Artificial organs最新文献

{"title":"Differential Impact of Polymyxin B Hemadsorption on Long-Term Mortality in Septic Shock: A Retrospective Analysis of Intra-Abdominal Versus Extra-Abdominal Infections.","authors":"Tomoki Tanaka, Kazunori Fujino, Yasuyuki Tsujita, Yugo Matsumoto, Mitsuhiro Fujino, Hidemitsu Miyatake, Naoto Mizumura, Junji Shimizu, Takuma Kishimoto, Naoto Shiomi","doi":"10.1111/aor.70023","DOIUrl":"https://doi.org/10.1111/aor.70023","url":null,"abstract":"<p><strong>Background: </strong>The long-term benefit of polymyxin B hemadsorption (PMX-HA) in septic shock patients remains unclear and may depend on the site of infection. We evaluated the association between PMX-HA use and 1-year mortality in patients with intra-abdominal infection (IAI) and extra-abdominal infection (EAI).</p><p><strong>Methods: </strong>We retrospectively analyzed adult patients with septic shock (Sepsis-3) admitted to an ICU between January 2017 and July 2023. Patients were categorized as IAI or EAI and further stratified by PMX-HA use. One-year mortality was assessed using Kaplan-Meier analysis, multivariable Cox regression (adjusted for age, sex, and SOFA score), and inverse probability of treatment weighting (IPTW), balancing age, sex, SOFA, CRRT use, and with or without surgical and/or radiological interventions.</p><p><strong>Results: </strong>Among 182 patients (98 IAI, 84 EAI), PMX-HA was administered to 71 IAI and 32 EAI patients. In the IAI group, PMX-HA was associated with significantly lower 1-year mortality (32.3% vs. 59.2%, p = 0.005), supported by Cox regression (adjusted HR: 0.485; 95% CI: 0.252-0.935; p = 0.031) and IPTW (weighted HR: 0.415; 95% CI: 0.215-0.787; p = 0.007). In contrast, in the EAI group, 1-year mortality was similar between the non-PMX and PMX groups (44.4% vs. 56.6%, p = 0.516), with no significant association in Cox analysis (adjusted HR: 0.790; 95% CI: 0.404-1.543; p = 0.49) or IPTW (weighted HR: 0.85; 95% CI: 0.446-1.617; p = 0.62).</p><p><strong>Conclusion: </strong>PMX-HA was significantly associated with a lower risk of 1-year mortality in patients with IAI, but not in those with EAI.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145243352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimization Studies of Robocasted Bioceramic Bone Scaffolds Using Analytical Hierarchy Process and TOPSIS.","authors":"Umanath Puthillam, Jishita Ravoor, Renold Elsen Selvam, Deepan Karuppan, Balaji Bakthavachalam, Govind Purohit","doi":"10.1111/aor.70014","DOIUrl":"https://doi.org/10.1111/aor.70014","url":null,"abstract":"<p><strong>Background: </strong>A bone scaffold is used to treat critical size bone defects and demands contradictory physical and mechanical properties. It is difficult to achieve the desirable properties using a single material, and composite materials are used to develop the scaffolds.</p><p><strong>Methods: </strong>A combination of bioceramics such as hydroxyapatite (HAP), calcium silicate (CS), or calcium phosphate (CP) with different percentages of multiwalled carbon nanotubes (MWCNT) is used to develop the scaffolds using Robocasting 3D printing to treat the cancellous bone defects. The bioceramics will enhance the biocompatibility and bone regeneration of the scaffold while the MWCNT will improve the mechanical properties. Compressive strength, density, shrinkage, and porosity are selected as deciding factors, and the analytic hierarchy process (AHP) and technique for order of preference by similarity to ideal solution (TOPSIS) are used to identify the best composite materials for the required properties.</p><p><strong>Results: </strong>The scaffolds are printed and sintered and observed that CS with 1 mass % of MWCNT sintered at 1200°C, HAP with 0.5 mass % of MWCNT sintered at 1100°C, and CP with 0.5 mass % of MWCNT sintered at 1200°C are the best bone scaffold options.</p><p><strong>Conclusion: </strong>The ideal processing parameters for developing bioceramic bone scaffolds using the robocasting technique are identified and reported.