Search Results (99)

Background/Objectives: Artificial intelligence (AI) is increasingly used to support chest radiograph interpretation, but its clinical value depends not only on stand-alone accuracy but also on whether its errors differ from those of clinicians. We evaluated CT-referenced, target-specific diagnostic performance and complementary error patterns of a commercial chest radiograph AI system and a single emergency physician. Methods: In this retrospective, single-center, paired diagnostic accuracy study, 920 consecutive adults who underwent posteroanterior chest radiography and thoracic computed tomography (CT) within 4 h during the same emergency department encounter were included. A commercial AI system (hChestXR version 1) and a single blinded emergency physician independently assessed eight prespecified thoracic findings using CT as the reference standard. Paired differences were estimated with 10,000 patient-level bootstrap resamples and tested with exact McNemar tests with Holm adjustment. Exact-target complementarity and simulated same-target OR/AND rules were secondary exploratory analyses. Results: Across 7360 patient–target assessments, including 1232 CT-positive findings, AI had significantly greater Holm-adjusted sensitivity for pneumothorax (90.8% vs. 50.8%), nodule/mass (63.3% vs. 32.7%), and rib fracture (77.2% vs. 46.5%). AI-only detections were most frequent for pneumothorax (47.7%), nodule/mass (44.9%), and rib fracture (43.6%), whereas physician-only detections were most frequent for atelectasis (24.8%), pulmonary edema (21.0%), and lung opacity (19.7%). In exploratory pooled analyses, sensitivity was 73.0% for AI and 62.0% for the physician. Exploratory simulated same-target OR/AND analyses demonstrated a sensitivity–specificity trade-off across pooled patient–target assessments but did not represent observed AI-assisted clinical performance. Conclusions: The AI system and the single emergency-physician reader in the study showed target-dependent, partly non-overlapping error patterns in this CT-selected emergency cohort. The findings support prospective multireader evaluation of AI as a second-reader tool but do not establish benefit from real-time AI-assisted interpretation. Full article

Background: A narrow waist is one of the central objectives of esthetic body contouring, and it is closely tied to the waist-to-hip ratio that observers associate with a feminine silhouette. Conventional soft-tissue techniques such as liposuction and liposculpture are constrained by patient-specific anatomy, including the pattern of adipose tissue distribution and the transverse dimensions of the bony rib cage. Minimally invasive rib remodeling was developed to overcome these constraints and to produce a more pronounced waist-narrowing effect without rib removal. The factors that determine the magnitude of the result and patient satisfaction have not been characterized in sufficient detail. Methods: A combined retrospective–prospective single-center study was conducted on 60 female patients aged 22 to 55 years (mean age, 35.5 years) who underwent minimally invasive rib remodeling using the Kudzaev technique between 2017 and 2025. The variables assessed included anthropometric measurements, body mass index (BMI), subcutaneous and visceral adipose distribution, body shape, endocrine status, and psychological readiness to adhere to the postoperative regimen. Outcomes were evaluated at three months on the basis of the change in waist circumference, standardized photographic documentation, and patient satisfaction (five-point scale) and the BODY-Q Satisfaction with body scale. Safety was assessed clinically during the first postoperative day and at every follow-up contact, and union of the osteotomies was assessed by computed tomography at three months. Results: The mean reduction in waist circumference was 7.82 ± 2.14 cm. Both the reduction and patient satisfaction decreased with increasing BMI (Pearson r = −0.30, p = 0.02 and r = −0.42, p < 0.001 respectively): patients with a BMI ≤ 25 kg/m² (n = 59) achieved a mean reduction of 7.86 ± 2.12 cm and a satisfaction score of 4.25 ± 0.96, whereas the single patient with a BMI > 25 kg/m² obtained a smaller reduction (5 cm) and the lowest satisfaction score. The BODY-Q Satisfaction with body scale corroborated these results (Rasch-transformed score, 82.6 ± 18.1) and correlated strongly with the five-point rating (Pearson r = 0.90). Elevated BMI and a pronounced visceral fat component were associated with a less favorable esthetic outcome. Endocrine disease, in particular hyperparathyroidism, was associated with delayed rib consolidation and lower satisfaction. Poor postoperative compliance, especially inconsistent corset wear, was linked to unsatisfactory results. No pulmonary, pleural or infectious complications occurred. Access by needle puncture left no scars, analgesic use lasted two to four days, and computed tomography at three months showed consolidation in 58 of the 60 patients. No patient reported loss of the achieved narrowing during subsequent contact. Conclusions: The effectiveness of minimally invasive rib remodeling depends substantially on patient selection. The most favorable outcomes were obtained in patients with a normal BMI, minimal adipose tissue, and a high level of compliance. Elevated BMI, excess visceral fat, parathyroid disease and low motivation were each associated with a smaller effect and lower satisfaction, and identify patients in whom the procedure is less likely to satisfy. These findings support rigorous preoperative selection that accounts for both somatic and behavioral characteristics. Full article

