Internal and emergency medicine
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Acute myocardial infarction (AMI) is a critical medical emergency worldwide and a leading cause of mortality. This study aims to investigate the predictive utility of the neutrophil-to-platelet ratio (NPR) in identifying AMI patients at an increased risk of in-hospital mortality. We enrolled 664 patients, including 421 with ST-elevation myocardial infarction (STEMI) and 243 with non-ST-elevation myocardial infarction (NSTEMI), at Zhongshan Hospital, Fudan University, from January 2020 to September 2023. ⋯ The optimal cutoff values for predicting mortality were determined as 0.042 for NPR (sensitivity 80%, specificity 62.2%) and 8.02 for NLR (sensitivity 62.2%, specificity 67.5%). Bootstrap validation with 1000 iterations confirmed the robustness of these findings, with validated AUCs of 0.755 (95% CI, 0.681-0.826) for NPR and 0.674 (95% CI, 0.587-0.766) for NLR. This study identifies NPR as an independent and valuable predictor of in-hospital mortality among AMI patients, The findings underscore NPR's potential utility in clinical practice for risk stratification and early intervention strategies aimed at reducing mortality rates in this high-risk patient population.
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Carbon monoxide (CO) poisoning continues to result in hospitalization and mortality. We sought to analyze risk factors associated with inpatient admission for CO poisoning. Retrospective study of the US National Inpatient Sample (NIS) database. ⋯ In multivariable analysis, male sex (OR 1.98; 95% CI 1.83-2.15), alcohol use disorder (OR 1.89; 95% CI 1.71-2.10), cannabis use disorder (OR 1.26; 95% CI 1.09-1.47), mood disorders (OR 2.65; 95% CI 2.44-2.88), and suicide ideation (OR 1.74; 95% CI 1.50-2.02) were independently associated with hospitalization. In this 5-year analysis, cannabis use, mood disorders, and suicidality were significant risk factors for CO-related hospitalization in addition to previously known risks of alcohol use and male gender. Since mood and substance use disorders are increasing globally, these modifiable risk factors deserve priority attention from clinicians and policymakers.
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Patients with an elevated admission National Early Warning Score (NEWS) are more likely to die while in hospital. However, it is not known if this increased mortality risk is the same for all diagnoses. The aim of this study was to determine and compare the increased risk of in-hospital mortality associated with an elevated NEWS and different primary discharge diagnoses in unselected emergency admissions to a UK university teaching hospital. ⋯ There is enormous variation in the mortality risk associated with an increased admission NEWS in different commonly encountered diagnoses. Therefore, the mortality risk of some 'low risk' conditions can be dramatically increased if their admission NEWS is elevated, whereas some 'high risk' conditions are still likely to die even if their admission NEWS is low.