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145243379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and Preclinical Evidence on a Novel Percutaneous Pulsatile Ventricular Assist Device (PulseCath): A Scoping Review.","authors":"Viviana Teresa Agosta, Jacopo D'Andria Ursoleo, Corrado D'Andria, Alice Bottussi, Fabrizio Monaco","doi":"10.1111/aor.70022","DOIUrl":"https://doi.org/10.1111/aor.70022","url":null,"abstract":"<p><strong>Background: </strong>In recent decades, temporary mechanical circulatory support (tMCS) devices have garnered increasing interest for the treatment of cardiogenic shock. PulseCath-a pulsatile ventricular assist device-may address a critical unmet need within the tMCS array, offering an intermediate level of support between that of intra-aortic balloon pump (IABP) and more invasive tMCS devices (e.g., Impella and ECMO).</p><p><strong>Methods: </strong>We conducted a systematic search of PubMed/MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Web of Science, Scopus, and Google Scholar databases to retrieve available clinical and preclinical in vivo data regarding the implantation of PulseCath.</p><p><strong>Results: </strong>Five preclinical in vivo studies (38 animal models) and 16 clinical studies (386 patients) were identified and retrieved. When implanted in humans, PulseCath was mostly employed with a \"pre-emptive\" strategy, particularly in the context of high-risk percutaneous coronary interventions. However, cases reporting its \"bail-out\" deployment in instances of hemodynamic instability were also identified.</p><p><strong>Conclusions: </strong>While the underreporting of adverse events and of PulseCath use as a bailout strategy across literature constrains a definitive evaluation of the device, preliminary findings suggest an apparent ease of use. Therefore, further research is warranted to better delineate which specific patient population would most likely benefit from the implantation of such a device. As such, the integration of underlying pathophysiological data, individualized risk assessment, and more robust clinical studies may potentially expand its use.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145243407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel Artificial Detrusor System and Preliminary Experimental Study.","authors":"Mao Yin, Li Xiao","doi":"10.1111/aor.70013","DOIUrl":"https://doi.org/10.1111/aor.70013","url":null,"abstract":"<p><strong>Background: </strong>Neurogenic bladder, a bladder dysfunction resulting from injury or disease affecting the central or peripheral nervous systems, significantly compromises patient quality of life and poses potentially life-threatening risks. Currently, no reliably effective clinical treatments are available. In this context, medicine-engineering integrated approaches aimed at developing artificial detrusor systems to facilitate voluntary voiding demonstrate unique value and advantages. However, existing artificial detrusor system designs face significant challenges, including structural complexity and suboptimal biomechanical compatibility.</p><p><strong>Methods: </strong>This study proposes a novel artificial detrusor system, inspired by the physiological mechanisms of human urine storage and voiding, driven by shape memory alloy (SMA) springs and powered via transcutaneous energy transfer (TET). The system employs the shape memory effect of SMA springs to mimic detrusor contraction and utilizes TET for non-contact energy transmission. The driving performance and feasibility of the system were evaluated using simulation experiments and animal studies.</p><p><strong>Results: </strong>Results indicate that excitation voltage, SMA spring specifications, and energization duration significantly influence the voiding rate and temperature increment of the artificial detrusor. The animal-tested prototype effectively induced bladder voiding.</p><p><strong>Conclusion: </strong>This study presents a promising artificial detrusor system that combines SMA-driven actuation with TET to address neurogenic bladder dysfunction. This system features a simple structure and a feasible working principle, providing a basis for subsequent optimization of artificial detrusor designs and offering a new technical pathway for assistive solutions addressing neurogenic bladder dysfunction.