BACKGROUND: In the recent years, National Early Warning Score2 (NEWS2) is utilized to predict early on, the worsening of clinical status in patients. To this date the predictive accuracy of National Early Warning Score (NEWS2), Revised Trauma Score (RTS), and Trauma and injury severity score (TRISS) regarding the trauma patients\' mortality rate have not been compared. Therefore, the objective of this study is comparing NEWS2, TRISS, and RTS in predicting mortality rate in trauma patients based on prehospital data set.
METHODS: This cross-sectional retrospective diagnostic study performed on 6905 trauma patients, of which 4191 were found eligible, referred to the largest trauma center in southern Iran, Shiraz, during 2022-2023 based on their prehospital data set in order to compare the prognostic power of NEWS2, RTS, and TRISS in predicting in-hospital mortality rate. Patients are divided into deceased and survived groups. Demographic data, vital signs, and GCS were obtained from the patients and scoring systems were calculated and compared between the two groups. TRISS and ISS are calculated with in-hospital data set; others are based on prehospital data set.
RESULTS: A total of 129 patients have deceased. Age, cause of injury, length of hospital stay, SBP, RR, HR, temperature, SpO2, and GCS were associated with mortality (p-value < 0.001). TRISS and RTS had the highest sensitivity and specificity respectively (77.52, CI 95% [69.3-84.4] and 93.99, CI 95% [93.2-94.7]). TRISS had the highest area under the ROC curve (0.934) followed by NEWS2 (0.879), GCS (0.815), RTS (0.812), and ISS (0.774). TRISS and NEWS were superior to RTS, GCS, and ISS (p-value < 0.0001).
CONCLUSIONS: This novel study compares the accuracy of NEWS2, TRISS, and RTS scoring systems in predicting mortality rate based on prehospital data. The findings suggest that all the scoring systems can predict mortality, with TRISS being the most accurate of them, followed by NEWS2. Considering the time consumption and ease of use, NEWS2 seems to be accurate and quick in predicting mortality based on prehospital data set.

UNASSIGNED: Neonatal deaths often result from preventable conditions that can be addressed with appropriate interventions. This study aims to analyze the distribution of the causes of neonatal death and explore genetic variations that lead to congenital anomalies in Northwest China.
UNASSIGNED: This multi-center observational study was conducted across six medical centers in Shaanxi province, Northwest China. Clinical data were retrospectively collected from neonates admitted between 2016 and 2020. Kaplan-Meier analysis was utilized to estimate survival rates, while high-throughput sequencing platforms were employed to detect mutations causing congenital anomalies.
UNASSIGNED: Among 73,967 neonates requiring hospital care, 424 neonatal deaths were recorded, leading to a neonatal mortality rate of 0.57%. The primary causes of death included neonatal respiratory distress syndrome (23.8%), birth asphyxia (19.8%), neonatal septicemia (19.3%), and congenital anomalies (13.6%). The leading causes of neonatal deaths due to congenital anomalies were congenital heart defects (38.6%), bronchopulmonary dysplasia (14.0%), and inherited metabolic disorders (10.5%). Genetic analysis identified 83 pathogenic or likely pathogenic variants in 23 genes among the neonates with congenital anomalies, including four novel mutations (c.4198+1G>T, c.1075delG, c.610-1G>A, c.7769C>T) in the ABCC8, CDKL5, PLA2G6, and NIPBL genes.
UNASSIGNED: Congenital anomalies represent a significant and preventable cause of neonatal deaths in Northwest China. Early detection of congenital anomalies through genetic testing and comprehensive prenatal care are crucial for reducing neonatal mortality rates and improving pregnancy outcomes.

