Background/Objectives: Accurate and timely triage is essential for optimizing clinical outcomes and resource allocation in emergency departments (EDs). The Peripheral Perfusion Index (PPI), a non-invasive and objective parameter derived from pulse oximetry, may offer added value in early risk stratification. This study aimed to analyze the correlation between the PPI measured at triage and at Emergency Severity Index (ESI) levels, as well as to determine if the PPI may function as a predictive tool to facilitate early risk identification before patient disposition. Methods: In this prospective cross-sectional study, adult ambulatory patients presenting to a tertiary care ED were enrolled. At triage, PPI and standard vital signs were recorded, and patients were classified using the five-level ESI system. The diagnostic performance of PPI and ESI in predicting ED discharge was assessed using receiver operating characteristic (ROC) curve analysis, with comparative evaluation performed via DeLong’s test. Results: Lower PPI values were consistently associated with higher ESI acuity levels and more intensive care requirements. Patients who were discharged had significantly higher median PPI values (4.0) compared to those admitted to wards (2.1) or intensive care units (1.9). PPI also distinguished survivors from non-survivors (median PPI: 3.60 vs. 1.15). ROC analysis showed that the PPI demonstrated a good discriminative capacity for forecasting ED discharge, equal to the efficacy of ESI (AUC: 0.926 vs. 0.903; p < 0.001). Conclusions: The PPI could improve post-triage risk classification and enhance current triage techniques like ESI, especially in cases of unclear or borderline presentations, but further validation in prospective trials is required.

Acute cholecystitis is a common inflammatory condition encountered in emergency departments (EDs), with severity varying widely among patients. Rapid risk stratification and appropriate management are critical in preventing complications and mortality. This study aimed to evaluate the association between the acute-phase reactant index (APhRI) and disease severity, and to investigate the potential prognostic value of APhRI in clinical decision-making. We conducted a single-center, retrospective observational study of adult patients diagnosed with acute cholecystitis in a tertiary ED between January 2024 and January 2025. APhRI was calculated as (C-reactive protein [CRP] × procalcitonin [PCT])/ albumin. Patients were stratified according to the Tokyo Guidelines 2018 (TG18). Statistical analyses included chi-square/Fisher exact tests, t -test/Mann–Whitney U test, receiver operating characteristic curve analysis, and DeLong test. A total of 547 patients were included. According to TG18, 28.7% were classified as moderate-to-severe acute cholecystitis. APhRI levels were significantly higher in these patients. The area under the curve of APhRI for predicting severity was 0.687, superior to CRP (0.673), PCT (0.567), and albumin (0.618) ( P < .05 for all). Higher APhRI values were also observed in patients requiring surgery ( P = .008) or interventional radiology ( P < .001), and positively correlated with hospital stay (ρ = 0.327, P < .001). APhRI appears to be a practical and useful biomarker not only for predicting severity in acute cholecystitis but also for supporting early triage and treatment decisions in the ED.

Background:Traumatic brain injury (TBI) is a critical public health issue, particularly among young adults, and the presence of intracranial hemorrhage (ICH) has a direct impact on clinical outcomes. In patients presenting with mild head trauma, early prediction of ICH remains challenging. In recent years, hematologic biomarkers such as platelet indices have attracted increasing interest as potential diagnostic tools in trauma evaluation. Objective:This study aimed to investigate the association between platelet indices—including mean platelet volume (MPV), platelet distribution width (PDW), and platelet-large cell ratio (P-LCR), and the presence of ICH in patients presenting to the emergency department (ED) with isolated head trauma. Methods:This retrospective observational study included adult patients aged ≥18 years who presented to the ED with isolated head trauma between March 1, 2023 and March 1, 2024. Patients were divided into two groups based on the presence or absence of ICH on brain computed tomography. Hematological and biochemical parameters were recorded, and comparisons between the groups were conducted using appropriate parametric and non-parametric tests (significance level set at p <0.05). Results:A total of 215 patients were included to the trial, of whom 45 (20.9%) had confirmed ICH. White blood cell (WBC) counts were significantly higher in the ICH group (11.6 ± 4.0 vs. 9.6 ± 3.5; p = 0.003). No significant differences were observed between groups for MPV (p = 0.484), PDW (p = 0.724), or P-LCR (p = 0.567). Similarly, no significant associations were found between platelet indices and emergency department disposition. Conclusion:While WBC count was associated with both the presence of ICH and hospital admission, MPV, PDW and P-LCR did not demonstrate predictive value for ICH in patients with isolated head trauma. Further prospective, multicenter studies with serial measurements are needed to clarify the clinical utility of these indices in neurotrauma.

Aims: Renal colic is a prevalent urological emergency, yet the global research landscape on this condition has not been systematically evaluated. Bibliometric analysis provides insights into scientific productivity, citation impact, collaboration patterns, and emerging research trends. The aim of this study was to evaluate scientific productivity, citation impact, and collaboration networks in the field of renal colic by analyzing the 100 most-cited original research articles. Methods: A bibliometric study was conducted using the Web of Science Core Collection database. Following inclusion and exclusion criteria, the 100 most-cited original research articles on renal colic were identified. Data cleaning was performed with BibExcel, and co-authorship, co-occurrence, and bibliographic coupling analyses were conducted using VOSviewer (version 1.6.20). Results: A total of 3367 eligible publications were retrieved, from which the 100 most-cited original articles were analyzed. These articles were published in 33 journals, authored by 508 researchers from 26 countries, and accumulated significant citation impact. The United States emerged as the most productive and influential country (h-index 46), with Yale University leading at the institutional level. The most impactful journals included American Journal of Roentgenology, Journal of Urology, and Radiology. Prominent authors were Smith RC, Verga M, and Rosenfield AT, all of whom demonstrated high total link strength. Keyword analysis revealed that “renal colic,” “computed tomography,” “radiation dose,” and “calculi” were the most frequent and central research themes, while bibliographic coupling highlighted clusters emphasizing diagnostic imaging and radiation safety. Conclusion: This bibliometric analysis identified the United States as the most productive country, Yale University as the leading institution, and American Journal of Roentgenology, Journal of Urology, and Radiology as the most influential journals. Diagnostic imaging and radiation safety emerged as central research themes. Strengthening international collaboration and generating data from low- and middle-income countries are critical to addressing current gaps