Clinical features and outcomes of peripartum obstetric patients admitted to the intensive care unit: A nationwide inpatient database in Japan.

Background: Pregnant and postpartum women face an increasing risk of severe complications due to pathophysiological changes, advanced maternal age, obesity, and reproductive technologies. Globally, maternal mortality remains a critical concern, with numerous critically ill obstetric patients requiring intensive care each year. However, comprehensive nationwide data on obstetric intensive care unit (ICU) admissions in Japan remain scarce.

Association of Combined Enzymatic and Surgical Debridement with Clinical Outcomes in Extensive Burn Patients.

: Burned tissue has traditionally been removed surgically, but the effectiveness of enzymatic debridement with NexoBrid has been reported in burn patients and has gained attention in recent years. This agent was approved for use in Japan in 2023. However, even in Japan, there have been few studies examining its effectiveness in patients with extensive burns.

A case report of heterotopic ossification of the tendon sheath after blunt trauma.

Rationale: Heterotopic ossification of the hand is relatively rare. Herein we report a case of heterotopic ossification around the tendon sheath.

Patient Concerns: A 46-year-old man presented to the hospital with an inability to flex his right index finger, and with pain during motion.

Perioperative cardiac arrest requiring admission to intensive care units in Japan: epidemiological differences between emergency and elective surgery.

Background: Perioperative cardiac arrest is more prevalent in emergency surgery and carries substantial mortality risks; however, large-scale studies examining its incidence, aetiology, and outcomes remain scarce. This study investigated the epidemiology of perioperative cardiac arrest in emergency and elective surgeries in Japan.

Methods: We conducted a multicentre retrospective cohort study using the Japanese Intensive care PAtient Database (JIPAD), a nationwide ICU registry.

Clinical characteristics and outcomes of proximal clavicle fractures: A retrospective cohort study from a single Japanese institution.

Background: Clavicle fractures are common injuries, with proximal clavicle fractures being relatively rare. Previous studies have suggested that proximal clavicle fractures are often associated with high-energy trauma and carry a high risk of complications. However, no studies have comprehensively described their clinical characteristics and severity in Japan.

Association between postoperative body temperature and in-hospital mortality: a nationwide cohort study of 157,028 critically ill patients in Japan.

Purpose: The association between postoperative body temperature and in-hospital mortality remains unclear. We sought to evaluate this association across all surgical patients and assessed whether it is affected by the indication for surgery (i.e.

Current status and adverse events of tracheal intubation for patients with COVID-19 in emergency department: A multicenter cohort study.

Background: During the COVID-19 pandemic, the demand for tracheal intubations increased in emergency departmeants (EDs). We aimed to describe tracheal intubations during the COVID-19 pandemic in Japan and investigate the association between COVID-19 and intubation-related adverse events in EDs.

Methods: This is an analysis of a prospective observational multicenter study involving patients who underwent tracheal intubations in the ED between April 2020 and March 2023.

Epidemiological Investigation of Unplanned Intensive Care Unit Admissions From the Operating Room After Elective Surgery: A Nationwide Observational Study in Japan.

Background: Over 75% of surgeries worldwide are elective and unplanned ICU admissions after these surgeries pose a major-albeit rare-challenge. However, few epidemiological studies have focused on patients requiring unplanned ICU admission directly from the operating room after elective surgeries are lacking. This study uses the Japanese Intensive Care Patient Database (JIPAD) to describe unplanned ICU admissions after elective surgeries.

Effectiveness of an Impella Versus Intra-Aortic Balloon Pump in Patients Who Received Extracorporeal Membrane Oxygenation.

Background: It is unclear whether an intra-aortic balloon pump (IABP) or percutaneous ventricular assist device (Impella) in combination with extracorporeal membrane oxygenation (ECMO) is better.

Methods: Using the Japanese Diagnosis Procedure Combination database from September 2016 to March 2022, we identified inpatients who received an Impella or IABP in combination with ECMO (ECPella or ECMO+IABP group, respectively). The primary outcome was in-hospital mortality, and the secondary outcomes included the length of hospital stay, length of ECMO, total hospitalization cost, complications, and durable mechanical circulatory support implantations.

Tetanus toxoid vaccination uptake by trauma patients in Japan: A retrospective cohort study using large administrative claims data.

