Annals of emergency medicine最新文献

{"title":"Preparing for the Next Pandemic: Designing Resilient Information-Sharing Systems in Acute Care.","authors":"Jaskaran Karan Bains,Nicholas Stark,Jaskirat Dhanoa,Tuna Hayirli,Mai Vu,Michaela Kerrissey,Hemal Kanzaria,Christopher Peabody","doi":"10.1016/j.annemergmed.2025.06.615","DOIUrl":"https://doi.org/10.1016/j.annemergmed.2025.06.615","url":null,"abstract":"STUDY OBJECTIVESWe describe a human-centered design process of creating a centralized digital information hub for information sharing in the emergency department (ED), called E∗Drive. We assessed its usage during the coronavirus 2019 (COVID-19) and monkeypox (Mpox) pandemics and discuss how to replicate a similar resource.METHODSWe recruited an interdisciplinary team of 6 clinicians and designers to build this digital tool with the guiding principles of reliability, agility, and accessibility. We compared average unique page views to our ED's previous clinical guideline system and tracked views alongside COVID-19 and Mpox case counts to assess E∗Drive usage during both pandemics.RESULTSOur process simplified complex clinical guidelines into single-page, color-coded workflows that could be updated without specialized technical knowledge. After initial launch during the COVID-19 pandemic, E∗Drive (https://edrive.ucsf.edu) reached more than 61 unique daily users by February 2023. This infrastructure and process enabled proactive dissemination of Mpox resources well before case rates rose. Web traffic for our Mpox guidelines rose as San Francisco became the United States epicenter of Mpox, peaking at 126 unique daily views in a department staffed by 25 to 30 clinicians per day.CONCLUSIONBy instituting a clear, replicable process for information dissemination and investing in human-centered design during the COVID-19 pandemic, we achieved clinician trust and adoption of a digital information hub. This enabled a more proactive response to the next infectious disease outbreak (Mpox). By using a similar process with off-the-shelf content creation tools, E∗Drive can be adapted to many different ED settings to improve information dissemination without specialized technological expertise.","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"6 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144787160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment Initiation and Outcomes Associated With Receipt of Emergency Department-Based Peer Support Following Opioid Overdose.","authors":"Peter Treitler,Kristen Lloyd,Joel Cantor,Sujoy Chakravarty,Stephen Crystal,Anna Kline,Cory Morton,Kristen Gilmore Powell,Suzanne Borys,Nina A Cooperman","doi":"10.1016/j.annemergmed.2025.06.616","DOIUrl":"https://doi.org/10.1016/j.annemergmed.2025.06.616","url":null,"abstract":"STUDY OBJECTIVESTo examine whether participation in the New Jersey Opioid Overdose Recovery Program (OORP), an emergency department-based peer recovery support service, was associated with drug treatment initiation and other postdischarge outcomes.METHODSThis retrospective cohort study used the 2015 to 2020 New Jersey Medicaid claims linked to OORP evaluation data. Outcomes during 180-day follow-up were compared between opioid overdoses among OORP participants and a propensity score-matched group of overdoses among nonparticipants. Outcomes included any medication for opioid use disorder initiation (primary), percentage of days covered with medication for opioid use disorder, psychosocial treatment initiation and engagement, repeat opioid and any drug overdose, and all-cause and opioid-related acute care utilization. Outcomes were assessed using linear regression (for medication for opioid use disorder percentage of days covered and psychosocial treatment engagement) and Cox proportional hazards (for all other outcomes) models.RESULTSA total of 7,109 overdose events among 5,475 patients were included (62.2% men; 28.1% Black, 8.0% Hispanic, 56.1% White; mean age: 40.1 years). OORP participants (N=1,383 events) initiated medication for opioid use disorder at higher rates than nonparticipants (15% versus 12%; hazard ratio [HR]=2.31, 95% confidence interval [CI] 1.55 to 3.45). OORP participation was also associated with greater medication for opioid use disorder percentage of days covered (3.56 percentage points, 95% CI 0.72 to 6.47), psychosocial treatment initiation (HR=1.73, 95% CI 1.13 to 2.65), and psychosocial treatment engagement (11.97 percentage points, 95% CI 7.23 to 16.73), and lower risk of all-cause acute care utilization (HR=0.83; 95% CI 0.72 to 0.97). The association of the program with repeat overdose and opioid-related ED or inpatient visits was not statistically significant.CONCLUSIONPeer recovery support service can support treatment linkages following ED-treated opioid overdose. Additional efforts are needed to retain patients in medication for opioid use disorder long-term, to reduce their risk for repeat overdose.","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"112 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144787161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Prognostic Accuracy of Frailty and Vulnerability Screening for Older Adults in the Emergency Department: A Systematic Review and Meta-analysis.","authors":"Nai-Wen Ku,Yu-Chi Hsu,Jasmine Mudhur,Juan Li,Nirusha Jebanesan,Lusine Abrahamyan,Chu-Lin Tsai,Shabbir M H Alibhai,Martine Puts","doi":"10.1016/j.annemergmed.2025.05.018","DOIUrl":"https://doi.org/10.1016/j.annemergmed.2025.05.018","url":null,"abstract":"OBJECTIVEFrailty and vulnerability are associated with increased morbidity and mortality in older adults, yet the optimal screening tool for predicting adverse outcomes in the emergency department (ED) remains unclear. Our question is: Which frailty or vulnerability screening instrument has the highest prognostic accuracy for adverse outcomes in older adults visiting the ED?METHODSWe included observational studies involving patients aged more than or equal to 60 years presenting to the ED that applied frailty or vulnerability instruments and reported sensitivity, specificity, and area under the curve (AUC). We searched MEDLINE, EMBASE, Cochrane Library, CINAHL, and CNKI through January 2025. Study quality was assessed using an updated the Quality in Prognosis Studies tool. Two investigators independently screened studies. Meta-analysis was conducted for instruments with consistent cutoffs reported in more than or equal to 4 studies.RESULTSFifty-seven studies (125,412 patients) assessed 39 instruments with varied cutoffs. The Identification of Seniors at Risk and Clinical Frailty Scale were studied most. Most tools demonstrated high sensitivity but low specificity. For 30-day mortality, pooled Identification of Seniors at Risk estimates were as follows: sensitivity 92% (95% confidence interval, 84 to 96), specificity 37% (26 to 50), likelihood ratio (LR)+ 1.47 (1.25 to 1.79), LR- 0.24 (0.11 to 0.42), and AUC 0.84 (0.60-0.89). Clinical Frailty Scale (cut-off of more than or equal to 5) showed sensitivity of 81% (62 to 91), specificity 71% (54 to 83), LR+ 2.80 (1.96 to 3.82), LR- 0.29 (0.15 to 0.48), and AUC 0.82 (0.77 to 0.85).CONCLUSIONCurrent screening instruments fail to identify older individuals who will experience adverse outcomes. Our findings suggest that EDs should reconsider relying on existing screening tools as standalone prognostic instruments and explore incorporating additional domains to improve accuracy.","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"5 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144766008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tranexamic Acid Timing and Mortality Impact After Trauma.","authors":"Adnan Ali,Russell L Gruen,Stephen A Bernard,Brian Burns,Andrew B Forbes,Dashiell C Gantner,Colin J McArthur,Marc Maegele,Biswadev Mitra, ","doi":"10.1016/j.annemergmed.2025.06.609","DOIUrl":"https://doi.org/10.1016/j.annemergmed.2025.06.609","url":null,"abstract":"STUDY OBJECTIVETrauma resuscitation guidelines across the world have incorporated the administration of tranexamic acid (TXA) within 3 hours of injury. The 3-hour window was deduced from the Clinical Randomisation of an Antifibrinolytic in Significant Haemorrhage (CRASH-2) trial and has not been replicated. The aim of this study was to determine whether death within 28 days after trauma varied according to time from injury to the first TXA dose and, if so, precisely determine the therapeutic window.METHODSThis was an exploratory analysis of the Prehospital Tranexamic Acid for Severe Trauma (PATCH-Trauma) trial, which enrolled adults with major trauma and suspected trauma-induced coagulopathy. Eligible patients were randomized to receive either TXA (administered intravenously as a bolus dose of 1 g before hospital admission, followed by a 1 g infusion over a period of 8 hours after arrival at the hospital) or matched placebo. In this analysis, we examined the effect of time from injury to first treatment dose on death within 28 days utilizing a continuous scale with linear, first-degree fractional polynomial, and second-degree fractional polynomial functions of time from injury to first treatment dose. Further log-binomial regression analyses were performed in subgroups based on the information obtained from the previous step.RESULTSThe intention-to-treat study cohort comprised 1,287 patients, of which 635 had been allocated to the placebo arm and 652 to the TXA arm. The median time from injury to first treatment dose was 79 (interquartile range [IQR] 55 to 112) minutes. Risk of death within 28 days increased as the time to first dose of treatment increased, with benefit most pronounced up to 90 minutes. Beyond 90 minutes, the upper 95% confidence interval (CI) crossed the line of equivalence (risk ratio, 1). Administration of TXA within 90 minutes significantly reduced the risk of death within 28 days (67/393 [17%] in the TXA group versus 91/363 [25%] in placebo group; adjusted risk ratio 0.64, 95% CI 0.50 to 0.82), whereas administration beyond 90 minutes did not decrease mortality at 28 days (adjusted risk ratio 1.04, 95% CI 0.74 to 1.47).CONCLUSIONThe optimal therapeutic window for TXA after trauma may be within 90 minutes.","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"15 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144766014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergency Physician Employer Market Share and Concentration by Ownership Type.","authors":"Angela G Cai,Zachary J Jarou,Alexander T Janke,Cameron J Gettel,Craig Rothenberg,Leon C Adelman,Matthew Simpson,Jonathan Fisher,Arjun K Venkatesh","doi":"10.1016/j.annemergmed.2025.06.610","DOIUrl":"https://doi.org/10.1016/j.annemergmed.2025.06.610","url":null,"abstract":"STUDY OBJECTIVEWith rapid consolidation and corporatization of the emergency physician workforce over recent years, little is known about the current state of the emergency physician market. We characterized employer group market share by ownership structure and market concentration by ownership across geographies.METHODSWe selected hospitals from the Centers for Medicare and Medicaid Services (CMS) Hospital General Information Dataset (2021). Ivy Clinicians (2024) defined ownership category (majority ownership by health system, private equity, or clinician partnerships [single-site, regional, national]). National Emergency Department Inventories 2021, the most recent data set available, served as a proxy for 2024 emergency department (ED) visit volumes. The primary outcome was market share defined as the percentage of national ED annual visits staffed by employers within each ownership category. Secondary outcomes measured market concentration.RESULTSOur sample included 3,998 hospital-based EDs, accounting for 109.7 million ED visits in 2021. Per 2024 ownership data, health system groups staffed 33.0% of ED visits followed by private equity 24.7%, regional partnership 20.8%, national partnership 13.4%, and single-site partnership 8.1%. The top 3 private equity groups staffed 93.5% of the private equity visits. In contrast, the top 31 regional partnerships, 51 single-site partnerships, and 63 health system groups comprised 50% market share within their respective categories. Three national partnerships staff all visits in this category. Of the 306 hospital referral regions, 258 (84%) were highly concentrated.CONCLUSIONGroups with majority physician ownership staffed less than half of ED visits. The emergency medicine market is highly concentrated regionally, as well as within the private equity and national partnership ownership categories.","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"10 26 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergency Medicine Clinician Research Pipeline: Understanding the National Institutes of Health Diversity Supplemental Award.","authors":"Sean Treacy-Abarca,Richelle J Cooper,David L Schriger","doi":"10.1016/j.annemergmed.2025.05.028","DOIUrl":"https://doi.org/10.1016/j.annemergmed.2025.05.028","url":null,"abstract":"","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"11 