British journal of hospital medicine最新文献

{"title":"Management of SGLT-2 Inhibitors in the Perioperative Period: Withhold or Continue?","authors":"Zack Pittack","doi":"10.12968/hmed.2024.0611","DOIUrl":"10.12968/hmed.2024.0611","url":null,"abstract":"<p><p>Sodium-glucose cotransporter 2 (SGLT-2) inhibitors are commonly prescribed in diabetes mellitus and increasingly for cardiorenal protection. They carry the risk of euglycaemic diabetic ketoacidosis (eDKA). Guidelines around the perioperative handling of these medications are limited and some evidence suggests that withholding them can lead to more surgical complications and poorer glycaemic control. This article gives an overview of arguments for and against withholding SGLT-2 inhibitors in the perioperative period.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 1","pages":"1-4"},"PeriodicalIF":1.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of Cardiac Rehabilitation Aerobic Exercise in Patients with Stable Angina in Coronary Heart Disease.","authors":"Jin Zhou, Ying Liu, Hua Zhao, Wei Yan, Litao Chen, Xing Sun, Xiaoman Feng, Jing Wang, Yongbin Pei, Shuya Li","doi":"10.12968/hmed.2024.0408","DOIUrl":"10.12968/hmed.2024.0408","url":null,"abstract":"<p><p><b>Aims/Background</b> A novel exercise protocol for cardiac rehabilitation aerobic (CRA) has been developed by Hebei Sport University, demonstrating efficacy in patients with coronary heart disease (CHD). The objective of this study was to evaluate the impact of CRA on precise cardiac rehabilitation (CR) for CHD patients presenting with stable angina pectoris. <b>Methods</b> The study cohort comprised patients with stable angina who were categorized into three groups: the CRA group (n = 35), the power bicycles (PB) group (n = 34), and the control group (n = 43). In addition to standard treatment, the CRA group underwent a 12-week CRA-based CR intervention, while the PB group participated in a similar program centered on PB exercise, and the control group received only standard treatment. <b>Results</b> At the end of the 12-week intervention, significant differences were observed among the groups in several physiological parameters, including systolic blood pressure (SBP), fasting blood glucose (FBG), triglycerides (TG), total cholesterol (TC), low-density lipoprotein (LDL), Glycated Haemoglobin (Hb-A1c), peak oxygen uptake (Peak VO₂), anaerobic threshold (AT), and Peak VO₂/heart rate (HR) (<i>p</i> < 0.05). Both the CRA and PB groups showed significant reductions in SBP, FBG, TG, TC, LDL, and Hb-A1c compared to the control group (<i>p</i> < 0.05). Additionally, both groups exhibited significant improvements in Peak VO₂, AT, and Peak VO₂/HR (<i>p</i> < 0.05). Intra-group analysis revealed that the CRA group showed significant improvements from baseline to post-intervention in SBP, diastolic blood pressure (DBP), FBG, TG, TC, high-density lipoprotein (HDL), LDL, Hb-A1c, Peak VO₂, AT, and Peak VO₂/HR (<i>p</i> < 0.05). Similarly, the PB group demonstrated significant improvements across these parameters (<i>p</i> < 0.05). <b>Conclusion</b> Both CRA and PB exercises are safe and effective for achieving precise CR in patients with CHD. A 12-week CRA intervention, conducted three times per week for 30 minutes per session, significantly improves cardiopulmonary function and biochemical makers in patients with stable angina. These improvements are comparable to those achieved through PB exercise in precise CR.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 1","pages":"1-12"},"PeriodicalIF":1.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143036990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glucagon-Like Peptide-1 Receptor Agonists in the Peri-Operative Period.","authors":"Purnima Narasimhan","doi":"10.12968/hmed.2024.0566","DOIUrl":"10.12968/hmed.2024.0566","url":null,"abstract":"<p><p>Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are emerging as an important class of drugs in the management of Type 2 Diabetes Mellitus (T2DM) and obesity. There are rising concerns of pulmonary aspiration with these medications due to drug-induced gastroparesis. While definitive association is uncertain, it is essential to be prudent and manage these patients as per the current evidence and recommendations.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 1","pages":"1-4"},"PeriodicalIF":1.