1.Clinical and genetic analysis of an individual with Lan-negative rare blood group due to variant of ABCB6 gene.
Xianguo XU ; Kairong MA ; Ying LIU ; Xiaozhen HONG ; Yanling YING ; Faming ZHU
Chinese Journal of Medical Genetics 2025;42(3):286-291
OBJECTIVE:
To investigate a case of antibodies against high-frequency erythrocyte antigens and elucidate the genetic mechanism underlying the blood group.
METHODS:
A Lan-negative patient referred to the Zhejiang Blood Center by Quzhou Hospital of Traditional Chinese Medicine in August 2016 was selected as the study subject. A retrospective study was conducted to collect the proband's clinical data. The proband's erythrocyte antigens and unexpected serum antibodies were identified using tube saline and microcolumn agglutination anti-human globulin methods. Antibody specificity was determined by treating erythrocytes with 7 enzymes and 2 chemical reducing agents. Genomic DNA was extracted from the proband's blood sample for whole genome sequencing (WGS) and erythrocyte blood group gene analysis, with validation by Sanger sequencing. Multiple bioinformatics tools were used to analyze the pathogenicity of the variant. The rare blood group and unexpected antibody specificity were comprehensively determined based on the results of serological and genetic testing. This study has been approved by the Zhejiang Provincial Blood Center Medical Ethics Committee(Ethics No.20190201).
RESULTS:
The proband was a 91-year-old Han Chinese male with prostatitis, cystitis, and malnutrition in conjunct with emaciation. He had a history of multiple erythrocyte transfusions without observable adverse reactions. Prior to the most recent transfusion, major crossmatch agglutination was observed, which prompted antibody identification. Antibodies against high-frequency antigens were detected in the proband's serum, with enzyme and reducing agent treatments ruling out antibody specificities associated with 17 blood group systems, e.g., MNS, LU, KEL. WGS analysis identified 4 525 SNPs and 1 046 INDEL variants among erythrocyte blood group genes. Further screening revealed that the proband had a rare blood group due to a homozygous rs755723161 variant. This variant in the ABCB6 gene (c.459delC) has led to a frameshifting mutation (p.Trp154GlyfsTer96), resulting in the Lan-negative rare blood group with a high-frequency antigen deficiency and the production of IgG anti-Lan antibodies in the serum.
CONCLUSION
This study has identified anti-Lan alloantibodies in a Lan-negative patient and, for the first time, elucidated the ABCB6 gene variant underlying the Lan-negative rare blood group in the Chinese population.
Humans
;
Male
;
Blood Group Antigens/immunology*
;
Aged, 80 and over
;
Retrospective Studies
;
ATP-Binding Cassette Transporters
2.A multicenter retrospective study on the clinicopathological features, genetic variant profiles and prognosis of patients with previously untreated Diffuse large B-cell lymphoma.
Yongning JIANG ; Jie ZHANG ; Yaping ZHANG ; Yi XIA ; Yi MIAO ; Haiwen NI ; Jinning SHI ; Xiaohui ZHANG ; Min XU ; Haiying HUA ; Yun ZHUANG ; Wenzhong WU ; Maozhong XU ; Xiaoyan XIE ; Zhuxia JIA ; Yuqing MIAO ; Min ZHAO ; Jianyong LI ; Wenyu SHI
Chinese Journal of Medical Genetics 2025;42(9):1069-1077
OBJECTIVE:
To explore the impact of age on the genetic variant spectrum and prognosis of patients with previously untreated Diffuse large B-cell lymphoma (DLBCL).
METHODS:
A retrospective analysis was conducted on the clinical data and follow-up information of 254 previously untreated DLBCL patients from 14 hospitals in the Jiangsu Cooperative Lymphoma Group (JCLG) enrolled from July 2018 and July 2023. Following extraction of DNA from tumor tissue samples, next-generation sequencing (NGS) technique was employed to analyze the genetic variant spectrum of the DLBCL patients, with an evaluation of the relationship between age and genetic variants as well as prognosis. This study was approved by the Medical Ethics Committee of the Affiliated Hospital of Nantong University (Ethics No.: 2023-K048-01).
