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Driving under the influence of drugs is a major cause of road traffic accidents, and alcohol markedly increases crash risk. A clinical test of impairment (CTI) is in some countries performed alongside blood sampling in apprehended drivers, yielding a conclusion of either "impaired" or "not impaired". While the relationship between CTI results and blood drug concentrations has been examined, no previous studies have evaluated CTI outcomes in relation to traffic accidents. This study assesses whether ethanol-positive drivers judged as "impaired" have a higher risk of traffic accident involvement than those assessed as "not impaired", and whether accident involvement increases with impairment severity and ethanol concentration. Drivers positive for ethanol alone were included if a valid CTI conclusion was available and blood sampling occurred 0.25-3&#x2009;h after the incident. Cases were categorized as either traffic accident group or non-accident controls, the latter including police stops unrelated to accidents (e.g., routine checks, license issues, erratic driving). Age, sex, blood ethanol concentration and CTI results were compared between groups. Associations between impairment level and accident risk were analyzed using multivariable logistic regression. The accident included group 5,290 cases and the non-accident group included 17,596 cases. Accident-involved drivers were younger (median 30 vs. 34&#x2009;years, p&#x2009;<&#x2009;0.001), had higher ethanol concentrations (median [IQR] 1.60&#x2009;g/kg [1.06, 2.05] vs. 1.29&#x2009;g/kg [0.63, 1.89], p&#x2009;<&#x2009;0.001) and were more often assessed as "impaired" (94.8% vs. 90.3%, p&#x2009;<&#x2009;0.001) compared to non-accident drivers. After adjusting for age, sex, ethanol concentration and driving time, CTI-assessed impairment remained significantly associated with accident involvement (OR 1.47; 95% CI 1.28, 1.69). Accident odds increased progressively with both impairment severity and ethanol concentration (ptrend&#x2009;<&#x2009;0.001). Ethanol-positive drivers assessed as "impaired" by the CTI had 47% higher odds of being involved in traffic accidents compared with drivers apprehended for other reasons, independent of ethanol concentration and demographic factors. Being assessed as "impaired" by the CTI therefore appear to be independently associated with accident risk among alcohol-positive drivers.

Falls on the same level (FSLs) are a major cause of occupational injuries in the social welfare industry, especially in aging societies. Here, we conducted a questionnaire survey to investigate how social welfare workers perceive the risk of occupational accidents, with a focus on FSLs, and to examine the effects of age on risk perception. Respondents (n=294) rated their estimated likelihood of experiencing five major types of occupational accidents across six levels of injury severity. The results indicated that the FSL risk was not consistently underestimated relative to other accident types. However, when the subjective risk was compared with the objective accident frequency, the non-fatal FSL risk was systematically underestimated, whereas the fatal FSL risk was overestimated. Perceived risk of leaving work for more than 3 months due to non-fatal occupational accidents also decreased with age across accident types, with younger workers reporting the highest estimates and older workers the lowest. These findings suggest that underestimation of FSL risk is specific to certain injury severities and that age-related differences in risk perception are robust. Understanding how workers perceive fall risk may contribute to the development of age-sensitive interventions to improve fall prevention in the social welfare sector.

Electric scooters (ES) have become increasingly popular among children and adolescents in France. To date, very little is known about their impact on the incidence and severity of pediatric head trauma (HT). We conducted a retrospective single-center study of patients aged 2 to 18 years admitted to a pediatric neurosurgery ward between 2021 and 2025 for HT related to ES, nonmotorized two-wheeled vehicles (bicycles, kick-scooters; NMTV), or motorbikes. Demographics, accident characteristics, helmet use, clinical and radiological severity, neurosurgical management, hospital course, and need for rehabilitation were collected. Injury severity was assessed using a multivariate model combining neurological, radiological, and in-hospital outcomes. A follow-up phone interview was conducted in a subset of ES patients to assess long-term functional outcome and postinjury behavior regarding mobility habits. ES-related HT rose from 1 case in 2021 to 25 in 2025, whereas the number of HT related to NMTV and motorbikes remained stable. Nearly half of injured ES riders were below the legal age, and helmet use was rare. The severity profile of ES-related HT was greater than that of bicycle and kick-scooter accidents, and comparable to that of motorbike accidents. Five ES patients required surgical intervention, most commonly for epidural hematoma evacuation. At follow-up, most patients had favorable functional outcomes, but nearly one-third experienced persistent disability, and helmet adoption after injury remained limited. ES have emerged as a high-severity mechanism of pediatric HT, comparable to motorbikes. Enhanced prevention strategies, including helmet enforcement, and age regulation, are urgently needed.