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145243365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating Dialysis in Ex Situ Machine Perfusion: A Systematic Review and Meta-Analysis of Outcomes.","authors":"Yomna E Dean, Sean Frisbie, James Gaston, Diwakar Phuyal, Bahareh Tabatabaei, Florian Huwyler, Matthias Pfister, Jonas Binz, Antonio Rampazzo, Gábor Szabó, Mark W Tibbit, Pierre-Alain Clavien, Bahar Bassiri Gharb","doi":"10.1111/aor.70011","DOIUrl":"https://doi.org/10.1111/aor.70011","url":null,"abstract":"<p><strong>Background: </strong>Ex situ machine perfusion (EVMP) leads to the accumulation of metabolites and electrolytes in the perfusate. This review aimed to examine the impact of dialysis on biochemical and functional parameters during EVMP.</p><p><strong>Methods: </strong>A systematic review was conducted per PRISMA guidelines. Studies integrating dialysis in lungs, liver, pancreas, and heart EVMP, either in large animals or humans, were included. Biochemical and metabolic parameters, organ weight, inflammatory markers, and organ-specific outcomes were extracted. Meta-analyses and longitudinal regression were conducted.</p><p><strong>Results: </strong>Nineteen studies were included. Dialysis maintained sodium (p = 0.17), potassium (p = 0.75), lactate concentrations (p = 0.3), and pH (p = 0.1). A significant decrease was seen in chloride concentration (p < 0.01), while calcium levels increased significantly over time in the dialysis group (p < 0.001). Interleukin 6 was elevated in dialysis relative to the controls during porcine lung perfusion (p < 0.05) and trended toward significance in humans (p = 0.08). During heart perfusion, the dialysis group exhibited higher cardiac contractility, expressed as a percentage of baseline (71.2% ± 7.7 vs. 55.3% ± 8.2, p < 0.05). During liver perfusion, bile production increased significantly from baseline (β = +1.85 IU/L/h, p < 0.001). Lung compliance was stable in the dialysis (β = -2.34 mL/H₂O/h, p = 0.36) and control groups (β = +0.12 mL/H₂O/h, p = 0.27).</p><p><strong>Conclusion: </strong>Dialysis maintained biochemical homeostasis during EVMP. Significant functional benefits were seen in cardiac EVMP and should be investigated in other organs, including appropriate control groups.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145237789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative Atrial Fibrillation Does Not Impact Long-Term Survival and Complications in Left Ventricular Assistance Device Recipients.","authors":"Miloud Cherbi, Vincent Galand, Valentin Barré, Pierre Groussin, Melvyn Dezecot, Paul Gautier, Philippe Maury, Clément Delmas, Erwan Flecher, Raphael Martins","doi":"10.1111/aor.70020","DOIUrl":"https://doi.org/10.1111/aor.70020","url":null,"abstract":"<p><strong>Introduction: </strong>A substantial proportion of patients receiving left ventricular assist devices (LVADs) present with pre-existing atrial fibrillation (AF). However, the prognostic significance of AF-particularly regarding overall survival and ventricular arrhythmias (VAs)-remains unclear.</p><p><strong>Methods: </strong>Patients included were those from the multicenter ASSIST-ICD observational study. The association between AF and the primary endpoint of all-cause mortality was evaluated using a 1:1 propensity score-matched cohort. Secondary outcomes included cardiovascular and non-cardiac mortality, bleeding, stroke, pump thrombosis, and the occurrence of early (≤ 30 days post-implant) and late VAs.</p><p><strong>Results: </strong>Among 652 LVAD recipients, 286 patients (43.9%) had a history of AF before LVAD implantation, with a median follow-up of 9.1 months (2.5-22.1). AF patients were older, with higher rates of dilated cardiomyopathy, a history of VAs, and longer heart failure duration. After matching, AF was not associated with higher mortality (HR 0.93 [0.69-1.26]). AF subtype (paroxysmal, persistent, permanent) had no impact on mortality. There were no significant differences in cardiovascular/non-cardiac mortality, bleeding, ischemic stroke, pump thrombosis, or early VAs. However, AF was linked to a higher incidence of late VAs.