RESULTS:
The median age of the 254 DLBCL patients was 62 years old, with 55% of patients aged 60 years or above. Clinical evaluation showed that younger (< 60 years) patients had higher complete response (CR) (70% vs. 59%), and objective response rate (ORR) (88% vs. 79%) than older patients, though the difference between the two groups was not statistically. Survival analysis indicated that both the five-year overall survival (OS) (82.7% vs. 71.7%, P = 0.006) and progression-free survival (PFS) (70.6% vs. 50.2%, P < 0.05) rates were significantly higher in younger patients. NGS showed that 99.6% of the patients harbored genetic variants, with PIM1, KMT2D, TP53, MYD88, and CD79B being the most common genes. Age significantly affected the variant frequency of certain genes, with MYC variants serving an adverse prognostic factor for OS in younger patients (P = 0.002), while TP53 (P = 0.024) and BCL2 (P = 0.002) variants significantly impacted OS in older patients. Prognostic analysis identified age ≥ 60 years (HR = 3.439, 95%CI: 1.318~9.874), presence of B symptoms (HR = 2.871, 95%CI = 1.133~7.307), and elevated lactate dehydrogenase (HR = 3.528, 95%CI = 1.231~10.66) as independent adverse prognostic factors.
CONCLUSION
Age, genetic variants, and clinical factors may significantly affect the prognosis of the DLBCL patients. Younger patients have better survival compared to older patients. Variants of the MYC, BCL2, and TP53 genes are closely associated with poor prognosis.
Humans
;
Lymphoma, Large B-Cell, Diffuse/diagnosis*
;
Middle Aged
;
Female
;
Male
;
Retrospective Studies
;
Aged
;
Prognosis
;
Adult
;
Aged, 80 and over
;
High-Throughput Nucleotide Sequencing
;
Young Adult
;
Adolescent
;
Genetic Variation
3.Clinical characteristics of elderly patients with sepsis and development and evaluation of death risk assessment scale.
Fubo DONG ; Liwen LUO ; Dejiang HONG ; Yi YAO ; Kai PENG ; Wenjin LI ; Guangju ZHAO
Chinese Critical Care Medicine 2025;37(1):17-22
OBJECTIVE:
To analyze the clinical characteristics of elderly patients with sepsis, identify the key factors affecting their clinical outcomes, construct a death risk assessment scale for elderly patients with sepsis, and evaluate its predictive value.
METHODS:
A retrospective case-control study was conducted. The clinical data of sepsis patients admitted to intensive care unit (ICU) of the First Affiliated Hospital of Wenzhou Medical University from September 2021 to September 2023 were collected, including basic information, clinical characteristics, and clinical outcomes. The patients were divided into non-elderly group (age ≥ 65 years old) and elderly group (age < 65 years old) based on age. Additionally, the elderly patients were divided into survival group and death group based on their 30-day survival status. The clinical characteristics of elderly patients with sepsis were analyzed. Univariate and multivariate Logistic regression analyses were used to screen the independent risk factors for 30-day death in elderly patients with sepsis, and the regression equation was constructed. The regression equation was simplified, and the death risk assessment scale was established. The predictive value of different scores for the prognosis of elderly patients with sepsis was compared.
