Investigating the Benefit-Risk Profile of Drugs: From Spontaneous Reporting Systems to Real-World Data for Pharmacovigilance.

Rapid and detailed post-marketing surveillance of drugs and vaccine is required to enable assessment of their real-world safety and effectiveness. Spontaneous reporting from healthcare professionals and citizens is recognized as the basic method in the passive post-marketing surveillance of drugs and vaccines, allowing the identification of rare adverse drug reactions (ADRs) and adverse events following immunization (AEFIs). According to the current law, online platforms for ADRs and AEFI reporting and related databases are available in every country and at the global level. Recently, the use of electronic health records and the establishment of networks of databases as different sources of real-world data is emerging allowing high-quality, large-scale evaluations and providing real-world evidence on questions of clinical and regulatory interests. Here, we summarize the adverse event pharmacovigilance reporting systems in place at the global, European and in some European countries, and provide examples from recent literature of how the analysis of pharmacovigilance reports can provide evidence for unexpected and novel adverse drug reactions. Furthermore, we discuss the role of real-world data to generate real-world evidence in pharmacovigilance and regulatory activities.

Community dynamics and assembly is driven by environmental microbiota mediated by spatiotemporal distribution: The case of Daqu fermentation.

In almost all environments, microbial interaction is shaped by differences in environmental microbial transport, resulting in synergistic or antagonistic effects among community members. Unfortunately, the current understanding of how environmental microbiota affect spontaneous fermentation is very limited. Here, we selected Daqu workshops with different usage times (named X (60 years), Y (10 years), and Z (0 year)) as research model. The microbial contribution of raw material and environments to the microbiota of Daqu fermentation among workshops was compared, raw material microbiota contributed more bacterial genera (44.70 %-73.56 %) to the fermentation, and environmental microbiota contributed more fungal genera (10.09 %-99.76 %) to the fermentation. The deterministic assembly ratio and interaction intensity of workshop X were the highest, followed by Y and Z. We analyzed the relationship between environmental microbiota, fermentation microbiota, fermentation characteristics and flavor compounds. Environmental microbiota negatively drove the microbial diversity during fermentation (path coefficient = -1, P = 0.004), and further indirectly affected the community dynamics and assembly (path coefficient = -0.990, P < 0.001). Finally, community dynamics and assembly drove flavor compound diversity (path coefficient = 0.923, P < 0.001), it indicated the positive effect of environmental microbiota on flavor compound diversity. This work will help to understand the relationship between environmental microbiota and fermentation quality, supporting quality improvement of spontaneously fermented food in new workshop.

Spontaneous suprachoroidal hemorrhage treated by gas tamponade in a refractory glaucoma patient with rhegmatogenous retinal detachment: a case report.

We are reporting the successful treatment of a rare case of spontaneous suprachoroidal hemorrhage (SSCH) in a young refractory glaucoma patient with rhegmatogenous retinal detachment (RRD). The 34-year-old male was admitted to our hospital having experienced pain in his right eye for two days. The patient had a history of glaucoma and long axial length in the right eye with chronic poorly controlled intraocular pressure (IOP) and acute hypotony. Following clinical examinations, the patient was diagnosed with SSCH with RRD in the right eye. The patient underwent drainage of the suprachoroidal hemorrhage and vitrectomy combined with gas injection to address retinal and choroidal detachment. During the following two months, the patient's retina remained attached. Long axial length and persistent high IOP are two major risk factors of SSCH with RRD, while acute hypotony appeared to be a precipitating factor in this case. Surgeons can consider alternative tamponade options, such as gases, during vitrectomy to treat SSCH with RRD.

Secondary spontaneous pneumothorax during chemotherapy with bevacizumab for cervical cancer: a case report and literature review.