Background/Objectives: Evidence on longitudinal changes in nutrition, inflammation, and body composition during adjuvant chemotherapy for Stage II/III colorectal cancer (CRC) remains limited. We therefore evaluated these changes and explored preoperative factors associated with treatment discontinuation and prognosis. Methods: This single-center retrospective study included patients with Stage II/III CRC who underwent curative surgery and adjuvant chemotherapy. Body mass index (BMI), computed tomography (CT)-derived psoas muscle index (PMI), psoas muscle density (PMD), modified intramuscular adipose tissue content (mIMAC), Geriatric Nutritional Risk Index (GNRI), Prognostic Nutritional Index (PNI), hemoglobin–albumin–lymphocyte–platelet (HALP) score, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) were assessed preoperatively and 6 months after chemotherapy initiation. Analyses were stratified into oxaliplatin-based doublet therapy (CAPOX/FOLFOX) and fluoropyrimidine monotherapy. Results: Among 142 patients, GNRI, PNI, and HALP score increased, whereas BMI, NLR, and PLR decreased from preoperative assessment to follow-up. Adjuvant therapy was discontinued in 45 patients (31.7%). In the doublet therapy group, discontinuation was associated with lower preoperative GNRI, PNI, and HALP scores and higher NLR and PLR. In the monotherapy group, only older age was associated with discontinuation. Lower preoperative PMD and mIMAC, but not PMI, were associated with poorer overall survival. No other nutritional or inflammatory markers were associated with overall survival. Conclusions: Several nutritional and inflammatory markers improved from preoperative assessment to follow-up. Preoperative nutritional and inflammatory markers were associated with treatment discontinuation, particularly in the doublet therapy group. CT-derived muscle quality markers were associated with overall survival, suggesting prognostic relevance of muscle quality in this setting. Full article

Fat-poor angiomyolipoma (fp-AML), a common benign renal mass, closely mimics renal cell carcinoma (RCC) on preoperative computed tomography (CT), frequently resulting in unnecessary surgical intervention. This multicenter retrospective study aimed to develop and externally validate an AI-assisted radiomics model based on triphasic contrast-enhanced CT to accurately distinguish fp-AML from RCC. A total of 655 eligible patients with sporadic solid renal lesions were enrolled and divided into a training cohort (n = 364), an internal test cohort (n = 156), and an independent external validation cohort (n = 135), with a stable fp-AML to RCC ratio of approximately 1:4. Tumor segmentation was performed using an nnU-Net-assisted workflow with radiologist refinement, followed by cross-phase image registration, radiomic feature extraction, LASSO feature reduction, and random forest classifier construction. The established model achieved favorable and stable diagnostic performance across all cohorts, with AUCs of 0.868 in the training and internal test sets and 0.803 in the external validation set, maintaining reliable discrimination even in the small renal mass subgroup (≤4 cm). This externally validated AI radiomics model demonstrates promising diagnostic performance across centers and may serve as a preoperative decision-support tool for differentiating fp-AML from RCC; however, prospective multicenter validation is required before routine clinical implementation. Full article

