Conectar
by Xinyu Zhang, Yoo Jung Oh, Yunhan Zhang, Jianfeng Zhu
The digital age has fueled a surge in ADHD self-diagnosis as people turn to online platforms for mental health information. However, the relationship between validation-seeking behaviors and self-perception in these online communities and users’ self-perception has received limited scholarly focus. Drawing on self-verification theory and utilizing natural language processing to analyze 452,026 posts from the r/ADHD subreddit, our study uncovers distinct patterns in validation-seeking behaviors. Results show that (a) self-diagnosed individuals with ADHD are more likely to seek social validation and media validation and to report higher levels of negative self-image and internalized stigma than clinically diagnosed individuals, (b) social validation was strongly associated with both positive and negative self-perceptions; and (c) diagnosis status significantly moderated these relationships, such that the effects of social validation on self-image and stigma were consistently weaker for the self-diagnosed group. Theoretically, this study extends self-verification theory by demonstrating that professional verification hierarchically moderates self-verification effectiveness. This implies a practical need for clinicians to acknowledge online validation seeking and for digital communities to affirm user experiences while mitigating stigma.by Haoyang Zhou, Jinfeng Yang, Na Li, Jinying Li, Jianxin Ran, Yan Zheng, Yifan Long, Fang Cheng, Yuanpeng Liao
BackgroundSarcopenia is an age-associated disorder characterized by a progressive decline in skeletal muscle mass, strength, and physical function. The condition is linked to low levels of anabolic hormones such as insulin-like growth factor 1 (IGF-1), with its downstream phosphatidylinositol 3 kinase (PI3K)/ protein kinase B (AKT)/ forkhead box protein O3 (FOXO3) signaling pathway. There is growing evidence that resistance training (RT) or vibration training (VT) could improve physical functioning in individuals with sarcopenia. However, the related physiological influence of exercise on sarcopenia remains elusive.
MethodThis prospective randomized controlled trial will be conducted among 96 participants, aged between 65 and 80 years. In participants, sarcopenia diagnosis will be confirmed based on the Asian Working Group for Sarcopenia criteria, and participants will be randomized into either control, RT, VT, or RVT (combined RT and VT) groups. The intervention will last 12 weeks, with assessments performed at baseline, 12 weeks (after intervention), and 24 weeks (follow-up). The primary outcomes will include skeletal muscle mass, handgrip strength, and gait speed. Secondary outcomes comprise IGF-1 concentrations, PI3K/AKT and FOXO3 protein activity, quality of life, and timed-up-and-go test performance assessments.
DiscussionThis clinical study aims to elucidate the potential modulation of molecular mechanisms in vivo for combined RT and VT in sarcopenia patients and to identify the effects of the intervention on physical function.
Trial registrationChiCTR, ChiCTR2400083643. Registered on April 29, 2024.
To investigate the correlation between fat-to-muscle ratio (FMR) or other body composition and secondary osteoporosis (OP) in patients with rheumatoid arthritis (RA) and to develop a predictive model using FMR and related clinical factors.
Cross-sectional observational study with machine learning-based risk modelling.
Tertiary hospital in eastern China, secondary care level.
A total of 670 hospitalised RA patients (135 males and 535 females; aged 58.00 (50.00–67.00) years; disease duration 8.00 (2.00–16.00) years) and 126 healthy controls were recruited between October 2019 and October 2022. There were no differences in basic indicators such as gender, age distribution and body mass index between the two groups. RA diagnosis followed American College of Rheumatology (ACR) 1987 or ACR/European League Against Rheumatism 2010 criteria. Exclusion criteria included major organ dysfunction, endocrine disease, infection or long-term hormone or psychotropic drug use.
Primary outcomes included total skeletal muscle mass, fat mass, FMR measured by bioelectrical impedance analysis and bone mineral density measured by dual-energy X-ray absorptiometry. Secondary outcomes included RA disease activity scores (clinical disease activity index (CDAI), simplified disease activity index, disease activity score in 28 joints (DAS28)) and glucocorticoid use. Logistic regression and four additional machine learning algorithms were used to build predictive models for OP.
The RA group (age, 58.00; duration, 8.00; DAS28, 5.03; rheumatoid factor, 104.75; C-reactive protein, 25.65; erythrocyte sedimentation rate (ESR), 59.00) exhibited reduced total skeletal muscle mass (19.49 vs 25.38, p
FMR may serve as a useful clinical indicator of secondary OP in RA patients. A model based on FMR and associated risk factors can predict the possibility of secondary OP.
