British journal of hospital medicine最新文献

{"title":"Mitigating Opioid Dependence in Orthopaedic Surgery: Current Strategies and Future Directions.","authors":"Hugo Humphries, Andreas Fontalis, Warran Wignadasan, Fares S Haddad","doi":"10.12968/hmed.2024.1022","DOIUrl":"10.12968/hmed.2024.1022","url":null,"abstract":"<p><p>The opioid crisis presents a significant burden to patients and healthcare systems. Orthopaedic surgery involves treating patients with significant pain demands, therefore opioid stewardship in this specialty is an important area in targeting the opioid crisis. A number of strategies have been outlined in the literature to help reduce prescription of opioids for patients with painful orthopaedic conditions. Enhanced recovery after surgery (ERAS) protocols involving multimodal analgesia (MMA) and multi-disciplinary team (MDT) involvement have been proven effective. Pre-operative counselling of patients with clear communication and educational resources helps to educate patients on the negative effects overuse of opioids can have post-operatively. Novel strategies are being investigated to reduce opioid dependence, particularly in the areas of artificial intelligence (AI) and machine learning (ML), which can help predict patients at increased risk of opioid dependence post-operatively and therefore provide personalised treatment to prevent the harmful sequelae.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 7","pages":"1-7"},"PeriodicalIF":1.8,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706386","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":"Genetic Analyses Identify Human Serum Metabolites Associated With Risk of Gastroesophageal Reflux Disease: A Mendelian Randomization Study.","authors":"Xiang Shi, Lu Zhang, Wei Huang, Min Li, Yuyan Chen, Yilin Hu, Cuihua Lu, Chenzhou Xu, Zhaoxiu Liu","doi":"10.12968/hmed.2025.0067","DOIUrl":"https://doi.org/10.12968/hmed.2025.0067","url":null,"abstract":"<p><p><b>Aims/Background</b> Gastroesophageal reflux disease (GERD) is a widespread upper esophagogastric disease with incompletely understood biological mechanisms. Emerging evidence supports a complex link between GERD and metabolic markers. Therefore, Mendelian randomization (MR), an innovative genomic approach, was used to evaluate the causal impacts of serum metabolites on GERD, aiming to identify novel biomarkers and elucidate underlying metabolic pathways. <b>Methods</b> A two-sample MR framework was employed to examine causal relationships between circulating metabolites and GERD. Genetic instruments for 486 metabolic traits were derived from a comprehensive metabolomics genome-wide association study (GWAS), with disease outcome data from GERD cohorts. Primary causal inference was conducted using the inverse variance weighted (IVW) method, supported by complementary and sensitivity analyses to validate the reliability of the findings. The analytical framework incorporated multiple validation approaches, including replication, meta-analysis, linkage disequilibrium score regression, colocalization analysis, reverse MR analysis, and multivariable MR analysis. Systematic pathway analysis was employed to elucidate associated pathways and underlying disease mechanisms. <b>Results</b> The IVW analysis identified 32 causal associations between serum metabolites and GERD. Through subsequent sensitive analyses, robust causal links were identified between 13 metabolites and GERD. By applying several advanced approaches, such as replication, meta-analysis, linkage disequilibrium score regression, colocalization analyses, reverse MR analysis, and multivariable MR analysis, two metabolites, adrenate (22:4n6) and 2-palmitoylglycerophosphocholine, were confirmed to have stable and independent impacts on GERD. Pathway analysis revealed that three metabolic pathways, such as tryptophan metabolism, bile acid biosynthesis, and carnitine synthesis, exhibited significant association with GERD. <b>Conclusion</b> Using integrative genomics and metabolomics approaches, this study provides evidence supporting the causal influence of two serum metabolites and three metabolic pathways on GERD, highlighting the potential of these metabolites as promising biomarkers for early screening, diagnosis, and targeted treatment strategies. Moreover, these findings underscore the significance of integrating genomics and metabolomics in understanding disease pathophysiology.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 7","pages":"1-19"},"PeriodicalIF":1.