Background and Objectives: The 2024 Korean medical–political conflict caused the mass resignation of trainee physicians, raising concerns about the quality of care for time-critical emergencies. This study aimed to assess the impact of workforce disruptions on the management and outcomes of adults presenting to the emergency department (ED) with septic shock. Materials and Methods: This retrospective single-center cohort study was conducted at a tertiary care ED and included adults with septic shock between September 2022 and August 2025. This study compared the pre-conflict period, operating under a resident-supported model, with the conflict period characterized by a specialist-led staffing model. The primary outcome was the all-cause in-hospital mortality. The secondary outcomes included process-related time intervals and clinical course measurements. Multivariate logistic regression was used to identify the independent predictors of mortality. Results: Altogether, 343 patients were included (159 pre-conflict, 184 conflict). During the conflict, ED crowding significantly decreased (average concurrent ED patients: 14.9 vs. 7.6, p < 0.001). Key diagnostic process metrics, including time to blood gas analysis, blood sampling, blood culture, computed tomography, and total ED length of stay, were significantly shortened. Time-critical therapeutic intervals, such as time to empirical antibiotics, remained unchanged. In-hospital mortality did not differ significantly between the pre- and conflict periods. Multivariate analysis demonstrated that the conflict period was not independently associated with mortality; only initial serum lactate levels and Acute Physiology and Chronic Health Evaluation II scores remained significant predictors. Conclusions: The 2024 Korean medical–political conflict was not associated with increased in-hospital mortality among patients with septic shock. Process-related metrics improved, while key therapeutic intervals and overall clinical outcomes remained stable. These findings may reflect reduced ED crowding, organizational adaptation, and continued adherence to established septic shock management practices. Reduced ED volume likely contributed substantially to improvements in diagnostic and throughput-related processes. Full article

Background/Objectives: Pretreatment sarcopenia predicts adverse outcomes in head and neck squamous cell carcinoma (HNSCC). The conventional L3 skeletal muscle index (SMI) requires abdominal imaging, whereas the predictive value of the more accessible C3 muscle index for acute treatment-related complications remains uncertain. We compared pretreatment L3 SMI and the C3 index for identifying patients at risk of severe oral intake impairment, radiation interruption, and a longer treatment-to-discharge interval during definitive chemoradiotherapy. Methods: This retrospective single-center study included 55 patients with HNSCC treated with 80 mg/m² cisplatin every three weeks and 66 Gy intensity-modulated radiotherapy. Pretreatment computed tomography (CT) was analyzed using deep-learning-based automated segmentation. Firth-penalized logistic and multivariable linear regression were adjusted for age, sex, performance status, body mass index, and stage, with estimates standardized per 1-standard-deviation (SD) increase. Results: L3 SMI was associated with severe oral intake impairment (adjusted odds ratio per SD, 0.248; 95% CI, 0.053–0.891) and the treatment-to-discharge interval (adjusted β, −6.23 days; 95% CI, −11.89 to −0.58); the C3 index was not associated with any outcome. The standardized coefficients differed for oral intake impairment (p = 0.014) but not for other outcomes. Each binary outcome comprised only 10 events. Conclusions: L3 SMI was associated with nutritional vulnerability, whereas the fully automated C3 index was not; in an exploratory direct comparison, the two indices differed for severe oral intake impairment. These findings are hypothesis-generating and require confirmation in larger, multicenter cohorts. Full article