Secondary spontaneous pneumothorax (SSP) due to bevacizumab has been reported in other malignancies but not in cervical cancer. We present the case of a 57-year-old woman with stage IIIB cervical cancer who developed SSP during bevacizumab chemotherapy. Despite complete remission with cisplatin-based chemoradiotherapy, she experienced a recurrence 9 months later. A thoracoscopic surgery was performed to remove a lung nodule and bulla. Subsequently, local cervical lesion recurrence and lung metastases were noted, and paclitaxel and carboplatin combined with bevacizumab were administered. After two cycles, a grade-1 left pneumothorax occurred, attributed to bevacizumab-induced tissue fragility. The patient improved within 7 days with conservative management. Bevacizumab was discontinued, and pneumothorax did not recur. This case highlights the rare occurrence of SSP in patients with cervical cancer treated with bevacizumab and underscores the importance of appropriate management of such patients, especially those who have undergone early thoracic surgery.

Spontaneous spinal epidural hematoma in children: a case report and literature review.

Background: Spontaneous spinal epidural hematoma (SSEH) is a hematoma within the spinal epidural space without the underlying causes of trauma or iatrogenic and is considered a very rare neurosurgical emergency disease in children that can cause spinal cord compression and neurological dysfunction. This article provides useful information and guidance to the clinician about SSEH in children regarding its specific characteristics, clinical presentation, and management strategy to achieve a better outcome. Case Description: A 14-year-old boy presented with an acute onset of neck pain radiating to the right shoulder and progressive right hemiparesis. The cervical spine magnetic resonance imaging (MRI) revealed a right posterolateral hyperacute spinal epidural hematoma at C4-C7. The patient underwent an emergent open-door laminoplasty (C5-C6) with partial laminectomy (C4 and C7) and complete evacuation of the hematoma. The patient had a complete recovery after surgery with no neurological deficits. A literature search in the PubMed electronic database was performed to identify published English articles between January 2000 to December 2023 focusing on SSEH in children. We have found 81 articles with a total of 95 cases of SSEH in children, providing comparison data on sex, age, clinical presentation, etiology, location of the hematoma, treatment modalities, and outcomes. Conclusions: SSEH in children is a very rare neurosurgical emergency disease. Prompt and proper examination is essential to establish the diagnosis and early surgical decompression. Adequate surgical decompression may reduce intradural pressure and increase the blood perfusion to the spinal cord, thus, this will eventually reduce ischemia and prevent secondary spinal injury. As a result, complete recovery can be expected.

Whole exome sequencing identifies a novel mutation in Annexin A4 that is associated with recurrent spontaneous abortion.

Background: Recurrent spontaneous abortion (RSA) is a multifactorial disease, the exact causes of which are still unknown. Environmental, maternal, and genetic factors have been shown to contribute to this condition. The aim of this study was to investigate the presence of mutations in the ANXA4 gene in patients with RSA. Methods: Genomic DNA was extracted from 325 patients with RSA and 941 control women with a normal reproductive history for whole-exome sequencing (WES). The detected variants were annotated and filtered, and the pathogenicity of the variants was predicted through the SIFT online tool, functional enrichment analyses, Sanger sequencing validation, prediction of changes in protein structure, and evolutionary conservation analysis. Furthermore, plasmid construction, Western blotting, RT-qPCR, and cell migration, invasion and adhesion assays were used to detect the effects of ANXA4 mutations on protein function. Results: An ANXA4 mutation (p.G8D) in 1 of the 325 samples from patients with RSA (RSA-219) was identified through WES. This mutation was not detected in 941 controls or included in public databases. Evolutionary conservation analysis revealed that the amino acid residue affected by the mutation (p.G8D) was highly conserved among 13 vertebrate species, and the SIFT program and structural modeling analysis predicted that this mutation was harmful. Furthermore, functional assays revealed that this mutation could inhibit cell migration, invasion and adhesion. Conclusion: Our study suggests that an unreported novel ANXA4 mutation (p.G8D) plays an important role in the pathogenesis of RSA and may contribute to the genetic diagnosis of RSA.