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144720022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinician Risk Tolerance and Rates of Admission From the Emergency Department for Medicare Patients.","authors":"Peter B Smulowitz,Daniel Ostrovsky,Ryan C Burke,Victor Novack,Linda Isbell,Vincent Kan,Lawrence Zaborski,Bruce E Landon","doi":"10.1016/j.annemergmed.2025.06.611","DOIUrl":"https://doi.org/10.1016/j.annemergmed.2025.06.611","url":null,"abstract":"STUDY OBJECTIVETo characterize the association between emergency department (ED) clinician risk tolerance and the decision to admit, a common and high-cost decision.METHODSIn this observational cohort study, data on 100% of traditional Medicare beneficiaries for all ED visits in Massachusetts from October 2015 through September 2020 were linked to surveys of clinician risk tolerance. We estimated a generalized mixed-effect linear regression model to assess the association between the risk scales, divided into tertiles, and the decision to admit. The main outcome measure was ED disposition, defined as admitted or discharged to home. Risk tolerance was measured using 4 related scales: the Risk-Taking Scale, the Stress from Uncertainty Scale, the Fear of Malpractice Scale, and the Need for (Cognitive) Closure Scale.RESULTSThe total study sample included 421,301 ED visits seen by 889 emergency clinicians. Patients were predominantly women (57.4%), and the average age was 72.6 years. Mean clinician age was 46.5 years. In total, 77.1% were physicians, 59.3% were men, and 86.6% were White. We found a consistent relationship between lower risk tolerance and higher admission rates. This magnitude of the relationship was stronger for conditions with a higher rate of admissions.CONCLUSIONThe risk scales were significantly associated with the tendency to admit. This suggests that clinician risk tolerance meaningfully contributes to variation in clinician behavior and points to the potential utility for interventions that interface with clinician behavior to affect admission rates.","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"20 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144720023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of a Regional Emergency Physician-Initiated Extracorporeal Cardiopulmonary Resuscitation System.","authors":"Zachary Shinar,Saul Levine,Kristi Koenig,Michael Assof,Colin King,Shawn Evans","doi":"10.1016/j.annemergmed.2025.06.011","DOIUrl":"https://doi.org/10.1016/j.annemergmed.2025.06.011","url":null,"abstract":"","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"33 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144693503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Two Preoxygenation Approaches With Hypoxemia During Tracheal Intubation: A Secondary Analysis.","authors":"Christopher D Chou,Jessica A Palakshappa,HarLeigh Haynie,Katelyn Garcia,Dustin Long,Kevin W Gibbs, ","doi":"10.1016/j.annemergmed.2025.06.003","DOIUrl":"https://doi.org/10.1016/j.annemergmed.2025.06.003","url":null,"abstract":"STUDY OBJECTIVESOxygen masks (bag-valve-mask device and nonrebreathing facemask oxygen) are the most common method of preoxygenation in critically ill patients undergoing emergency tracheal intubation in the emergency department and intensive care unit. Whether the type of oxygen mask used for preoxygenation alters the risk of hypoxemia during intubation is uncertain. We sought to compare the incidence of hypoxemia during intubation in patients preoxygenated with a bag-valve-mask device to the incidence of hypoxemia in patients preoxygenated with facemask oxygen.METHODSWe conducted a secondary analysis of 2 randomized trials of emergency tracheal intubation. The primary outcome of hypoxemia was defined as a peripheral oxygen saturation <85% between induction of anesthesia and 2 minutes after tracheal intubation. We used a propensity-weighted multivariable logistic regression model to compare the incidence of hypoxemia between groups. We hypothesized that preoxygenation with a bag-valve-mask device would be associated with a lower incidence of hypoxemia compared to preoxygenation with facemask oxygen.RESULTSWe included 1,156 patients in this analysis, of whom 136 were preoxygenated with a bag-valve-mask device and 1,020 were preoxygenated with facemask oxygen. Hypoxemia occurred in 20 of 