RESULTS:
(1) A total of 833 patients with sepsis were finally enrolled, including 485 in the elderly group and 348 in the non-elderly group. Compared with the non-elderly group, the elderly group showed significantly lower counts of lymphocyte, T cell, CD8+ T cell, and the ratio of T cells and CD8+ T cells [lymphocyte count (×109/L): 0.71 (0.43, 1.06) vs. 0.83 (0.53, 1.26), T cell count (cells/μL): 394.0 (216.0, 648.0) vs. 490.5 (270.5, 793.0), CD8+ T cell count (cells/μL): 126.0 (62.0, 223.5) vs. 180.0 (101.0, 312.0), T cell ratio: 0.60 (0.48, 0.70) vs. 0.64 (0.51, 0.75), CD8+ T cell ratio: 0.19 (0.13, 0.28) vs. 0.24 (0.16, 0.34), all P < 0.01], higher natural killer cell (NK cell) count, acute physiology and chronic health evaluation II (APACHE II) score, ratio of invasive mechanical ventilation (IMV) during hospitalization, and 30-day mortality [NK cell count (cells/μL): 112.0 (61.0, 187.5) vs. 95.0 (53.0, 151.0), APACHE II score: 16.00 (12.00, 21.00) vs. 13.00 (8.00, 17.00), IMV ratio: 40.6% (197/485) vs. 31.9% (111/348), 30-day mortality: 28.9% (140/485) vs. 19.5% (68/348), all P < 0.05], and longer length of ICU stay [days: 5.5 (3.0, 10.0) vs. 5.0 (3.0, 8.0), P < 0.05]. There were no statistically significant differences in the levels of inflammatory markers such as C-reactive protein (CRP), procalcitonin (PCT), tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ), and interleukins (IL-2, IL-4, IL-6, IL-10) between the two groups. (2) In 485 elderly patients with sepsis, 345 survived in 30 days, and 140 died with the 30-day mortality of 28.9%. Compared with the survival group, the patients in the death group were older, and had lower body mass index (BMI), white blood cell count (WBC), PCT, platelet count (PLT) and higher IL-6, IL-10, N-terminal pro-brain natriuretic peptide (NT-proBNP), total bilirubin (TBil), blood lactic acid (Lac), and ratio of in-hospital IMV and continuous renal replacement therapy (CRRT). Multivariate Logistic regression analysis indicated that BMI [odds ratio (OR) = 0.783, 95% confidence interval (95%CI) was 0.678-0.905, P = 0.001], IL-6 (OR = 1.073, 95%CI was 1.004-1.146, P = 0.036), TBil (OR = 1.009, 95%CI was 1.000-1.018, P = 0.045), Lac (OR = 1.211, 95%CI was 1.072-1.367, P = 0.002), and IMV during hospitalization (OR = 6.181, 95%CI was 2.214-17.256, P = 0.001) were independent risk factors for 30-day death in elderly patients with sepsis, and the regression equation was constructed (Logit P = 1.012-0.244×BMI+0.070×IL-6+0.009×TBil+0.190×Lac+1.822×IMV). The regression equation was simplified to construct a death risk assessment scale, namely BITLI score. Receiver operator characteristic curve (ROC curve) analysis showed that the area under the ROC curve (AUC) of BITLI score for predicting death risk was 0.852 (95%CI was 0.769-0.935), and it was higher than APACHE II score (AUC = 0.714, 95%CI was 0.623-0.805) and sequential organ failure assessment (SOFA) score (AUC = 0.685, 95%CI was 0.578-0.793). The determined cut-off value of BITLI score was 1.50, while achieving a sensitivity of 83.3% and specificity of 74.0%.
CONCLUSIONS
Elderly patients with sepsis often have reduced lymphocyte counts, severe conditions, and poor prognosis. BMI, IL-6, TBil, Lac, and IMV during hospitalization were independent risk factors for 30-day death in elderly patients with sepsis. The BITLI score constructed based above risk factors is more precise and reliable than traditional APACHE II and SOFA scores in predicting the outcomes of elderly patients with sepsis.
Humans
;
Sepsis/mortality*
;
Aged
;
Retrospective Studies
;
Risk Assessment
;
Case-Control Studies
;
Prognosis
;
Male
;
Female
;
Intensive Care Units
;
Risk Factors
;
Aged, 80 and over
;
Logistic Models
;
Middle Aged
4.Predictive value of norepinephrine equivalence score on the 28-day death risk in patients with sepsis: a retrospective cohort study.