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective Analysis of the Correlation between Umbilical Blood Flow Index and Maternal and Fetal Outcomes in Pregnant Women with Gestational Diabetes.","authors":"Qiong Liu, Sinan Shu, Xiuping Zhao, Huiling Yu","doi":"10.12968/hmed.2024.0582","DOIUrl":"10.12968/hmed.2024.0582","url":null,"abstract":"<p><p><b>Aims/Background</b> Gestational diabetes mellitus (GDM) is a common complication during pregnancy. This retrospective study investigates the correlation between umbilical blood flow index and maternal-fetal outcomes in pregnant women with GDM, aiming to contribute to evidence-based risk assessment and management strategy in this high-risk obstetric population. <b>Methods</b> This retrospective study recruited 119 pregnant women with GDM who were admitted to the Yichang Central People's Hospital, between January 2022 and January 2024. Based on the umbilical blood flow index, the study participants were divided into a normal umbilical blood flow (UBF) index group (n = 56) and a high UBF index group (n = 63). Colour Doppler ultrasound was used to assess umbilical blood flow, and relevant data on maternal, fetal, and neonatal outcomes were obtained from the hospital's electronic medical records. <b>Results</b> We observed that, compared to the normal UBF index group, the high UBF index group exhibited significantly higher rates of adverse pregnancy outcomes, including the cesarean section (<i>p</i> = 0.022), preterm delivery (<i>p</i> = 0.020), gestational hypertension (<i>p</i> = 0.019), neonatal hypoglycemia (<i>p</i> = 0.015), as well as increased incidence of neonatal complications such as respiratory distress syndrome (<i>p</i> = 0.009), neonatal jaundice (<i>p</i> = 0.022), neonatal intensive care unit (NICU) admission (<i>p</i> = 0.015), lower 5-minute Apgar scores (<i>p</i> = 0.013), and neonatal sepsis (<i>p</i> = 0.005). Furthermore, significant differences were observed in fetal biometric parameters and placental morphology between the two groups (fetal weight: <i>p</i> = 0.003; estimated fetal weight percentile: <i>p</i> = 0.017; femur length: <i>p</i> = 0.018; placental weight: <i>p</i> = 0.019; placental volume: <i>p</i> = 0.021). Additionally, correlation analyses indicated significant associations between umbilical blood flow index and maternal and fetal outcomes (<i>p</i> < 0.05). <b>Conclusion</b> We observed a significant correlation between umbilical blood flow indices and maternal and fetal outcomes in pregnant women with gestational diabetes mellitus, implying its utility as a non-invasive parameter for risk stratification and personalized management in this high-risk obstetric population.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 1","pages":"1-12"},"PeriodicalIF":1.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Application Value of an Artificial Intelligence-Driven Intestinal Image Recognition Model to Evaluate Intestinal Preparation before Colonoscopy.","authors":"Xirong Xu, Jiahao Liu, Jianwei Qiu, Benfang Fan, Tao He, Shichun Feng, Jinjie Sun, Zhenming Ge","doi":"10.12968/hmed.2024.0577","DOIUrl":"10.12968/hmed.2024.0577","url":null,"abstract":"<p><p><b>Aims/Background</b> Artificial intelligence (AI), with advantages such as automatic feature extraction and high data processing capacity and being unaffected by fatigue, can accurately analyze images obtained from colonoscopy, assess the quality of bowel preparation, and reduce the subjectivity of the operating physician, which may help to achieve standardization and normalization of colonoscopy. In this study, we aimed to explore the value of using an AI-driven intestinal image recognition model to evaluate intestinal preparation before colonoscopy. <b>Methods</b> In this retrospective analysis, we analyzed the clinical data of 98 patients who underwent colonoscopy in Nantong First People's Hospital from May 2023 to October 2023. Among them, 47 cases were evaluated based on the intestinal preparation map and the last fecal characteristics (Regular group), and 51 cases were evaluated using an AI-driven intestinal image recognition model (AI group). The duration of colonoscopy examination, intestinal cleanliness, incidence of adverse reactions, and satisfaction with intestinal preparation of the two groups were analyzed. <b>Results</b> The time for colonoscopy in the AI group was shorter than that in the Regular group, and the intestinal cleanliness score in the AI group was higher than that in the Regular group (<i>p</i> < 0.05). The incidence of adverse reactions in the AI group (3.92%) was lower than that in the Regular group (10.64%), but the difference was not statistically significant (<i>p</i> > 0.05). The satisfaction rate of intestinal preparation in the AI group (96.08%) was comparable to that of the Regular group (82.98%) (<i>p</i> > 0.05). <b>Conclusion</b> Compared with the assessment based solely on the intestinal preparation map and the last fecal characteristics, the application of AI intestinal image recognition model in intestinal preparation before colonoscopy can shorten the time of colonoscopy and improve intestinal cleanliness, but with comparable patient satisfaction and safety.