136 (14.7%) participants in the bag-valve-mask device group and 153 of 1,020 (15.0%) participants in the facemask oxygen group. In the multivariable analysis, participants preoxygenated with a bag-valve-mask device had similar odds of hypoxemia to those preoxygenated with facemask oxygen (adjusted odds ratio 1.22, 95% confidence interval 0.72 to 2.16).CONCLUSIONIn critically ill patients undergoing tracheal intubation, preoxygenation with a bag-valve-mask device did not reduce the risk of hypoxemia compared to preoxygenation with facemask oxygen.","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"15 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144684368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors for Traumatic Intracranial Hemorrhage in Older Adults Sustaining a Head Injury in Ground-Level Falls: A Systematic Review and Meta-analysis.","authors":"Xavier Dubucs,Véronique Gingras,Valérie Boucher,Pierre-Hugues Carmichael,Marianne Ruel,Kerstin De Wit,Keerat Grewal,Éric Mercier,Pierre-Gilles Blanchard,Axel Benhamed,Sandrine Charpentier,Marcel Émond","doi":"10.1016/j.annemergmed.2025.05.021","DOIUrl":"https://doi.org/10.1016/j.annemergmed.2025.05.021","url":null,"abstract":"STUDY OBJECTIVEGround-level falls have become the leading cause of head injury in older adults. However, the risk factors for traumatic intracranial hemorrhage (ICH) in this population remain unclear. We aimed to identify risk factors for traumatic ICH in older patients who sustained a ground-level fall-related head injury presenting in the emergency department.METHODSA systematic search of Medline (Ovid), Embase (Embase.com), Cochrane Library (Wiley), CINAHL (EBSCO), and Web of Science Core Collection was performed on December 9, 2024. The studies' eligibility criteria included patients aged 65 years and over who consulted in an emergency department following a ground-level fall-related head trauma and who presented with a Glasgow Coma Scale score of at least 13. Head injury was defined as any trauma to the head, including the face. Odds ratios (ORs) for each risk factor were pooled from the selected studies. For each potential risk factor, a random-effects model was used to compare the risk of traumatic ICH between patients with and without the risk factor. We restricted sensitivity analyses to studies providing adjusted odds ratios (AORs) and high-quality studies according to the Newcastle-Ottawa quality assessment Scale (defined as Newcastle-Ottawa quality assessment Scale score ≥7).RESULTSA total of 17 observational studies involving 22,520 patients were included in this systematic review with meta-analysis. Seven were prospective (11,501 individuals), and 8 were multicenter studies (14,376 individuals). The prevalence of traumatic ICH was 6.8% (95% confidence interval [CI]: 6.5 to 7.2), occurring in 1,538 patients. Among patients with traumatic ICH, urgent neurosurgery intervention prevalence was 8.0% (95% CI: 5.0 to 12.0). The unadjusted ORs indicate that the risk factors of traumatic ICH were suspected open or depressed skull fracture (OR: 10.9 [95% CI 6.4 to 18.7]), signs of basal skull fracture (OR: 4.7 [95% CI 3.4 to 6.5]), reduced baseline Glasgow Coma Scale score (OR: 4.0 [95% CI 3.4 to 4.7]), focal neurologic signs (OR: 3.8 [95% CI 3.2 to 4.5]), seizure (OR: 3.2, [95% CI 1.5 to 7.0]), vomiting (OR: 2.7 [95% CI 2.1 to 3.5]), amnesia (OR: 2.4 [95% CI 2.0 to 3.0]), loss of consciousness (OR: 2.3 [95% CI 1.9 to 2.8]), headache (OR: 2.1 [95% CI 1.6 to 2.9]), external sign of head trauma (OR: 2.0 [95% CI 1.7 to 2.3]), male sex (OR: 1.5 [95% CI 1.3 to 1.6]), chronic kidney disease (OR: 1.4 [95% CI 1.0 to 1.9]), preinjury single antiplatelet (OR: 1.2 [95% CI 1.0 to 1.3]), and dual antiplatelet medication (OR: 2.3 [95% CI 1.5 to 3.5]). Preinjury anticoagulant was not a significant risk factor (OR: 0.8 [95% CI 0.7 to 1.0]). Based on AOR, only focal neurologic signs (AOR: 4.4 [95% CI 3.0 to 6.5]), external sign of head trauma (AOR: 2.7 [95% CI 2.1 to 3.5]), loss of consciousness (AOR: 1.6 [95% CI 1.2 to 2.1]), and male sex (AOR: 1.4 [95% CI 1.2 to 1.6]) remained associated with traumatic ICH.CONCLUSIONSThis study identified risk factors for tr","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"15 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144684369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}