Archives of Academic Emergency Medicine最新文献

{"title":"Prevalence of acute kidney injury after hematopoietic stem cell transplantation in pediatric populations: a systematic review and meta-analysis.","authors":"Sajjad Jabermoradi, Parsa Paridari, Ainaz Mohammadi, Negini Karim, Mahta Mardani, Mojtaba Fazel, Neamatollah Ataei, Pantea Gharin, Hamzah Adel Ramawad, Mostafa Hosseini, Mahmoud Yousefifard","doi":"10.22037/aaem.v14i1.2254","DOIUrl":"https://doi.org/10.22037/aaem.v14i1.2254","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of acute kidney injury (AKI) associated with hematopoietic stem cell transplantation (HSCT) is well-established in the adult population. Similarly, AKI following HSCT is frequently encountered in the pediatric population. However, adequate information regarding the prevalence among children and adolescents is lacking. We conduct a systematic review to investigate the current literature specifically addressing the prevalence of AKI in children treated with HSCT.</p><p><strong>Method: </strong>An extensive search was performed using Medline, Embase, Scopus, and Web of Science databases until May 5, 2025. We systematically reviewed and included all clinical trials and observational studies. Two independent researchers screened the studies, recorded the required data, and assessed the risk of bias. The studied outcomes included the prevalence of AKI and the need for renal replacement therapy (RRT). The data included were analyzed in the STATA 18.0 statistical program.</p><p><strong>Results: </strong>Forty-nine articles were eligible for inclusion. The prevalence of pediatric AKI after HSCT was 34.18% (95% confidence interval (CI): 28.08 to 40.53; I2=97.79%). The need for RRT following HSCT was equal to 3.54% (95% CI: 1.98 to 5.45; I2= 95.10%). The origin of hematopoietic stem cells and AKI determination cutoff points were found to be the most predictive of AKI prevalence. The prevalence of AKI after transplantation of hematopoietic cells derived from umbilical cord blood was significantly higher than other cell sources (69.55%; 95% CI: 22.23, 100.0).</p><p><strong>Conclusion: </strong>The prevalence of pediatric AKI and RRT after hematopoietic cell transplantation is significant, and is 34.18% and 3.54%, respectively. The highest prevalence of AKI among the different sources of hematopoietic stem cells was observed in cord blood transplantation. However, the available evidence on the prevalence of AKI following the transplantation of hematopoietic stem cells derived from cord blood is insufficient, and more research is needed in this field. As a suggestion, it is recommended to use sources other than hematopoietic cells derived from umbilical cord blood until sufficient evidence is available.</p>","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"14 1","pages":"e6"},"PeriodicalIF":2.0,"publicationDate":"2026-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13265073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148257119","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":"Performance Indicators in Emergency Medical Services: A Scoping Review of Dashboard Applications in the Context of Crisis Management.","authors":"Shiva Karimi, Hassan Emami, Farkhondeh Asadi, Milad Ahmadi Marzaleh, Ali Delpisheh, Mojtaba Pourmehdi","doi":"10.22037/aaem.v14i1.3096","DOIUrl":"https://doi.org/10.22037/aaem.v14i1.3096","url":null,"abstract":"<p><strong>Background: </strong>Emergency medical services (EMS) are critical for responding to crises and mass casualty incidents (MCIs). Rapid decision-making and effective patient flow management are essential for improving survival. Digital technologies-particularly dashboards-enable real-time monitoring of performance indicators and data-driven decision-making. This scoping review aimed to identify and classify key performance indicators (KPIs) used in EMS and to examine the role of dashboards in monitoring these indicators in both routine and crisis conditions.</p><p><strong>Methods: </strong>A systematic search was conducted in PubMed, Scopus, Embase, and Web of Science from inception to January 2026, supplemented by gray literature. Two independent reviewers screened titles/abstracts and full texts. Data were extracted using a standardized form and synthesized narratively in accordance with PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines.</p><p><strong>Results: </strong>Twenty-six studies were included. KPIs were categorized using the Donabedian model into structure (resources), process (response time, triage, coordination), and outcome (survival, satisfaction). Time-based indicators were most frequent. Eight studies (31%) reported dashboards, all in routine operations. Eight studies (31%) used real-time feedback devices (not classified as dashboards), and ten studies (38%) employed other digital tools. Only one study addressed crisis conditions, and it did not use a dashboard.</p><p><strong>Conclusion: </strong>Dashboards are predominantly applied in routine EMS operations, with very limited evidence in crisis contexts. Developing crisis-specific, context-adaptive dashboards and standardized indicators should be prioritized to support decision-making and coordination in emergencies and disasters.</p>","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"14 1","pages":"e50"},"PeriodicalIF":2.8,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13637433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103226","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":"A protocol for Data Registry system for Reconstructive Urology procedures in Iran.","authors":"Jalil Hosseini, Arshia Zamani Hajiabadi, Rayka Sharifian, Samira Shariatpanahi, Somayeh Derakhshan, Seyed Mohamad Sadrameli, Keshvar Samadaee-Gelehkolaee","doi":"10.22037/aaem.v14i1.2888","DOIUrl":"https://doi.org/10.22037/aaem.v14i1.2888","url":null,"abstract":"<p><p>Data registry systems are vital tools for systematically collecting, storing, and analyzing disease-specific data within defined patient populations. This protocol presents a national registry system designed to prospectively collect data on patients undergoing reconstructive urology surgeries in Iran. A web-based registry involving multiple centers across Iran with official collaboration agreements will collect demographic, clinical, surgical, and follow-up data. Patients meeting inclusion criteria are enrolled following informed consent. Data confidentiality and integrity are maintained using a secure software hosted at the Men's Health and Reproductive Health Research Center in Tehran. Standardized clinical questionnaires (IIEF, IPSS, USS_PROM, ICIQ-LUTSqol) and checklists capture patient outcomes prospectively up to 27 months post-surgery. The registry will provide epidemiological insights, monitor treatment outcomes, complications, and clinical improvements, extraction of guidelines, and policy brief, and support collaborative research nationally and internationally. This registration system was designed to achieve evidence-based data with the coherence of patient data for policy-making and therapeutic interventions.</p>","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"14 1","pages":"e48"},"PeriodicalIF":2.8,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13637426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103256","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":"Machine Learning Models for Predicting In-Hospital Mortality and Pressure Ulcer Development following Traumatic Spinal Cord Injury; A Cross-sectional Study.","authors":"Arash Bagherian Ghotbi, Iman Kiani, Ali Golestani, Mohsen Hajiqasemi, Zahra Ghodsi, Mahgol Sadat Hassan Zadeh Tabatabaei, Vafa Rahimi-Movaghar, Mahmoud Yousefifard","doi":"10.22037/aaem.v14i1.3098","DOIUrl":"https://doi.org/10.22037/aaem.v14i1.3098","url":null,"abstract":"<p><strong>Introduction: </strong>Traumatic spinal cord injury (TSCI) remains a significant cause of long-term disability, with mortality and pressure ulcer (PU) development being key determinants of patient outcomes. This study aimed to develop and interpret machine learning (ML) models for predicting in-hospital mortality and PU formation in TSCI patients using data from the National Spinal Cord Injury Registry of Iran (NSCIR-IR).</p><p><strong>Methods: </strong>Patients with TSCI admitted between 2015 and 2023 were included in the analysis. Data preprocessing included iterative imputation, feature selection with cross-validation, and class balancing using SMOTE. Nine ML algorithms were trained and validated on an 80:20 split dataset. Model performance was assessed using the area under the receiver operating characteristic curve (AUC) and other standard metrics. Feature importance and interpretability were evaluated using permutation importance and Shapley Additive Explanations (SHAP) analysis.</p><p><strong>Results: </strong>A total of 499 patients were included. The LightGBM classifier achieved the highest performance in mortality prediction (AUC = 0.85; 95% CI: 0.73-0.94), followed by KNN and Naive Bayes. For PU prediction, the Random Forest model performed best (AUC = 0.83; 95% CI: 0.72-0.93), outperforming XGBoost and LightGBM. Ventilator use, ASIA grade, and sensory and motor scores were the strongest predictors of mortality, while first aid given, ventilator use, and the number of injured vertebrae were the strongest predictors of PU risk. SHAP analysis confirmed these findings.