Wenzhe LI ; Jingyan WANG ; Qihang ZHENG ; Yi WANG ; Xiangyou YU
Chinese Critical Care Medicine 2025;37(4):331-336
OBJECTIVE:
To elucidate the predictive value of norepinephrine equivalence (NEE) score on the 28-day death risk in patients with sepsis and provide evidence for its application in the diagnosis and treatment of sepsis and septic shock.
METHODS:
A retrospective cohort study was conducted based on the data of patients with sepsis from Medical Information Mart for Intensive Care-IV 2.2 (MIMIC-IV 2.2). The patients who received vasoactive agents within 6 hours after the diagnosis of sepsis or septic shock were enrolled, and they were divided into survival and non-survival groups based on their 28-day outcomes. The baseline characteristics, vital signs, and treatment data were collected. Multivariate Cox regression analysis was performed to identify factors influencing the 28-day death risk. Receiver operator characteristic curve (ROC curve) was drawn to analyze the predictive value of various parameters on the 28-day death risk of septic patients. Kaplan-Meier survival curve was used to evaluate cumulative survival rate in patients classified by different quantitative parameters based on the cut-off values obtained from ROC curve analysis.
RESULTS:
A total of 7 744 patients who met the Sepsis-3 diagnostic criteria and received vasopressor treatment within 6 hours post-diagnosis were enrolled, of which 5 997 cases survived and 1 747 died, with the 28-day mortality of 22.6%. Significant differences were observed between the two groups regarding age, gender, height, body weight, race, type of intensive care unit (ICU), acute physiology and chronic health evaluation II (APACHE II) score, sequential organ failure assessment (SOFA) score, Charlson comorbidity index (CCI) score, underlying comorbidities, and vital signs. Compared with the survival group, the non-survival group had poorer blood routine, liver and kidney function, coagulation function, blood gas analysis and other indicators. Multivariate Cox regression analysis revealed that age > 65 years old [hazard ratio (HR) = 0.892, 95% confidence interval (95%CI) was 0.801-0.994, P = 0.039] and male (HR = 0.735, 95%CI was 0.669-0.808, P < 0.001) were protective factors for 28-day death in patients with sepsis, and NEE score (HR = 1.040, 95%CI was 1.021-1.060, P < 0.001), shock index (HR = 1.840, 95%CI was 1.675-2.022, P < 0.001), APACHE II score (HR = 1.076, 95%CI was 1.069-1.083, P < 0.001), SOFA score (HR = 1.035, 95%CI was 1.015-1.056, P < 0.001), and CCI score (HR = 1.135, 95%CI was 1.115-1.155, P < 0.001) were independent risk factors for 28-day death in septic patients. ROC curve analysis showed that the area under the ROC curve (AUC) of NEE score for predicting the 28-day death risk of septic patients was 0.743 (95%CI was 0.730-0.756), which was comparable to the predictive value of APACHE II score (AUC = 0.742, 95%CI was 0.729-0.755) and ratio of mean arterial pressure (MAP)/NEE score (MAP/NEE; AUC = 0.738, 95%CI was 0.725-0.751, both P > 0.05), and better than SOFA score (AUC = 0.609, 95%CI was 0.594-0.624), CCI score (AUC = 0.658, 95%CI was 0.644-0.673), shock index (AUC = 0.613, 95%CI was 0.597-0.629) and ratio of diastolic blood pressure (DBP)/NEE score (DBP/NEE; AUC = 0.735, 95%CI was 0.721-0.748, all P < 0.05). According to the cut-off values of APACHE II and NEE scores obtained from ROC curve analysis, the patients were stratified for Kaplan-Meier survival curve analysis, and the results showed that the 28-day cumulative survival rate in the septic patients with an APACHE II score ≤ 22.5 was significantly higher than that in those with an APACHE II > 22.5 (Log-Rank test: χ2 = 848.600, P < 0.001), and the 28-day cumulative survival rate in the septic patients with an NEE score ≤0.120 was significantly higher than that in those with an NEE score > 0.120 (Log-Rank test: χ2 = 832.449, P < 0.001).
