Search Results (387)

Background and Objectives: Acute exacerbation of COPD (AECOPD) poses a major burden on healthcare systems, with critically ill AECOPD patients having increased morbidity and mortality. Since adverse outcomes are due both to respiratory failure and the systemic inflammatory response, prognostic markers accounting for these patterns are needed. Our aim was to investigate the predictive power of derived hematological indices for intensive care unit (ICU) mortality in patients with non-infectious versus infectious AECOPD. Materials and Methods: This is a retrospective, observational, monocentric cohort study on 88 AECOPD patients admitted to the ICU between 2018 and 2023. Descriptive statistics were performed for the entire cohort, and for predefined subgroups (non-infectious, infectious and bacterial AECOPD). Receiver Operating Characteristics (ROC) analysis was performed to test the predictive power of the studied indices. Cut-off values were identified using the Youden index. Kaplan–Meier analysis was conducted to test the association with ICU mortality. Results: Overall ICU mortality was 44%. For the whole cohort, neutrophil-to-lymphocyte ratio (NLR), neutrophil-to-platelets ratio (NPR) and systemic inflammation response index (SIRI) showed moderate predictive power for ICU mortality (areas under the curve (AUCs) of 0.71–0.73). Non-infectious and infectious subgroups were comparable in terms of size, demographics, comorbidities and baseline COPD characteristics (p > 0.05). Mortality was significantly higher in infectious AECOPD (64.6% versus 20%, p < 0.001). For non-infectious AECOPD, monocyte-to-lymphocyte ratio (MLR) and SIRI had very good predictive power (AUCs between 0.82 and 0.855), while NPR and systemic inflammation index (SII) showed moderate AUC values (between 0.7 and 0.79). In infectious AECOPD, only NPR retained fair predictive power (AUC 0.691), which improved in bacterial AECOPD (AUC 0.781). Conclusions: Derived hematological indices have different predictive values for ICU mortality. MLR and SIRI exhibited very good predictive power in non-infectious AECOPD, while NPR was the best discriminator in bacterial AECOPD. These stress the importance of individualized prognostication in AECOPD. Full article

Background: Chronic liver disease (CLD) in children requires long-term monitoring. Liver biopsy and transient elastography (TE) are resource-intensive methods that require specialized equipment and trained personnel. Simple indirect fibrosis scores based on routine laboratory parameters offer a potentially cost-effective alternative but have not been systematically evaluated in pediatric populations with diverse CLD etiologies. Objectives: This study aimed to assess the performance of several indirect fibrosis and cirrhosis scores in predicting significant (≥F2) and advanced (≥F3) fibrosis and cirrhosis (F4) in children with CLD using TE as a comparator. Methods: We retrospectively reviewed medical records of children with CLD evaluated at a tertiary center between January 2023 and June 2025. TE results and routine laboratory data were used to calculate fibrosis scores, including APRI, FIB-4, FibroIndex, FORNS, GPR, GUCI, King’s score, and Lok’s index. ROC analyses were performed to assess each score’s ability to discriminate significant fibrosis, advanced fibrosis and cirrhosis. Optimal cut-offs were established using the Youden index. Results: GPR showed the strongest concordance with TE-based fibrosis classification across both fibrosis thresholds, achieving an AUROC of 0.835 for significant fibrosis and a superior 0.917 for advanced fibrosis. FibroIndex and APRI also demonstrated good discriminatory power for advanced disease. Utilizing mathematically optimized cut-offs, GPR (0.45) and APRI (0.84) achieved good negative predictive values (100% and 95%) and sensitivities (100% and 85%) for advanced fibrosis, establishing them as potentially valuable screening tools. For cirrhosis detection (F4), Lok’s Index performed best (AUROC 0.854). Conclusions: In this diverse pediatric cohort, simple indirect scores—particularly GPR, APRI, and FibroIndex—demonstrated the highest concordance relative to TE findings, with negative predictive values up to 100% for GPR. This indicates that they can serve as reliable first-line screening tools when TE is unavailable. While their good negative predictive values allow for the confident exclusion of severe disease—potentially sparing many children from invasive testing—their low positive predictive values limit their role in definitive diagnosis. The systematic failure of adult-derived, age-dependent formulas in this cohort underscores the critical need for specialized pediatric biomarkers. Full article