Geometric misalignment degrades industrial cone-beam computed tomography (CBCT), particularly when a dedicated calibration phantom cannot be deployed during object acquisition. This study presents a three-stage, scan-specific geometric refinement framework that searches a bounded five-coordinate correction space around a nominal geometry. Coarse candidates are screened using the normalized residual between a geometry-corrected center-of-mass trajectory and its best-fitting low-order periodic model. Translation- and rotation-dominant coordinates are then refined within system-specific physical bounds, and an energy-normalized nuclear-norm score of corrected row-wise sinograms is used for local correlation refinement. The periodic and low-rank terms are treated as object-dependent surrogate objectives rather than as standalone guarantees of physical parameter identifiability. An exact-ASTRA implementation check using a Shepp–Logan volume verified the detector-plane reindexing convention: applying the injected correction reduced valid-mask projection discrepancy to 35.2%, 13.7%, and 8.66% of the uncorrected values for small, medium, and large perturbations, respectively, with round-trip resampling NRMSE of 0.022–0.023 and a mean valid fraction of 98.4%. Three industrial datasets acquired with horizontal gantry CT, temperature-stage in situ CT, and vertical micro-CT provided comparative reconstruction evidence. In addition, a controlled reduced-resolution industrial object reprojection benchmark was used for direct comparison with MI-PSO, PR, and a stability-regularized implementation of the public epipolar-consistency formulation (Open-ECC-R). Over 20 fixed-ROI axial slices, Open-ECC-R increased the mean SSIM from 0.6852 ± 0.0454 for the uncalibrated reconstruction to 0.8450 ± 0.0155 and reduced the NRMSE from 0.5180 ± 0.0526 to 0.1671 ± 0.0125. The proposed method achieved the highest mean SSIM of 0.9933 ± 0.0002 and the lowest NRMSE of 0.0321 ± 0.0009. For the Bluetooth earphone dataset, local sagittal and axial MTF₅₀ estimates increased from 0.84 to 0.94 lp/mm and from 0.45 to 1.05 lp/mm, respectively. These results support scan-specific image-quality refinement around a nominal geometry while avoiding unsupported claims of absolute parameter recovery. Full article

Background/Objectives: Whether the prognostic contribution of low skeletal muscle mass varies with age in ventilated patients is untested. We assessed whether the association between low computed tomography (CT)-derived thoracic muscle area and ventilator-liberation outcomes differs by age. Methods: This single-center retrospective cohort included 607 adults with pneumonia requiring invasive ventilation in the intensive care unit (ICU) between 2016 and 2021. Thoracic muscle area was quantified by deep-learning segmentation of the whole thoracic musculature (first to twelfth thoracic vertebra) on the chest CT obtained closest to ICU admission and normalized to the length of the thoracic spine (median offset 0 days; 86% within ±7 days, before or after); low thoracic muscle area was the sex-specific lowest quartile. The primary outcome was composite weaning failure (extubation failure, tracheostomy, or ventilation >21 days). Multivariable logistic regression stratified at 75 years tested a muscle-area-by-age interaction. Results: Composite weaning failure occurred in 290 patients (47.8%). In fully adjusted complete-case models (n = 539), low thoracic muscle area was associated with composite weaning failure in younger patients (adjusted odds ratio 3.63; 95% CI 1.67–7.87) but not significantly in older patients (1.68; 0.91–3.13); the age interaction was not significant (p = 0.061) and was removed by height-normalization and by correction for multiple comparisons. A graded association across muscle-area quartiles was present in both strata (lowest vs. highest quartile: younger 4.79, older 2.53). Low thoracic muscle area was not associated with ICU mortality in either stratum, although an exploratory landmark analysis showed higher 7-day mortality in younger patients with low muscle area (20.6% vs. 10.8%). Conclusions: Low CT-derived thoracic muscle area was associated with composite weaning failure in both age strata, with a larger point estimate in patients younger than 75 years, although the age interaction was not significant in the fully adjusted model and was removed by height-normalization and by correction for multiple comparisons. The graded association in both age strata is hypothesis-generating and requires prospective validation. Full article