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706384","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 Risk Factors Impacting the Severity of Coronary Artery Lesions in Kawasaki Disease.","authors":"Guangli Zhu, Ping Zhang","doi":"10.12968/hmed.2025.0047","DOIUrl":"https://doi.org/10.12968/hmed.2025.0047","url":null,"abstract":"<p><p><b>Aims/Background</b> Kawasaki disease (KD) is a systemic vasculitis primarily affecting children under five. Coronary artery lesions (CAL), a severe complication associated with KD, can lead to long-term cardiovascular problems and even life-threatening conditions. However, the pathological mechanisms underlying CAL in KD patients remain unexplored. Therefore, this study aims to investigate the risk factors affecting the severity of CAL in KD patients, providing valuable insights for early identification and clinical intervention of KD. <b>Methods</b> This single-center retrospective study included 326 KD patients treated at the pediatric clinic of The Second People's Hospital of Changzhou between January 2016 and December 2023. Baseline data, clinical characteristics, cardiac function-related indicators, and CAL severity-related information were retrieved from the hospital's electronic record system. Furthermore, risk factors affecting CAL severity were identified using logistic regression analysis. <b>Results</b> Among the 326 patients, 51 (15.64%) developed varying degrees of CAL, with 3.07% exhibiting severe CAL. KD patients were presented with clinical symptoms, such as fever, rash, oral mucosal changes, lymphadenopathy, and swelling of the hands and feet. Univariate analysis revealed younger age, longer fever duration, higher platelet count (PLT), elevated C-reactive protein (CRP) levels, faster erythrocyte sedimentation rate (ESR), increased white blood cell (WBC) count, elevated lactate dehydrogenase (LDH) levels, lower left ventricular ejection fraction (LVEF), and lower cardiac indices as significant risk factors for CAL development (<i>p</i> < 0.05). Furthermore, multivariate logistic regression analysis identified longer fever duration, higher PLT levels, increased CRP levels, and lower LVEF as independent risk factors for CAL development (<i>p</i> < 0.05). <b>Conclusion</b> Evaluating CAL development in KD patients requires a comprehensive assessment of clinical characteristics, inflammatory indicators, and cardiac function indices.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 7","pages":"1-12"},"PeriodicalIF":1.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706391","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":"Social Prescribing: What It Is and What It Can Do.","authors":"Joelle Bradly, Monica Boulton","doi":"10.12968/hmed.2025.0007","DOIUrl":"https://doi.org/10.12968/hmed.2025.0007","url":null,"abstract":"<p><p>Social prescribing is proposed as a way to address social determinates of health and improve health and well-being outcomes and increasingly, acute hospitals, secondary and specialist care services are also implementing the approach. There are many local small-scale studies that have explored the benefits of social prescribing and, more recently, larger scale evaluations have brought together evidence across different areas. These studies suggest that social prescribing is able to reach those facing inequalities and can lead to economic benefits to health services as well as social and health related outcomes for individuals. However, it is also important to consider the systems that link workers fit into and how this contributes to addressing social determinates of health.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 7","pages":"1-5"},"PeriodicalIF":1.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706393","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":"A Correlation Analysis of Early Sepsis Recognition and Patient Prognosis: A Single-Center Retrospective Study.","authors":"Yingxia Jing, Yunlong Wu","doi":"10.12968/hmed.2025.0166","DOIUrl":"https://doi.org/10.12968/hmed.2025.0166","url":null,"abstract":"<p><p><b>Aims/Background</b> Sepsis is a critical medical emergency with a significantly high mortality rate. This study aims to investigate the relationship between changes in early indicators and prognosis, exploring the link between early sepsis recognition and patient outcomes. <b>Methods</b> This retrospective analysis included clinical data from 183 sepsis patients admitted to the hospital between July 2021 and November 2024. Based on the recognition time, patients were divided into an early recognition group (within 6 hours after admission, n = 136) and a delayed recognition group (6 hours after admission, n = 47). The baseline characteristics, early recognition indicators, therapeutic measures, and prognostic outcomes were collected, and the relationship between these variables was analyzed using the logistic regression analysis. <b>Results</b> There were no significant differences between the early and delayed recognition groups regarding age, gender, immunity status, and the distribution of common underlying conditions (<i>p</i> > 0.05). However, the sequential organ failure assessment (SOFA) scores were significantly higher in the delayed recognition group compared