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 1","pages":"1-11"},"PeriodicalIF":1.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Efficacy and Safety of Crisaborole in Managing Childhood Mild to Moderate Atopic Dermatitis: A Systematic Review and Meta-Analysis.","authors":"Jianhua You, Huanmei Li, Zhongyun Wang, Yunfei Zhao","doi":"10.12968/hmed.2024.0575","DOIUrl":"10.12968/hmed.2024.0575","url":null,"abstract":"<p><p><b>Aims/Background</b> Atopic dermatitis (AD) is a common chronic inflammatory skin disorder globally. Crisaborole, a nonsteroidal topical phosphodiesterase 4 inhibitor (PDE4i), has been utilized in treating AD. Crisaborole regulates the production of inflammatory cytokines, which are usually overactive among AD patients. Therefore, this study aimed to explore the efficacy and safety of crisaborole in treating AD in patients aged ≤18 years. <b>Methods</b> A literature search was performed across PubMed, MEDLINE, Embase, Cochrane, and Google Scholar. The inclusion criteria involved primary studies evaluating the effect of crisaborole in treating dermatitis, articles exploring the use of crisaborole in AD patients below 18 years (>two years), and articles published in English between 2000 and 2022. However, the studies evaluating AD in adult patients, those reporting treatments other than crisaborole, those published before 2000, and articles written in languages other than English were excluded from this analysis. Furthermore, secondary data sources such as case reports, newspaper articles, magazines, and other systematic reviews and meta-analyses were excluded. A meta-analysis was conducted using RevMan 5.4. The risk of bias in the manuscripts was assessed using the Cochrane tool. The I-square test statistic was used to determine heterogeneity, and Egger's test was used to evaluate publication bias. <b>Results</b> Ten studies met the eligibility criteria and were included in the final analysis. Most of the studies exhibited a low risk of bias with no publication bias. Meta-analysis indicated a significant difference in the number of patients attaining Investigator Static Global Assessment (ISGA) success at day 29, with significantly higher patients in the crisaborole group than in the vehicle group (odds ratio (OR) 1.56, 95% CI 1.24 to 1.96; I² = 77%; <i>p</i> = 0.0001). Similarly, pruritus improvement was significant between the two cohorts at day 29, indicating significantly higher heterogeneity (OR 1.70, 95% CI 1.10 to 2.63; I² = 91%; <i>p</i> = 0.02). Furthermore, the safety profiling of the treatments was insignificant, demonstrating no statistical difference in the treatment-emergent adverse events (TEAEs) between the two groups with high heterogeneity (OR 0.53, 95% CI 0.14 to 1.98; I² = 99%; <i>p</i> = 0.35). <b>Conclusion</b> Crisaborole demonstrates substantial efficacy in treating mild to moderate AD compared to vehicle therapies, as it reduces the signs and symptoms of the disease. Furthermore, crisaborole is well tolerated and has an acceptable safety profile in treating mild to moderate AD patients.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 1","pages":"1-19"},"PeriodicalIF":1.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Geriatric Nutritional Risk Index Scores with Outcomes in Patients Undergoing Maintenance Hemodialysis.","authors":"Yuting Yang, Yujuan Yang, Yanping Hu, Xintian Shi, Jiayan Huang, Junhui Wan, Hong He, Qinkai Chen, Yu Wang, Qing Zhao","doi":"10.12968/hmed.2024.0501","DOIUrl":"10.12968/hmed.2024.0501","url":null,"abstract":"<p><p><b>Aims/Background</b> The Geriatric Nutritional Risk Index (GNRI) is an effective tool for identifying malnutrition, and helps monitor the prognosis of patients undergoing maintenance hemodialysis. However, the association between the GNRI and cardiovascular or all-cause mortality in hemodialysis patients remains unclear. Therefore, this study investigated the correlation of the GNRI with all-cause and cardiovascular mortality in patients undergoing maintenance hemodialysis. <b>Methods</b> This study included 402 incident hemodialysis patients. Based on the first-dialysis GNRI quartile, the patients were divided into four