BMC Emergency Medicine最新文献

{"title":"A real-time communication and information system for triage, positioning, and documentation (TriPoD) in mass-casualty incidents: a qualitative observational study.","authors":"Veronica Lindström, Klara Jepsen, Sara Heldring, Torkel Kanfjäll, Monica Rådestad","doi":"10.1186/s12873-025-01274-0","DOIUrl":"10.1186/s12873-025-01274-0","url":null,"abstract":"<p><strong>Background: </strong>In mass-casualty incidents (MCIs), command centers often rely on oral or written reports, leading to communication gaps, misunderstandings, and inadequate logistics of available resources. This study developed a real-time communication and information system for Triage, Position, and Documentation (TriPoD) via action research in collaboration with end-users to ensure high usability. TriPoD integrates commercially available technology, utilizing a digital triage tag with a unique ID that attaches to each individual with an injury. Emergency medical service (EMS) providers scan the electronic triage tag (e-triage tag) via a mobile app, instantly sending data to command centers through a web portal. The developed TriPoD enables seamless sharing of patient information from the MCI scene during transport to and within hospitals.</p><p><strong>Aim: </strong>This study aimed to explore the usability of TriPoD during a simulated MCI with figurants.</p><p><strong>Methods: </strong>A qualitative observational design was employed, with non-participant observers stationed at the incident site, a regional command center, and a hospital command center. The observers compared TriPoD with standard procedures and management, and collected user perspectives on the system evaluated. A thematic analysis was used to guide the analysis.</p><p><strong>Results: </strong>The results revealed that command centers receive real-time updates on patient count, triage status, and location faster and with more accurate numbers of injuries than traditional methods do. Data transmitted through the web portal was updated each time a new patient was scanned, enabling continuous real-time monitoring and informed decision-making. EMS providers and command center users observed TriPoD usability, with delays when EMS providers did not consistently scan injured individuals.</p><p><strong>Conclusion: </strong>This study demonstrates that seamless information sharing from the scene of an MCI enhances reliable communication and management efforts. Although TriPoD shows strong potential for improving MCI response and management, further development, testing, and collaboration with intended end-users are essential for its continued improvement. The study was approved by the Swedish Ethical Review Authority (No: 2023-04615-01). International Registered Report Identifier (IRRID): PRR1- https://doi.org/10.2196/57819 .</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"115"},"PeriodicalIF":2.3,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12232746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144574798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Location-based response times of emergency physicians in rural Germany: an observational study.","authors":"Maria Raker, Christian Weilbach, Maximilian Scharonow","doi":"10.1186/s12873-025-01278-w","DOIUrl":"10.1186/s12873-025-01278-w","url":null,"abstract":"<p><strong>Background: </strong>The number of emergency callouts in Germany has doubled in the last 20 years. The shortage of doctors and social developments have led to challenges in ensuring emergency medical services and to temporary closures of entire emergency medical service areas. Stationing the emergency doctor on duty in the home environment is one option for making emergency medical services more attractive and could help to alleviate the problem of staff scheduling.</p><p><strong>Objective: </strong>The response times of emergency physicians stationed in their home environment were compared with those of emergency doctors stationed at hospitals or rescue stations.</p><p><strong>Methods: </strong>The response intervals and arrival times at the patient's location were statistically analyzed depending on the physician's location and distance from the rescue station. A support vehicle was used to reduce response times. The emergency physician met the full-time emergency vehicle at predefined points depending on the direction of the call.