to the early recognition group (<i>p</i> < 0.05). The two groups showed significant differences in key indicators such as body temperature, heart rate, respiratory rate, white blood cell count (WBC), C-reactive protein (CRP), neutrophil ratio, procalcitonin (PCT), lactate, platelet count, and D-dimer levels (<i>p</i> < 0.05). The early recognition group received anti-infective treatment timely, had reasonable fluid resuscitation, a lower proportion of vasoactive drug usage, and reduced mechanical ventilation use (<i>p</i> < 0.05). The early recognition group had a shorter duration of hospitalization, good recovery of organ function at discharge, and significantly lower mortality and complication rates than the delayed recognition group (<i>p</i> < 0.05). Logistic regression analysis revealed that heart rate, respiratory rate, CRP, PCT, neutrophil ratio, lactate, D-dimer, and SOFA score ≥8 points were independent risk factors affecting prognosis (<i>p</i> < 0.05). <b>Conclusion</b> Early sepsis recognition, followed by prompt therapeutic measures, significantly improves patient prognosis, and relevant indicators help early sepsis identification and prognosis assessment.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 7","pages":"1-12"},"PeriodicalIF":1.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706375","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 Between Maternal Autoantibody Levels and Neurodevelopmental Outcomes in Infants Born to Mothers With Rheumatic Disease.","authors":"Bingqing Liu, Jia Xu, Mengxian Liu, Xia Gu, Peijun Xu","doi":"10.12968/hmed.2024.0411","DOIUrl":"https://doi.org/10.12968/hmed.2024.0411","url":null,"abstract":"<p><p><b>Aims/Background</b> Maternal autoimmune conditions have been associated with adverse pregnancy outcomes and neonatal complications, with potential impacts on fetal neurodevelopment. However, the specific associations between maternal autoantibody levels and neurodevelopmental outcomes in the context of rheumatic diseases remain incompletely understood. Therefore, this study aimed to investigate the relationship between maternal autoantibody profiles and infant neurodevelopmental outcomes in a cohort of mothers with rheumatic diseases, and to evaluate their diagnostic value in predicting neurodevelopmental disorders. <b>Methods</b> This retrospective case-control study included patients admitted for antenatal care with rheumatic conditions from January 2017 to June 2022. Participants were categorised into the normal neurodevelopment group (n = 404) and the neurodevelopmental disorder group (n = 111) based on infant neurodevelopmental outcomes. Maternal cytokines and hormone levels, as well as autoantibody levels, were measured and analysed. Statistical analyses, including correlation and multivariable logistic regression, were employed to evaluate associations between maternal biomarkers and infant neurodevelopmental outcomes. <b>Results</b> Statistically significant differences were observed between the two groups in terms of birth length, maternal cytokine levels (interleukin-6 [IL-6], interleukin-10 [IL-10], interleukin-4 [IL-4]), hormone levels (progesterone, thyroxine), and maternal autoantibody levels (anti-Sjögren's-syndrome-related antigen A [anti-SSA], anti-Sjögren's-syndrome-related antigen B [anti-SSB], anti-double-stranded DNA [anti-dsDNA], anti-ribonucleoprotein [anti-RNP], and anti-Smith [anti-Sm] antibodies) (<i>p</i> < 0.05). Correlation analysis revealed significant associations between specific maternal autoantibodies and neurodevelopmental parameters, as well as a positive correlation between birth length and neurodevelopmental parameters (<i>p</i> < 0.001). The multiple regression model showed that maternal autoantibody levels had a strong diagnostic value for predicting infant neurodevelopment. <b>Conclusion</b> This study provides compelling evidence supporting the relationship between maternal autoantibodies, cytokines, and hormone levels and neurodevelopmental outcomes in infants born to mothers with rheumatic disease.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 7","pages":"1-15"},"PeriodicalIF":1.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706377","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":"Impact of Family-Centred Continuity of Care on Depression, Anxiety, Self-Esteem, and Quality of Life in Children With Leukemia.","authors":"Yanhua Zhang, Ying Shen, Qian Zhang, Fei Wang, Yingwei Wang, Cuifang Zhao, Yuqiao Diao, Dong Xie","doi":"10.12968/hmed.2025.0256","DOIUrl":"https://doi.org/10.12968/hmed.2025.0256","url":null,"abstract":"<p><p><b>Aims/Background</b> Leukemia is the most prevalent pediatric malignancy and has a significant impact on the psychological, emotional well-being, and quality of life of affected children. This study aimed to evaluate the effects of family-centred continuity of care (FCCC) on the psychological state, self-esteem, and quality of life in children with leukemia. <b>Methods</b> A retrospective analysis was conducted on 243 pediatric leukemia patients admitted to the Fourth Hospital of Hebei Medical University between January 2019 and December 2022. Patients were divided into two groups: Routine care (n = 135), who received standard hospital care, and home care (n = 108), who received FCCC. Data were collected and analysed using the Self-Esteem Scale (SES), Screen for Child Anxiety Related Emotional Disorders (SCARED), Depression Self-Rating Scale for Children (DSRSC), and Pediatric Quality of Life Inventory Multidimensional Fatigue Scale (PedsQL MFS). <b>Results</b> Post-intervention, the home care group demonstrated significant improvements in self-management, emotional and mental health functioning, and physical and social functioning (<i>p</i> < 0.05). The group also demonstrated decreased depression, enhanced self-esteem, improved quality of life, and reduced anxiety levels, indicating the efficacy of FCCC. <b>Conclusion</b> FCCC significantly enhances psychological well-being and quality of life in pediatric leukemia patients by integrating family members into the care process and offering emotional support and empowerment.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 7","pages":"1-16"},"PeriodicalIF":1.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706385","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 Ageing of the Human Lower Bowel.","authors":"Nicholas Baidoo, Gareth J Sanger","doi":"10.12968/hmed.2024.0734","DOIUrl":"https://doi.org/10.12968/hmed.2024.0734","url":null,"abstract":"<p><p>Older people suffer a greater number of disorders of the gastrointestinal tract, including chronic constipation and faecal incontinence. In this review, we examine the age-related degenerative changes that have been identified in the lower bowel of humans. Firstly, older individuals may experience less abdominal pain and a lower incidence of gut-brain disorders that are defined partly by abdominal pain (e.g., irritable bowel syndrome); the causes are unclear. Secondly, an age-dependent reduction in mucosal barrier functions may follow a decline in intestinal stem cell activity, a reduced density of tight junction proteins linking epithelial cells and a decline in mucus layer thickness. This allows antigenic and toxic material to enter the wall of the colon. Thirdly, degenerative changes within the wall of the colon occur in both the ascending and descending regions, but the ascending colon appears most vulnerable. Here, there is reduced cholinergic neuromuscular function (potentially reducing colonic motility), perhaps because of dysfunctional nerve axon transport, and associated senescence-like activity. These changes lower the 'intestinal reserve', that is the capacity of neuromuscular functions to absorb other 'life events' that affect bowel motility (e.g., changes in lifestyle or eating habits, medications that affect neuromuscular functions and diseases such as diverticulosis) without generating symptoms such as constipation. When combined, symptoms are more likely to develop.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 7","pages":"1-16"},"PeriodicalIF":1.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706394","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":"Clinicopathological Determinants of Lymph Node Metastasis in Early-Stage Cervical Cancer: A Retrospective Cohort Study.","authors":"Shanliang Shang, Jianhua Yang, Zhi Ma, Xiao Zhang","doi":"10.12968/hmed.2025.0175","DOIUrl":"https://doi.org/10.12968/hmed.2025.0175","url":null,"abstract":"<p><p><b>Aims/Background</b> Accurate identification of lymph node metastasis is critical for optimising surgical strategies in early-stage cervical cancer. This study aimed to analyse multiple clinicopathological factors which are potentially associated with lymph node metastasis to guide personalised lymphadenectomy decisions. <b>Methods</b> This retrospective cohort study included 266 patients with early-stage cervical cancer (International Federation of Gynecology and Obstetrics [FIGO] stage IA1 to IIA2) who underwent surgical treatment at Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, between 1 December 2014 and 31 December 2019. Patients were followed up every 3 months for the first 2 years, every 6 months for the next 3 years, and annually thereafter. The presence of lymph node metastasis was included as the primary outcome, while the associated factors as secondary outcomes. The univariate and multivariate logistic regression were performed to identify risk factors associated with lymph node metastasis. <b>Results</b> The mean age of the study participants (n = 266) was 44.26 years (standard deviation [SD] = 10.19), and the median follow-up duration was 48.7 months (range 12-72 months). Lymph node