Development and Validation of a Machine Learning Model for Early Prediction of Acute Kidney Injury in Neurocritical Care: A Comparative Analysis of XGBoost, GBM, and Random Forest Algorithms.

Acute Kidney Injury (AKI) is a pivotal concern in neurocritical care, impacting patient survival and quality of life. This study harnesses machine learning (ML) techniques to predict the occurrence of AKI in patients receiving hyperosmolar therapy, aiming to optimize patient outcomes in neurocritical settings. We conducted a retrospective cohort study of 4886 patients who underwent hyperosmolar therapy in the neurosurgical intensive care unit (ICU).

Compression Rate Progression of Osteoporotic Vertebral Compression Fracture in Conservative Treatments.

Background: The treatment of osteoporotic vertebral compression fracture (OVCF) aims to alleviate pain and prevent further compression; however, compression often progresses during conservative treatments. Furthermore, studies on the factors affecting compression rate progression and the timing at which compression progresses the most are limited.

Methods: A total of 122 patients with OVCF, who were follow-up duration > 6 months, were included.

Ethnic Differences in the Diagnostic Accuracy of a Quantitative Ultrasound-Derived Fat Fraction Estimator for Hepatic Steatosis: External Validation in Asian and Caucasian Cohorts.

Purpose: Ultrasound fat fraction estimation (USFF) using quantitative ultrasonography (QUS) is a promising method for assessing liver fat in metabolic dysfunction-associated steatotic liver disease (MASLD). However, its performance across different ethnicities remains unclear. This study aimed to externally validate and compare USFF accuracy in Asian and Caucasian cohorts.

Biomarkers in cerebrospinal fluid of persistent neuropathic pain after lumbar stenosis surgery.

Purpose: To analyze which CSF biomarkers affect persisting neuropathic pain (NP) after surgery.

Methods: CSF samples were gathered from patients who had a dural tear injury during surgery or who underwent myelography, from July 2022 to July 2023. Patients were evaluated for pain and NP using LANSS, PDQ, DN4, ODI, and NRS questionnaires preoperatively, and at 1 month, 3 months, and 1 year postoperatively, and divided into three groups based on the presence of NP.

Paraspinal Muscle Fat Infiltration as a Key Predictor of Symptomatic Intravertebral Vacuum Cleft: A Machine Learning Approach.

: Symptomatic intravertebral vacuum cleft (SIVC) is a complication of vertebral compression fractures (VCFs) that leads to persistent pain and deformity. Its prediction remains challenging due to multifactorial causes. Paraspinal muscle fat infiltration has been associated with spinal fracture outcomes but has not been extensively explored in SIVC prediction.

Beyond SOFA and APACHE II, Novel Risk Stratification Models Using Readily Available Biomarkers in Critical Care.

Current severity scoring systems in intensive care units (ICUs) are complex and time-consuming, limiting their utility for rapid clinical decision-making. This study aimed to develop and validate simplified prediction models using readily available biomarkers for assessing in-hospital mortality risk. We analyzed 19,720 adult ICU patients in this retrospective study.

Bone fusion materials: past, present, and future.

Bone fusion is one of the mainstay managements for degenerative spinal diseases and critical-sized bone defects resulting from trauma, tumors, infection, and nonunion. Bone graft materials are required for promoting bone healing, with autografts historically considered the gold standard due to their osteogenic, osteoinductive, and osteoconductive properties. However, donor site morbidities have led to the development of alternative bone graft substitutes.

Thoracic vertebral body erosion due to a perianeurysmal outpouching lesion after thoracic endovascular aortic repair: a case report and literature review.

Background: The safety of endovascular treatment, such as thoracic endovascular aortic repair (TEVAR), for a descending thoracic aortic aneurysm has been well-established, with a reported low postoperative mortality rate but higher incidences of long-term complications such as endo-leakage, device failure, and aneurysm-related death. Based on this, we report the first case of massive thoracic vertebral body erosion due to a perianeurysmal outpouching lesion after TEVAR.