Spontaneous Focal Hemorrhage of Optic Disc in Peripapillary Hyperreflective Ovoid Mass-Like Structures.

Introduction: Spontaneous focal hemorrhage of optic disc in peripapillary hyperreflective ovoid mass-like structures (PHOMS) is rare. This study reports the image features of two cases of spontaneous hemorrhage of an optic disc in PHOMS. Methods: Case 1: A 51-year-old woman complained of visual fatigue for 1 week. Small patchy hemorrhage was observed in the optic disc of the right eye. Case 2: A 17-year-old female presented with complaints of experiencing floaters in the left eye for a duration of 1 day. Small patchy hemorrhage was observed in the left optic disc. The patients underwent the color fundus photograph (CFP), fundus autofluorescence (FAF), spectral-domain optical coherence tomography (SD-OCT), optical coherence tomography angiography (OCTA), and Minimum intensity projection (Min-IP) images. Results: Case 1: The right eye showed a small patchy hemorrhage of optic disc. PHOMS on SD-OCT of both eyes exhibited an ovoid shape and manifested as peripapillary hyperreflective bright regions on en-face Min-IP image, the active blood flow signal of PHOMS was detected on SD-OCT/OCTA and FAF revealed a hypofluorescent. The optic cup-to-disc (C/D) ratio of both eyes was 0.06, respectively. Case 2: Small patchy hemorrhage was observed in the left optic disc and FAF showed hypofluorescence. PHOMS on SD-OCT of the left eye showed an ovoid shape and manifested as peripapillary hyperreflective bright regions on en-face Min-IP image, the active blood flow signal of PHOMS was detected on SD-OCT/OCTA. C/D in the right eye was 0.4. Conclusion: Spontaneous focal hemorrhage of optic disc may occur in PHOMS. The space-occupying effect of PHOMS may lead to compression of surrounding tissues, resulting in the optic disc congestion and a reduced C/D ratio, thereby involving the microvascular system of the optic disc.

Minimally Invasive Approach to the Management of Recurrent Spontaneous Hemarthrosis After Total Knee Replacement: A Report of Two Cases.

Spontaneous recurrent hemarthrosis of the knee after total knee arthroplasty is an infrequent complication. Early recognition and prompt diagnosis are essential to avoid issues such as joint stiffness, chronic pain, and limited mobility. Conservative treatment methods are often effective. However, in cases where the bleeding recurs, imaging studies like CT or MRI angiograms are necessary to confirm the diagnosis and guide treatment. We discuss two instances of spontaneous recurrent hemarthrosis that appeared six months and two years after total knee arthroplasty, both characterized by painful knee swelling and movement restriction. Following conservative management, both patients underwent CT angiograms and selective embolization, leading to excellent recovery without recurrence. In summary, selective arterial embolization of the genicular arteries is a minimally invasive, safe, and effective procedure for treating recurrent spontaneous hemarthrosis after total knee replacement.

Sensory representations in primary visual cortex are not sufficient for subjective imagery.

The contemporary definition of mental imagery is characterized by two aspects: a sensory representation that resembles, but does not result from, perception, and an associated subjective experience. Neuroimaging demonstrated imagery-related sensory representations in primary visual cortex (V1) that show striking parallels to perception. However, it remains unclear whether these representations always reflect subjective experience or if they can be dissociated from it. We addressed this question by comparing sensory representations and subjective imagery among visualizers and aphantasics, the latter with an impaired ability to experience imagery. Importantly, to test for the presence of sensory representations independently of the ability to generate imagery on demand, we examined both spontaneous and voluntary imagery forms. Using multivariate fMRI, we tested for decodable sensory representations in V1 and subjective visual imagery reports that occurred either spontaneously (during passive listening of evocative sounds) or in response to the instruction to voluntarily generate imagery of the sound content (always while blindfolded inside the scanner). Among aphantasics, V1 decoding of sound content was at chance during voluntary imagery, and lower than in visualizers, but it succeeded during passive listening, despite them reporting no imagery. In contrast, in visualizers, decoding accuracy in V1 was greater in voluntary than spontaneous imagery (while being positively associated with the reported vividness of both imagery types). Finally, for both conditions, decoding in precuneus was successful in visualizers but at chance for aphantasics. Together, our findings show that V1 representations can be dissociated from subjective imagery, while implicating a key role of precuneus in the latter.