OBJECTIVE: Bacteremia with anaerobic bacteria is generally a marker of severe prognosis. However, population-based data is lacking. Our aim was to describe the epidemiology and the 30-day mortality rate of anaerobic bacteremia in a Danish population-based setting.
METHODS: In this population-based cohort study, all first-time episodes of anaerobic bacteremia from the North Denmark Bacteremia Research Database during 1994-2019 were identified. Information on comorbidities, discharge diagnoses, and mortality was retrieved. 30-day mortality rates were calculated and a multivariate logistic regression analysis to identify risk factors for death was performed.
RESULTS: 1750 episodes with anaerobic bacteremia were identified, corresponding to an incidence rate of 12.5 per 100,000 inhabitants (increasing from 11.2 in 1994-2014 to 17.7 in 2015-2019). Of these episodes, a third were polymicrobial, and the majority (70 %) of patients had one or more comorbid conditions. Abdominal infection was the source of bacteremia in 61 % of patients, while it was unknown for 15 %. The most frequently isolated genera were Bacteroides (45 %), Clostridium (20 %) and Fusobacterium (6 %). The overall crude 30-day mortality rate was 27 %, but rates were even higher for patients of high age, with liver disease, and solid tumors. The odds ratio (OR) for 30-day mortality was 1.32 for Clostridium species, and 1.27 for polymicrobial bacteremia with aerobic bacteria.
CONCLUSIONS: The incidence rate of anaerobic bacteremia increased, and the 30-day mortality rate remained high during the study period. Multiple factors influence 30-day mortality rates, including high age, liver disease, solid tumor, polymicrobial bacteremia, and bacteremia with Clostridium species.

OBJECTIVE: To evaluate patients with prosthetic valves who developed infective endocarditis by comparing treatment outcomes in both early- and late-onset IE episodes following prosthetic valve replacement surgery. This study sought to conduct a comprehensive assessment of the efficacy of these methodologies. The insights derived from this assessment can be utilized to enhance the quality of care for individuals with infective endocarditis who have undergone prosthetic valve replacement surgery.
RESULTS: During the period of investigation (January 2017-December 2022), 78 patients diagnosed with infective endocarditis (IE) on a prosthetic valve were admitted to the Infectious Diseases Department of the \"Dr. Carol Davila\" Central Military Emergency University Hospital in Bucharest. In 28 patients (35.8%), the onset of PVE occurred within 12 months of surgery (early onset), whereas in 50 patients (64.2%), the onset occurred more than 12 months after surgery (late onset). The mortality rate was 35.9% (53.6% among the early onset patients and 26% among the late-onset patients). Among patients who received surgical and medical therapy, the mortality rate was 29.6%, whereas among those who received only medical therapy, a 39.2% mortality rate was reported. According to the extracted data, antibiotic therapy was successful in 72.6% of the patients. In contrast, a combination of surgical and drug-based approaches resulted in a cure in 76.1% of patients. The most common etiological agent was Staphylococcus aureus (38.5%), followed by Enterococcus faecalis (26.9%) and Streptococcus mitis (10.3%). The mortality rate of patients infected with S. aureus was 29.2%, indicating the severity of this infectious agent.
CONCLUSIONS: Prosthetic valve endocarditis (PVE) is a serious condition associated with a high mortality rate both in the short and long term. Regardless of the therapy used, the risk of death remains high.