</p><p><strong>Results: </strong>The response interval from the emergency station was 2.2 ± 1.0 min, from the hospital 3.1 ± 1.2 min and from the home environment 3.8 ± 1.6 min (p < 0.0001/Kruskal-Wallis test). In terms of the time taken to reach the patient, there was a significant advantage (p < 0.0001/Kruskal-Wallis test) in the group of call-outs from the rescue station (8,6 ± 3,9 min min. 2 and max. 23 min) compared to call-outs from the hospital (10.0 ± 4.4 min; min. 2 and max. 31 min) and the home environment (10.2 ± 4.2; min. 2 max. 33 min), with the difference between the hospital and the home environment not being significant at p = 0.256 (Kruskal-Wallis test). The actual distance of the emergency physician from the rescue station provides the best results for modeling response interval and showed no significant difference compared to being stationed at the hospital in terms of time to arrival at the scene for distances less than 3 km (p < 0.0001/Kruskal-Wallis test).</p><p><strong>Conclusions: </strong>Stationing the emergency doctor in a domestic environment with a support vehicle and establishing fixed meeting points with the full-time emergency vehicle shows no disadvantage compared to stationing the emergency doctor in the hospital.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"116"},"PeriodicalIF":2.3,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12232860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144574799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prehospital respiratory interventions during six waves of COVID-19: results from Israel's Emergency Medical Services system.","authors":"Maximilian P Nerlander, Evan Avraham Alpert, Roman Sonkin, Ziv Dadon, Ari M Lipsky, Eli Jaffe","doi":"10.1186/s12873-025-01279-9","DOIUrl":"10.1186/s12873-025-01279-9","url":null,"abstract":"<p><strong>Background: </strong>Despite COVID-19 having been the subject of extensive scientific research, there is a paucity of studies on the respiratory management needs of patients in the pre-hospital setting. This retrospective cohort study utilizes data from Magen David Adom (MDA), Israel's Emergency Medical Services (EMS) to investigate how prehospital respiratory management needs changed throughout the first six waves of the COVID-19 pandemic in Israel.</p><p><strong>Methods: </strong>All EMS responses due to respiratory complaints, from March 21, 2020, to July 31, 2022, were included. Odds ratios (ORs) for each wave were calculated for each intervention with the previous wave as reference. Wave 1 (W1) was compared to a pre-pandemic period.</p><p><strong>Results: </strong>The study included 141,027 responses. Throughout the pandemic, no endotracheal intubations were performed. The use of mask-based 90% FiO₂ decreased from the pre-COVID-19 period to W1 (OR 0.61, p < 0.0001), increased during waves 2-3 (OR 1.24, p < 0.0001 [W2]; OR 1.11, p < 0.0001 [W3]), and plateaued throughout W5 and W6 (OR 0.99, p = 0.71 [W5]; OR 0.01, p = 0.8 [W6]). The use of nasal cannula increased throughout the six waves (OR 1.2 [W1]; OR 1.48 [W2]; 1.39 [W3]; OR 1.45 [W4]; 1.11 [W5]; 1.24 [W6], p < 0.05). The use of nebulized bronchodilators decreased from the pre-pandemic period to W1 (OR 0.41, p < 0.0001). From W3 to W6, the use increased significantly for each wave (OR 1.43 [W4]; OR 1.12 [W5]; 1.31 [W6], p < 0.05).</p><p><strong>Conclusions: </strong>MDA advised staff not to perform endotracheal intubations during the pandemic due to concerns of transmission through aerosol. Similarly, the initial drops in high-concentration O2 and nebulized bronchodilators may be due to concerns with its aerosolizing potential. The gradual replacement of high-concentration prehospital oxygen by mask with nasal cannulas over the pandemic waves may be due to the decreased pathogenicity of the new strains and expanded vaccination coverage. The increased use of nebulized bronchodilators seen during the latter waves may be due to the re-emergence of non-covid pathogens with greater bronchoconstrictive effect as social restrictions were eased. Further, as vaccine coverage expanded among providers over time, these may have been more comfortable administering bronchodilators.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"117"},"PeriodicalIF":2.3,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12232843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144574800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of disaster risk perceptions on disaster preparedness levels of students at a university in Turkey.","authors":"Bahar Kalın, Maide Yeşilyurt","doi":"10.1186/s12873-025-01263-3","DOIUrl":"10.1186/s12873-025-01263-3","url":null,"abstract":"<p><strong>Background: </strong>Disaster risk perception significantly influences individuals' preparedness behaviors, shaping how they respond to potential hazards. Understanding students' risk perceptions and preparedness levels is crucial for developing targeted educational programs that enhance resilience within university communities.