論文

査読有り 国際誌
2020年8月5日

Predictive accuracy of biomarkers for survival among cardiac arrest patients with hypothermia: a prospective observational cohort study in Japan.

Scandinavian journal of trauma, resuscitation and emergency medicine
  • Yohei Okada
  • ,
  • Takeyuki Kiguchi
  • ,
  • Taro Irisawa
  • ,
  • Kazuhisa Yoshiya
  • ,
  • Tomoki Yamada
  • ,
  • Koichi Hayakawa
  • ,
  • Kazuo Noguchi
  • ,
  • Tetsuro Nishimura
  • ,
  • Takuya Ishibe
  • ,
  • Yoshiki Yagi
  • ,
  • Masafumi Kishimoto
  • ,
  • Hiroshi Shintani
  • ,
  • Yasuyuki Hayashi
  • ,
  • Taku Sogabe
  • ,
  • Takaya Morooka
  • ,
  • Haruko Sakamoto
  • ,
  • Keitaro Suzuki
  • ,
  • Fumiko Nakamura
  • ,
  • Norihiro Nishioka
  • ,
  • Tasuku Matsuyama
  • ,
  • Satoshi Matsui
  • ,
  • Takeshi Shimazu
  • ,
  • Kaoru Koike
  • ,
  • Takashi Kawamura
  • ,
  • Tetsuhisa Kitamura
  • ,
  • Taku Iwami

28
1
開始ページ
75
終了ページ
75
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1186/s13049-020-00765-2

BACKGROUND: There is limited information on the predictive accuracy of commonly used predictors, such as lactate, pH or serum potassium for the survival among out-of-hospital cardiac arrest (OHCA) patients with hypothermia. This study aimed to identify the predictive accuracy of these biomarkers for survival among OHCA patients with hypothermia. METHODS: In this retrospective analysis, we analyzed the data from a multicenter, prospective nationwide registry among OHCA patients transported to emergency departments in Japan (the JAAM-OHCA Registry). We included all adult (≥18 years) OHCA patients with hypothermia (≤32.0 °C) who were registered from June 2014 to December 2017 and whose blood test results on hospital arrival were recorded. We calculated the predictive accuracy of pH, lactate, and potassium for 1-month survival. RESULTS: Of the 34,754 patients in the JAAM-OHCA database, we included 754 patients from 66 hospitals. The 1-month survival was 5.8% (44/754). The areas under the curve of the predictors and 95% confidence interval were as follows: pH 0.829 [0.767-0.877] and lactate 0.843 [0.793-0.882]. On setting the cutoff points of 6.9 in pH and 120 mg/dL (13.3 mmol/L) in lactate, the predictors had a high sensitivity (lactate: 0.91; pH 0.91) and a low negative likelihood ratio (lactate: 0.14; pH 0.13), which are suitable to exclude survival to 1 month. Furthermore, in additional analysis that included only the patients with potassium values available, a cutoff point of 7.0 (mmol/L) for serum potassium had high sensitivity (0.96) and a low negative likelihood ratio (0.09). CONCLUSION: This study indicated the predictive accuracy of serum lactate, pH, and potassium for 1-month survival among adult OHCA patients with hypothermia. These biomarkers may help define a more appropriate resuscitation strategy.

リンク情報
DOI
https://doi.org/10.1186/s13049-020-00765-2
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/32758271
PubMed Central
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7404926
ID情報
  • DOI : 10.1186/s13049-020-00765-2
  • PubMed ID : 32758271
  • PubMed Central 記事ID : PMC7404926

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