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common chronic liver disease worldwide and represents a major component of the global burden of metabolic disorders. Simple anthropometric markers capable of identifying individuals at increased risk of hepatic steatosis are of considerable interest for population-level screening. Methods: In this cross-sectional population-based study, we evaluated the performance of waist-to-height ratio (WtHR) for identifying individuals with a high Fatty Liver Index (FLI ≥ 60), a widely used surrogate marker of hepatic steatosis. The study included 146,318 adult participants with available anthropometric and biochemical data. Discriminatory performance was assessed using receiver operating characteristic (ROC) curve analysis. Optimal WtHR thresholds were determined using the Youden index. Associations between WtHR and high FLI were evaluated using age-adjusted logistic regression models. Non-linear relationships were explored using restricted cubic spline models. Additional analyses included a comparison with body mass index (BMI) and waist circumference, decision curve analysis, and subgroup analyses across age and BMI strata. Results: The prevalence of high FLI in the study population was 18.1%. WtHR demonstrated excellent discriminatory performance, with area under the ROC curve (AUC) values of 0.908 (95% CI 0.906–0.910) in men and 0.972 (95% CI 0.971–0.974) in women. Optimal WtHR thresholds for identifying individuals with high FLI were 0.52 in men and 0.53 in women. Each 0.01 increase in WtHR was strongly associated with higher odds of high FLI (OR 1.56 in men and 1.69 in women). Restricted cubic spline analysis demonstrated a non-linear relationship, with a marked increase in predicted probability of high FLI above WtHR values of approximately 0.50–0.52. WtHR showed discriminatory performance comparable to BMI and waist circumference and maintained strong associations with high FLI across age groups and BMI categories. Conclusions: Waist-to-height ratio is a simple anthropometric marker strongly associated with a high Fatty Liver Index in a large population-based cohort. Given its simplicity, low cost, and ease of calculation, WtHR may represent a practical screening indicator for identifying individuals at increased risk of MASLD-related phenotypes in both clinical practice and population health strategies. Full article

To address the low accuracy of traditional freshness detection/grading and poor adaptability to different shell colors in the duck egg industry, this study developed a non-destructive detection model and an integrated device for duck egg freshness based on machine vision combined with eggshell optical property analysis. A four-sided yolk transmission imaging system was designed, and accurate yolk region segmentation was achieved via grayscale conversion, a weighted improved Otsu algorithm for whole-egg segmentation, histogram equalization enhancement, and K-means clustering in the LAB color space. A relational model between the average four-angle yolk projected area ratio and Haugh Units (HU) freshness grades was constructed, with grading thresholds determined by constrained optimization combined with the Youden index to balance food safety and grading accuracy. Experimental results showed the model achieved an overall freshness grade discrimination accuracy of 91.3%, with a sensitivity of 97.1% and specificity of 98.9% for inedible Grade B (HU < 60) duck eggs and below. An automated testing device was further developed, adopting a roller-rotating motor collaborative mechanism for automatic flipping and imaging, and equipped with a 10 W/5500 K LED cool white light source to solve the problem of poor adaptability to different shell colors. The device achieved an overall discrimination accuracy of 88.5% with a detection time of ≤5 s per egg, and its host computer can real-time output the yolk area ratio, predicted HU value, and freshness level. This study provides a high-precision and low-cost technical solution for the refined grading of the poultry egg industry. Full article