This study aimed to (1) evaluate the effectiveness of e-health interventions in improving physical activity and associated health outcomes during pregnancy, (2) compare the e-health functions employed across interventions and (3) systematically identify the behaviour change techniques (BCTs) used and examine their interrelationships.
A systematic review and meta-analysis following the PRISMA 2020 guidelines.
Randomised controlled trials were included. Meta-analyses and subgroup analyses were performed using RevMan 5.3. Social network analysis was conducted to determine the most central BCTs within the intervention landscape.
Ten databases were searched, including PubMed, Embase, Web of Science, Cochrane Library, ProQuest, Scopus, SinoMed, China National Knowledge Infrastructure, WanFang and the China Science and Technology Journal Database, from inception to April 22, 2024.
Thirty-five studies were included. Pooled analyses indicated that e-health interventions significantly improved both total (SMD: 0.19; 95% CI: 0.10 to 0.27; I 2 = 55%) and moderate-to-vigorous physical activity (SMD: 0.16, 95% CI: 0.06 to 0.26; I 2 = 53%) in pregnant women. Subgroup analyses revealed that interventions based on theoretical frameworks and those not specifically targeting overweight or obese women demonstrated greater effectiveness. Additionally, e-health interventions were associated with significant reductions in both total and weekly gestational weight gain. Six of the twelve e-health functions were utilised, with ‘client education and behaviour change communication’ being the most prevalent. Thirty unique BCTs were identified; among them, ‘instruction on how to perform the behaviour’, ‘self-monitoring’, ‘problem solving’, and ‘goal setting’ showed the highest degree of interconnectedness.
E-health interventions are effective in enhancing physical activity and reducing gestational weight gain during pregnancy. Incorporating theoretical frameworks and well-integrated BCTs is recommended to optimise intervention outcomes.
Integrating e-health interventions into existing perinatal care models holds promise for enhancing physical activity among pregnant women and improving maternal health outcomes.
This study adhered to the PRISMA checklist.
No patient or public involvement.
The study protocol was preregistered in the International Prospective Register of Systematic Reviews (CRD42024518740)
by Xing Chen, Zhixiong Zhang, Jiwei Xiang, Ruliu Xiong, Xingmao Zhou
BackgroundSoft tissue and other extraosseous sarcomas (STSES) are rare malignant tumors originating from mesenchymal tissues with complex etiologies. A systematic analysis of global burden trends is urgently needed.
MethodsUtilizing the Global Burden of Disease (GBD) 2021 database, we assessed STSES incidence, mortality, disability-adjusted life years (DALYs), age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and age-standardized DALY rate (ASDR) across regions and countries from 1990 to 2021, stratified by sociodemographic index (SDI). Spatiotemporal models, Joinpoint regression (to calculate average annual percentage changes, AAPC), and decomposition analysis were employed to evaluate the impacts of population growth, aging, and epidemiological factors on disease burden.
ResultsIn 2021, there were 96,201 new STSES cases globally, resulting in 50,203 deaths and 1.678 million DALYs. While age-standardized rates (per 100,000 person-years) showed declining trends (AAPC for ASIR = −0.13, ASMR = −0.60, ASDR = − 0.94), absolute burden increased by 77.97% due to population growth. Males exhibited consistently higher burden than females, with incidence peaking at 55–74 years. Notably, young females (10–29 years) transiently surpassed males in DALYs. Significant regional disparities emerged: High-SDI regions (e.g., Western Europe) demonstrated lower ASMR attributable to advanced diagnostics and treatment, whereas low-SDI regions (e.g., Uganda, ASMR = 1.96/100,000) faced poorer prognoses due to healthcare deficiencies. SDI exhibited a nonlinear association with disease burden—middle-SDI regions (0.4–0.8) showed rising ASIR, potentially linked to industrial pollution and improved diagnostic capabilities. These findings underscore the critical need for context-specific prevention and resource allocation strategies to address the evolving global STSES burden.
ConclusionsThe global STSES burden is predominantly driven by population growth, necessitating targeted prevention strategies addressing occupational exposures in males and subtype-specific risks among young females. While high-SDI regions demonstrate mortality reduction through precision oncology, low-SDI regions require urgent improvements in healthcare accessibility to mitigate survival disparities. Persistent regional heterogeneity underscores the imperative for international collaboration to standardize diagnostic protocols and ensure equitable resource allocation. These insights emphasize the need for stratified surveillance systems and translational research to optimize context-specific intervention frameworks.