</p><p><strong>Conclusion: </strong>ML algorithms can accurately identify TSCI patients at high risk of mortality and PU development using routinely collected clinical data. Integrating such interpretable ML tools into early triage systems could enable timely preventive interventions and improve patient outcomes.</p>","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"14 1","pages":"e49"},"PeriodicalIF":2.8,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13637429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103218","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":"Electroencephalography (EEG) and Quantitative EEG for Acute Stroke Triage and Post-Reperfusion Monitoring: A Systematic Review.","authors":"Shirwan Hamasalih Omer, Sivan Jabbar Alimohammed, Mohammed Ibrahim Mohialdeen Gubari","doi":"10.22037/aaem.v14i1.3101","DOIUrl":"https://doi.org/10.22037/aaem.v14i1.3101","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Electroencephalography and quantitative EEG are candidate functional biomarkers that may complement clinical examination and imaging for acute ischemic stroke triage and post-reperfusion monitoring. This review aimed to evaluate the value of electroencephalography (EEG) and quantitative EEG (QEEG) for acute stroke triage and post-reperfusion monitoring.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A systematic search was performed in PubMed, Embase, Scopus, and Web of Science on 4 February 2026, with supplementary backward and forward citation tracking. Eligible studies evaluated EEG, QEEG, processed EEG, visual EEG grading, or EEG-derived physiological markers for acute stroke/transient ischemic attack (TIA) classification, large-vessel occlusion (LVO)/medium-vessel occlusion (MeVO) detection, lesion-related classification, stroke control/severity classification, or post-endovascular treatment/mechanical thrombectomy (EVT/MT) monitoring. Diagnostic components were interpreted in line with Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 and PRISMA for diagnostic test accuracy (PRISMA-DTA) principles. Risk of bias was assessed using Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-2 for diagnostic/classification evidence and Quality in Prognostic Studies (QUIPS)-oriented criteria for post-EVT/MT monitoring studies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;From 4,796 database records, 3,179 unique records were screened, 51 full texts were assessed, and 15 study records were retained: seven diagnostic/classification studies and eight post-EVT/MT monitoring studies. Acute triage evidence suggested candidate value for EEG/QEEG in acute stroke/TIA or LVO/MeVO identification, with promising individual-study signals for slow-to-fast ratios, hemispheric asymmetry/ pairwise-derived brain symmetry index (pdBSI), relative alpha/theta power, and clinical-plus-EEG models. However, devices, settings, target conditions, thresholds, and validation status varied, and no diagnostic domain was poolable. No diagnostic meta-analysis was performed because target conditions, thresholds, reference standards, EEG systems, and intended-use settings were too heterogeneous. Post-EVT/MT monitoring studies suggested candidate value for QEEG slowing/frontal delta alpha ratio (DAR), relative alpha loss, visual EEG grading, Non-Convulsive Status Epilepticus (NCSE) detection, bispectral index (BIS)/near-infrared spectroscopy (NIRS), and EEG-transcranial Doppler (TCD) neurovascular coupling (NVC) in relation to early neurological deterioration (END), edema, seizure-related complications, infarct growth, or functional outcome. Certainty was very low for diagnostic domains and low for post-EVT/MT monitoring.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;EEG/QEEG is a promising but still investigational adjunct for acute ischemic stroke triage and post-reperfusion monitoring. Current evidence does not support a universal diagnostic threshol","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"14 1","pages":"e44"},"PeriodicalIF":2.8,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13637425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103281","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":"The Value of Serum CK in Predicting Traumatic Rhabdomyolysis Induced Acute Kidney Injury: A Systematic Review and Meta-Analysis.","authors":"Koohyar Ahmadzadeh, Shayan Roshdi Dizaji, Shayan Dasdar, Nika Kianfar, Seyed Mohamad Sajjadi, Iraj Najafi, Mahmoud Yousefifard, Saeed Safari","doi":"10.22037/aaem.v14i1.3042","DOIUrl":"https://doi.org/10.22037/aaem.v14i1.3042","url":null,"abstract":"<p><strong>Introduction: </strong>Creatine kinase (CK) has frequently been introduced as a predictive factor of rhabdomyolysis induced acute kidney injury (AKI) in several studies. However, its value, especially in traumatic and disaster settings, remains to be fully clarified.