Background and Objectives: Postpartum depression (PPD) is a prevalent mental health condition with substantial consequences for mothers, infants, and families. The Edinburgh Postnatal Depression Scale (EPDS) is the most widely used screening instrument for PPD; however, optimal cut-off scores vary across populations, necessitating local validation. No prior study has evaluated the diagnostic performance of the EPDS against a structured clinical interview in Latvia. To assess the reliability and diagnostic accuracy of the Latvian version of the EPDS and to determine the optimal cut-off score for detecting PPD in a Latvian outpatient population 4–6 weeks after childbirth. Materials and Methods: A cross-sectional study was conducted at the outpatient department of Riga Maternity Hospital between June 2024 and May 2025. Women aged ≥18 years attending routine postnatal check-ups were screened using the Patient Health Questionnaire-9 (PHQ-9). Those scoring ≥5 were invited to complete the EPDS and participate in a structured diagnostic interview using the Mini International Neuropsychiatric Interview (MINI) 7.0.2. Internal consistency was assessed using Cronbach’s alpha. Receiver operating characteristic (ROC) analysis was performed to evaluate diagnostic accuracy and identify the optimal cut-off score based on sensitivity, specificity, likelihood ratios, and the Youden Index. Results: A total of 272 women were screened, and 101 completed the EPDS; 78.63% of screen-positive participants underwent the MINI. The EPDS demonstrated excellent internal consistency (Cronbach’s α = 0.871). ROC analysis indicated strong discriminative ability (AUC = 0.852, 95% CI 0.759–0.945, p < 0.001). A cut-off score of ≥11 provided the optimal balance between sensitivity (0.74) and specificity (0.82), with the highest Youden Index (0.56) and a positive likelihood ratio of 4.14. Conclusions: The Latvian version of the EPDS is a reliable and diagnostically accurate screening instrument for PPD 4–6 weeks after delivery. A cut-off score of ≥11 appears optimal for routine screening in Latvian outpatient settings. These findings support the integration of EPDS-based screening into structured postpartum care and underscore the value of validating screening instruments within specific cultural and clinical contexts. Full article

Distinguishing Active from Inactive Tuberculosis (TB) on Chest X-rays presents a clinical challenge due to overlapping radiological signs. This study introduces Vision Mamba CGSM, a deep learning framework integrating a State Space Model (SSM) backbone with a Context-Guided Slot Mixing (CGSM) module. The SSM captures global anatomical context, while the CGSM module isolates subtle pathological features by applying localized spatial attention. We validated the model using a hierarchical diagnostic scheme covering Normal, Pneumonia, Active TB, and Inactive TB. Experimental evaluations demonstrate an accuracy of 92.96% and a Youden Index of 79.55% on the independent test set. In the specific binary classification of Active vs. Inactive TB, the model recorded a specificity of 97.04%, outperforming standard baseline architectures including ResNet152 and ViT-B. Additional validations on external datasets confirm the consistent generalization of the proposed feature extraction mechanism. Full article

Objective: To evaluate the diagnostic and prognostic utility of the hemoglobin–albumin–lymphocyte–platelet (HALP) score and several systemic inflammatory indices derived from routine blood parameters—including the systemic immune-inflammation index (SII), platelet-to-lymphocyte ratio (PLR), pan-immune inflammation value (PIV), and systemic inflammatory response index (SIRI)—for pathogen differentiation and clinical assessment in culture-proven late-onset neonatal sepsis (LOS). Methods: A retrospective analysis was conducted on a cohort of 150 neonates with culture-proven LOS. Systemic inflammatory indices were calculated at baseline (first week of life) and at the time of septic insult. The discriminative power of these indices was assessed via ROC curve analysis, with optimal cut-off points determined by the Youden Index. Risk stratification was performed using Odds Ratio (OR) modeling with 95% Confidence Intervals (CIs) to evaluate the predictive strength of each marker according to its respective threshold. Results: Diagnosis-phase assessments identified SII as the premier discriminator for microbiological etiology (AUC = 0.869; OR = 44.57), outperforming PLR and PIV. Although HALP demonstrated moderate efficacy in distinguishing pathogens, it lacked prognostic value regarding mortality. Conversely, SIRI displayed limited clinical utility, yielding the lowest predictive performance in our cohort. Conclusions: In neonatal sepsis, the HALP score provided additional clinical information when compared with several hematological inflammatory indices. Although HALP was not associated with mortality, prospective multicenter studies are needed to clarify the role of these cost-effective markers in pathogen differentiation and clinical assessment of LOS. Full article