CONCLUSIONS
NEE score is an independent risk factor for 28-day death in septic patients who received vasoactive treatment within 6 hours of diagnosis and possesses significant predictive value. It can be used for severity stratification in sepsis management.
Humans
;
Retrospective Studies
;
Sepsis/diagnosis*
;
Male
;
Female
;
Norepinephrine/therapeutic use*
;
Middle Aged
;
Aged
;
Prognosis
;
Predictive Value of Tests
;
Shock, Septic/mortality*
;
Adult
;
ROC Curve
;
Risk Factors
;
Survival Rate
;
Aged, 80 and over
5.Xuebijing injection reduces COVID-19 patients' mortality as influenced by the neutrophil to lymphocyte platelet ratio.
Man LIAO ; Li-Ting ZHANG ; Li-Juan BAI ; Rui-Yun WANG ; Yun LIU ; Jing HAN ; Li-Hua LIU ; Ben-Ling QI
Journal of Integrative Medicine 2025;23(3):282-288
OBJECTIVE:
Xuebijing injection has been recommended as a therapeutic approach for individuals with severe and critical COVID-19. This study aims to explore the correlation of neutrophil to lymphocyte platelet ratio (NLPR) with the severity and prognosis of COVID-19, and the effect of XBJ on the prognosis of patients with COVID-19 in different inflammatory states.
METHODS:
This was a retrospective study conducted at Wuhan Union Hospital in China. COVID-19 patients admitted between November 1, 2022 and February 1, 2023 were included. In predicting prognosis for individuals with COVID-19, new inflammatory indicators were used, and their prognostic value was assessed by using Cox regression models and receiver operating characteristic curves. Furthermore, a calculation was made to determine the cutoff value for NLPR. Relative risk and Cox regression models were used to examine the effects of Xuebijing injection on prognosis in patient cohorts that had been stratified by the NLPR cutoff.
RESULTS:
This research included 455 participants with COVID-19, with a mean age of 72 years. Several inflammatory indicators were found to be strongly correlated with prognosis, and NLPR shows the greatest predictive power. Patients with NLPR > 3.29 exhibited a mortality rate of 17.3%, which was 6.2 times higher than in patients with NLPR ≤ 3.29. Importantly, providing Xuebijing injection to patients with NLPR > 3.29 was associated with a lower risk of 60-day all-cause mortality. However, there was no discernible improvement in survival among patients with NLPR ≤ 3.29 who received Xuebijing injection.
CONCLUSION
NLPR is the most reliable inflammatory marker for predicting prognosis among individuals with COVID-19, and can accurately identify individuals who may benefit from Xuebijing injection. Please cite this article as: Liao M, Zhang LT, Bai LJ, Wang RY, Liu Y, Han J, Liu LH, Qi BL. Xuebijing injection reduces COVID-19 patients mortality as influenced by the neutrophil to lymphocyte platelet ratio. J Integr Med. 2025; 23(3): 282-288.
Humans
;
Drugs, Chinese Herbal/administration & dosage*
;
Male
;
Female
;
Retrospective Studies
;
Aged
;
Neutrophils
;
COVID-19 Drug Treatment
;
COVID-19/blood*
;
Middle Aged
;
Prognosis
;
Lymphocytes
;
Blood Platelets
;
Platelet Count
;
SARS-CoV-2
;
Aged, 80 and over
;
Adult
6.Development of a machine learning-based risk prediction model for mild cognitive impairment with spleen-kidney deficiency syndrome in the elderly.
