p><p><strong>Results: </strong>In total, 805 patients [median (IQR) age 67 (56-76) years, 68% males] were included. APACHE II, Charlson, and SOFA scores were 14 (11-19), 3 (2-5) and 7 (4-9), respectively; 674 (84%) patients required invasive mechanical ventilation. ICU length of stay was 15 (8-29) days, and mechanical ventilation duration was 11 (4-24) days. ICU and hospital mortality was 48% and 54%, respectively. Kaplan-Meier survival curves revealed no significant differences in ICU mortality among the four waves. Age, malignancy, chronic pulmonary disease and SOFA score were independent predictors of ICU mortality, but the pandemic waves themselves were not. Age had a significant impact on ICU mortality across all waves.</p><p><strong>Conclusion: </strong>The effect of COVID-19 wave (and consequently of the SARS- CoV-2 variant) on ICU mortality seems to be trivial, and therefore our focus should be shifted to other risk factors, such as age and comorbidities. These findings along with those of other studies could be useful for modelling the evolution of future outbreaks.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"11 4","pages":"417-428"},"PeriodicalIF":1.7,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12593355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145483266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe acute respiratory syndrome coronavirus 2 infection and West Nile encephalitis in a patient with chronic kidney disease.","authors":"Vince Akos Andrejkovits, Alexandra Ioana Asztalos, Nina Ioana Bodnar, Erzsebet Iringo Zaharia-Kezdi, Anca Meda Vasiesiu","doi":"10.2478/jccm-2025-0040","DOIUrl":"10.2478/jccm-2025-0040","url":null,"abstract":"<p><strong>Objective: </strong>We describe a peculiar combination of West Nile virus (WNV) and SARS-CoV-2 infection, suggesting crucial clinical implications for diagnosis and management.</p><p><strong>Case report: </strong>We present a case of a 57-year-old woman with a past medical history of end-stage renal disease (ESRD), on chronic hemodialysis, and arterial hypertension. She was admitted to the hospital for a 5-day history of fever, headache, vomiting, psychomotor slowing, a diffuse tremor on the four limbs, and diarrhea. Evaluation revealed the presence of neutrophilic leukocytosis, hemoglobin level of 10.5g/dL, elevated C-reactive protein (60 mg/L), serum creatinine of 13.4 mg/dL with hyperkaliemia. Neurologic examination described the following findings: neck stiffness, confusion with motor aphasia, bradylalia, bradypsychia, global hyperreflexia, diffuse tremor, and unstable gait. Brain CT described a calcified temporo-lateral meningioma, CSF examination revealed colorless appearing, 560 leucocytes/3microL (97% lymphocytes), 848 mg/L proteins, glycorrhachia: 54 mg/dL (serum glucose: 101 mg/dL), and the multiplex Real-Time PCR test result was negative. On the second day of admission, the patient tested positive for COVID-19 and she was commenced on therapy with remdesivir, ceftriaxone, dexamethasone, and clexane. Adequate hemodialysis sessions were performed. On the eighth day of admission, the diagnosis of WNV infection was made based on the positive serological findings and the presence of IgM antibodies in the cerebrospinal fluid. After 15 days of hospitalization, the patient was discharged in good clinical condition, except for mild tremor in her limbs.</p><p><strong>Conclusions: </strong>Periodic epidemic bursts of WNV infection have been reported in Mures County, but present coinfection is rare; the severity and prognosis of the disease are unforeseeable.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"11 4","pages":"429-434"},"PeriodicalIF":1.7,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12593358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145483302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidental hyperglycemia and myocardial infarction risk in non-diabetic patients in the emergency department: A retrospective cohort analysis.","authors":"Erkan Boğa","doi":"10.2478/jccm-2025-0033","DOIUrl":"10.2478/jccm-2025-0033","url":null,"abstract":"<p><strong>Objective: </strong>This study investigated whether incidental hyperglycemia serves as an independent risk factor for myocardial infarction (MI) among non-diabetic patients in the emergency department.</p><p><strong>Methods: </strong>A retrospective case-control study analyzed data from one thousand non-diabetic patients aged 18-85 years who visited the emergency department during January through October two thousand twenty-four Patients were classified into two equal groups based on their random blood glucose levels: patients with glucose levels above 140 mg/dL formed the hyperglycemia group and patients with glucose levels below 140 mg/dL belonged to the normoglycemia group. The analysis employed logistic regression to assess how hyperglycemia related to MI while controlling for various demographic and clinical variables.</p><p><strong>Results: </strong>The incidence of MI was found in 61.4% of patients with hyperglycemia but only in 25.8% of patients with normoglycemia. Multivariable analysis revealed that incidental hyperglycemia increased the odds of MI by 2.42 times. The risk was higher among male patients and further increased when glucose levels exceeded 180 mg/dL.</p><p><strong>Conclusions: </strong>Non-diabetic emergency department patients who experience incidental hyperglycemia show a high risk of developing MI. The evaluation of cardiovascular risk should begin with emergency physicians, who should consider elevated random blood glucose as a potential marker for identifying patients likely to benefit from early assessment and follow-up.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"11 4","pages":"383-388"},"PeriodicalIF":1.7,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12593357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145483216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}