Background: We evaluated the association between admission serum glucose-to-potassium ratio (GPR) and injury severity as well as early transfusion requirements in patients with traumatic pelvic fractures. Methods: This single-center, retrospective cohort study included 84 adult patients with isolated or predominantly pelvic fractures admitted between January 2020 and December 2024. Patients with concomitant non-pelvic skeletal fractures were excluded to isolate the metabolic response attributable to pelvic injury. GPR was calculated from admission serum glucose and potassium levels. Higher transfusion requirement (HT) was defined as ≥4 units of packed red blood cells within 24 h. Receiver operating characteristic (ROC) analysis identified the optimal GPR cut-off using the Youden index. Internal validation was performed using bootstrap resampling (1000 iterations), and model calibration was assessed with the Hosmer–Lemeshow test. The incremental discriminatory value of GPR beyond the Injury Severity Score (ISS) was evaluated by comparing AUC values using the DeLong test, and reclassification metrics including the category-free net reclassification improvement (NRI) and integrated discrimination improvement (IDI) were calculated. Sensitivity analyses were conducted using alternative transfusion thresholds (≥6 and ≥10 units). Results: The optimal GPR cut-off was 34 (area under the curve (AUC) = 0.730; 95% CI: 0.593–0.853; sensitivity 78.8%; specificity 59.0%). Patients with GPR ≥ 34 (n = 43) had significantly higher ISS values (median 25 [IQR: 16–34] vs. 9 [5–17]; p < 0.001), greater transfusion volumes (median 3 [0–6] vs. 0 [0–1] units; p < 0.001), and longer intensive care unit (ICU) stays (3 (0–6) vs. 0 (0–1) days; p < 0.001). In univariable logistic regression, GPR was significantly associated with HT (OR = 1.059 per unit increase; 95% CI: 1.015–1.104; p = 0.008); however, significance was not retained in the multivariable model after adjustment for ISS (p = 0.194). ISS remained the sole independent predictor (OR = 1.128; p < 0.001). The combined ISS + GPR model yielded an AUC of 0.857, representing a modest increment over ISS alone (AUC = 0.849; ΔAUC = 0.009; DeLong p = 0.566). Bootstrap-corrected AUCs confirmed minimal optimism (GPR alone: 0.726; ISS + GPR: 0.847). The Hosmer–Lemeshow test indicated adequate calibration for all models (p > 0.05). The category-free NRI was 0.627 (p = 0.009), whereas the IDI did not reach significance (0.017; p = 0.290). Sensitivity analysis at the ≥6-unit threshold yielded consistent results (GPR AUC = 0.709). Conclusions: Admission GPR is significantly associated with injury severity, hemorrhagic burden, and transfusion requirements in patients with traumatic pelvic fractures. Although GPR does not independently predict transfusion needs beyond ISS, it yields significant reclassification improvement and may serve as a practical, rapidly obtainable adjunct for early risk stratification in the acute trauma setting. Level of Evidence: III (retrospective prognostic study). Full article