Background and Objectives: Non-traumatic spontaneous adrenal mass rupture (SAMR) is a rare and life-threatening surgical emergency. It has around a 32% mortality rate based on the underlying pathology. We aimed to explore the presentations, management, and outcomes of SAMR with various pathologies. Materials andMethods: We reviewed electronic and operative records over the last eight years to identify SAMR at our institute. Patients’ demographics, comorbidities, presentations, pathology, interventions, and outcomes were analyzed. Results: There were 14 unilateral SAMR patients who arrived at the emergency department (ED)presenting with abdominal pain. The median age at presentation was 34 years (range 27–56). In total, 12 patients were male (83.3%), and 2 were female, including a 32-week-pregnant woman. Ten were South Asians and four were Arabs. All the patients with SAMR did not have a history of prior adrenal disorders. Nine patients had hypotension at presentation. After the initial clinical examination, the patients underwent a computed tomography (CT) scan in the ED, which revealed unilateral SAMR. There was no medical history of adrenal mass or trauma prior to index admission. The CT scan size of the masses ranged from 5.5 to 23.6 cm (eight were right-sided and six left-sided). Time to intervention ranged from 1 to 11 days. Histopathology showed four pheochromocytomas, four myelolipomas, three normal adrenal tissues with hemorrhagic cysts, one adrenal gland hemorrhage, one pseudocyst, and one angiosarcoma. Six adrenal masses were non-functioning. All patients were managed with open adrenalectomy (two had pre-operative interventional radiological embolization). Blood transfusion was required in most cases. Ten patients required post-operative surgical intensive care with an average stay of 2.42 days. There were no perioperative deaths during the hospital course. Conclusions: Ruptured adrenal masses most commonly present with acute abdominal pain requiring urgent surgical intervention, particularly in patients with hemodynamic instability, insufficient initial conservative management or malignancy. Despite the dramatic presentation, outcomes are favorable in experienced centers when early diagnosis and hemodynamic optimization precede interventions and are accompanied by multidisciplinary team involvement. Full article

Background/Objectives: Bezoars are described as masses of undigested substances that can be found within the gastrointestinal tract. This study aimed to explore the types of bezoars observed in pediatric patients and examine the underlying factors contributing to the formation of these bezoars and treatment outcomes. Method: This retrospective study was conducted at a tertiary medical center in Northern Taiwan from January 2000 to June 2023. We enrolled pediatric patients diagnosed with bezoars in the gastrointestinal tract from the medical database of esophagogastroduodenoscopy, upper gastrointestinal series, lower gastrointestinal series, abdominal computed tomography, and surgical procedural codes. Demographic characteristics, presenting symptoms, imaging findings, and clinical course were reviewed. Results: A total of 25 patients, including 14 females (56%), with a median age of 12.0 years (interquartile range: 5.9–15.0 years), were enrolled in this study. Phytobezoars were observed in 17 patients, while trichobezoars were found in 5 patients, and 3 patients had lactobezoars. The stomach was identified as the most frequent site. Among these patients, gastrointestinal anomalies were found in 15 patients (60%), with neuropsychiatric disorders in 11 patients (44%). Surgical intervention was required for 14 patients (56%), 5 patients (20%) underwent endoscopic treatment, and 6 patients (24%) passed the bezoar spontaneously. Trichobezoars (100%, p = 0.040), as well as bezoars of larger size (p = 0.005) or those located in the lower gastrointestinal tract (57%, p = 0.033), were associated with a significantly higher likelihood of requiring surgical intervention. Conclusions: Phytobezoars are the predominant type of bezoar observed in children, with gastrointestinal anomalies and neuropsychiatric disorders being potential contributing factors. Patients with trichobezoars or bezoars located in the lower gastrointestinal tract, especially those of larger size, are more likely to require surgery for treatment. Full article