Case Presentation: A 77-year-old female with a history of TEVAR due to descending thoracic aortic arch aneurysm 4 years ago was referred from the cardiovascular clinic to the spine center.

Analysis of Risk Factors Associated with Proximal Junctional Kyphosis Following Long Instrumented Fusion from L1 to Sacrum: Age Itself Does Not Independently Increase the Risk.

This study is a retrospective analysis aimed at understanding the incidence and risk factors of proximal junctional kyphosis (PJK) following long-instrumented spinal fusion from L1 to the sacrum in patients with mild to moderate sagittal imbalance. It recruited consecutive patients undergoing instrumented fusion from L1 to the sacrum for degenerative lumbar disease between June 2006 and November 2019 in a single institution. The patients' preoperative clinical data, muscle status at T12-L1 on magnetic resonance images, and sagittal spinopelvic parameters were analyzed.

Donor Characteristics and Outcomes of Pediatric Heart Transplantation in South Korea.

Background: Heart transplantation is often limited by the availability of transplantable donor heart and understanding of donor aspects that would influence transplant outcomes becomes important. In this study, donor characteristics and their impact on the outcomes of pediatric heart transplantations performed in South Korea were investigated.

Methods: We reviewed the medical records of patients less than 18 years old who received heart transplantation between 2002 and 2022 in three tertiary hospitals located in South Korea.

Effects of inhalation versus total intravenous anaesthesia on long-term mortality in older patients after noncardiac surgery: a retrospective observational study.

Background: Whether the anaesthetic agent used influences postoperative mortality in older patients remains unclear. We evaluated the effect of total intravenous anaesthesia (TIVA) vs inhalation anaesthesia on long-term mortality in older patients after noncardiac surgery.

Methods: We retrospectively analysed 45,879 patients aged ≥60 yr who underwent noncardiac surgery under general anaesthesia (for ≥2 h) between January 2011 and June 2019.

Restrictive calcium replacement in septic shock: a multicenter before-after intervention study.

Objectives: To study the impact of a restrictive calcium replacement protocol in comparison with a liberal one in patients with septic shock.

Material And Methods: Multicenter retrospective before-after study that estimated the impact of implementing a restrictive calcium replacement protocol in patients with septic shock. Patients admitted to an intensive care unit between May 2019 and April 2021 were assigned to liberal calcium replacement, and those admitted between May 2021 and April 2022 were assigned to a restrictive protocol.

Anterior Column Realignment Through Open Pre-posterior Release-Anterior-Posterior Fusion Versus Hybrid Minimally Invasive-Anterior-Posterior Fusion for Dynamic Sagittal Imbalance of the Spine.

Study Design: Retrospective comparative study.

Objectives: To investigate the clinical and radiological outcomes after anterior column realignment (ACR) through pre-posterior release-anterior-posterior surgery (PAP) and minimally invasive surgery -lateral lumbar interbody fusion (MIS-LLIF) using hybrid anterior-posterior surgery (AP).

Methods: A total of 91 patients who underwent ACR with long fusions from T10 vertebra to the sacropelvis with a follow-up period of at least 2 years after corrective surgery for adult spinal deformity were included and divided into two groups by surgical method: AP and PAP.

Association of Mechanical Energy and Power with Postoperative Pulmonary Complications in Lung Resection Surgery: A Post Hoc Analysis of Randomized Clinical Trial Data.

Background: Mechanical power (MP), the rate of mechanical energy (ME) delivery, is a recently introduced unifying ventilator parameter consisting of tidal volume, airway pressures, and respiratory rates, which predicts pulmonary complications in several clinical contexts. However, ME has not been previously studied in the perioperative context, and neither parameter has been studied in the context of thoracic surgery utilizing one-lung ventilation.

Methods: The relationships between ME variables and postoperative pulmonary complications were evaluated in this post hoc analysis of data from a multicenter randomized clinical trial of lung resection surgery conducted between 2020 and 2021 (n = 1,170).