Preventing skin tears (STs) in older adults is an urgent public health concern, especially in long-term care (LTC) facilities. However, limited research on ST prevention among care workers exists due to a lack of suitable assessment tools. This study aims to develop and psychometrically evaluate the Knowledge, Attitude and Practice instrument for care workers in preventing Skin Tears (KAP-ST) in older adults.
The KAP-ST was developed and validated in four phases during May–October 2024. First, an item pool was generated through a comprehensive literature review. Second, a preliminary instrument was developed through a Delphi expert consultation and pilot testing. Third, the items and the final instrument were optimised through a cross-sectional survey involving 317 care workers from 29 LTC facilities in China. Finally, a psychometric evaluation was conducted in another cross-sectional survey involving 373 care workers from 18 LTC facilities.
The final KAP-ST contains 35 items across knowledge, attitude and practice dimensions. Exploratory factor analysis (EFA) revealed a nine-factor structure (factor loadings ranging from 0.451 to 0.799, accounting for 61.35% of total variance). The Item-Level Content Validity Index (I-CVI) values ranged from 0.926 to 1.000, and the Scale-Level Content Validity Index (S-CVI/Ave) was 0.991. The instrument's Cronbach's α, split-half, and test–retest reliability coefficients were 0.887, 0.744, and 0.934, respectively. The CFA analysis revealed an ideal absolute fit validity (RMSEA = 0.068; RMR = 0.029) and parsimony fit validity (PGFI = 0.684).
The KAP-ST demonstrates strong reliability, structural validity and content validity. It is well-suited for assessing care workers' knowledge, attitudes and practices in preventing STs among older adults. Further research is required to enhance and confirm its validity.
STs in the spotlight recently necessitate the use of appropriate investigative tools to facilitate in-depth research, especially for care workers, who should prioritise access to specialised knowledge. Introducing professional guidance in LTC facilities is recommended to enhance the knowledge, attitude and practice of care workers.
Standardised Guidelines for Scale Construction and COSMIN checklist.
No patient or public contributions.
To explore how the mentor-student relationship affects nursing graduate students' satisfaction with mentors, as well as how mentoring mode and learning motivation work together.
A multi-centre cross-sectional study.
Thirty universities and colleges in eastern, central and western China.
A total of 826 nursing graduate students from thirty universities and colleges participated in this study in April 2024.
Data were collected using the general information questionnaire, mentor-student relationship entry, mentoring mode questionnaire, graduate students' satisfaction item and learning motivation scale. Data were analysed using SPSS 25.0 software. The PROCESS macro-plugin and the bootstrap method were utilised to examine the mediating and moderating effects of learning motivation and mentoring mode.
There was a positive correlation between nursing graduate students' satisfaction with mentors and the mentor-student relationship (r = 0.377, p < 0.001), learning motivation (r = 0.600, p < 0.001), and mentoring mode (r = 0.292, p 0.001). Learning motivation exerted a partial mediation effect between the mentor-student relationship and graduate students' satisfaction with mentors (mediation effect value = 0.182, 95% CI = 0.148–0.218). Mentoring mode moderated the path of learning motivation in the mentor-student relationship (interaction term coefficient = 0.031, 95% CI = 0.005–0.056).
Mentor-student relationship positively predicted nursing graduate students' satisfaction with mentors significantly. Learning motivation played a partial mediating effect between mentor-student relationship and graduate students' satisfaction with mentors and mentoring mode moderated between mentor-student relationship and learning motivation pathways. Therefore, cultivating positive teacher/helpful friend relationship, boosting students' learning motivation and improving mentoring mode techniques can all increase nursing graduate students' satisfaction with mentors.
No patient or public contribution.
Pressure injuries (PIs) remain a problem for patient safety and the sustainability of healthcare systems. Difficulties persist in their assessment, prevention and monitoring by multidisciplinary teams. International recommendations point to this problem as a priority area for resolution in terms of patient safety. Research on the subject has been positive, resulting in several guidelines for clinical practice, but professionals' adherence remains below what is expected for their implementation. This scoping review aimed to identify interventions that increase multidisciplinary teams' adherence to the prevention and management of PIs between hospitals and the communities. The search was carried out in the MEDLINE (via PubMed), CINAHL, Scopus, Web of Science, JBI, Cochrane and grey literature databases by two independent reviewers, and led to the identification of 16 articles that met the eligibility criteria and made it possible to answer the research question. Strategies to improve adherence by health professionals include the creation and training of multidisciplinary teams, the implementation of new risk assessment models, Wound Boards, injury prevention reminders, video consultation apps, multidisciplinary rounds, documentation and recording. No studies were identified that assessed staff adherence to interventions aimed at preventing and managing PIs in the continuum between hospitals and communities, which is suggestive of the need for further research in this area.