</p><p><strong>Methods: </strong>This study aimed to determine the effect of disaster risk perception of health services students on their disaster preparedness levels. This descriptive and correlational study was conducted between February and May 2024 with 403 students studying at a vocational school of health services of a university in Türkiye. The sample selection aimed to include the entire population. The study data were collected face-to-face using a descriptive characteristics form, the University Students' Disaster Risk Perception Scale, and the Disaster Preparedness Scale. The data were analyzed using SPSS software. Descriptive statistics including frequency, percentage, mean, and standard deviation were calculated. Additionally, correlation analysis, independent samples t-test, one-way ANOVA, and regression analysis were performed.</p><p><strong>Results: </strong>The mean age of the students was 19.92 ± 1.32 years, and 60% were female. Among the students, 60.8% had experienced a disaster, and 91.8% of those who had experienced a disaster had experienced an earthquake. The percentage of students harmed by disasters was 41.9%. The mean score of the Disaster Risk Perception Scale was 2.80 ± 0.81, and the mean score of the Disaster Preparedness Scale was 29.73 ± 7.40, which was interpreted as moderate. A positive and statistically significant correlation was found between the disaster preparedness levels of the students and their disaster risk perception levels.</p><p><strong>Conclusions: </strong>The students' disaster risk perception and preparedness scores were found to be at a moderate level, with a significant positive correlation between the two variables. In light of these findings, it is crucial to plan comprehensive awareness-raising trainings aimed at enhancing students' disaster risk perception and preparedness levels. Furthermore, it is recommended to extend disaster education beyond the health sciences fields to other faculties and departments as well. This approach will contribute to increasing disaster awareness among a broader student population and strengthening community resilience.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"114"},"PeriodicalIF":2.3,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12224602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144551871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with hypothermia and its response to resuscitation among major trauma patients at St Francis Hospital Nsambya: a prospective observational study.","authors":"Patrick Akena, Ronald Kiweewa, Ronald Olum, Andrew Basenero, Rebecca Nabulya, Assumpta Nabawanuka, Didace Mugisa","doi":"10.1186/s12873-025-01254-4","DOIUrl":"10.1186/s12873-025-01254-4","url":null,"abstract":"<p><strong>Background: </strong>Hypothermia, defined as a core body temperature below 35 °C, is a common yet underappreciated complication among trauma patients. It leads to coagulopathy, impaired immune response, and higher morbidity, with mortality rates rising by 25% after its onset among severely injured trauma patients. This study sought to determine the factors associated with hypothermia and its response to resuscitation among major trauma patients at St. Francis Hospital Nsambya.</p><p><strong>Methods: </strong>This was a prospective observational study among 99 adult major trauma patients admitted to the emergency department at St. Francis Hospital Nsambya between November 2022 and April 2023. Patients were consecutively enrolled upon arrival and their temperatures were taken using the Braun infrared tympanic thermometer. A pretested data abstraction tool collected information on demographics, injury characteristics, and pre-admission events. The primary outcome was the prevalence of hypothermia. Data analysis was conducted using STATA Version 17.0, employing multivariable logistic regression analysis to determine factors associated with hypothermia.