Background: Mindray BC-6800 Plus ^TM (Mindray, Shenzhen, China) measures reticulocyte counts and provides the reticulocyte hemoglobin (RHe, reticulocyte Hb expression) and mean reticulocyte volume (MRV). We studied the performance of those reticulocyte-derived parameters for the detection of iron-restricted erythropoiesis in older patients, compared with standard laboratory tests. Methods: A total of 220 anemic patients, age > 65 years, were recruited in the context of routine health controls. Group differences were assessed using analysis of variance (ANOVA), with p values < 0.05 considered statistically significant. Receiver operating characteristic (ROC) curve analysis was performed to assess the diagnostic performance of RHe and MRV for detecting iron-restricted erythropoiesis. The reference standard for iron deficiency was sTfR > 52 nmol/L. A multivariable logistic regression model was constructed for iron-restricted erythropoiesis, including MRV, Ret-He and s-ferritin as independent covariates, and adjusted for inflammatory status and renal function. Results: Overall, 30.1% in the group had IDA and 29.0% had mixed IDA/ACD, so 59.1% had absolute or functional iron deficiency, while 40.9% had adequate iron supply. RHe and MRV values differed significantly between both groups (p = 0.0001). For s-ferritin, ROC analysis yielded an AUC of 0.685 (95% CI 0.606–0.767), with the best Youden index at a cut-off of 100 µg/L, corresponding to 72.5% sensitivity and 65.9% specificity. An MRV cut-off of 97.4 fL identified iron-restricted erythropoiesis with 88.2% sensitivity and 82.7% specificity (AUC 0.878, 95% CI 0.799–0.957); RHe AUC 0.860, 95% CI 0.777–0.947; cut-off 30.4 pg; sensitivity 82.4%, specificity 79.8%). In multivariable logistic regression adjusted for CRP and eGFR, s-ferritin was not an independent predictor of iron-restricted erythropoiesis, whereas MRV and RHe remained significant. The overall model demonstrated good discrimination, with an AUC 0.808 (95% CI 0.804–0.814). Conclusions: RHe and MRV are reliable parameters for assessing iron supply to erythropoiesis in older patients and can assist in distinguishing iron-restricted erythropoiesis in complex, inflammation-driven settings. Full article

Colic is a leading cause of mortality in horses, particularly when associated with systemic inflammation and organ dysfunction. In human medicine, these complications are associated with sepsis, defined as organ dysfunction caused by a dysregulated, life-threatening host response to infection. However, no consensus sepsis score exists for adult horses. This retrospective study aimed to develop a diagnostic sepsis score for adult horses. Medical records from 295 horses admitted for colic to the Oniris equine emergency department (Nantes, France) between July 2011 and November 2021 were analyzed. Horses were classified as having sepsis or colic based on their final diagnosis. Clinical and laboratory parameters were assessed, and univariate and multivariate logistic regression analyses yielded a predictive score. The optimal threshold was determined by maximizing sensitivity and specificity. Sepsis was diagnosed in 89 horses (30.2%). Six parameters—temperature, heart rate, leukocyte count, red blood cells, creatine kinase, and lactate—were included in the model. The score showed 79% accuracy, with 59% sensitivity and 88% specificity. At a threshold of 3, sensitivity was 52.7%, specificity was 91.6%, and the Youden index was 0.44. This study proposes a rapid, practical sepsis diagnostic score for adult horses with acute gastrointestinal disease, serving as a highly specific tool for confirming sepsis. Full article

Background/Objectives: Predicting 30-day mortality after in-hospital cardiac arrest (IHCA) remains challenging. We developed an interpretable CatBoost model that incorporates the m-NUTRIC score, age, and selected micronutrient biomarkers (i.e., magnesium, zinc, vitamin D, and vitamin B12). We compared its performance with that of logistic regression and quantified variable contributions using SHAP. Methods: Variables were extracted from the electronic medical records of 880 patients with IHCA admitted to a medical intensive care unit. The CatBoost and logistic regression models were trained on a stratified 80/20 split. The decision threshold was optimized using the Youden index (0.482). Discrimination (ROC-AUC with bootstrap confidence intervals), classification metrics, precision–recall analysis, calibration, and decision curve analysis were reported. Results: CatBoost achieved a ROC-AUC of 0.850 (95% confidence interval [CI]: 0.822–0.879) in the training set and 0.827 (95% CI: 0.760–0.887) in the internal test set, outperforming logistic regression (0.797; 95% CI: 0.720–0.861). The test set accuracy, precision, recall, F1-score, specificity, and average precision were 0.761, 0.847, 0.790, 0.817, 0.702, and 0.909, respectively. The Brier score was 0.186. Decision curve analysis showed net benefit across threshold probabilities of 0.20–0.70. The SHAP analysis identified m-NUTRIC and age as the dominant predictors, whereas micronutrients served as complementary contextual factors. Conclusions: The CatBoost model consistently outperformed the logistic regression and warrants prospective multicenter validation. Full article