groups: N1 (GNRI ≤85.04), N2 (GNRI 85.05-91.04), N3 (91.05-96.49), N4 (GNRI ≥96.5) groups. The risk of all-cause and cardiovascular mortality among the different GNRI groups was compared using the Kaplan-Meier survival curve analysis through log-rank tests. Furthermore, Cox regression analysis was used to assess the association between the GNRI groups and all-cause mortality. Additionally, the predictive capability of the GNRI groups on the prognosis was evaluated by employing receiver operating characteristic (ROC) curve analysis. <b>Results</b> Patients in the N1 group exhibited a significantly higher risk of all-cause mortality (<i>p</i> < 0.001) and cardiovascular mortality (<i>p</i> = 0.004) compared to the other groups. ROC curve analysis revealed that GNRI, age, and serum creatinine had moderate predictive value for mortality, with GNRI indicating an area under the curve (AUC) of 0.605 for all-cause mortality and 0.565 for cardiovascular mortality. Moreover, the N2 and N3 groups had a significantly reduced risk of cardiovascular mortality compared to the N1 group. <b>Conclusion</b> A lower GNRI is closely associated with a higher risk of all-cause and cardiovascular mortality in hemodialysis patients.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 1","pages":"1-18"},"PeriodicalIF":1.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Assessment Prior to Cardiotoxic Anticancer Therapies in 7 Steps.","authors":"Jieli Tong, Isabelle Senechal, Sivatharshini Ramalingam, Alexander R Lyon","doi":"10.12968/hmed.2024.0632","DOIUrl":"10.12968/hmed.2024.0632","url":null,"abstract":"<p><p>The burdens of cardiovascular (CV) diseases and cardiotoxic side effects of cancer treatment in oncology patients are increasing in parallel. The European Society of Cardiology (ESC) 2022 Cardio-Oncology guidelines recommend the use of standardized risk stratification tools to determine the risk of cardiotoxicity associated with different anticancer treatment modalities and the severity of their complications. The use of the Heart Failure Association-International Cardio-Oncology Society (HFA-ICOS) is essential for assessing risk prior to starting cancer treatment, and validation of these methods has been performed in patients receiving anthracyclines, human epidermal receptor 2 (HER2)-targeted therapies and breakpoint cluster region-abelson oncogene locus (BCR-ABL) inhibitors. The benefits of performing baseline CV risk assessment and stratification include early recognition of cardiotoxicities, personalisation of cancer treatment and monitoring strategies, and allocation of cardioprotection to those at the highest risk. This review summarizes the key points of risk stratification in these patients. The steps include identifying the target population, assessing nonmodifiable and modifiable CV risk factors, reviewing previous oncologic therapies and CV histories, and performing baseline investigations. In summary, this review aims to provide general physicians with a simple 7-step guide that will help steer and navigate them through cardiac risk evaluation of potentially cardiotoxic oncologic treatment strategies.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 1","pages":"1-21"},"PeriodicalIF":1.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of General Magnetic Therapy and Motor-Evoked Potential-Guided Precision Magnetic Therapy in Patients with Overactive Bladder: A Randomized Controlled Trial.","authors":"Hongzhe Xu, Zhangji Zhu, Yinan Lv, Jiawei Gong, Yue Duan","doi":"10.12968/hmed.2024.0532","DOIUrl":"10.12968/hmed.2024.0532","url":null,"abstract":"<p><p><b>Aims/Background</b> Overactive bladder (OAB) is a prevalent chronic condition affecting approximately 12% of adults, with incidence increasing with age. While pharmacological and behavioural therapies are standard treatments, their efficacy is often limited by side effects and poor adherence. This study aimed to compare the therapeutic effects of precision magnetic stimulation guided by motor-evoked potential with general magnetic therapy in patients with OAB. <b>Methods</b> This randomized controlled trial included 45 patients diagnosed with OAB at The Second Affiliated Hospital of Zhejiang Chinese Medicine University between January 2022 and September 2022. Participants were randomly divided into Group 1 (n = 15) which received bladder training (BT) alone, Group 2 (n = 15) received BT combined with general magnetic therapy, and Group 3 (n = 15) received BT combined with precision magnetic therapy. Clinical efficacy was evaluated using the Overactive Bladder Symptom