A case of subarachnoid hemorrhage due to vertebral artery dissection following spontaneous coronary artery dissection on the same day: Clinical image.

A woman in her 60s with well-controlled dyslipidemia presented with anterior chest pain. The electrocardiogram, chest radiograph, and echocardiogram were unremarkable; however, cardiac enzymes levels were elevated. Coronary angiography performed after dual antiplatelet therapy revealed spontaneous coronary artery dissection (SCAD). On the same day, the patient complained of mild headache that was initially treated as migraine. Hours later, the patient reported severe headache, followed by a decline in consciousness. Computed tomography of the head showed subarachnoid hemorrhage, while the angiography revealed bilateral vertebral artery dissection. The ruptured right vertebral artery dissecting aneurysm was treated with coil embolization. Despite treatment, the patient died seven days later. Autopsy confirmed dissections of the coronary and vertebral arteries. Although SCAD is rare, it often coexists with extracoronary vascular abnormalities due to systemic arterial fragility. Therefore, consider cerebrovascular disorders and promptly implementing diagnostic and management strategies in patients with SCAD and headaches is necessary.

Uncommon triple vessel spontaneous coronary artery dissection in the setting of polyarteritis nodosa: a case report.

INTRODUCTION AND IMPORTANCE: Spontaneous coronary artery dissection is a rare cause of acute coronary syndromes not related to atherosclerosis. It involves the sudden tearing of the coronary artery wall, separating the inner intimal lining from the outer vessel wall, typically affecting a single coronary vessel. In 20% of cases, the cause of spontaneous coronary artery dissection is unknown. The other cases often occur in pregnant or postpartum women or in individuals with conditions such as connective tissue disorders or vasculitis. CASE PRESENTATION: Here, we describe a case of a 69-year-old African female presenting with non-ST-segment elevation myocardial infarction. Coronary angiography revealed an unusual triple-vessel spontaneous coronary artery dissection affecting peripheral segments, with further investigations suggesting polyarteritis nodosa. CONCLUSION: While triple-vessel spontaneous coronary artery dissection and polyarteritis nodosa (PAN) are individually rare, their coexistence is exceptionally uncommon and presents diagnostic and therapeutic challenges. Clinicians should be alert to vasculitic causes in patients with spontaneous coronary artery dissection, especially with atypical clinical features.

Coexistence of Spontaneous Pneumomediastinum and a Parapharyngeal Space Tumor: A Case Report of a Patient Initially Referred for Descending Necrotizing Mediastinitis.

Spontaneous pneumomediastinum is conventionally defined as a disease that does not result from trauma or underlying disease. In recent years, many patients have had some kind of triggering factor, such as sports or a strong cough. Herein, we report a case of mediastinal emphysema with a parapharyngeal tumor at the time of initial examination. Although the patient was referred to our hospital on suspicion of cervical abscess such as descending necrotizing mediastinitis by symptoms, it seemed that the cause was a spontaneous pneumomediastinum associated with a parapharyngeal tumor coincidentally. The pneumomediastinum resolved day by day, and the parapharyngeal tumor was extracted without recurrence, which turned out to be a pleomorphic adenoma. As far as we are concerned, there have been no reports of spontaneous pneumomediastinum associated with a parapharyngeal space tumor.

Comparative Analysis of Microbial Diversity and Metabolic Profiles during the Spontaneous Fermentation of Jerusalem Artichoke (Helianthus tuberosus L.) Juice.