Background: HIV and drug overdose continue to be the leading causes of death among people who inject drugs (PWID). Mizoram, a small state in the northeast of India, has the highest prevalence of HIV in India and a high HIV prevalence among PWID. Objective: To estimate the mortality among HIV-positive and HIV-negative PWID and to describe its associated factors. Methods: Cross-sectional datasets from the 2007-2021 Mizoram State AIDS Control Society (MSACS) data comprising 14626 PWID were analyzed. Logistic regression analysis was conducted to examine the factors associated with mortality among HIV-negative and HIV-positive PWID after adjusting for potential confounding factors. Results: Mortality among HIV-negative PWID declined by 59% between 2007 and 2021. The mortality rate among HIV-positive PWID also declined by 41% between 2007 and 2021. The multiple logistic regression analysis revealed that being divorced/separated/widowed (AOR = 1.41, 95% CI 1.03-1.94) remained positively associated with mortality among HIV-positive PWID. Mortality among HIV-negative PWID remained positively associated with ages of 24-34 years (AOR = 1.54, 95% CI 1.29-1.84) and above 35 years (AOR = 2.08, 95% CI 1.52-2.86), being divorced/separated/widowed (AOR = 1.28, 95% CI 1.02-1.61), and the sharing of needles/syringes (AOR = 1.28, 95% CI 1.34-2.00). Mortality among HIV-negative PWID was negatively associated with being married (AOR = 0.72, 95% CI 0.57-0.90), being employed (AOR = 0.77, 95% CI 0.64-0.94), and having a monthly income. Conclusions: The mortality rate among HIV-negative and HIV-positive PWID declined significantly between 2007 and 2021 in Mizoram. To further reduce mortality among PWID, interventions should target those sharing needles/syringes, those above 24 years of age, and unmarried participants.

UNASSIGNED: Despite an increasing number of studies, there is as yet no definite treatment developed for the coronavirus disease 2019 (COVID-19). In this clinical trial, we examined the efficacy of a novel herbal antiviral preparation in critically ill COVID-19 patients.
UNASSIGNED: A total number of 120 ICU-admitted patients with a diagnosis of COVID-19 pneumonia were recruited to the trial. Participants were equally randomized to receive either the novel antiviral preparation sublingually, for up to two consecutive weeks or till discharge, or placebo. Clinical and laboratory parameters as well as survival rates were compared between the two groups.
UNASSIGNED: The cumulative incidence of death throughout the study period was 8.33% in the intervention group and 60% in the placebo group (risk ratio: 0.14; 95% confidence interval [CI], 0.05 to 0.32; p<0.001). On day 7, several parameters including white blood cells (WBCs) count, C-reactive protein, and SpO2 were improved for the treatment group compared with the placebo group (p-values of 0.05, 0.01, and <0.001, respectively).
UNASSIGNED: This preparation might be suggested as a potentially promising COVID-19 treatment.

UNASSIGNED: Ludwig\'s angina is a serious life-threatening infective condition of maxillofacial region due to odontogenic origin which is clinically diagnosed by its clinical signs and symptoms. Airway management and early surgical decompression is the main stay of management. The mortality rates in Ludwig\'s angina remains multivariate. There is a paucity in literature regarding the mortality rates of this disease.
UNASSIGNED: Aim of this retrospective study is to describes the characteristics, probable cause of death and mortality rates of patients with co-morbidities presenting to the emergency department (ED) who were subsequently admitted with a primary diagnosis of Ludwig\'s angina.
UNASSIGNED: Study was conducted in the department of maxillofacial surgery in a tertiary care teaching hospital from Jan 2011 to Dec 2022. Data of 17 patients who were clinically diagnosed as Ludwig\'s angina were included in the study. The comorbidity, source of odontongenic cause, mode of intubation and the outcome of the disease were evaluated.
UNASSIGNED: Comparison of categorical variables was done using Fishers exact test. A p-value of <0.7 was considered statistically significant. The results suggested that Out of 17 patients 12 patients (70.5%), 7 male and 5 females had comorbidities and four cases (23.5%) had complication of death, all having co-morbidities.
UNASSIGNED: It concludes that associated comorbidity has a significant role in progress and outcome of the disease and incidence of death is more common in cases having associated comorbidity.