Tetanus remains a major global health issue in both developing and developed countries. Although guidelines are established on tetanus prophylaxis protocol for trauma patients, adherence to tetanus vaccination is unknown. In this study, we aimed to investigate the administration of tetanus toxoid among trauma patients in Japan, where approximately 100 patients are hospitalized for tetanus annually.

Predictive accuracy of lactate albumin ratio for mortality in intensive care units: a nationwide cohort study.

Background: The lactate albumin ratio (LAR), a simple prognostic marker used in intensive care units (ICUs), combines lactate and serum albumin levels to predict patient outcomes. Despite its potential, the predictive accuracy of the LAR remains insufficiently explored. This study aimed to assess the usefulness of the LAR in predicting mortality among patients in the ICU.

Key challenges in prehospital and emergency care in Indonesia and Malaysia: a survey of frontline clinicians.

Rapid economic growth in Indonesia and Malaysia has widened the gap in emergency care supply and demand, intensifying challenges. Our study, from August to November 2022, assesses current diverse challenges in both countries' emergency care systems from frontline staff perspectives. The online survey involved emergency department (ED) personnel from 11 hospitals in Indonesia and Malaysia, drawing from an existing network.

The association between introduction of the micro-axial flow pump Impella in hospitals and in-hospital mortality in patients treated with extracorporeal membrane oxygenation: interrupted time-series analyses.

Background: The micro-axial flow pump Impella, a new mechanical circulatory device for cardiogenic shock, is still only available in a limited number of hospitals, due to the facility certification requirements and insufficient evidence of the benefit of introducing Impella in hospitals. This study aimed to evaluate the impact of introducing Impella in hospitals on in-hospital mortality of patients treated with extracorporeal membrane oxygenation (ECMO).

Methods: Using a nationwide Japanese inpatient database, we identified patients who received ECMO during hospitalization between 1 April 2014 and 31 March 2021.

Effect of fluid resuscitation with albumin on mortality in patients with severe burns: A nationwide inpatient data analysis.

The present study aimed to evaluate the effect of albumin administration on mortality in patients with severe burns. We retrospectively analyzed data from the Diagnosis Procedure Combination Database, a nationwide inpatient database in Japan. We identified patients in the database aged ≥ 15 years who were admitted with severe burns (burn index ≥15) from April 2014 to March 2021.

Association Between Head Computed Tomography Findings and In-Hospital Mortality in COVID-19 Patients.

Objective: The present study investigated the association between head computed tomography (CT) findings and mortality in patients with COVID-19. Specifically, we focused on low-density lesions identified on head CT screenings.

Materials And Methods: We performed a single-center, retrospective cohort study based on data obtained from the medical charts of inpatients admitted to the Tokyo Metropolitan Hiroo Hospital between January 1 and December 31, 2021.

The Accuracy and Potential Racial and Ethnic Biases of GPT-4 in the Diagnosis and Triage of Health Conditions: Evaluation Study.

Background: Whether GPT-4, the conversational artificial intelligence, can accurately diagnose and triage health conditions and whether it presents racial and ethnic biases in its decisions remain unclear.

Objective: We aim to assess the accuracy of GPT-4 in the diagnosis and triage of health conditions and whether its performance varies by patient race and ethnicity.

Methods: We compared the performance of GPT-4 and physicians, using 45 typical clinical vignettes, each with a correct diagnosis and triage level, in February and March 2023.

Trends in Mechanical Circulatory Support Use and Outcomes of Patients With Cardiogenic Shock in Japan, 2010 to 2020 (from a Nationwide Inpatient Database Study).

Little is known about the impact of the downgrade of guideline recommendations for intra-aortic balloon pump (IABP) use and the approval of the Impella in Japan, where IABPs have been predominantly used. This study aimed to describe the annual trends in the mechanical circulatory support (MCS) use and outcomes in patients with cardiogenic shock (CS) requiring MCS. Using the Japanese Diagnosis Procedure Combination database from July 2010 to March 2021, we identified inpatients with CS requiring MCS.

Early initiation of angiotensin-converting enzyme inhibitor in patients with scleroderma renal crisis: a nationwide inpatient database study.

Objectives: To evaluate the effectiveness of early initiation of angiotensin-converting enzyme inhibitor (ACEi) in patients with scleroderma renal crisis (SRC).

Methods: This was a retrospective cohort study using a nationwide inpatient database in Japan from July 2010 to March 2020. All hospitalized patients with SRC were divided into those who received ACEi within 2 days of admission (early ACEi group) and those who did not (control group).