</p><p><strong>Results: </strong>A total of 99 trauma patients were included in the study, of which 39(39%) were hypothermic on hospital arrival. The majority were males, 78(78.8%) aged 26 to 45 years, 49(49.5%) (range: 27-52). Blunt trauma was the most common mechanism of injury 9(86.9%), followed by penetrating injuries 9(9.1%). Hypothermia was associated with age (Adjusted Odds Ratios [AOR]: 19.94, CI: 1.6-248.65, p = 0.02), body region injured (AOR = 6.28, CI: 1.6-27.75, p = 0.015), ambient temperature (AOR = 0.09, CI: 0.01-0.6, p = 0.012), and warm clothing (AOR = 0.05, CI: 0.01-0.39, p = 0.004). After 30 min of resuscitation, most patients had transitioned from a hypothermic state to a normothermic state, according to initial temperature measurements. This resuscitation involved keeping the patients warm using blankets and external warming devices and administering heated intravenous fluids.</p><p><strong>Conclusion: </strong>Hypothermia affected 39% of major trauma patients, with advanced age and injured regions as key associations. Routine temperature monitoring, especially for older patients and those with extremity injuries, is essential. Hospitals should implement standardized hypothermia prevention protocols, ensure adequate warming equipment, and train healthcare providers in early detection and management. Further research is needed to optimize warming techniques and resuscitation strategies in trauma care.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"104"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12219614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-invasive hemodynamic monitoring and cardiac preload assessment in severely injured children in the emergency department.","authors":"Jing Chen, Jia Li, Xingpeng Wang, Kai Ma, Jie Xu, Huifang Zhang, Yufei Su, Hua Li","doi":"10.1186/s12873-025-01264-2","DOIUrl":"10.1186/s12873-025-01264-2","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate cardiac preload and identify early predictors of severe trauma in pediatric patients using non-invasive hemodynamic monitoring in the pediatric emergency department.</p><p><strong>Methods: </strong>A prospective cohort study was conducted at Xi'an Children's Hospital (June 2022-October 2024) with 167 patients, divided into mild (84) and severe (83) trauma groups. Non-invasive monitoring began shortly after admission, collecting parameters alongside clinical and laboratory assessments.</p><p><strong>Results: </strong>No significant differences in demographics or injury characteristics were found between groups. The severe trauma group had higher blood transfusion requirements (TAR) (p < 0.01). Hemodynamic parameters showed reduced pre-ejection period (PEP), left ventricular ejection time, and thoracic fluid content (t = 5.655, z = -4.368, z = -3.702; p < 0.01), indicating insufficient preload. Elevated heart rate (t = -4.127; p < 0.01) compensated for this. Reduced stroke volume index (t = 2.339, p < 0.05) and higher cardiac index (z = -1.979; p < 0.05) suggested compensation for low hemoglobin. The severe group also had elevated white blood cells, blood glucose, lactate, interleukin-6, interleukin-10, ALT, and AST (p < 0.01), while hemoglobin, fibrinogen, and albumin were decreased (p < 0.01). Logistic regression identified PEP, albumin, interleukin-6, and TAR as independent risk factors for severe trauma (p < 0.05). PEP and interleukin-6 had the highest area under the curve values (> 0.70).</p><p><strong>Conclusions: </strong>Non-invasive hemodynamic monitoring can detect early signs of insufficient preload in severe pediatric trauma, and the combination of PEP and interleukin-6 aids in severity assessment and clinical decision-making.</p><p><strong>Clinical trial registration: </strong>Not applicable.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"108"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12219919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The establishment of a clinical protocol for hostages returning from captivity.","authors":"Daniel Trotzky, Idit Segal, Ronit Koren, Orna Tal, Gal Pachys, Galina Goltzman, Karen Or, Margarita Alpro, Ronit Zaidenstein, Maayan Bachar, Baruch Berzon, Roni Enten Vissoker, Inbar Hartmann, Miri Avraham, Vered Shinar, Ada Azar, Osnat Levtzion Korach","doi":"10.1186/s12873-025-01257-1","DOIUrl":"10.1186/s12873-025-01257-1","url":null,"abstract":"<p><strong>Background: </strong>As part of a hostage-prisoner exchange negotiation, 105 hostages were released to hospitals throughout Israel for treatment after being taken into captivity by Hamas to the Gaza Strip on October 7, 2023. The aim of this study is to describe the establishment of a clinical protocol for hostages returning from captivity.</p><p><strong>Method: </strong>The process of the creation of procedures for implementation of and the clinical protocol itself is described.