Ya-Ting AI ; Shi ZHOU ; Ming WANG ; Tao-Yun ZHENG ; Hui HU ; Yun-Cui WANG ; Yu-Can LI ; Xiao-Tong WANG ; Peng-Jun ZHOU
Journal of Integrative Medicine 2025;23(4):390-397
OBJECTIVE:
As an age-related neurodegenerative disease, the prevalence of mild cognitive impairment (MCI) increases with age. Within the framework of traditional Chinese medicine, spleen-kidney deficiency syndrome (SKDS) is recognized as the most frequent MCI subtype. Due to the covert and gradual onset of MCI, in community settings it poses a significant challenge for patients and their families to discern between typical aging and pathological changes. There exists an urgent need to devise a preliminary diagnostic tool designed for community-residing older adults with MCI attributed to SKDS (MCI-SKDS).
METHODS:
This investigation enrolled 312 elderly individuals diagnosed with MCI, who were randomly distributed into training and test datasets at a 3:1 ratio. Five machine learning methods, including logistic regression (LR), decision tree (DT), naive Bayes (NB), support vector machine (SVM), and gradient boosting (GB), were used to build a diagnostic prediction model for MCI-SKDS. Accuracy, sensitivity, specificity, precision, F1 score, and area under the curve were used to evaluate model performance. Furthermore, the clinical applicability of the model was evaluated through decision curve analysis (DCA).
RESULTS:
The accuracy, precision, specificity and F1 score of the DT model performed best in the training set (test set), with scores of 0.904 (0.845), 0.875 (0.795), 0.973 (0.875) and 0.973 (0.875). The sensitivity of the training set (test set) of the SVM model performed best among the five models with a score of 0.865 (0.821). The area under the curve of all five models was greater than 0.9 for the training dataset and greater than 0.8 for the test dataset. The DCA of all models showed good clinical application value. The study identified ten indicators that were significant predictors of MCI-SKDS.
CONCLUSION
The risk prediction index derived from machine learning for the MCI-SKDS prediction model is simple and practical; the model demonstrates good predictive value and clinical applicability, and the DT model had the best performance. Please cite this article as: Ai YT, Zhou S, Wang M, Zheng TY, Hu H, Wang YC, Li YC, Wang XT, Zhou PJ. Development of a machine learning-based risk prediction model for mild cognitive impairment with spleen-kidney deficiency syndrome in the elderly. J Integr Med. 2025; 23(4): 390-397.
Humans
;
Cognitive Dysfunction/diagnosis*
;
Aged
;
Male
;
Female
;
Machine Learning
;
Spleen
;
Aged, 80 and over
;
Kidney
;
Medicine, Chinese Traditional
7.Use of metallic ureteric stents for chronic ureteric obstruction and its association with value-based care.
Yu Xi Terence LAW ; Ang ZHOU ; David Terrence CONSIGLIERE ; Benjamin Yen Seow GOH ; Ho Yee TIONG
Singapore medical journal 2025;66(1):28-32
INTRODUCTION:
We aimed to compare the real-world data and our clinical experience with metallic stents (MSs) and conventional polymeric stents (PSs) in the management of both malignant and benign chronic ureteric obstruction (CUO), in terms of clinical outcomes and costs.
METHODS:
Clinical data from our institution, including outcomes for all ureteric stents inserted for long-term management of CUO from all causes from 2014 to 2017, were retrospectively reviewed and compared between the MS and PS episodes.
RESULTS:
A total of 247 stents were placed in 63 patients with CUO over the 4-year study period. Of these, 45 stents were MSs. There was no significant difference in all baseline characteristics between the MS and PS groups, except for the aetiology of obstructive cause. Mean indwelling stent duration was significantly greater for MS than for PS (228.6 ± 147.0 vs. 146.1 ± 66.0 days, P < 0.001), thereby leading to lower average number of stent changes per year in the MS group compared to the PS group (1.4 vs. 6.3 times, respectively). Despite the higher unit cost of MS compared to PS, there was no significant mean cost difference overall (cost per dwelling day SGD 7.82 ± SGD 10.44 vs. SGD 8.23 ± SGD 20.50, P = 0.888).
