Background: While hyperuricemia has been widely studied in cardiovascular and renal diseases, the prognostic impact of low serum uric acid (UA) remains unclear. Emerging evidence suggests hypouricemia may be linked to increased mortality and adverse outcomes. This study aimed to assess the relationship between low UA levels and poor outcomes, including mortality and intensive care unit (ICU) admission, in hospitalized patients. Methods: This retrospective cohort study included 1679 hospitalized patients (744 females, 935 males) from the Internal Medicine Clinic. Patients were categorized into normal and low UA groups based on sex-specific thresholds (male: <3.4 mg/dL, female: <2.4 mg/dL). The primary outcome was in-hospital mortality; secondary outcomes were ICU admission and discharge status. Logistic regression models adjusted for age, chronic kidney disease (CKD), hypertension (HT), and coronary artery disease (CAD). A Prognostic Uric Acid Score (PUAS) was developed using significant predictors and evaluated by Receiver Operating Characteristic (ROC) analysis. Results: Low UA levels were significantly associated with higher ICU admission and mortality (p = 0.012). Multivariate analysis identified age (OR: 1.032), low UA (OR: 2.285), and CKD (OR: 1.571) as predictors of poor prognosis. PUAS showed moderate performance (AUC: 0.664), with a cutoff score of 3.5 optimizing sensitivity and specificity. Conclusions: Low UA levels independently predict mortality and poor prognosis in hospitalized patients. These findings support routine UA monitoring and suggest hypouricemia may be a useful prognostic biomarker. Further studies are needed to understand clinical implications and guide UA-targeted interventions.

Background/Objectives: Acute pancreatitis (AP) is characterized by pancreatic gland inflammation, and its clinical course ranges from mild to severe. Predicting the severity of AP early and reliably is important. In this study, we investigate the potential use of the Controlling Nutritional Status (CONUT) score as a prognostic marker in acute pancreatitis. Methods: We examined 336 patients who had been hospitalized with an AP diagnosis in the internal medicine clinic. The patients included in the study were followed up for 5 years. The study analyzed the specific variables of age, gender, and AP etiology as recorded biochemical parameters for all study participants and calculated the effects of age, sex, Bedside Index of Severity in AP (BISAP), the revised Atlanta classification, and the CONUT score on mortality. Results: When compared with surviving patients, non-surviving patients had higher scores for BISAP, CONUT, and the Atlanta Classification (p ˂ 0.001). In the non-surviving group, hemoglobin, lymphocyte, and albumin levels were significantly lower and creatinine, uric acid, and procalcitonin levels were significantly higher compared to the surviving group (p ˂ 0.001, 0.003, ˂0.001, ˂0.001, 0.005, ˂0.001, respectively). The multivariate analysis showed a significant association of mortality with age, CONUT, and BISAP scores (p ˂ 0.003, 0.001, 0.012 respectively). The CONUT score was separated into two groups based on the median value. The predicted survival time in the group with a CONUT score > 2 (53.8 months) was significantly lower than in the group with a CONUT score ≤ 2 (63.8 months). The cumulative incidence of all-cause mortality was significantly higher in the patients with higher CONUT scores. Conclusions: This study has assigned the CONUT score as an independent risk factor for mortality in AP.

Background: Parathyroid hormone (PTH) is closely linked to mineral metabolism, kidney function, inflammation, and cardiovascular disease. However, its clinical significance in unselected hospitalized populations remains insufficiently characterized. We aimed to evaluate the prevalence of elevated PTH and its association with long-term mortality in a real-world cohort of internal medicine inpatients. Methods: In this retrospective cohort study, electronic records of adults hospitalized in an internal medicine department in 2019 were reviewed. Patients with available in-hospital PTH measurements were included. Elevated PTH was defined as >88 pg/mL. Clinical characteristics and laboratory parameters were recorded. The primary outcome was all-cause mortality with a minimum follow-up of 2 years. Cox proportional hazards models adjusted for clinically relevant covariates were used to examine the association between PTH and mortality. Results: A total of 1595 patients were included, of whom 567 (35.5%) had elevated PTH levels. Patients with elevated PTH were older and had a higher burden of chronic kidney disease, cardiovascular disease, and inflammatory and nutritional abnormalities. During a mean follow-up of 22 ± 13 months, mortality occurred more frequently in patients with elevated PTH than in those with normal levels (56.1% vs. 33.7%, p < 0.001). After multivariable adjustment, elevated PTH remained independently associated with increased mortality risk-adjusted HR (1.36, 95% CI 1.15–1.62, p < 0.001). Conclusions: Elevated PTH is common among hospitalized internal medicine patients and is associated with increased long-term mortality. PTH may represent an integrated biomarker reflecting disease burden, inflammation, and renal dysfunction and could contribute to risk stratification in hospitalized populations. Prospective studies are warranted to clarify underlying mechanisms and clinical implications.