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J Korean Soc Emerg Med > Volume 32(2); 2021 > Article
Journal of The Korean Society of Emergency Medicine 2021;32(2): 103-111.
노인 심정지의 초기 동맥혈가스분석에서 자발순환회복 예측 지표에 대한 연구
임현준1 , 조준휘1,2 , 문중범1,2 , 박찬우1,2 , 신명철1,2 , 김가을1,2 , 박윤수1,2 , 양고은1,3 , 옥택근1,2
1강원대학교병원 응급의학과
2강원대학교 의학전문대학원 응급의학교실
3강원대학교 의학전문대학원 영상의학교실
A study on the predictive indicators for the recovery of spontaneous circulation in the early arterial blood gas analysis of cardiac arrest in the elderly
Hyun Joon Lim1 , Jun Hwi Cho1,2 , Joong Bum Moon1,2 , Chan Woo Park1,2 , Myoung Cheol Shin1,2 , Ka Eul Kim1,2 , Yoon Soo Park1,2 , Go Eun Yang1,3 , Taek Geun Ohk1,2
1Department of Emergency Medicine, Kangwon National University Hospital
2Department of Emergency Medicine, Kangwon National University School of Medicine
3Department of Radiology, Kangwon National University School of Medicine
Correspondence  Taek Geun Ohk ,Tel: 033-258-2438, Fax: 033-258-2451, Email: otgotg11@gmail.com,
Received: July 3, 2020; Revised: August 16, 2020   Accepted: October 6, 2020.  Published online: April 30, 2021.
The number of elderly patients in Korea has been on the rise recently, and hence the number of out-of-hospital cardiac arrest (OHCA) elderly patients is also rising. The causes of cardiac arrest for the elderly vary, and, it is difficult to predict the recovery of spontaneous circulation (ROSC) in OHCA patients. Therefore, the purpose of this study was to ascertain the predictive value of arterial blood gas analysis (ABGA) results in achieving ROSC in the elderly.
A retrospective analysis of emergency department patients with OHCA was performed at the Kangwon National University Hospital, Korea from 1 January 2016 to 31 December 2019. The initial ABGA results were compared between two patient groups, those who had achieved a return of spontaneous circulation and those who had not. Univariate and multivariable analyses were performed to elucidate the factors associated with ROSC.
Overall, 229 OHCA patients were included in the final analysis. The lactate level was independently related to ROSC. A receiver operating characteristics (ROC) curve was plotted to obtain the best cutoff value. The lactate level <9.85 mmol/L showed the largest area under the ROC curve (AUC) to predict ROSC (AUC, 0.666; 95% confidence interval, 0.588-0.743). Multiple regression analysis was performed using the cutoff value, which was a lactate level of 9.85 (odds ratio, 2.907; 95% confidence interval, 1.432-5.902; P=0.003).
The ABGA results during the cardiopulmonary resuscitation of OHCA patients, showed that the lactate level was an independent factor associated with ROSC. The lactate cutoff value was 9.85 mmol/L.
Key words: Out-of-hospital cardiac arrest; Blood gas analysis; Lactate
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