Background and Objectives: Metastatic pancreatic ductal adenocarcinoma carries a dismal prognosis and there is an unmet need for simple, widely available prognostic biomarkers to guide risk stratification and treatment planning. This study aimed to evaluate whether baseline EASIX score, calculated from routine laboratory parameters (LDH, creatinine, platelet count), predicts overall survival (OS) in patients with de novo metastatic pancreatic cancer. Materials and Methods: We performed a retrospective cohort study at a single tertiary center (Medical Oncology Department, Kocaeli University Faculty of Medicine) including 332 patients diagnosed with de novo metastatic pancreatic ductal adenocarcinoma between January 2019 and October 2025. Baseline EASIX was calculated using LDH, creatinine, and platelet count. Statistical analyses included ROC analysis with Youden index to determine exploratory cut-off, Kaplan–Meier survival estimation with log-rank test, and univariate and multivariate Cox proportional hazards regression to identify independent prognostic factors. The primary endpoint was OS, defined as time from initiation of first-line therapy to death from any cause. Results: A total of 332 patients were included. Median OS was 8.0 months overall. Patients with high EASIX (>2.505) had significantly shorter median OS compared with low EASIX patients (8.4 vs. 27.6 months, p < 0.001). ROC analysis was considered exploratory for overall survival; therefore, an additional fixed-time (12-month mortality) ROC analysis was performed to provide a discrimination estimate accounting for censoring. The AUC for EASIX was 0.887 (95% CI: 0.816–0.958), and the exploratory cut-off determined was 2.505 (sensitivity 96.95%, specificity 72.97%). In multivariate Cox regression, high EASIX remained an independent predictor of worse OS (HR 4.124; 95% CI: 2.011–8.457; p < 0.001) after adjustment for relevant covariates. Conclusions: Baseline EASIX score is an independent prognostic marker for overall survival in de novo metastatic pancreatic cancer, based on routine laboratory tests, and may facilitate exploratory risk stratification. Prospective validation in independent cohorts is warranted before clinical implementation. Full article

Background/Objectives: The global increase in metabolic dysfunction-associated steatotic liver disease underscores the need for accessible and reliable markers to assess hepatic steatosis. The triglyceride–glucose (TyG) index, derived from fasting plasma glucose and triglyceride levels, has emerged as a practical surrogate marker of insulin resistance and has been increasingly associated with metabolic liver involvement. This study aimed to evaluate the relationship between the TyG index and the severity of hepatic steatosis assessed by ultrasonography. Methods: This retrospective cross-sectional study included 480 adult patients without a prior diagnosis of diabetes mellitus or hypertension who underwent fasting laboratory testing and abdominal ultrasonography between January 2024 and May 2025. Fasting plasma glucose and triglyceride levels were obtained on the same day as ultrasonographic evaluation. Hepatic steatosis was assessed by a single experienced radiologist using standardized ultrasonographic criteria, and patients were categorized into three groups according to steatosis grade (grade 0, grade 1, and grade 2–3; n = 160 for each group). Demographic data and laboratory parameters, including glucose, triglycerides, HbA1c, platelet count, neutrophils, lymphocytes, monocytes, ALT, AST, and total cholesterol levels, were recorded. The TyG index was calculated using the formula: TyG = ln[(fasting triglycerides × fasting glucose)/2]. Results: A total of 480 patients (30.6% male) were included in the analysis. Mean fasting glucose, triglyceride, and TyG index values were 94.20 ± 11.15 mg/dL, 146.91 ± 83.94 mg/dL, and 8.70 ± 0.55, respectively. Metabolic and inflammatory parameters increased significantly with advancing steatosis grades (all p < 0.05). The TyG index demonstrated a clear stepwise increase from grade 0 (8.29 ± 0.42) to grade 1 (8.74 ± 0.42) and grade 2–3 steatosis (9.07 ± 0.49) (p < 0.001), with all pairwise comparisons remaining statistically significant. Receiver operating characteristic (ROC) analysis showed good discriminative performance of the TyG index for hepatic steatosis (AUC = 0.829), and an optimal cutoff value of 7.90 was identified using the Youden index, yielding high sensitivity for detection. In multivariable logistic regression analysis, the TyG index remained the strongest independent predictor of hepatic steatosis (adjusted OR 11.41, 95% CI 6.10–21.34; p < 0.001). Conclusions: The TyG index increased progressively with the severity of hepatic steatosis and showed strong associations with metabolic and inflammatory parameters. These findings support the TyG index as a simple and accessible marker reflecting metabolic dysfunction and hepatic steatosis, with potential value for early risk stratification in clinical practice. Full article