</p><p><strong>Results: </strong>A total of 24 returning hostages arrived at Shamir Medical Center (SMC); all were foreign workers and all but one were from the same nationality. The majority group of 23 returning hostages from the same nationality received testing for Q-fever, Hepatitis B, and human immunodeficiency virus (HIV). Orthopedic, dermatological, and ear nose and throat (ENT) consultation, chest and limb X-rays, head and abdominal CT scans, and antibiotics were also utilized by the 23 returning hostages of the same nationality. The returning hostage from a different nationality of origin utilized consults with an ENT, underwent a hearing test, and tests for Q-fever, urine toxicology, Hepatitis B and HIV. Among the group of 23 hostages from the same nationality of origin, the mean percentage loss of body weight was 10%±10%. No correlation was found between age and change in weight (rho = -0.227; p = 0.350). In addition, 17.4% tested positive for Q fever, 30.4% tested positive for Hepatitis B and 13% tested positive for a sexually transmitted disease. They spent a mean of 5 ± 1 days hospitalized. The sole hostage of different nationality of origin lost 15% of his body weight, tested positive for Q fever and spent 3 days hospitalized. Consults with social workers and dietitians, translators and COVID-19 tests were used by all returning hostages.</p><p><strong>Conclusion: </strong>In this study, no significant correlation was found between age and change in weight among returning hostages. This novel clinical protocol was successfully utilized in real-time and may serve as a framework for the complex and sensitive clinical management of returning hostages, in case of need.</p><p><strong>Clinical trial number: </strong>Not Applicable.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"105"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12220378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time-based tracking of temperature and humidity of emergency medical service rapid response vehicles in Qatar: a prospective observational study.","authors":"Nour Alhuda Alaghawani, Abrar Mohamed, Ahmed Makhlouf, Habib Kerkeni, Loua Al Shaikh, Guillaume Alinier, Alaaldin M Alkilany, Ousama Rachid","doi":"10.1186/s12873-025-01255-3","DOIUrl":"10.1186/s12873-025-01255-3","url":null,"abstract":"<p><strong>Background: </strong>Paramedics working in emergency medical services (EMS) routinely administer life-saving medications to patients under urgent conditions. However, these medications are frequently subjected to undocumented fluctuations in environmental conditions, particularly temperature and humidity, which may lead to drug degradation and potentially compromise patient safety. In countries like the State of Qatar, known for its elevated temperatures and humidity, the environmental exposure of EMS medications stored in rapid response cars (RRCs) has not yet been systematically assessed. In this study, we aimed to evaluate the fluctuations in temperature and humidity experienced by ambulatory medications over a 12-month period.</p><p><strong>Methods: </strong>Six RRCs, each with three temperature and humidity loggers were utilized to collect real-life environmental data. Two loggers were placed in two paramedic bags stored at the back of the RRCs while a third logger was attached in the middle inside each car. Temperature and humidity readings were recorded at 10-minute intervals over 12 months for assessment. Data was then extracted using ElitechLog software, visualized using Python, and statistically analyzed. The mean kinetic temperature (MKT) was also calculated.</p><p><strong>Results: </strong>Temperature values reached 59.1 and 65.7 °C in the bags and inside the RRC, respectively. The MKT exceeded the United States Pharmacopeia recommendations of 30 °C, and in some instances, it exceeded 50 °C. Little to no difference was observed between the two bags in each car however, greater temperature values and MKT violations were reported by the centrally located sensor inside the RRCs.</p><p><strong>Conclusion: </strong>The reported MKT violations highlight the need to develop and implement improved storage strategies for EMS medications in emergency vehicles operating in extremely hot climates. However, given that medication bags are frequently exposed to high ambient temperatures when carried outside by paramedics, storage solutions alone are insufficient to fully prevent deviations from manufacturers' recommended conditions. This underscores the importance of specialized training for paramedics on stringent medication handling protocols to minimize temperature exposure and ensure drug safety and efficacy.