Acinetobacter baumannii (AB) infections have become a global public health concern due to the continued increase in the incidence of infection and the rate of resistance to carbapenems. This study aimed to investigate the genomic features of AB strains recovered from a tertiary hospital and assess the clinical implications of the findings. A total of 217 AB strains were collected between 2016 and 2018 at a tertiary hospital in Guangzhou, with 183 (84.33%) being carbapenem-resistant AB (CRAB), with the main mechanism being the carriage of the blaOXA-23 gene. The overall mortality rate of patients caused by such strains was 15.21% (n = 33). Artificial lung ventilation and the use of meropenem were mortality risk factors in AB-infected patients, while KL2 AB infection was negatively associated. Core genome multilocus sequence typing and clustering analysis were performed on the integrated AB genome collection from the NCBI database and this study to illustrate the population structure among China. The results revealed diverse core genome profiles (n = 17) among AB strains from China, and strains from this single hospital exhibited most of the core genome profiles (n = 13), suggesting genetic variability within the hospital and transmission across the country. These findings show that the high transmission potential of the CRAB strains and meropenem usage that confers a selective advantage of CRAB clinically are two major factors that pose significant challenges to the effective clinical management of AB infections. Understanding the genetic features and transmission patterns of clinical AB strains is crucial for the effective control of infections caused by this pathogen.

UNASSIGNED: The intensive care unit (ICU) mortality rate remains high, especially in developing countries, regardless of the advances in critical management. There is a lack of studies about mortality causes in hospitals and particularly ICUs in Palestine.This study evaluated the demographic and clinical characteristics of critically ill patients and determined the predictors of mortality among patients in the ICU.
UNASSIGNED: A retrospective study assessed all patients who stayed in the ICU for more than 24 h from January 2017 to January 2019. Data were collected from the patient\'s files. Patient characteristics (background, clinical variables, and comorbidities) were recorded.
UNASSIGNED: The study included 227 eligible ICU patients. The cases\' mean age was 55.5 (SD ± 18.2) years. The overall ICU mortality rate was 31.7%. The following factors were associated with high adjusted mortality odds: admission from inside the hospital (adjusted odds ratio (aOR), 2.1, 95% CI: 1.1-3.9, p < 0.05), creatinine level ≥2 mg/dl on admission (aOR, 2.7, 95% CI: 1.3-5.8, p < 0.01), hematology malignancy patients (aOR, 3.4, 95% CI: 1.6-6.7, p = 0.001), immune-compromised (aOR, 2.5, 95% CI: 1.3-4.7, p < 0.01), septic shock (aOR, 27.1, 95% CI: 7.9-88.3, p < 0.001), hospital-acquired infections (aOR: 13.4, 95% CI: 4.1-57.1, p < 0.001), and patients with multiple-source infection (aOR: 16.3, 95% CI: 6.4-57.1, p < 0.001). Also, high SOFA and APACHE scores predicted morality (p < 0.001).
UNASSIGNED: The mortality rate among ICU patients was high. It was higher among those admitted from the hospital wards, septic shock, hospital-acquired infection, multiple infection sources, and multi-drug resistance infections. Thus, strategies should be developed to enhance the ICU environment and provide sufficient resources to minimize the effects of these predictors.

OBJECTIVE: Care for people with spina bifida can be improved. This may be done by evaluating mortality rates and causes of death.
METHODS: Between 1973 and 2021, 1735 people with spina bifida appeared in registers of the Swedish population. Survival rates and causes of death were calculated according to age and decade.
RESULTS: Over almost 50 years, the prevalence of spina bifida decreased from 5.2 to 1.2 per 10 000 births. Mortality fell sharply during the first year of life, with survival rising from 75% to 94%. For children aged 2-18 years and adults, mortality rates were low and differences between decades were minimal. Causes of childhood deaths were congenital abnormalities, hydrocephalus and infections, the latter two also in adults. Adult causes also included self-inflicted injuries and substance abuse, with suicidal or unclear intent, both more common than in the general population. Bladder malignancies were also more frequent, although after reconstructive bladder surgery, mortality rates were similar.
CONCLUSIONS: Survival in the first year of life increased in children with spina bifida, whereas there was no difference in survival rates between adults born between 1973 and 1999. For adults, proactive prevention methods regarding self-inflicted injury, substance abuse and bladder cancer are warranted.