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Acute pancreatitis (AP) is a common inflammatory disorder that may develop into severe AP (SAP), resulting in life-threatening complications and even death. The purpose of this study was to explore two different machine learning models of multilayer perception-artificial neural network (MPL-ANN) and partial least squares-discrimination (PLS-DA) to diagnose and predict AP patients' severity.

The MPL-ANN and PLS-DA models were established using candidate markers from 15 blood routine parameters and five serum biochemical indexes of 133 mild acute pancreatitis (MAP) patients, 167 SAP (including 88 moderately SAP) patients, and 69 healthy controls (HCs). The independent parameters and combined model's diagnostic efficiency in AP severity differentiation were analyzed using the area under the receiver operating characteristic curve (AUC).

The neutrophil to lymphocyte ratio (NLR) is the most useful marker in 20 parameters for screening AP patients [AUC=0.990, 95% confidence interval (CI) 0.984-0.997, sensitivity 94.3%, specificity 98.6%]. The MPL-ANN model based on six optimal parameters exhibited better diagnostic and predict performance (AUC=0.984, 95% CI 0.960-1.00, sensitivity 92.7%, specificity 93.3%, accuracy 93.0%) than the PLS-DA model based on five optimal parameters (AUC=0.912, 95% CI 0.853-0.971, sensitivity 87.8%, specificity 84.4%, accuracy 84.8%) in discriminating MAP patients from SAP patients.

The results demonstrated that the MPL-ANN model based on routine blood and serum biochemical indexes provides a reliable and straightforward daily clinical practice tool to predict AP patients' severity.

The results demonstrated that the MPL-ANN model based on routine blood and serum biochemical indexes provides a reliable and straightforward daily clinical practice tool to predict AP patients' severity.

The main objective was to evaluate the effect of carbon dioxide on hospital mortality in chronic obstructive pulmonary disease (COPD) and non-COPD patients with out-of-hospital cardiac arrest (OHCA).

We conducted a retrospective observational study in OHCA patients from the eICU database (eicu-crd.mit.edu). The main exposure was the partial pressure of arterial carbon dioxide (PaCO

). The proportion of time spent (PTS) within four predefined PaCO

ranges (hypocapnia <35mmHg, normocapnia 35-45mmHg, mild hypercapnia 46-55mmHg, and severe hypercapnia >55mmHg) were calculated respectively. The primary outcome was hospital mortality. Multivariable logistic regression models were performed to assess the independent relationship between PTS within PaCO

range and hospital mortality, and the interaction between PTS within PaCO

range and COPD was explored.

A total of 1721 OHCA patients were included, of which 272 (15.8%) had COPD. After adjusted for the confounders, the PTS within mild hypercapnia waspatients but reduced hospital mortality for COPD patients. It would be reasonable to adjust PaCO2 targets in OHCA patients with COPD.

The early detection and treatment of sepsis and septic shock patients in emergency departments are critical. Ischemia modified albumin (IMA) is a biomarker produced by ischemia and oxygen free radicals which are related to the pathogenesis of sepsis-induced organ dysfunction. This study aimed to investigate whether IMA was associated with short-term mortality in quick sequential organ failure assessment (qSOFA)-positive sepsis or septic shock patients screened by the sepsis management program.

From September 2019 to April 2020, patients who arrived at the emergency departments with qSOFA-positive sepsis or septic shock were included in this retrospective observational study.

Among 124 patients analyzed, IMA was higher in the non-surviving group than in the surviving group (92.6±8.1 vs. https://www.selleckchem.com/ 86.8±6.2U/mL, p<0.001). The area under the receiver operating characteristics curve was 0.703 (95% CI 0.572-0.833, p<0.001). The optimal IMA cutoff was 90.45 (sensitivity 60.9%, specificity 79.2%). IMA values were independently associated with 28-day mortality in the multivariate Cox proportional hazard model (adjusted hazard ratio (aHR)=1.16, 95% CI 1.06-1.27, p<0.01).

In this study, we showed that IMA in the emergency departments was associated with 28-day mortality in qSOFA-positive sepsis and septic shock patients. Further studies are needed to evaluate the clinical value of IMA as a useful biomarker in large populations and multicenter institutions.

In this study, we showed that IMA in the emergency departments was associated with 28-day mortality in qSOFA-positive sepsis and septic shock patients. Further studies are needed to evaluate the clinical value of IMA as a useful biomarker in large populations and multicenter institutions.

Although electrolyte abnormalities are related to worse clinical outcomes in patients with acute myocardial infarction (AMI), little is known about the association between admission serum magnesium level and adverse events in AMI patients complicated by out-of-hospital cardiac arrest presenting with malignant ventricular arrhythmias (OHCA-MVA). We investigated the prognostic value of serum magnesium level on admission in these patients.

We retrospectively analyzed the data of 165 consecutive reperfused AMI patients complicated with OHCA-MVA between April 2007 and February 2020 in our university hospital. Serum magnesium concentration was measured on admission. The primary outcome was in-hospital death.

Fifty-four patients (33%) died during hospitalization. Higher serum magnesium level was significantly related to in-hospital death (Fine & Gray's test; p<0.001). In multivariable logistic regression analyses, serum magnesium level on admission was independently associated with in-hospital death (hazard ratio 2.68, 95% confidence interval 1.24-5.80) even after adjustment for covariates. Furthermore, the incidences of cardiogenic shock necessitating an intra-aortic balloon pump (p=0.005) or extracorporeal membrane oxygenation (p<0.001), tracheal intubation (p<0.001) and persistent vegetative state (p=0.002) were significantly higher in patients with higher serum magnesium level than in those with lower serum magnesium level.

In reperfused AMI patients complicated by OHCA-MVA, admission serum magnesium level might be a potential surrogate marker for predicting in-hospital death.

In reperfused AMI patients complicated by OHCA-MVA, admission serum magnesium level might be a potential surrogate marker for predicting in-hospital death.