Objectives: Although transudative pleural effusions are generally associated with benign conditions, a subset may represent malignant pleural effusions (MPE). Because pleural fluid cytology is often not performed in transudative effusions, malignancy may be underdiagnosed. We aimed to identify predictors of malignancy in transudative pleural effusions and develop a clinical prediction score. Methods: We conducted a retrospective cohort study including patients with transudative pleural effusion who underwent pleural fluid cytological analysis between January 2022 and January 2026 at a tertiary chest diseases center. Among 3253 patients who underwent thoracentesis, 314 patients with transudative pleural effusions were included. Clinical, radiological, laboratory, and pleural fluid characteristics were analyzed. Univariable and multivariable logistic regression analyses were performed to identify independent predictors of MPE. A simplified risk score was developed from the final multivariable model and internally validated using bootstrap resampling. Results: Among 314 patients, 24 (7.6%) were diagnosed with MPE. In multivariable analysis, pleural pathology on thoracic computed tomography (CT) (OR 7.07, 95% CI 2.61–19.16), parenchymal nodule/mass OR 5.18, 95% CI 1.85–15.54), pleural fluid lactate dehydrogenase (LDH) > 150 U/L (OR 5.09, 95% CI 1.86–13.93), and pleural fluid glucose < 100 mg/dL (OR 3.52, 95% CI 1.12–11.1) were independent predictors of MPE. The 16-point scoring system showed excellent discriminative performance (AUC 0.89). Bootstrap validation confirmed good calibration and model robustness. Conclusions: In patients with transudative pleural effusions, pleural pathology on thoracic CT, parenchymal nodule or mass, pleural fluid LDH > 150 U/L, and pleural fluid glucose < 100 mg/dL were independent predictors of MPE. A simple 16-point prediction score derived from these variables demonstrated excellent discriminative performance and may assist in identifying patients who warrant pleural fluid cytological evaluation despite transudative pleural fluid characteristics. Full article

Background: The available evidence highlights that low back pain (LBP) can be categorized into neuropathic or nociceptive pain, according to mechanical- or lesion/disease-related issues. Both types of pain are associated with increased psychological and sleep problems and well-being. However, little is known about how a specific type of LBP pain (neuropathic vs. nociceptive) has an impact on these lifestyle factors. Therefore, the main purpose of the study was to examine the differences in depression and anxiety symptoms, quality of life (QoL) and quality of sleep in patients with LBP. Materials and Methods: In this cross-sectional study, we included 150 patients [mean ± standard deviation (SD) age: 46.54 ± 13.36 years; height: 178.06 ± 10.80 cm; weight: 85.26 ± 15.53 kg; body mass index (BMI): 26.77 ± 3.63 kg/m²; 45.0% women] from three centers in Bosnia and Herzegovina and Croatia between July and October 2025. All patients suffered from chronic LBP confirmed by computerized tomography (CT). The classification of pain was conducted using the Leeds Assessment of Neuropathic Symptoms and Signs (LANNS), the Douleur Neuropathique 4 (DN4) and the PainDETECT (PD-Q) questionnaires. Positive scores in all three questionnaires denoted neuropathic pain. Factors of depression (Beck’s Depression Inventory), anxiety [Hamilton Anxiety Rating Scale (HARS)], QoL (SF-36 scale) and sleep quality [Pittsburgh Sleep Quality Index (PSQI)] were also collected. Results: After adjusting for sociodemographic covariates, neuropathic patients reported higher depression [F_1,149 = 7.790, p = 0.006, partial eta squared (ηp²) = 0.051] and anxiety level scores (F_1,149 = 8.140, p = 0.005, ηp² = 0.053), lower QoL (F_1,149 = 19.088, p < 0.001, ηp² = 0.116) and poorer sleep quality (F_1,149 = 19.654, p < 0.001, ηp² = 0.119). Conclusions: In summary, this study shows that neuropathic patients with LBP are more depressed and anxious, and have lower levels of QoL and poorer sleep quality, in comparison to nociceptive patients. The findings suggest that these lifestyle factors need to be considered when establishing the appropriate rehabilitation and management of LBP. Full article