Foreign bodies embedded in the maxillofacial region following traumatic injuries pose a significant challenge to oral and maxillofacial surgeons. These retained objects may become a source of persistent pain, infection, and other complications. Early diagnosis can be achieved through the use of computed tomography (CT), which facilitates accurate localization of the foreign body. Once identified, prompt removal is recommended to prevent further morbidity. Here, we report a case in which early diagnosis of a foreign body embedded within the maxillofacial soft tissues enabled its successful retrieval without complications. Soft tissue impaction of orthodontic brackets following facial trauma is rarely reported in the literature, with only a few isolated case reports describing orthodontic appliances embedded within facial soft tissues after road traffic accidents or sports-related injuries.

The primary goal of human-machine collaborative driving is to improve driving safety, and the inconsistent tracking goals between humans and machines are one of the main factors causing safety accidents. Therefore, this article proposes a human-machine collaborative safe trajectory planning algorithm that considers the intervention feasible region (IFR) and the driver risk capacity (DRC), aiming to ensure driving safety from the planning perspective. On the one hand, the IFR solution and DRC assessment method are constructed. Based on the trajectory predicted by the constant turn rate and acceleration (CTRA) model and feasible boundary constraints, the IFR for the safe action space is solved. A method for quantifying the bidirectional subjective perceived risk is proposed to accurately assess personalized risk capacities. Provide an accurate decision-making basis for trajectory planning. On the other hand, a risk-adaptive safe deep reinforcement learning (DRL) trajectory planning algorithm, RAS- $\beta $ -SAC, is designed. Specifically, the beta distribution is introduced to adapt to the bounded safe action space defined by the IFR. At the same time, the risk relabeling module is designed to make the planned trajectory meet the personalized driving pReferences of drivers, thereby reducing human-machine conflicts and further improving trajectory safety. Experimental results show that the planned trajectory not only meets the safety constraints, but also satisfies the DRC, achieving dual safety guarantees of objective physical safety and driver's subjective acceptability.

A poor safety culture has led to numerous major incidents in the chemical process industry. Empirical evidence proves that sectors with high safety culture maturity (SCM) levels have fewer incidents and accidents. A macroergonomics approach could increase the resilience. This study identifies SCM variables in chemical process-based industries and develops a conceptual framework and model using a macroergonomics approach to achieve organizational resilience. This study will employ a systematic literature review (SLR) approach to conduct an SLR on the safety culture maturity model (SCMM) research. The SLR aims to find measurement variables and models used in previous research. Then, the variables found were classified into five work subsystems: 1) organization, 2) tools and technology, 3) human, 4) job and tasks, and 5) environment. Validation was then proposed by 11 experts using the content validity ratio method to identify relevant variables to measure SCM in chemical process-based industries. Fifteen variables were classified into the organizational subsystem, six were in the tools and technology subsystem variables, nine were included in the human subsystem variables, five were in the job and task subsystem variables, and six were included in the environment subsystem variables. A six-level SCM model is presented: Pathological, Reactive, Calculative, Proactive, Generative, and Resilient. This study successfully identified and mapped key variables contributing to SCMM in chemical process-based industries using a macroergonomics approach, resulting in 41 measurement variables. A six-level SCMM can be used to develop measurement tools and improve organizational resilience.