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"98"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of the Lactate-to-Albumin ratio in predicting ICU admission and mortality in patients with UGIB presenting to the ED: a prospective observational study.","authors":"İlter Ağaçkıran, Merve Ağaçkıran","doi":"10.1186/s12873-025-01261-5","DOIUrl":"10.1186/s12873-025-01261-5","url":null,"abstract":"<p><strong>Background: </strong>Upper gastrointestinal bleeding (UGIB) remains a common and potentially life-threatening condition frequently encountered in emergency departments (EDs). Early risk stratification tools are essential for predicting outcomes such as intensive care unit (ICU) admission and in-hospital mortality.</p><p><strong>Objectives: </strong>To evaluate the predictive performance of the serum lactate-to-albumin ratio (LAR) for ICU admission and in-hospital mortality in patients presenting to the ED with UGIB.</p><p><strong>Methods: </strong>This prospective observational study included 181 patients who presented to a university hospital ED with UGIB. Demographic characteristics, laboratory parameters, medication use, and clinical outcomes were recorded. The diagnostic performance of LAR, blood urea nitrogen (BUN) -to-albumin ratio (BAR), and AIMS65 scores for ICU admission and mortality was assessed using ROC analysis and multivariate logistic regression.</p><p><strong>Results: </strong>LAR was significantly elevated in patients requiring ICU admission (p < 0.001). LAR showed a similar predictive value to AIM65 and a superior predictive value to BAR for both ICU admission and in-hospital mortality, compared to BAR and AIM65. The area under the curve (AUC) for LAR was 0.789 for ICU admission and 0.858 for mortality. Multivariate analysis identified LAR, underlying liver disease, and high AIMS65 score as independent predictors of in-hospital mortality.</p><p><strong>Conclusion: </strong>The lactate-to-albumin ratio is a simple, readily available, and effective biomarker for predicting adverse outcomes in UGIB patients. It may serve as a rapid and practical decision-making tool in emergency settings, complementing or potentially replacing existing scoring systems.</p><p><strong>Clinical trial number: </strong>not applicable.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"99"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic models for predicting patient arrivals in emergency departments: an updated systematic review and research agenda.","authors":"Luka Petravić, Kaja Gril Rogina, Tit Albreht, Andreja Kukec, Janez Žibert","doi":"10.1186/s12873-025-01250-8","DOIUrl":"10.1186/s12873-025-01250-8","url":null,"abstract":"<p><strong>Background: </strong>Emergency departments (ED) are struggling with an increased influx of patients. One of the methods to help departments prepare for surges of admittance is time series forecasting (TSF). The aim of this study was to create an overview of current literature to help guide future research. Firstly, we aimed to identify external variables used. Secondly, we tried to identify TSF methods used and their performance.</p><p><strong>Methods: </strong>We included model development or validation studies that were forecasting patient arrivals to the ED and used external variables. We included studies on any forecast horizon and any forecasting methodology. Literature search was done through PubMed, Scopus, Web of Science, CINAHL and Embase databases. We extracted data on methods and variables used. The study is reported according to TRIPOD-SRMA guidelines. The risk of bias was assessed using PROBAST and authors' own dimensions.</p><p><strong>Results: </strong>We included 30 studies. Our analysis has identified 10 different groups of variables used in models. Weather and calendar variables were commonly used. We found 3 different families of TSF methods. However, none of the studies followed reporting guidelines and model code was seldom published.</p><p><strong>Conclusions: </strong>Our results identify the need for better reported results of model development and validation to better understand the role of external variables used in created models, as well as for more uniform reporting of results between different research groups and external validation of created models. Based on our findings, we also suggest a future research agenda for this field.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"106"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12219896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}