</p><p><strong>Methods: </strong>Online databases of Medline (via PubMed), Embase, Scopus, and Web of Science were systematically searched until May 15th, 2026 and studies evaluating the association between serum CK and AKI in traumatic rhabdomyolysis patients were included. Reports of CK were collected as mean differences between the AKI and non-AKI groups, odds ratios (ORs), and performance metrics such as sensitivity and specificity. Analyses were performed using STATA 17.0 statistical software. The study's protocol has been registered with PROSPERO (CRD420251250906).</p><p><strong>Results: </strong>17 articles were included in this study. Twelve studies encompassing 3122 rhabdomyolysis patients (AKI: 30.94%) evaluated mean CK values in AKI and non-AKI patients with a pooled mean difference of 21770.75 (95% CI: 8987.39 to 34554.11) IU/L between groups. Four studies of 3549 patients (AKI: 20.29%) reported a pooled adjusted OR of 7.62 (95% CI 2.80 to 20.76). Ten articles, including 3421 patients (AKI: 18.42%), reported prediction accuracy measures. The pooled analysis showed an AUC of 0.73 (95% CI: 0.69 to 0.77), with sensitivity 0.68 (95% CI: 0.55 to 0.78) and specificity of 0.68 (95% CI: 0.54 to 0.78).</p><p><strong>Conclusion: </strong>Our findings indicate that, across traumatic rhabdomyolysis populations, AKI was associated with higher CK levels, with a more pronounced elevation observed in earthquake-related settings, although heterogeneity was high. CK alone demonstrated only fair discriminatory performance, suggesting its use as part of a broader clinical risk assessment rather than as a sole predictor of AKI.</p>","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"14 1","pages":"e47"},"PeriodicalIF":2.8,"publicationDate":"2026-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13637432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103253","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":"Minocycline in Acute Traumatic Spinal Cord Injury: A Systematic Review and Exploratory Meta-Analysis of Preclinical and Clinical Evidence.","authors":"Farzan Fahim, Mahsa Faramin Lashkarian, Farbod Tabasi Kakhki, Reihane Qahremani, Aydin Ghaffari, Seyed Mahrad Moosavian, Mohadese Jafari, Mahshid Ebrahimabad, Marzieh Ghasemi, Hossein Mahmoodi, Alireza Zali","doi":"10.22037/aaem.v14i1.2983","DOIUrl":"https://doi.org/10.22037/aaem.v14i1.2983","url":null,"abstract":"<p><strong>Introduction: </strong>Minocycline as a tetracycline derivative agent with anti-inflammatory and neuroprotective properties, has been investigated in both experimental and clinical settings. This study aimed to evaluated the therapeutic efficacy of Minocycline in acute traumatic spinal cord injury (SCI).</p><p><strong>Methods: </strong>This systematic review and meta-analysis was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Major electronic databases were comprehensively searched to identify preclinical animal studies and human clinical studies evaluating minocycline, alone or in combination therapies, for acute traumatic SCI management. Risk of bias was assessed using Joanna Briggs Institute (JBI) critical appraisal tools tailored to study design. Qualitative synthesis included all eligible studies, while quantitative synthesis was restricted to clinical studies reporting extractable effect estimates for neurological improvement.</p><p><strong>Results: </strong>A total of 9 studies met inclusion criteria for qualitative synthesis. Preclinical studies demonstrated consistent biological effects of minocycline on inflammatory markers, oxidative stress, and histopathological outcomes, particularly in combination therapies, although functional recovery with minocycline monotherapy was inconsistent. Clinical studies indicated that minocycline was generally well tolerated; however, most trials did not demonstrate statistically significant improvements in neurological or functional outcomes. Only two clinical studies provided suitable data for meta-analysis, yielding a pooled odds ratio of 1.70 (95% confidence interval (CI): 0.95-3.06) for neurological improvement, which did not reach statistical significance.