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J Korean Soc Emerg Med > Volume 28(5); 2017 > Article
Journal of The Korean Society of Emergency Medicine 2017;28(5): 475-483.
가스 흡입으로 응급실로 내원한 환자의 초기 중증도 예측 인자
황정성, 최욱진, 김선휴, 최병호, 이혜지, 안 력, 홍은석
울산대학교 의과대학 울산대학교병원 응급의학과
Early Predictors of Critical Cases for the Patients Who Visited Emergency Department due to Gas Inhalation: Early Predictors of Severity in Gas Inhalation
Jung Sung Hwang, Wook Jin Choi, Sun Hyu Kim, Byung Ho Choi, Hye Ji Lee, Ryeok Ahn, Eun Seog Hong
Department of Emergency Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
Correspondence  Ryeok Ahn ,Tel: 052-250-8508, Fax: 052-250-8150, Email: uuh0729166@hanmail.net,
Received: June 21, 2017; Revised: June 22, 2017   Accepted: August 24, 2017.  Published online: October 31, 2017.
ABSTRACT
Purpose:
To define early predictors of critical cases involving patients who visited the emergency department (ED) due to gas inhalation, with the goal of identifying patients who require intensive monitoring and treatment.
Method:
The retrospective study was carried out for patients who visited the ED at Ulsan University Hospital due to gas inhalation from March 2014 to February 2016. General demographics, mechanism of accident, critical symptoms, vital signs, blood lab test results, severity, and clinical manifestation were investigated. Patients were divided into a critical group and non-critical group, and predictors of critical cases were investigated by comparing both groups.
Results:
Of the 180 patients, 26 patients were in the critical group. In this group, more patients displayed altered mentality and cardiac arrest (both p<0.001). The critical group also showed significantly higher fractions for low-blood pressure (systolic blood pressure<90 mmHg; p<0.001), number of critical symptoms (p<0.001), transport by emergency medical services (p=0.003), and consultation involving other departments (p<0.001). Patients in the critical group showed higher Korean Triage and Acuity Scale (KTAS) level (p<0.001), lactate value (p=0.001), and carboxy-hemoglobin value (p=0.017) as well as older age (p=0.001), lower pH (p=0.001), and HCO3 - value (p<0.001). Multiple regression analysis revealed that predictors of critical cases were older age and higher KTAS level (both p<0.001).
Conclusion:
Patients admitted to the ED for treatment of gas inhalation, who were older and had a higher KTAS level, require intensive monitoring and treatment.
Key words: Predictive value of tests, Smoke inhalation injury, Triage, Blood gas analysis, Emergency medicine
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