Jerusalem artichoke juice is valued for its nutritional content and health benefits. Spontaneous fermentation enhances its flavor, quality, and functional components through microbial metabolic activities. This study used high-throughput sequencing to analyze microbial community changes, and LC-MS and GC-MS to detect secondary metabolites and flavor compounds during fermentation. During natural fermentation, beneficial bacteria like Lactobacillus and Pediococcus increased, promoting lactic acid production and inhibiting harmful bacteria, while environmental bacteria decreased. Similarly, fungi shifted from environmental types like Geosmithia and Alternaria to fermentation-associated Pichia and Penicillium. A total of 1666 secondary metabolites were identified, with 595 upregulated and 497 downregulated. Key metabolic pathways included phenylpropanoid biosynthesis, with significant increases in phenylalanine, tryptophan, and related metabolites. Lipid and nucleotide metabolism also showed significant changes. Flavor compounds, including 134 identified alcohols, esters, acids, and ketones, mostly increased in content after fermentation. Notable increases were seen in Phenylethyl Alcohol, Ethyl Benzenepropanoate, 3-Methylbutyl Butanoate, Ethyl 4-Methylpentanoate, 5-Ethyl-3-Hydroxy-4-Methyl-2(5H)-Furanone, Ethyl Decanoate, Hexanoic Acid, and 1-Octanol. γ-aminobutyric acid (GABA) and other functional components enhanced the health value of the juice. This study provides insights into microbial and metabolic changes during fermentation, aiding in optimizing processes and improving the quality of fermented Jerusalem artichoke juice for functional food development.

Does hCG-trigger in the mild stimulation protocol for endometrial preparation have any effect on pregnancy outcome in frozen-thawed embryo transfer?

BACKGROUND: Recent literature has explored the role of human chorionic gonadotropin (hCG) triggering in frozen embryo transfer (FET) cycles with natural endometrial preparation. Despite this, the impact of hCG triggering on pregnancy outcomes following endometrial preparation with mild stimulation (mST) using Letrozole and Gonadotropins remains inadequately characterized. This study aimed to elucidate the effects of hCG-trigger on pregnancy outcomes in mST-FET cycles. METHODS: In the present retrospective cohort study, the pregnancy outcomes of 409 eligible patients who underwent FET cycles with endometrial preparation using a mild ovarian stimulation protocol by letrozole plus low dose gonadotropins at the Royan Institute between 2020 and 2022, were investigated. The study population were segregated into two distinct groups according to type of ovulation: the spontaneous ovulation group (n = 138) and the hCG-trigger group (n = 271). The pregnancy outcomes including implantation and clinical pregnancy rates (CPR) and live birth rates (LBR) were compared between two groups. The multivariable logistic regression was performed to detect the most significant variables related to the LBR in the mST-FET cycles. RESULTS: Demographic and baseline characteristics were comparable between groups. No significant difference was found in terms of implantation rate (0.65 ± 0.32 vs. 0.60 ± 0.30, P-value: 0.31), CPR (37% vs. 39.7%, P-value: 0.53), and LBR (35.5% vs. 37.3%, P-value: 0.74) in the spontaneous ovulation and hCG-trigger groups, respectively. The logistic regression analysis revealed that only the stage of the transferred embryo exhibited a significant relationship with LBR (blastocyst vs. cleavage: odds ratio (OR); 2.33, 95% confidence interval (CI):1.41-3.86, P-value = 0.001). CONCLUSION: Pregnancy outcomes in the mST-FET cycles, including implantation rate, CPR, and LBR are comparable in cycles with or without hCG triggering. Based on the findings from multivariate regression analysis, the sole significant predictive factor for the LBR was the transfer of blastocyst embryos. It is recommended that these results be examined and discussed in future prospective studies with a larger sample size, considering the lack of comparable research in this field.

A New Organic Laser Material Design Toward Ultra-Low Amplified Spontaneous Red Emission and Ultra-Bright Electroluminescence.