Road traffic injuries (RTIs) remain a major cause of trauma-related mortality worldwide. Although many patients die before reaching the hospital, mortality among hospitalized patients continues to impose a substantial public health burden. This study aimed to identify predictors of 30-day mortality among patients with road traffic injuries in Yazd, Iran. This retrospective case-control study included patients admitted to Shahid Dr. Rahnemoon Hospital between March 2022 and December 2024. The case group comprised 348 patients who died within 30 days of injury, while the control group included 698 randomly selected survivors. Data were extracted from hospital and prehospital records. Multivariable logistic regression analysis was performed to identify independent predictors of mortality. A total of 1,046 patients were included (mean age, 32.14&#x2009;&#xb1;&#x2009;19.69 years; 77.8% male), of whom 33.3% died within 30 days. Mortality was significantly associated with male sex, older age, comorbidities, suburban road accidents, and injuries occurring during holidays and warm seasons (P&#x2009;<&#x2009;0.001). Deceased patients had lower Glasgow Coma Scale (GCS) scores, lower Mean Arterial Pressure (MAP), and lower Revised Trauma Score (RTS). In multivariable analysis, male sex, injuries occurring during warm seasons and holidays, interhospital transfer, head injury, and prolonged prehospital transport time were identified as independent predictors of mortality. Higher RTS was associated with a lower risk of mortality. Mortality among patients with road traffic injuries was associated with demographic, environmental, clinical, and prehospital factors. Prolonged prehospital transport time emerged as an important predictor of mortality. Strengthening trauma systems and reducing transport delays may contribute to improved trauma outcomes.

BackgroundDespite advances in safety management, accidents in the chemical industry remain frequent, partly due to overlooked individual-level psychological factors.ObjectiveGrounded in the Job Demands-Resources (JD-R) model, this study introduces Occupational Stigma (OS) as a job demand impairing safety performance through Organizational Cynicism (OC), while identifying Perceived Organizational Support (POS) as a critical job resource for fostering high safety performance.MethodsUtilizing a hybrid analytical approach combining Structural Equation Modeling (SEM) and Fuzzy-set Qualitative Comparative Analysis (fsQCA) on 257 Chinese frontline chemical workers, we respectively capture variable-centered and configuration-centered relationships.ResultsSEM results show that higher occupational stigma is associated with greater organizational cynicism, which in turn is negatively related to safety performance. Specifically, cynicism fully mediates stigma's impact on safety compliance and partially mediates it on safety participation. Complementarily, fsQCA identifies specific configurations sufficient for high safety performance, establishing POS as a pivotal core condition.ConclusionsBy elucidating the stigma-induced psychological cascade and highlighting the protective function of perceived organizational support, these findings provide actionable recommendations for alleviating occupational stigma and improving safety in high-risk industries.

Sternal fractures (SF) are relatively uncommon but clinically important injuries, frequently accompanied by rib fractures, pulmonary complications, and the need for intensive care unit (ICU). Despite advances in imaging and trauma management, prognostic assessment in SF remains challenging. In particular, the comparative performance of commonly used trauma severity scores-Injury Severity Score (ISS), New Injury Severity Score (NISS), and Trauma and Injury Severity Score (TRISS)-has not been clearly established in this patient group. This retrospective observational study included 393 adult patients diagnosed with SF at a tertiary trauma center. The prognostic performance of ISS, NISS, and TRISS for ICU admission was evaluated using ROC analysis, pairwise ROC comparison, multivariable logistic regression, and exploratory decision-tree modeling. In-vehicle traffic accidents were the most common mechanism of injury (60.1%). Most patients were managed conservatively (95.7%), with an overall mortality rate of 3.1%. ROC analysis showed good discriminatory ability for ICU admission with NISS (AUC [Area Under the Curve] 0.876) and ISS (AUC 0.847), whereas TRISS performed moderately (AUC 0.743). In multivariable models, ISS and NISS remained independently associated with ICU admission. Decision-tree analysis identified rib fractures, abnormal respiratory findings, and high injury severity scores as key predictors of ICU admission. Although mortality is low, SF are associated with considerable morbidity. Rib fractures, fracture location, and injury severity scores are important prognostic indicators. In this exploratory single-center cohort, ISS and NISS showed better discrimination for ICU admission than TRISS; however, these findings should be interpreted cautiously and require validation in larger prospective studies.