To systematically analyse international empirical literature and establish a comprehensive understanding of the push and pull factors influencing retention and turnover among mid-career nurses.
An integrative review.
PubMed, Web of Science, Scopus, EMBASE (Ovid), and CINAHL (EBSCO) were searched for studies published between January 2001 and November 2024.
An integrative literature review was conducted following the five-step process outlined by Whittemore and Knafl. Articles were screened by title, abstract, and full text based on predefined inclusion and exclusion criteria. The quality of eligible studies was assessed using the Mixed Methods Appraisal Tool (MMAT). Data were extracted and synthesised narratively, and the findings were presented according to the socio-ecological framework.
A total of 1930 studies were identified, with 14 included for analysis: 10 qualitative, 3 quantitative, and 1 mixed-methods study. Guided by the socio-ecological framework, four themes and 10 subthemes emerged: (1) Intrapersonal (professional knowledge/skills, health issues, work-family balance); (2) Interpersonal (professional collaborative relationships, supervisor support); (3) Organisational (organisational characteristics, work characteristics, career development); and (4) Societal (salary/benefits, Social/governmental recognition).
This review reveals the heterogeneity of research on this topic and confirms previous findings. It identifies certain push-and-pull factors common to nurses across all stages of their careers. However, mid-career nurses face unique challenges, including more complex healthcare demands, declining health status, growing family caregiving responsibilities, unclear organisational roles, underutilisation of professional skills, career stagnation, and limitations on salary growth. These findings highlight the need for tailored retention strategies for mid-career nurses.
A “one-size-fits-all” retention strategy does not meet the needs of all nurses. To improve nurse retention rates, it is essential to address the shifting demands and priorities that arise as nurses reassess and transition through different career stages. For mid-career nurses, acknowledging and valuing their expertise and capabilities, providing sufficient resources, and fostering a supportive work environment that promotes career development may be effective strategies for retaining these experienced professionals.
Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
No Patient or Public Contribution.
To explore the perceptions and experiences of parents caring for children with paediatric feeding disorders requiring feeding tubes (PFD-T).
A descriptive qualitative approach was adopted in this study.
Using purposive sampling, 12 parents were recruited from paediatric inpatient wards and the outpatient paediatric feeding clinic at a tertiary public hospital in Singapore. Data collection was done from July to December 2024. Semi-structured one-on-one interviews were conducted with the parents (fathers or mothers) until data saturation. Thematic analysis was used to identify themes from the interview content.
A total of three themes and six subthemes were identified, encapsulating the challenges experienced by parents with caregiving and feeding tube management, as well as the sources of support they had. The themes are: (1) A sense of community, (2) Grieving over the loss of normalcy and (3) Facing the unknown.
Parents in this study felt supported being in a community of other parents with children who have PFD-T. It enabled them to gain valuable information and offered them a space where they felt understood. At the same time, they expressed feelings of guilt and isolation, as the caregiving demands led to limited capacity to cater to or interact with other loved ones. Additional challenges parents faced included transitioning between types of feeding tubes and insufficient support from healthcare professionals.
Ethical approval was obtained from the National Health Group Domain Specific Review Board (DSRB 2024/00064) on 8 May 2024.
This study followed the reporting guidelines outlined by the COnsolidated criteria for REporting Qualitative (COREQ) research checklist.
This study did not include patient or public involvement in its design, conduct, or reporting.
To develop a structured intervention aimed at enhancing family communication to reduce relapse in adolescents with depression.
This study follows a multi-stage process guided by the Intervention Mapping procedure with the Medical Research Council framework, assessing the layers of complexity. Its design comprises four interrelated stages to construct a family communication intervention, culminating in a pilot randomised controlled trial.
The program has four stages: (1) Identifying family interaction gaps through literature review and expert input; (2) Investigating communication needs of depressed adolescents and their families via a mixed methods study to develop a model intervention; (3) Refining the intervention with focus groups and expert e-Delphi; and (4) Finalising the intervention based on pilot randomised controlled trial outcomes. The research will be conducted in Greater Accra, Ghana.
The process will result in a family communication intervention tailored to the needs of adolescents with depression and their families. It will be pilot tested, and the results will inform a nationwide efficacy trial.