Background and Clinical Significance: Tumors of the lacrimal drainage system are rare but clinically important diagnostic pitfalls because they may mimic benign lacrimal drainage obstruction, chronic dacryocystitis, or sinonasal disease. Pleomorphic adenoma (PA) in this region is exceptionally rare, and delayed recognition may allow progressive extension into adjacent structures. Case Presentation: A 51-year-old woman presented with left nasal obstruction 16 years after external dacryocystorhinostomy for presumed lacrimal drainage obstruction. Examination showed a firm left lacrimal sac mass, proptosis, mild ocular motility limitation, and an intranasal mass. Computed tomography and magnetic resonance imaging showed a large lesion centered in the lacrimal sac region and extending into the nasolacrimal duct, nasal cavity, and maxillary sinus, with orbital displacement. Preoperative biopsy showed epithelial neoplastic tissue without definitive malignant features, but low-grade epithelial malignancy could not be excluded. Complete en bloc excision and medial/inferior orbital wall reconstruction with an autologous calvarial outer table bone graft were performed. The tumor measured 55 × 35 × 25 mm. Final histopathology confirmed PA without malignant transformation. At 2 years postoperatively, there was no recurrence, and proptosis and ocular motility limitation had improved. Conclusions: This case illustrates two diagnostic pitfalls: an underlying tumor may masquerade as lacrimal drainage obstruction, whereas a large benign PA may clinically and radiologically mimic malignancy. Long-standing or atypical unilateral lacrimal symptoms should prompt consideration of tumors and selected use of imaging and tissue diagnosis before lacrimal drainage surgery. Full article

Background and Objectives: Cachexia is a systemic wasting syndrome associated with poor outcomes in chronic diseases, including heart failure (HF). Although the cachexia index (CXI), which integrates skeletal muscle mass, serum albumin, and the neutrophil-to-lymphocyte ratio, has shown prognostic value in oncology, its clinical significance in HF remains poorly defined. Materials and Methods: This retrospective single-center cohort study evaluated a selected subgroup of adults hospitalized with decompensated heart failure between January 2020 and January 2025 who had undergone abdominal computed tomography within the preceding 6 months, enabling CT-based body composition assessment. Skeletal muscle index was measured at the L3 vertebral level, and CXI was calculated as (SMI × serum albumin)/neutrophil-to-lymphocyte ratio. Patients were followed for all-cause mortality and HF-related rehospitalizations. Results: A total of 127 patients were included (mean age 70.45 ± 12.73 years; 51.2% male). CXI showed excellent discrimination for mortality (AUC 0.951; 95% CI 0.905–0.996), with an optimal cut-off value of <20.87. Patients with low CXI had significantly higher all-cause mortality (80.5% vs. 4.7%, p < 0.001) and more HF-related hospitalizations [4 (3–5) vs. 0.5 (0–1), p < 0.001] than those with high CXI. Conclusions: In patients hospitalized with decompensated HF, low CXI was strongly associated with all-cause mortality and recurrent hospitalization, suggesting that CXI may serve as an integrative prognostic marker in this population. Full article

Background: Current cardiopulmonary resuscitation (CPR) guidelines recommend a uniform chest compression depth (5–6 cm) for all adults, disregarding anatomical variability. The primary objective was to determine whether thoracic anthropometric parameters are associated with 28-day mortality after in-hospital cardiac arrest (IHCA); the secondary objective was whether these associations vary with CPR duration. Methods: In this retrospective single-center cohort, 431 adults with IHCA and available chest computed tomography (CT) were analyzed. Body mass index (BMI), internal anteroposterior diameter (IAPD), and external anteroposterior diameter (EAPD) were measured. Patients were stratified by CPR duration (≤5, 5–10, >10 min), and multivariable logistic regression with interaction terms tested time-dependent effects on 28-day mortality. Results: Overall 28-day survival was 40.8% (176/431). During the early phase (≤5 min), higher BMI, IAPD, and EAPD were each associated with increased mortality, and underweight patients had lower mortality than normal-weight and overweight patients. These anatomical associations attenuated and lost significance during prolonged resuscitation (>10 min), when CPR duration dominated outcomes. Conclusions: The prognostic value of body composition after IHCA is time-dependent, being greatest during the first five minutes, supporting individualized, body composition-guided chest compression—particularly using readily available BMI—during early resuscitation. Full article