Objectives. Recent research on the influence of temporal factors on the safety behavior of new-generation construction workers remains limited. To investigate the impact mechanism of temporal leadership on the safety behavior of new-generation construction workers and effectively reduce the incidence of safety accidents, this study was conducted with a sample of more than 400 new-generation construction workers. Methods. Confirmatory factor analysis (CFA) and structural equation modeling (SEM) were used to empirically test the chain mechanism linking temporal leadership to the safety behavior of new-generation of construction workers, as well as the moderating effect of perceived work meaning. Results. This study found that temporal leadership exerts a direct and positive impact on the safety behavior of new-generation construction workers; that job stress and work-family balance play a mediating role in this relationship; and that perceived work meaning moderates the negative relationship between temporal leadership and job stress. Specifically, the stress-buffering effect of temporal leadership is more pronounced when workers perceive lower levels of work meaning. Conclusion. These findings provide theoretical and practical significance for understanding how temporal leadership influences the safety behavior of new-generation construction workers.

Epidemiological research suggests that most individuals in the U.S. will be exposed to potentially traumatic events (PTEs) at some point in their lifetime. Despite this, published rates of PTE exposure among individuals with obsessive-compulsive disorder (OCD) vary widely, ranging from 34-82%. Thus, presently available PTE estimates are too wide to be clinically informative and are incongruent with general population estimates, where the rate of PTE exposure would be expected to be comparable if not higher. Using data from The National OCD Survey, a large geographically representative study of adults with OCD across the U.S., demographically weighted PTE estimates were computed in a sample of 2808 participants with OCD (M age = 33.6 years). PTE rates were notably higher than previously reported in OCD research and better aligned with general population estimates. Nearly all participants endorsed at least one PTE (97.9%), including, most commonly, transportation accidents, sexual assault, physical assault, natural disaster, and life-threatening illness or injury. The present study is the first to provide robust PTE estimates among individuals with OCD, supporting the frequency of these experiences and highlighting the need for adequate assessment of trauma in clinical practice.

Vibrations can have harmful effects on the human brain and are associated with neurological damage, cognitive impairments, and an increased risk of traumatic brain injuries (TBI). Exposure to low-frequency vibrations, such as those encountered in blast events, contact sports, and accidents, can induce resonance within the brain, potentially amplifying mechanical stress and strain on neural structures. To better understand these effects, this study examines the mechanical response of a cerebrum-shaped human brain simulant subjected to vertical vibrations within the 1-12 Hz frequency range. Using a full-scale biofidelic brain model fabricated from a multi-part polymeric material, experimental measurements and a simplified mathematical model were employed to analyse vibration transmissibility characteristics. The first resonance peak was observed between 4-4.2 Hz, aligning with previously reported frequency ranges. Regional variations in transmissibility were observed within the experimental model, with relatively higher transmissibility in the temporal region at approximately 8 Hz, while the left and right hemispheric regions exhibited resonance peaks at 2, 9, and 11 Hz, along with an intermediate anti-resonance feature. The absence of surrounding anatomical structures, such as the skull and cerebrospinal fluid, may contribute to the observed transmissibility levels. These findings provide baseline experimental data on the vibration response of a developed biofidelic brain model and contribute to the understanding of vibration transmissibility behavior in controlled laboratory settings. The developed model offers a repeatable experimental platform that may support future investigations into brain vibration dynamics and the progressive development of more anatomically and mechanically representative models for safety and injury biomechanics research.

Combining traditional oil infrastructure with distributed renewable energy resources (DERs), including critical grid-edge assets like electric vehicle (EV) charging infrastructure that link transportation and power systems, has created hybrid energy systems that are more connected and digitally complex. These systems integrate legacy operational technologies (OT), such as SCADA, with decentralized, IoT-enabled assets that often rely on cloud-based analytics and remote connectivity. This conjunction introduces cybersecurity risks by linking historically isolated OT environments to modern, internet-exposed components, creating more entry points, inconsistent security baselines, and new attack surfaces. The resulting vulnerabilities extend beyond traditional IT-centric threat models. Conventional cybersecurity strategies, which prioritize technical controls in isolation, often fail to address systemic risks stemming from institutional fragmentation, regulatory gaps, and third-party dependencies. This study introduces a Socio-Technical Resilience Framework grounded in the Systems-Theoretic Accident Model and Processes (STAMP) and Socio-Technical Systems (STS) theory to access and mitigate cyber risks in hybrid grids. Through comparative case studies of the Colonial Pipeline ransomware event and cyber disruptions in European DER infrastructure, the paper finds that fragmented coordination, isolated threat intelligence, and weak human-system integration significantly amplify cyber impacts that undermine static, perimeter-based defense models. The study contributes a layered framework for cyber resilience that operates across three domains: (1) technical (via zero-trust architecture and distributed anomaly detection), (2) organizational (through shared situational awareness and cognitive decision-support tools), and (3) governance (by leveraging federated threat intelligence and regulatory harmonization). This multi-domain approach enhances both operational flexibility and long-term sustainability. Ultimately, the paper demonstrates that enduring cyber resilience in hybrid energy systems requires more than patching vulnerabilities. It demands a systemic rethinking of control, coordination, and design. The framework and findings offer a forward-looking roadmap for securing the energy sector against evolving threats in an era of distributed complexity.