</p><p><strong>Conclusion: </strong>Current evidence suggests that while minocycline exhibits promising biological activity and an acceptable safety profile in acute traumatic SCI, robust clinical efficacy has not been conclusively demonstrated. Well-designed, adequately powered randomized controlled trials with standardized outcome reporting are required to determine whether these biological effects translate into meaningful functional recovery.</p>","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"14 1","pages":"e46"},"PeriodicalIF":2.8,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13637424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103293","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":"The Impact of Pain on Triage Accuracy, Hospital Admission, and Length of Stay in Patients Presenting to the Emergency Department: A Systematic Review.","authors":"Seyed Mohammad Hosseini Kasnavieh, Maryam Milanifard, Mohsen Sedighi, Nader Tavakoli, Shima Sadat Aghahosseini, Roxana Hessam","doi":"10.22037/aaem.v14i1.3032","DOIUrl":"https://doi.org/10.22037/aaem.v14i1.3032","url":null,"abstract":"<p><strong>Introduction: </strong>Acute pain serves as a modifier in five-level triage systems, such as the Canadian Triage and Acuity Scale (CTAS) and the Korean Triage and Acuity Scale (KTAS). This systematic review aimed to synthesize existing evidence on the impact of pain on triage accuracy, hospital admission, and length of stay in patients presenting to the emergency department (ED).</p><p><strong>Methods: </strong>A systematic search was conducted in PubMed and Google Scholar for English studies published between 2000 and 2026. Studies that reported associations between pain score, triage accuracy, hospital admission, and length of stay in patients presenting to the ED were included. Data extraction and quality assessment were performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.</p><p><strong>Results: </strong>Out of 484 initial records, independent screening yielded 6 original cohort studies for final inclusion. The studies encompassed a total of 247,624 patients, with moderate to high methodological quality in the qualitative synthesis. Self-reported pain scores demonstrated no predictive relationship with admission rates or ED length of stay. However, their mandatory integration into triage protocols resulted in over-triage and reduced system accuracy. Based on the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, the overall certainty of evidence was determined to be moderate.</p><p><strong>Conclusion: </strong>Self-reported pain lacks independent predictive value for hospital admission or ED length of stay, and its mandatory integration into triage systems leads to over-triage. Rather than determining acuity priority, pain assessment should be decoupled from the primary triage decision and be linked to dedicated pain-management protocols instead.</p>","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"14 1","pages":"e45"},"PeriodicalIF":2.8,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13637428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103304","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":"Quantitative EEG and EEG-Derived Markers of Severity, Prognosis, and Recovery After Ischemic Stroke: A Systematic Review.","authors":"Shirwan Hamasalih Omer","doi":"10.22037/aaem.v14i1.3089","DOIUrl":"https://doi.org/10.22037/aaem.v14i1.3089","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Electroencephalography (EEG) and quantitative electroencephalography (QEEG) may provide noninvasive functional biomarkers that complement clinical and imaging predictors when evaluating stroke outcomes. This systematic review evaluated QEEG, selected routine EEG, processed EEG, and advanced neurophysiological biomarkers of severity, lesion burden, longitudinal prognosis, cognitive/language outcome, rehabilitation response, and recovery after ischemic stroke.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;PubMed, Embase, Scopus, and Web of Science were searched on 30 March 2026 using ischemic stroke or cerebral infarction terms, QEEG or EEG-derived biomarker terms, and prognosis, outcome, severity, infarct-volume, mortality, rehabilitation, motor-recovery, and language-recovery terms. Selected structured routine EEG, visual EEG grading, processed EEG/Bispectral Index (BIS), and EEG-derived neurovascular-coupling studies were included when they provided predefined severity, prognostic, monitoring, cognitive/language, rehabilitation, or recovery-related evidence. The search identified 2,564 records; 851 duplicates were removed, leaving 1,713 unique records for screening. Evidence was classified as cross-sectional severity or lesion-burden association, longitudinal functional prognosis, mortality or clinical deterioration, rehabilitation or motor recovery, cognitive/language outcome, selected routine or processed EEG evidence, or advanced QEEG/connectivity/nonlinear/neurovascular-coupling evidence. Risk of bias was assessed using Quality in Prognostic Studies (QUIPS)-oriented criteria, and certainty was summarized using domain-level Grading of Recommendations Assessment, Development and Evaluation (GRADE)-informed judgments.