Background: Delirium is a frequent and serious complication in elderly patients with hip fractures and is associated with adverse outcomes. Early identification requires a brief and reliable screening tool suitable for routine clinical practice. The 4 ‘A’s Test (4AT) is a rapid instrument for delirium detection that requires minimal training. Objective: To translate, culturally adapt, and validate the Greek version of the 4AT in elderly patients with hip fractures. Methods: A total of 103 patients aged ≥65 years who were admitted with hip fracture were enrolled. The 4AT was translated using a forward–backward translation process and culturally adapted according to established guidelines. Delirium diagnosis was established using DSM-5 criteria by trained clinicians, serving as the reference standard. The 4AT was administered independently within 3 h. Diagnostic accuracy was assessed by calculating sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the receiver operating characteristic curve (AUC). The optimal cut-off was determined using Youden’s index. Results: At a cut-off score ≥4, the Greek 4AT demonstrated a sensitivity of 87.5% and specificity of 91.1%, with PPV 75% and NPV 96%. The AUC was 0.94, indicating excellent diagnostic performance. Conclusions: The Greek version of the 4AT is a valid and reliable screening tool for detecting delirium in elderly patients with hip fractures. Full article

Background: The risk of morbidity and mortality increases in newborns requiring postpartum transport. Various scoring systems have been developed to determine mortality risk, such as the Transport Risk Index of Physiologic Stability (TRIPS) and Mortality Index for Neonatal Transportation (MINT) scores. This study aimed to evaluate the efficiency of MINT and TRIPS scores by comparing them with the Score for Neonatal Acute Physiology-Perinatal Extension (SNAPPE-II) scoring system in preterm and term infants transported within the first 24 h after birth. Methods: This retrospective study included neonates transported within the first 24 h of life to the NICU of Etlik Zübeyde Hanım Women’s Health Training and Research Hospital between 2016 and 2021, following ethics approval. Perinatal data, admission clinical and laboratory parameters, and TRIPS, MINT, and SNAPPE-II scores calculated within the were recorded. Mortality and short-term morbidities were analysed. Group comparisons were conducted using Mann–Whitney U and chi-square tests. Predictive performance and optimal cut-off values were determined by receiver operating characteristic curve analysis using the Youden index. p value <0.05 was considered significant. Results: A total of 137 newborns were included in the study. Seventy-two cases (52.6%) were preterm, and 65 cases (47.4%) were term newborns. The median gestational age and birthweight were 35.6 weeks and 2485 g, respectively. A total of 10 patients died. For mortality prediction, the areas under the curve for TRIPS, MINT, and SNAPPE-II were 0.919, 0.907, and 0.973, respectively (p < 0.001). The determined cut-off values for TRIPS, MINT, and SNAPPE-II were >19, >4, and >35, respectively. The TRIPS score showed the best accuracy for prediction of mortality in preterm infants. Conclusions: Our data show that MINT and TRIPS scores are efficient beyond SNAPPE-II. They demonstrated high diagnostic effectiveness in predicting mortality in preterm and term infants. The TRIPS score exhibits superior mortality prediction in preterm infants. Full article