CONCLUSION
Resonance MS is a better option than PS to manage CUO from malignant and benign causes because its significantly longer indwelling time mitigates the higher unit cost of the stent. It potentially reduces the number of procedures and operations in patients. Thus, it should be considered for all patients with CUO requiring long-term ureteric drainage.
Humans
;
Ureteral Obstruction/economics*
;
Female
;
Male
;
Retrospective Studies
;
Stents/economics*
;
Middle Aged
;
Aged
;
Treatment Outcome
;
Chronic Disease
;
Ureter/surgery*
;
Metals
;
Adult
;
Aged, 80 and over
8.Post-resuscitation care of patients with return of spontaneous circulation after out-of-hospital cardiac arrest at the emergency department.
Jing Kai Jackie LAM ; Jen Heng PEK
Singapore medical journal 2025;66(2):66-72
INTRODUCTION:
Out-of-hospital-cardiac-arrest (OHCA) is a major public health challenge and post-return-of-spontaneous-circulation (ROSC) goals have shifted from just survival to survival with intact neurology. Although post-ROSC care is crucial for survival with intact neurology, there are insufficient well-established protocols for post-resuscitation care. We aimed to evaluate post-resuscitation care in the emergency department (ED) of adult (aged ≥16 years) OHCA patients with sustained ROSC and its associated neurologically intact survival.
METHODS:
A retrospective review of electronic medical records was conducted for OHCA patients with sustained ROSC at the ED. Data including demographics, pre-hospital resuscitation, ED resuscitation, post-resuscitation care and eventual outcomes were analysed.
RESULTS:
Among 921 OHCA patients, 85 (9.2%) had sustained ROSC at the ED. Nineteen patients (19/85, 22.4%) survived, with 13 (13/85, 15.3%) having intact neurology at discharge. Electrocardiogram and chest X-ray were performed in all OHCA patients, whereas computed tomography (CT) was performed inconsistently, with CT brain being most common (74/85, 87.1%), while CT pulmonary angiogram (6/85, 7.1%), abdomen and pelvis (4/85, 4.7%) and aortogram (2/85, 2.4%) were done infrequently. Only four patients (4.7%) had all five neuroprotective goals of normoxia, normocarbia, normotension, normothermia and normoglycaemia achieved in the ED. The proportion of all five neuroprotective goals being met was significantly higher ( P = 0.01) among those with neurologically intact survival (3/13, 23.1%) than those without (1/72, 1.4%).
CONCLUSION
Post-resuscitation care at the ED showed great variability, indicating gaps between recommended guidelines and clinical practice. Good quality post-resuscitation care, centred around neuroprotection goals, must be initiated promptly to achieve meaningful survival with intact neurology.
Humans
;
Out-of-Hospital Cardiac Arrest/mortality*
;
Retrospective Studies
;
Male
;
Female
;
Middle Aged
;
Emergency Service, Hospital
;
Cardiopulmonary Resuscitation/methods*
;
Return of Spontaneous Circulation
;
Aged
;
Adult
;
Treatment Outcome
;
Electrocardiography
;
Tomography, X-Ray Computed
;
Aged, 80 and over
9.Oncology-related emergencies discharged from the emergency department.
Si-Hua Yvonne GOH ; Juin Jie NG ; Shi-En Joanna CHAN ; Wei-Lin Tallie CHUA ; Venkataraman ANANTHARAMAN
Singapore medical journal 2025;66(2):97-101
INTRODUCTION:
Cancer patients attending emergency departments (EDs) often present with acute symptoms and are frequently admitted. This study aimed to characterise the profile of oncology patients who were discharged from the ED.