This research integrates qualitative and quantitative data to inform the development of an evidence-based family communication intervention. The program will carefully examine data integration and contextual challenges encountered during its implementation.
The intervention has the potential to enhance family communication, thus playing a crucial role in adolescent depression recovery by reducing relapse rates. Healthcare professionals will benefit from a structured, evidence-based communication tool that can be used in clinical settings.
The study focuses on improving communication between families of adolescents with depression, aiming to develop a family communication package for clinical and community use. This intervention may enhance recovery outcomes and reduce relapse risk for adolescents.
This study adhered to the GUIDED guideline for reporting intervention development studies.
No Patient or Public Contribution.
To refine fall risk assessment scale among older adults with cognitive impairment in nursing homes.
A cross-sectional survey.
Mokken analysis was conducted to refine the assessment scale based on unidimensionality, local independence, monotonicity, dimensionality, and reliability. Data were gathered from cognitively impaired older adults in a nursing home from January to February 2023. Trained nursing assistants conducted face-to-face assessments and reviewed medical records to administer the scale.
Emotion and State Dimension did not meet unidimensionality criteria (H = 0.14), particularly item Q9, which also violated local independence. Monotonicity analysis showed all items exhibited monotonic increases. After refinement at c = 0.3, the scale consists of nine items. With increasing c-values, the first seven items were ultimately retained to form the final version of the scale. Both optimised scales (9-item and 7-item) satisfied reliability requirements, with all coefficients (Cronbach's α, Guttman's lambda-2, Molenaar-Sijtsma, Latent Class Reliability Coefficient) ≥ 0.74.
The scale is suitable for assessing fall risk among older adults with cognitive impairment, with a unidimensional scale of the first seven items recommended for practical use. Future efforts should refine the scale by exploring additional risk factors, especially emotion-related ones.
The refined 7-item scale provides nursing home staff with a practical, reliable tool for assessing fall risk in cognitively impaired older adults, enabling targeted prevention strategies to enhance safety and reduce injuries.
The refined 7-item scale provides nursing home staff with a reliable, practical, and scientifically validated tool specifically designed for assessing fall risk in older adults with cognitive impairment. Its simplicity enables efficient integration into routine clinical workflows, empowering caregivers to proactively identify risk factors and implement timely, targeted interventions. This approach directly enhances resident safety by translating assessment results into actionable prevention strategies within daily care practices.
This study was reported in accordance with the STROBE guidelines.
No Patient or Public Contribution.
Physiological, psychological, and social changes may make older adults more vulnerable to stressors and lead to adverse health outcomes. It remains unclear whether interventions targeting coping strategies in older adults are effective.
This study aimed to systematically review and summarize existing interventions aimed at improving coping strategies in older adults and analyze intervention effectiveness.
A systematic search was conducted using PubMed, EMBASE, Web of Science, Cochrane, CINAHL, PsycINFO, CNKI, SinoMed, VIP, and WanFang databases for randomized controlled trials (RCTs) and quasi-experimental studies. Two researchers independently performed literature screening, quality assessment, and data extraction.
A total of 9 studies were included, comprising 7 RCTs and 2 quasi-experimental studies. Meta-analysis revealed that the interventions significantly enhanced the use of problem-focused coping strategies among older adults (SMD = 0.37, 95% CI: 0.12 ~ 0.63, p = 0.005, I 2 = 39%). However, there was no significant effect on emotion-focused coping strategies (SMD = −0.07, 95% CI [−0.62, 0.48], p = 0.80, I 2 = 76%). Moreover, no significant statistical differences were observed between the intervention group and the control group in terms of positive (SMD = 1.49, 95% CI [−0.23, 3.21], p = 0.09, I 2 = 98%) or negative coping strategies (SMD = −0.76, 95% CI [−1.79, 0.28], p = 0.15, I 2 = 96%).
Interventions targeting coping strategies can significantly improve the problem-focused coping strategies of older adults. It is crucial to help older adults accurately recognize daily stressors, acquire emotional regulation strategies, and enhance coping skills. More large-scale RCTs are needed to draw more robust conclusions.
Ethnic minoritized women face cultural and systemic barriers in accessing antepartum and intrapartum care. Healthcare providers play a pivotal role in addressing these challenges, but their perspectives and experiences in delivering culturally competent care remain underexplored.
To synthesise healthcare providers' experiences and perspectives on providing culturally competent antepartum and intrapartum care for ethnic minoritised women.