</p><p><strong>Conclusion: </strong>In this large multicenter study, AF before LVAD implantation was not associated with increased risks of mortality, bleeding, stroke, or pump thrombosis, but was linked to a higher incidence of late VAs. These findings, based on earlier-generation devices, should be interpreted cautiously given the recent adoption of the HeartMate 3, offering improved hemocompatibility. Further studies are needed to identify LVAD patients where AF carries clinical significance and guide optimal management.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145224634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comparison Study Between Electrical Muscle Stimulation and Transcutaneous Electrical Nerve Stimulation on Treatment of Myofascial Pain Syndrome.","authors":"Seekaow Churproong, Benjamin Metcalfe, Polly Mcguigan, Dingguo Zhang","doi":"10.1111/aor.70017","DOIUrl":"https://doi.org/10.1111/aor.70017","url":null,"abstract":"<p><strong>Background: </strong>Myofascial pain syndrome (MPS) originates from myofascial trigger points (MTPs)- hypersensitive nodules commonly found in the trapezius muscle (TM) that cause pain and functional limitations. While transcutaneous electrical nerve stimulation (TENS) is a conventional treatment, a novel approach combining electrical muscle stimulation (EMS) with active stretching (AS) has recently been developed (EMS + AS).</p><p><strong>Methods: </strong>EMS electrodes were placed transversely across muscle fibers to induce localized contractions and thus greater stretch of MTP-containing regions compared to AS alone. EMS plays a role similar to a therapist's hand in passive stretching in that it provides resistance force. Forty-one participants with MTPs in the TM received single sessions of EMS + AS, sham stimulation (SS) + AS, and TENS. Each session included three 10-s stimulations with 10-s rest intervals. Pain intensity (PI), pressure pain threshold (PPT), and surface electromyography (sEMG) for maximal voluntary contraction (%MVC) amplitude analysis of TM function improvement were the three outcome measures used to assess treatment effectiveness. To evaluate the immediate effects of short-duration treatments with EMS + AS compared to SS + AS and TENS. All three treatments were applied in a randomized order.</p><p><strong>Results: </strong>EMS + AS showed significant improvements in PI and PPT (t₍₄₀₎ = -6.01 and t₍₄₀₎ = 5.38, p < 0.001, respectively). EMS + AS showed a small sEMG activity during TM function improvement of 0.49 ± 0.056 %MVC at post-treatment, normalized to pre-treatment values. Compared to SS + AS and TENS, EMS + AS significantly increased PPT changes (F_(2,120) = 13.442, p < 0.001); however, there were no significant differences in PI or mean %MVC.</p><p><strong>Conclusions: </strong>This study demonstrates that EMS generates a local contraction instead of a full contraction for a muscle. EMS's effect is related to the aim of mimicking passive stretching performed by the therapist's hand. Ultimately, EMS + AS has the potential to be an effective approach for alleviating MPS symptoms.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145224577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biliary Glutathione as a Potential Marker for Viability Assessment of Cholangiocytes During Normothermic Machine Perfusion of Livers.","authors":"Christina Bogensperger, Hannah Esser, Florian Ponholzer, Benno Cardini, Julia Hofmann, Franka Messner, Rupert Oberhuber, Thomas Resch, Dietmar Öfner, Stefan Schneeberger, Annemarie Weissenbacher","doi":"10.1111/aor.70024","DOIUrl":"https://doi.org/10.1111/aor.70024","url":null,"abstract":"<p><strong>Background: </strong>Normothermic machine perfusion (NMP) is increasingly used to assess liver grafts before transplantation. While viability assessment of the hepatocellular compartment has been widely adopted, viability assessment of the biliary compartment remains controversial due to the lack of reliable markers. Glutathione (GSH) plays a key role in bile formation and may serve as a marker for biliary viability. Thus, the present study aimed to investigate the suitability of GSH as a potential marker for biliary viability assessment during NMP.