Underreporting of near-miss incidents, unsafe acts, and unsafe conditions remains a critical barrier to proactive accident prevention in industrial settings. This study aimed to develop and evaluate an AppSheet-based reporting system to enhance safety reporting in a cassava starch factory. An action research approach guided by the Plan-Do-Check-Act (PDCA) cycle was employed. The results showed that the AppSheet-based system significantly improved reporting performance, with total reports increasing by 70.6%. The system also enhanced data quality, communication, and user engagement. In conclusion, the AppSheet-based reporting system effectively improved safety reporting behavior and data management. These findings highlight the potential of low-code digital solutions to strengthen proactive safety management and safety culture in industrial environments.

To evaluate the environmental impacts of tritiated wastewater discharge from the Fukushima Daiichi Nuclear Power Plant, we conducted a 10-year three-dimensional simulation of dissolved tracer dispersion in the Pacific Ocean and its marginal seas using the Regional Ocean Modeling System. The model domain was partitioned into 11 regions to quantify transport pathways, concentration evolution and inventory (accumulation) changes. Our results indicate that the dissolved tracer concentration is highest within the surrounding discharge location (SDL) and subsequently disperses to the deep western Pacific (DWP), the deep eastern Pacific, and eventually into western Pacific marginal seas, with subsurface tracer intruding into marginal seas earlier than surface layer. Discharge-induced concentration increments mostly remain below practical detection limits; detectable maxima exceeding natural background levels are primarily confined to the SDL (>70&#xa0;Bq/m3) and DWP (&#x223c;20-30&#xa0;Bq/m3). Median levels in the SDL and DWP remain on the order 10-4 or 10-3&#xa0;Bq/m3; in other open ocean and some marginal seas (e.g., South China Sea basin) largely stay near or below these values. Regional inventories remain orders of magnitude below natural background levels; and accumulation rates demonstrate a protracted dispersion from the open North Pacific toward the marginal seas under a decadal-scale discharge scenario.

Bird-aircraft collisions (bird strikes) pose threats to aviation safety and avian life. One of the tenets of airport-based management strategies to prevent bird strikes is the reduction of bird density within established separation distances from air operations areas. The rationale is that higher local bird densities could increase the spatial and temporal overlap in the use of airspace by both birds and aircraft, leading to a higher frequency of bird strikes. However, the strength and direction of this relationship have not been evaluated across published studies. This is an important gap, given how entrenched this assumed relationship has become to allocate limited resources to airport wildlife management. In this study, we assessed the strength of the relationship between avian abundance and bird strikes across studies using a meta-analytic approach. Through a reproducible literature search and screening criteria, we identified 20 outcomes (i.e., effect sizes) from 13 studies. We conducted a multilevel meta-analysis and found a positive correlation (Pearson's r&#x2009;=&#x2009;0.520, 95% confidence intervals: 0.308-0.683), supporting the positive relationship between bird abundance and bird strike frequency. We additionally found evidence that the existing literature has high levels of between-study heterogeneity and publication bias, low statistical power, and multiple methodological concerns. These issues suggest that our effect size estimation should be interpreted with care. Given the limitations of the published literature testing this relationship, we provide a set of methodological recommendations for improving future experiments. We call for prioritizing the empirical testing of the abundance-bird strike relationship on and near airports across the world, and the standardization of bird survey approaches. These future tests are key to aligning management efforts to local airport needs.