Diagnostic Performance of Cardiac CT and Transthoracic Echocardiography for Detection of Surgically Confirmed Bicuspid Aortic Valve: Effect of Calcium Extent and Valve Subtypes.

Purpose: This study aimed to compare the diagnostic performance of cardiac CT and transthoracic echocardiogram (TTE) depending on the degree of valvular calcification and bicuspid aortic valve (BAV) subtype.

Materials And Methods: This retrospective study included 266 consecutive patients (106 with BAV and 160 with tricuspid aortic valve) who underwent cardiac CT and TTE before aortic valve replacement. Cardiac CT was used to evaluate the morphology of the aortic valve, and a calcium scoring scan was used to quantify valve calcium.

Machine learning-based predictor for neurologic outcomes in patients undergoing extracorporeal cardiopulmonary resuscitation.

Background: We investigated the predictors of poor neurological outcomes in extracorporeal cardiopulmonary resuscitation (ECPR) patients using machine learning (ML) approaches.

Methods: This study was a retrospective, single-center, observational study that included adult patients who underwent ECPR while hospitalized between January 2010 and December 2020. The primary outcome was neurologic status at hospital discharge as assessed by the Cerebral Performance Categories (CPC) score (scores range from 1 to 5).

Risk of age older than 65 years for 30-day cardiac complication may be comparable to low-to-moderate risk according to revised cardiac risk index in non-cardiac surgery.

Revised cardiac risk index (RCRI) is widely used for surgical patients without containing age as a risk factor. We investigated age older than 65 years with respect to low-to-moderate risk of RCRI. From January 2011 to June 2019, a total of 203,787 consecutive adult patients underwent non-cardiac surgery at our institution.

Risk factors for mechanical complications after fusion extension surgery for lumbar adjacent segment disease.

Purpose: Adjacent segment disease (ASD) is a common complication in fusion surgery. In the event of solid segmental fusion, previous implants can be removed or preserved during fusion extension for ASD. To compare the surgical outcomes of patients with and without implants and analyzes the risk factors for postoperative mechanical complications.

Comparison of Early and Late Surgeries after Coronary Stent Implantation in Patients with Normal Preoperative Troponin Level: A Retrospective Study.

Current guidelines recommend delaying noncardiac surgery for 6 months after drug eluting stent implantation. However, this recommendation is largely based on limited evidence and various event definitions. Whether early surgery within 6 months of coronary stent implantation increases myocardial injury in patients with normal preoperative high-sensitivity cardiac troponin I (hs-cTnI) has not yet been investigated.

Sex differences in myocardial injury after non-cardiac surgery and postoperative mortality.

Background: Myocardial injury after non-cardiac surgery (MINS) has recently been accepted as a predictor of mortality. However, sex differences in the incidence of MINS and survival thereafter are not fully understood. This study aimed to compare the incidence of MINS and mortality among male and female patients.

Association between inflammation-based prognostic markers and mortality of non-cardiac surgery.

Background: To evaluate the association between inflammation and nutrition-based biomarkers and postoperative outcomes after non-cardiac surgery.

Methods: Between January 2011 and June 2019, a total of 102,052 patients undergoing non-cardiac surgery were evaluated, with C-reactive protein (CRP), albumin, and complete blood count (CBC) measured within six months before surgery. We assessed their CRP-to-albumin ratio (CAR), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and modified Glasgow Prognostic Score (mGPS).

Preoperative left atrial volume index may be associated with postoperative atrial fibrillation in non-cardiac surgery.

Background: Postoperative atrial fibrillation (POAF) is related to mortality after non-cardiac surgery. Left atrial volume index (LAVI) is known to be associated with prognosis and development of atrial fibrillation, but it has not been fully investigated in patients undergoing non-cardiac surgery.

Materials And Methods: A total of 203,787 consecutive adult patients underwent non-cardiac surgery at our institution between January 2011 and June 2019.