</p><p><strong>Methods: </strong>Between 2018 and 2021, livers undergoing NMP were included in the study. Bile samples were collected at 1 h, 6 h, and at the end of NMP, and then analyzed using enzyme-linked immunosorbent assay (ELISA). Results were correlated with perfusion parameters and clinical outcomes.</p><p><strong>Results: </strong>56 livers underwent NMP during the study period, of which 41 were successfully transplanted (73.2%). Within 1 year after transplantation, 19 patients (46.3%) developed biliary complications. 1-year patient survival was 80.5% and 1-year graft survival (death-censored) was 94.6%. The GSH in transplanted livers showed a significant increase over time (Hour 1: 25.9 ± 31.2 μM vs. End: 108.7 ± 95.3 μM, p < 0.001) and significant inverse correlation with the occurrence of biliary complications after transplantation (p < 0.05). GSH concentration at the first hour measurement was significantly lower in livers that were deemed non-transplantable (11.2 μM vs. 25.9 μM, p = 0.006).</p><p><strong>Conclusions: </strong>Our data show an increase of GSH in bile during liver ex situ NMP. We found a negative correlation between GSH concentration and the development of biliary complications, suggesting GSH as a new marker for biliary viability assessment.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Translating Research Into Clinical Practice and Harnessing Hybrid Technologies Using Electrical Stimulation.","authors":"Tamsyn Street, Gad Alon, Benjamin Metcalfe, Simona Ferrante","doi":"10.1111/aor.70010","DOIUrl":"https://doi.org/10.1111/aor.70010","url":null,"abstract":"","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine Learning-Based Prediction of Life-Threatening Complications During Hemodialysis in Hospitalized Patients With Poor General Conditions.","authors":"Naotaka Kato, Takeshi Goto, Tomoyuki Ohira, Hirotaka Kinoshita, Kugo Kurokawa, Kouhei Naganuma, Chikako Ohminato, Junko Ogasawara, Shingo Hatakeyama, Yoshihiro Sasaki, Kazuyoshi Hirota, Chikara Ohyama","doi":"10.1111/aor.70008","DOIUrl":"https://doi.org/10.1111/aor.70008","url":null,"abstract":"<p><strong>Background: </strong>Patients undergoing hemodialysis (HD) face a significantly elevated risk of cardiovascular mortality, with sudden events during treatment posing a critical threat to survival. These risks are particularly pronounced in high-risk populations, such as patients recovering from cardiovascular surgery or those being treated for sepsis. Therefore, the development of effective preventive strategies is essential for improving patient outcomes. This study aimed to develop a machine learning model that uses pretreatment patient characteristics to predict sudden adverse events during HD and within 24 h after treatment in high-risk inpatients at acute care hospitals.</p><p><strong>Methods: </strong>His retrospective study analyzed data from 739 patients who underwent HD at Hirosaki University Hospital between 2018 and 2021. Sudden events were defined as fatal arrhythmia, refractory intradialytic hypotension, or respiratory arrest. A logistic regression model was constructed using backward stepwise selection from 51 patient characteristics (demographic data, clinical parameters, laboratory data, and HD-related information).</p><p><strong>Results: </strong>Among the 739 patients, 17 (2.3%) experienced sudden events. The model identified 23 pre-HD covariates and achieved an area under the receiver operating characteristic curve (AUC) of 0.889. Key covariates included emergency hospitalization (present in 71% of patients with sudden events), recent surgery (76%), shorter HD history, elevated pre-HD heart rate, lower serum albumin levels, and higher C-reactive protein concentrations.</p><p><strong>Conclusions: </strong>Our model enables the early identification of high-risk inpatients receiving hemodialysis using pre-dialysis data, thereby supporting timely clinical interventions, optimized resource allocation, and improved patient safety.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}