Score (OABSS), urination diaries, initial bladder volume, and maximum bladder volume before and after treatment. <b>Results</b> At the end of the intervention, Groups 2 and 3 demonstrated significant improvements in OABSS scores, urgency of urination, initial bladder volume, and maximum bladder volume compared to Group 1 (<i>p</i> < 0.05). Group 3 exhibited superior urination frequency and initial bladder volume improvements compared to Group 2 (<i>p</i> < 0.05). <b>Conclusion</b> General magnetic therapy combined with BT and precision magnetic therapy combined with BT were more effective than BT alone in treating OAB. While there were no significant differences between the two magnetic stimulation methods in terms of OABSS scores, urgent urination, nocturnal urination, or maximum bladder volume, precision magnetic therapy showed greater efficacy in reducing urination frequency and improving initial bladder volume. These findings suggest that precision magnetic therapy offers an enhanced therapeutic benefit. <b>Clinical Trial Registration</b> Chinese Clinical Trial Registry (ChiCTR2400087888).</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 1","pages":"1-12"},"PeriodicalIF":1.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Validation of a GULP-Based Predictive Model for Dehydration in Elderly Patients with Post-Stroke Dysphagia.","authors":"Yan Liang, Xin Dai, Bing Wei, Haiyan Jia, Jinxiu Zhang, Zi Qiu, Qian Zhang","doi":"10.12968/hmed.2024.0366","DOIUrl":"10.12968/hmed.2024.0366","url":null,"abstract":"<p><p><b>Aims/Background</b> The background for establishing and verifying a dehydration prediction model for elderly patients with post-stroke dysphagia (PSD) based on General Utility for Latent Process (GULP) is as follows: For elderly patients with PSD, GULP technology is utilized to build a dehydration prediction model. This aims to improve the accuracy of dehydration risk assessment and provide clinical intervention, thereby offering a scientific basis and enhancing patient prognosis. This research highlights the innovative application of GULP technology in constructing complex medical prediction models and addresses the special health needs of elderly stroke patients. Based on GULP criteria, the study aims to establish and validate a dehydration prediction model for elderly patients with dysphagia following a stroke. <b>Methods</b> Two hundred patients with post-stroke dysphagia treated at Beijing Rehabilitation Hospital Affiliated with Capital Medical University, from January 2020 to December 2023, were selected retrospectively. The patients were randomly matched at a ratio of 1:4 to establish a verification group (n = 40) and a modelling group (n = 160). Based on the occurrence of dehydration, the modelling group patients were divided into two groups: the dehydration group (n = 55) and the non-dehydration group (n = 105). Univariate and multivariate logistic regression analyses were used to identify the influencing factors of dehydration in elderly patients with dysphagia after a stroke, and to establish a predictive model based on GULP. The predictive value of the model was evaluated using receiver operating characteristic (ROC) curve analysis. <b>Results</b> The results of univariate and multivariate logistic regression analyses showed significant differences in age, lesion location, muscle strength grade, homocysteine (Hcy), and swallowing function score (<i>p</i> < 0.05). When these influencing factors were included in the model, the slope of the calibration curve in both the training set and the validation set was close to 1, indicating that the predicted dehydration risk was consistent with the actual risk. ROC analysis results revealed that in the training set, the model predicted dehydration in elderly post-stroke patients with dysphagia with an area under the curve (AUC) of 0.934, a standard error of 0.034, and a 95% confidence interval (CI) of 0.916 to 0.981. The optimal cutoff value was 0.78, yielding a sensitivity of 88.84% and a specificity of 90.00%. In the validation set, the AUC was 0.867 with a standard error of 0.025 and a 95% CI of 0.694 to 0.934. The optimal cutoff value here was 0.66, with a sensitivity of 80.16% and a specificity of 85.94%. <b>Conclusion</b> This study successfully established and validated a GULP-based dehydration prediction model for elderly patients with dysphagia following a stroke, demonstrating high application value.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 1","pages":"1-16"},"PeriodicalIF":1.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}