A qualitative meta-synthesis study design was employed. Six electronic databases were searched from their inception date till January 2025. The included studies were assessed using the method of the Critical Appraisal Skills Programme tool, and findings were meta-synthesised using Sandelowski and Barroso's six-step approach. This review was registered via the International Prospective Register of Systematic Reviews.
Overall, 38 studies were included, and three themes emerged. The first theme revealed how providers' biases and professional training distorted their ability to understand and respect cultural practices. The second theme underscored the impact of systemic barriers such as time constraints, resource scarcity and lack of representation among providers. The final theme highlighted healthcare providers' aspirations for improved communication, targeted training and guidance on building trust to enhance care delivery.
Healthcare providers encounter notable challenges in delivering culturally competent antepartum and intrapartum care, but remain hopeful about bridging gaps in communication and understanding. Practical recommendations include implementing mandatory cultural competency training at all levels of healthcare professional education, increasing resources for interpreters and cultural liaisons and fostering diversity within the healthcare workforce. Future research should explore patient-centred interventions and systemic reforms to improve care for ethnic minoritised women. These findings highlight the need for policies and practices that empower providers to deliver equitable, culturally respectful antepartum and intrapartum care.
No patient or public contribution.
by Chenyu Zheng, Ming Fang, Yue Zhang, Xinyu Liu, Zhihuan Huang
Exposure to natural landscapes has been shown to affect both physiological and psychological well-being, with the extent of these effects varying across different landscape types. However, the underlying mechanisms remain poorly understood. The association among stress reduction, environments characteristics and individual differences requires further investigation, particularly considering the complexity of landscape attributes and the variability of personal responses. In this study, 98 university students participated in a survey to evaluate the effects of different landscape types on visual preference and fatigue recovery. Physiological data (blood pressure, heart rate), psychological data (Perceived Restorative Scale), and visual preferences were analyzed before and after participants viewed the images of eight representative landscape space types: mountain, field, waterscape, lawn, desert, forest, artificial nature, plant. The results indicated that landscape type significantly influenced both physiological responses and emotional states, as well as participants’ perceived recovery from stress. Among the eight landscape spaces, water features and forests were reported to be the most restorative. Compared to freshmen, juniors exhibited greater improvements in physical and psychological recovery, alongside more positive evaluations of the environments. Notably, the desert landscape elicited varied responses depending on participants’ grade level and gender, suggesting that restoration effects may be modulated by individual characteristics. This may reflect an evolutionary predisposition to prefer natural features that enhance survival. These findings contribute to environmental psychology and provide valuable insights for educational practice and environmental design.This study examines the incidence and risk factors of euglycaemic diabetic ketoacidosis (euDKA) in patients undergoing coronary artery bypass grafting (CABG) and evaluates their postoperative outcomes over a 6-month follow-up period.
This study is a single-centre, nested case-control study, conducted in Tianjin, China.
An international cardiovascular hospital.
A total of 1524 patients, with a mean age of 64 (9) years, who underwent isolated elective CABG surgery were reviewed.
Data were extracted from electronic medical records. EuDKA cases were identified by reviewing laboratory examination results until discharge, including arterial blood gas analysis and urine samples. Logistic regression analysis was used in a case-control design to identify potential risk factors of sodium-glucose cotransporter 2 inhibitor (SGLT2i)-associated euDKA. Post-discharge follow-up was conducted through regular outpatient visits.
15 patients with euDKA, all with type 2 diabetes, were identified post-surgery, 13 of whom were SGLT2i users. The cumulative incidence of euDKA within 7 days after surgery was 1% in the cohort, increasing to 7.6% among those who discontinued SGLT2i 1–6 days (n=171) before surgery. A case-control study added seven additional confirmed euDKA patients to the case group, resulting in 20 cases and 95 controls. Univariate regression analysis revealed that the risk of euDKA was 7.304 times higher (95% CI 2.517 to 21.197; p–1 (OR: 6.882, 95% CI 1.822 to 25.997; p=0.004) were associated with a higher risk of euDKA. Compared with controls, euDKA patients experienced a higher rate of type 5 myocardial infarction (6/20 (30%) vs 9/95 (9.5%); p=0.035) and recurrent ketosis post-discharge (3/19 (15.8%) vs 0/87 (0%); p=0.005).
This cohort study highlights a notable incidence of euDKA following CABG, particularly among patients using SGLT2i. Close monitoring in the ICU is recommended for patients with intraoperative abnormal blood glucose and pH levels to prevent euDKA.
FreshRSS 