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Thirty-three study records were included, representing 1,696 stroke or suspected-stroke participants, 1,598 EEG/QEEG/BIS/neurovascular coupling (NVC)-analyzable participants, and 317 controls or comparators. The most consistent prognostic pattern was that greater EEG/QEEG abnormality, particularly increased slow-wave activity and higher delta/alpha ratio (DAR) or delta-theta/alpha-beta ratio (DTABR), was associated with greater neurological severity, larger infarct or lesion burden, and poorer functional outcomes. Measures of interhemispheric imbalance, including a higher brain symmetry index (BSI), pairwise-derived brain symmetry index (pdBSI), and greater hemispheric asymmetry, were also generally associated with unfavorable outcomes, including greater disability, clinical deterioration, mortality, or less favorable recovery. Reduced alpha or beta activity was similarly associated with poorer neurological or functional outcomes in several studies. Post-endovascular treatment (EVT)/mechanical thrombectomy (MT) studies suggested potential monitoring value for detecting or predicting cortical dysfunction, early neurological deterioration, cerebral edema, nonconvulsive seizures/sta","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"14 1","pages":"e43"},"PeriodicalIF":2.8,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13637430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103221","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":"Independent Predictors of Major Adverse Cardiac and Hepatic Outcomes Following Acute Liver Complications of Pregnancy; A Retrospective Cohort Study.","authors":"Ellada Sariyeva, Gubakhanım Hajızada, Nurana Hamidova, Ilaha Guliyeva, Lamiya Aghakishiyeva, Farida Gurbanova, Parvana Javanshir, Elnur Imanov, Sahib Bilalzade, Ilaha Shahverdiyeva, Aida Bandalieva, Zumrud Abaszade","doi":"10.22037/aaem.v14i1.3099","DOIUrl":"https://doi.org/10.22037/aaem.v14i1.3099","url":null,"abstract":"<p><strong>Introduction: </strong>Acute liver complications of pregnancy (ALCP) remain major contributors to maternal morbidity. This study aimed to characterize cardio-hepatic crosstalk and identify independent predictors of hepatic failure and major cardiovascular events in patients with ALCP.</p><p><strong>Methods: </strong>This retrospective cohort study was conducted to investigate cardio-hepatic crosstalk, endothelial dysfunction, and cardiovascular risk stratification among pregnant women with ALCP (4 diagnostic categories: HELLP syndrome, pre-eclampsia with hepatic involvement, acute fatty liver of pregnancy, and intrahepatic cholestasis of pregnancy). Independent predictors of cardiac and hepatic outcomes following ALCP, among endothelial, cardiac, inflammatory, coagulation, and renal biomarkers, were detected using correlation, multivariable regression, and receiver operating characteristic (ROC) analyses.</p><p><strong>Results: </strong>400 patients with ALCP were studied. All 22 studied biomarkers differed significantly across diagnostic categories. The ratio of soluble fms-like tyrosine kinase-1 to placental growth factor (sFlt-1/PlGF ratio) correlated most strongly with N-terminal pro-B-type natriuretic peptide (NT-proBNP) (r = 0.57, p < 0.001) and independently predicted major cardiovascular events (adjusted odds ratio (OR) = 1.38, 95% confidence interval (CI) = 1.03-1.85). C-reactive protein and creatinine independently predicted hepatic failure, with C-reactive protein showing the highest discriminative accuracy (area under the ROC curve of 0.79 (95% CI: 0.69-0.89).</p><p><strong>Conclusions: </strong>Hepatic and cardiovascular derangement in ALCP constitute an interconnected, biomarker-detectable syndrome, supporting integrated biomarker-guided risk stratification for emergency management and delivery-timing decisions.</p>","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"14 1","pages":"e42"},"PeriodicalIF":2.8,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13637434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103290","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}