Significant efforts are dedicated to developing new classes of organic semiconductor materials to achieve electrically pumped lasing. However, further advancements are necessary to understand the relationship between the structure and property for the creation of innovative laser materials with high stability, low triplet yield, ultra-low lasing threshold, and low-efficiency roll-off at ultra-bright electroluminescence. Here, a new design principle is validated for organic semiconductor laser materials, demonstrating simultaneous enhancement in the key figures of merit of low amplified spontaneous emission thresholds (Eth), efficient electroluminescence, and low triplet yields. By applying the Einstein stimulated emission rate equation and Strickler-Berg approximation, Two red-emitting laser dimers of Cibalackrot with different linkers are constructed, leading to giant enhancement (≈250%) in oscillator strengths, and stimulated emission cross-sections. When blended in poly(9,9-dioctylfluorene-alt-benzothiadiazole), the new dimers achieve an ultra-low Eth (4.5 ± 0.3 µJ cm-2) in the deep red region (λASE = 655 nm), among the lowest reported for deep-red emitters. Organic light-emitting diodes (OLEDs) utilizing the dimer blend exhibit low-efficiency roll-off under DC mode. Under pulse operation, the OLEDs achieve high current densities (90 A m-2) and ultrahigh brightness (≈710 000 cd m-2). These findings highlight the dimerization design as an excellent platform to advance organic semiconductor laser materials.

Spontaneous Cooling Enables High-Quality Perovskite Wafers for High-Sensitivity X-Ray Detectors with a Low-Detection Limit.

Developing high-quality perovskite wafers is essential for integrating perovskite technology throughout the chip industry chain. In this article, a spontaneous cooling strategy with a hot-pressing technique is presented to develop high-purity, wafer-scale, pinhole-free perovskite wafers with a reflective surface. This method can be extended to a variety of perovskite wafers, including organic-inorganic, 2D, and lead-free perovskites. Besides, the size of the wafer with diameters of 10, 15, and 20 mm can be tailored by changing the mold. Furthermore, the mechanism of spontaneous cooling for improving the quality of perovskite wafers is revealed. Finally, the high-quality lead-free Cs3Cu2I5 perovskite wafers demonstrate excellent X-ray detection performances with a high sensitivity of 3433.6 µC Gyair -1 cm-2 and a low detection limit of 33.17 nGyair s-1. Moreover, the Cs3Cu2I5 wafers exhibit outstanding environmental and operational stability even without encapsulation. These research presents a spontaneous cooling strategy to achieve wafer-scale, high-quality perovskites with mirror-like surfaces for X-ray detection, paving the way for integrating perovskites into electronic and optoelectronic devices and promoting the practical application of perovskite X-ray detectors.

Development of a novel Japanese eel myoblast cell line for application in cultured meat production.

The present study investigates the isolation, analysis, and characterization of primary cultured cells derived from the muscle tissue of Japanese eel (Anguilla japonica), culminating in establishing a spontaneously immortalized myoblast cell line, JEM1129. We isolated satellite cells from eel muscle tissue to establish a foundation for cultured eel meat production. While initial cell cultures contained myoblasts, continued passaging led to a decline in myoblast characteristics and an increase in fibroblast-like cells. RNA-Seq and RT-qPCR analyses showed significant downregulation of well-established markers for satellite cells and myoblasts, such as pax7a and myoD, over successive passages, highlighting a loss of myoblastic traits. Single-cell cloning was employed to overcome this challenge and maintain myoblast purity, leading to the successful creation of the JEM1129 cell line. These JEM1129 cells demonstrated enhanced expression of myoblast marker genes, exceeding the initial primary culture cell population. The cells showed strong myotube formation, particularly when cultured in a differentiation medium, indicating their robust potential for muscle development. The JEM1129 cell line represents a significant advancement in the cultivation of eel muscle cells, offering a promising avenue for cultured meat production. The findings contribute to a deeper understanding of muscle cell biology and provide valuable insights into using fish-derived myoblasts for cultured meat production.

Spontaneous Coronary Artery Dissection: A Case Series and Review of the Literature.