Subaxial cervical spine fractures with facet dislocation are burdened by a high risk of neurological impairment. The surgical management of this severe clinical condition is poorly standardized, concerning the role of closed reduction and the use of anterior, posterior, or circumferential approaches. We performed a retrospective evaluation of our series to assess the safety and efficacy of our surgical strategy. Transcranial traction was progressively applied, followed by anterior decompression and arthrodesis. Whether adequate reduction was not obtained with traction, or in case of comminution of the posterior elements, a combined posterior-anterior approach was undertaken. In addition, we report the use of intraoperative ultrasound for the assessment of neural decompression. A total of 36 patients were treated in this series. The most frequently affected level was C6-C7 (14/36), and motor-vehicle accident was the most common mechanism of injury (20/36). According to AO Spine Subaxial Classification, C-F4 was the main type of lesion (25/36). The anterior approach was effective in 21 out of 36 cases, whereas a combined approach was needed in 12/36. Three patients were operated on only posteriorly. Frankel grade at follow-up was unchanged in 27/36, ameliorated in 6, and 3 patients died within 14 days. The anterior approach resulted to be sufficient in more than 50% of patients, and our findings corroborate the usefulness of closed traction. Posterior and circumferential stabilization were reserved for irreducible dislocations or substantial destruction of the posterior elements. Among patients initially treated anteriorly, a second operation was necessary in only two cases.

Radioactive cesium-bearing microparticles (CsMPs) were generated by the Fukushima Daiichi nuclear power plant (FNPP) accident. Despite their low radioactivity, CsMPs are insoluble and their dose distribution to the surrounding tissues is non-uniform, raising concerns about their biological effects. In this study, we investigated the cellular effects of CsMPs collected from soil contaminated by the FNPP accident. Each three CsMP was placed on immortalized normal human epithelial cells (hTERT-RPE1) and co-incubated for up to 72&#x2009;h. Induction of DNA double-strand breaks (DSBs) and cell proliferation were analyzed in relation to the distance from a CsMP. In addition, gene expression analysis was performed after cells were co-incubated with a CsMP for 24&#x2009;h. CsMP-1, which contains 1911&#x2009;Bq of radioactive Cs (134Cs&#xa0;+&#xa0;137Cs), induced DSBs and growth arrest in adjacent cells at high radiation doses. DSBs were also induced in cells 1&#x2009;cm distant from CsMP-1; however, these cells maintained their ability to proliferate. CsMP-1 also induced the expression of interferon-stimulated genes (ISGs) involved in inflammatory responses and stress tolerance in cells proximal to CsMP-1. Neither a non-radioactive mock particle nor CsMP-3, containing 7.6&#x2009;Bq of radioactive Cs, influenced DSB induction, even in the adjacent cells. Our study suggests that factors secreted by cells that undergo premature senescence following high-dose exposure to CsMP-1 may confer a growth advantage to cells experiencing DSBs at a distance from the CsMP.