METHODS:
This was a retrospective audit of patients with cancer-related diagnoses who presented to the ED at the Singapore General Hospital (SGH) over a 6-month period from 1 October 2018 to 31 March 2019 and were directly discharged from the ED. Data was extracted from the hospital's electronic medical record system.
RESULTS:
Of the 492 participants included in the study, the majority were triaged as Priority 2 (61.4%), while 30.7% were triaged as Priority 3, 6.9% as Priority 1 and 1.0% as Priority 4. There was no statistical difference between the National Early Warning scores across the different triage categories in these patients. The most common complaint was (44.3%), followed by genitourinary symptoms (19.5%) and those related to devices, catheters or stomas (17.3%). More investigations of all types were done for patients being managed in Priority 1 (57.6%) than in the other triage categories (40.1% for Priority 2, 23.2% for Priority 3 and 12.0% for Priority 4). Treatment procedures carried out were mainly symptomatic (analgesics, antiemetics, proton pump inhibitors) for 79.8% of the patients. There were no significant differences in the proportion of patients requiring various treatment modalities among the triage categories.
CONCLUSION
Selected oncological patients may potentially be managed in an ambulatory setting.
Humans
;
Emergency Service, Hospital/statistics & numerical data*
;
Retrospective Studies
;
Female
;
Neoplasms/diagnosis*
;
Male
;
Singapore
;
Patient Discharge/statistics & numerical data*
;
Middle Aged
;
Aged
;
Triage
;
Adult
;
Emergencies
;
Aged, 80 and over
10.Association of COVID-19 'circuit breaker' with higher rates of elderly trauma admissions.
Yee Har LIEW ; Zhenghong LIU ; Mian Jie LIM ; Pei Leng CHONG ; Norhayati Bte Mohamed JAINODIN ; Teng Teng PEH ; Jing Jing CHAN ; Sachin MATHUR ; Jeremy Choon Peng WEE
Singapore medical journal 2025;66(2):91-96
INTRODUCTION:
In December 2019, the severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) virus emerged and caused a worldwide pandemic, leading to measures being imposed by many countries to reduce its transmission. Singapore implemented the 'circuit breaker', which restricted all movements except for access to necessities and healthcare services. We aimed to investigate the impact of lockdown measures on the pattern of trauma and its effects.
METHODS:
An observational, retrospective, single-centre descriptive study was conducted using the trauma registry in Singapore General Hospital. It included patients above 18 years old who presented to the emergency department with trauma and were subsequently admitted. Patients admitted from 1 February 2020 to 31 July 2020 and those admitted during the same timeframe in 2019 were studied. Subgroup analyses were performed for patients aged ≥65 years and those <65 years.
RESULTS:
A total of 1,037 patients were included for analysis. A 17.6% increase in trauma presentations was seen from 2019 to 2020. Patients aged ≥65 years accounted for the rise in admissions. The predominant mechanism of injury was falls at home for older patients and vehicular accidents in patients <65 years. There were no significant differences in injury severity score, intensive care/high-dependency unit admission rates, length of stay, mortality rate, and subsequent need for inpatient rehabilitation.
CONCLUSION
Our study provided information on differences in trauma presentations before and during the COVID-19 pandemic. Further studies are required to better inform on additional precautionary measures needed to reduce trauma and improve safety during future lockdowns and pandemics.
Humans
;
COVID-19/prevention & control*
;
Aged
;
Retrospective Studies
;
Singapore/epidemiology*
;
Male
;
Female
;
Wounds and Injuries/epidemiology*
;
Aged, 80 and over
;
Middle Aged
;
SARS-CoV-2
;
Hospitalization/statistics & numerical data*
;
Adult
;
Emergency Service, Hospital/statistics & numerical data*
;
Registries
;
Accidental Falls/statistics & numerical data*
;
Pandemics
;
Patient Admission/statistics & numerical data*
;
Length of Stay
;
Accidents, Traffic/statistics & numerical data*

Result Analysis
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