metastasis was observed in 15.41% of patients. The metastatic rates increased with advancing FIGO stage: IA1 and IA2 (0%), IB1 (13.44%), IB2 (15.00%), IIA1 (23.33%), and IIA2 (66.67%). Univariate analysis identified FIGO stage (<i>p</i> < 0.001), depth of stromal invasion (<i>p</i> < 0.001), tumour size (<i>p</i> = 0.017), parametrial invasion (<i>p</i> < 0.001), and lymphovascular space invasion (LVSI) (<i>p</i> < 0.001) as significantly associated risk factors for lymph node metastasis. Multivariate analysis identified tumour size ≥4 cm (adjusted odds ratio [OR]: 3.857; 95% confidence interval [CI]: 1.530-9.728; <i>p</i> = 0.004), FIGO stage II (adjusted OR: 8.247; 95% CI: 3.171-21.455; <i>p</i> < 0.001), LVSI (adjusted OR: 2.974; 95% CI: 1.344-6.632; <i>p</i> = 0.008), and parametrial invasion (adjusted OR: 5.585; 95% CI: 1.900-16.415; <i>p</i> = 0.002) as independent risk factors for nodal metastasis. <b>Conclusion</b> This study identifies several key clinicopathological factors associated with lymph node metastasis in early-stage cervical cancer. These findings underscore the importance of meticulous preoperative risk assessment and offer an evidence-based foundation for tailored surgical planning to improve patient outcomes.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 7","pages":"1-14"},"PeriodicalIF":1.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706379","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":"Effects of Age and Parity on Pelvic Floor Dysfunction and Recovery in the Early Postpartum Period: A Retrospective Cohort Study.","authors":"Zhirong Mao, Dandan Hao, Qiang Gao, Yaping Meng, Minxia Zhou, Lin Zhang","doi":"10.12968/hmed.2025.0195","DOIUrl":"https://doi.org/10.12968/hmed.2025.0195","url":null,"abstract":"<p><p><b>Aims/Background</b> Pregnancy and childbirth can significantly alter pelvic floor structure and function, particularly during the postpartum period, often resulting in dysfunction. Although maternal age and the number of vaginal deliveries have been reported as risk factors for pelvic floor dysfunction, studies on how these factors interact to impact pelvic floor dysfunction and recovery in the postpartum period are limited. Therefore, this study explored the integrated effects of age groups and the number of vaginal deliveries on pelvic floor electromyography and structural indicators among postpartum women. <b>Methods</b> This retrospective cohort study collected data of 245 postpartum women 42-60 days after delivery from the clinic's records of the Jiading District Central Hospital Affiliated Shanghai University of Medicine and Health Sciences between January 2020 and December 2022. Of these patients, 108 were multiparous and 137 were primiparous. Based on age, participants were divided into two groups: ≤30 (n = 102) and >30 (n = 143) years groups. Pelvic floor recovery was compared across these subgroups using ultrasound and electromyography (EMG). <b>Results</b> Findings revealed age-related disparities in electromyography findings of slow-twitch pelvic floor muscles. Postpartum women aged ≤30 years exhibited higher endurance contraction variability of slow-twitch muscles (<i>p</i> = 0.049). Pelvic floor ultrasound showed that women aged >30 years had greater anorectal angles (<i>p</i> = 0.024) and levator hiatus areas (<i>p</i> = 0.034) after the Valsalva maneuver. Multiparous women exhibited increased variability in slow-twitch muscle contractions (<i>p</i> = 0.026) and prolonged relaxation time (<i>p</i> = 0.031). Primiparous women showed higher post-resting average values (<i>p</i> = 0.009). Pelvic floor ultrasound indicated greater bladder neck mobility (<i>p</i> < 0.001), levator hiatus area (<i>p</i> = 0.013), and urinary incontinence prevalence (<i>p</i> = 0.026) in multiparous women. When cross-grouped, multiparas ≤30 years exhibited higher pre-resting EMG values (<i>p</i> = 0.035). Additionally, tonic contraction variability (<i>p</i> = 0.014), tonic contraction relaxation time (<i>p</i> = 0.025), and post-resting mean values (<i>p</i> = 0.003) showed significant differences, particularly in women over 30. In contrast, multiparas demonstrated both increased bladder neck mobility (<i>p</i> = 0.004) and significant differences in the anorectal angle (<i>p</i> < 0.001) and levator hiatus area (<i>p</i> = 0.038) compared to other groups. <b>Conclusion</b> Reproductive-aged women over 30 years with multiple deliveries exhibit compounded pelvic floor dysfunction, particularly in slow-twitch muscle coordination and structural support parameters (anorectal angle and levator hiatus area), informing targeted rehabilitation strategies to optimize rapid recovery.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"86 7","pages":"1-24"},"PeriodicalIF":1.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706382","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}