Chronic kidney disease (CKD) is associated with an increased risk of cerebrovascular events, particularly intracranial hemorrhage (ICH), which carries high morbidity and mortality. The risk of ICH may increase with worsening renal function; however, data correlating ICH occurrence with CKD stages remain limited. To study the occurrence of ICH in patients with CKD and to assess its correlation with different stages of CKD and associated risk factors. This observational, cross-sectional study was conducted in a tertiary care hospital and included 60 adult patients diagnosed with CKD. Patients were classified into CKD stages based on estimated glomerular filtration rate (eGFR). Clinical data, laboratory parameters, and comorbidities were recorded. Neuroimaging with noncontrast computed tomography brain was performed in patients with neurological symptoms to identify and classify ICH. Outcomes including in-hospital mortality were analyzed. ICH was observed in 12 patients (20%). The occurrence of ICH increased progressively with advancing CKD stage, from 0% in Stage I to 33.3% in Stage V. All patients with ICH had hypertension and 83.3% had diabetes mellitus. Patients with ICH had significantly lower mean eGFR (24.5 vs. 55.3 mL/min/1.73 m2) and higher serum creatinine levels compared to those without ICH. In-hospital mortality was markedly higher among patients with ICH (33.3%) compared to those without ICH (2.1%). Intraparenchymal hemorrhage was the most common subtype. ICH is a frequent and serious complication in advanced CKD, with risk and mortality increasing as renal function declines. Early identification of high-risk patients and aggressive management of modifiable risk factors, particularly hypertension, may help reduce adverse outcomes. R&#xe9;sum&#xe9; Contexte:La maladie r&#xe9;nale chronique (MRC) est associ&#xe9;e &#xe0; un risque accru d&#x2019;&#xe9;v&#xe9;nements c&#xe9;r&#xe9;brovasculaires, en particulier l&#x2019;h&#xe9;morragie intracr&#xe2;nienne (HIC), qui entra&#xee;ne une morbidit&#xe9; et une mortalit&#xe9; &#xe9;lev&#xe9;es. Le risque d&#x2019;HIC peut augmenter avec la d&#xe9;t&#xe9;rioration de la fonction r&#xe9;nale; cependant, les donn&#xe9;es corr&#xe9;lant la survenue d&#x2019;HIC aux stades de la MRC restent limit&#xe9;es.Objectifs:&#xc9;tudier l&#x2019;occurrence de l&#x2019;HIC chez les patients atteints de MRC et &#xe9;valuer sa corr&#xe9;lation avec les diff&#xe9;rents stades de la MRC et les facteurs de risque associ&#xe9;s.Mat&#xe9;riels et M&#xe9;thodes:Cette &#xe9;tude observationnelle et transversale a &#xe9;t&#xe9; men&#xe9;e dans un h&#xf4;pital de soins tertiaires et a inclus 60 patients adultes diagnostiqu&#xe9;s avec une MRC. Les patients ont &#xe9;t&#xe9; class&#xe9;s selon les stades de la MRC en fonction du d&#xe9;bit de filtration glom&#xe9;rulaire estim&#xe9; (DFGe). Les donn&#xe9;es cliniques, les param&#xe8;tres de laboratoire et les comorbidit&#xe9;s ont &#xe9;t&#xe9; enregistr&#xe9;s. Une neuro-imagerie par tomodensitom&#xe9;trie c&#xe9;r&#xe9;brale sans contraste a &#xe9;t&#xe9; r&#xe9;alis&#xe9;e chez les patients pr&#xe9;sentant des sympt&#xf4;mes neurologiques afin d&#x2019;identifier et de classer l&#x2019;HIC. Les r&#xe9;sultats, y compris la mortalit&#xe9; intra-hospitali&#xe8;re, ont &#xe9;t&#xe9; analys&#xe9;s.R&#xe9;sultats:Une HIC a &#xe9;t&#xe9; observ&#xe9;e chez 12 patients (20 %). L&#x2019;occurrence de l&#x2019;HIC a augment&#xe9; progressivement avec l&#x2019;avanc&#xe9;e du stade de la MRC, passant de 0 % au stade I &#xe0; 33,3 % au stade V. Tous les patients atteints d&#x2019;HIC souffraient d&#x2019;hypertension et 83,3 % de diab&#xe8;te sucr&#xe9;. Les patients avec HIC pr&#xe9;sentaient un DFGe moyen significativement plus bas (24.5 vs 55.3 mL/min/1.73 m2) et des taux de cr&#xe9;atinine s&#xe9;rique plus &#xe9;lev&#xe9;s par rapport &#xe0; ceux sans HIC. La mortalit&#xe9; intra-hospitali&#xe8;re &#xe9;tait nettement plus &#xe9;lev&#xe9;e chez les patients avec HIC (33,3 %) compar&#xe9;e &#xe0; ceux sans HIC (2,1 %). L&#x2019;h&#xe9;morragie intraparenchymateuse &#xe9;tait le sous-type le plus fr&#xe9;quent.Conclusion:L&#x2019;HIC est une complication fr&#xe9;quente et grave de la MRC avanc&#xe9;e, dont le risque et la mortalit&#xe9; augmentent &#xe0; mesure que la fonction r&#xe9;nale d&#xe9;cline. L&#x2019;identification pr&#xe9;coce des patients &#xe0; haut risque et une prise en charge agressive des facteurs de risque modifiables, en particulier l&#x2019;hypertension, pourraient contribuer &#xe0; r&#xe9;duire les issues d&#xe9;favorables.