Although previously considered rare, spontaneous coronary artery dissection (SCAD) is increasingly recognized as an important cause of myocardial infarction in young women. We present three unique cases of SCAD: A 46-year-old woman with a history of trigeminal neuralgia and anxiety presenting elevated troponin-I and chest pain. A 36-year-old woman with recent miscarriage presenting with diffuse T wave inversions and elevated troponin-I. A 58-year-old man with a recent COVID-19 infection presenting with diffuse ST elevations. SCAD is associated with many risk factors. Conservative management is preferred due to spontaneous healing of vessels compared to PCI-driven management of atherosclerotic acute coronary syndrome.

Spontaneous rupture of an unscarred uterus at the early third trimester due to placenta percreta: a case report.

Uterine rupture during pregnancy is a complication of placenta percreta. We present the case of a woman in her early 30s with a history of incomplete abortion treated by dilatation and curettage who was admitted with abdominal pain and vomiting at 30 weeks of gestation. She was diagnosed with thrombophilia and was administered anticoagulant drugs. After 10 hours of monitoring, the patient abruptly deteriorated. An emergency cesarean delivery showed a ruptured uterus due to placenta percreta. She accepted localized excision and uterine repair, and recovered well. Rupture of an unscarred uterus due to placental percreta is an extremely rare obstetric complication with high maternal and fetal mortality. This condition should be suspected in all pregnant women who have severe abdominal pain without being in labor. The treatment of uterine rupture due to placental percreta should be individualized, and repair of the uterus is possible in the majority of women.

Postoperative fever and clinical outcomes after endoscopic surgery for spontaneous intracerebral hemorrhage: a retrospective database study.

BACKGROUND: Spontaneous intracerebral hemorrhage (SICH) is a severe stroke with high mortality and disability rates. Endoscopic surgery is an increasingly widely used minimally invasive method for the treatment of SICH. However, the impact of fever on patient outcomes remains unclear. METHODS: We retrospectively included patients aged 18 years or older with supratentorial SICH confirmed by CT, who underwent endoscopic hematoma evacuation within 48 h of symptom onset. The primary outcome was the modified Rankin Scale (mRS) score at 3 months. Secondary outcomes included hospital and neurosurgical intensive care unit (NSICU) stays, and perioperative complications. We analyzed the association between postoperative fever (highest temperature within 24 h after surgery) and these outcomes using multivariate analysis, generalized additive models, and segmented regression analysis. RESULTS: Of the 56 patients, 38 had favorable outcomes (mRS ≤ 3) and 18 had unfavorable outcomes (mRS > 3) at 3 months. A threshold effect at 38.2 °C was observed between postoperative body temperature and clinical outcomes. The mean age was 56 years (SD = 9) for the > 38.2 °C group and 58 years (SD = 8) for the ≤ 38.2 °C group, with a similar proportion of male patients (63% vs. 69%, P = 0.635). Patients with postoperative fever had larger hematoma volumes (65 vs. 56 mL; P = 0.008). Other characteristics were similar between the groups. Postoperative fever (> 38.2 °C) was independently associated with a 4.99-fold increased risk of unfavorable outcomes (95% CI = [1.13 to 25.90]; P = 0.040), which remained significant after excluding patients with postoperative complications (adjusted RR = 16.03, 95% CI = [1.69 to 417.24]; P = 0.033). The association was consistent across subgroups with different Glasgow Coma Scale scores, hematoma volumes, and intraventricular extension. Postoperative fever was also associated with longer NSICU stays (3.1 vs. 2.3 days; P = 0.023), longer hospital stays (17.2 vs. 13.6 days; P = 0.010), more residual hematoma, and greater edema volume. Different antipyretic therapies did not affect outcomes. CONCLUSIONS: This study identifies a temperature threshold (38.2 °C) associated with poor outcomes in SICH patients undergoing endoscopic surgery. Further research is needed to mitigate postoperative fever and improve patient outcomes.