Survival prediction of initial blood pH for nontraumatic out-of-hospital cardiac arrest patients in the emergency department

Ding Kuo Chien, Mau-Roung Lin, Shin-Han Tsai, Fang Ju Sun, Te Chu Liu, Wen Han Chang

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Most nontraumatic out-of-hospital cardiac arrest (NTOHCA) patients who fail in prehospital resuscitation receive continued cardiopulmonary resuscitation in the emergency department (ED). Initial blood pH, which can be assessed rapidly in the ED, was examined to see whether it is a strong survival predictor for these patients. Methods: A 1-year retrospective study included consecutive 225 NTOHCA patients at a medical center in northern Taiwan who presented through the emergency medical services system. On arrival at the ED, these patients received continued cardiopulmonary resuscitation, and their initial blood pH data were assessed. Results: The pH value was positively correlated with variables such as return of spontaneous circulation, witnessed arrest, short prehospital time (≤20 minutes), and survival. The best cut-off value of initial blood pH, revealed by the receiver operating characteristic curve, was 7.068. The lowest pH value of the survivors was 6.856. The results of logistic regression model analysis shows that the odds ratios of survival was 10.0 (95% confidence interval [CI], 2.1-47.7) for patients with initial blood pH ≥ 7.068, 5.3 (95% CI, 1.48-18.9) for those with nonasystole rhythm, 4.0 (95% CI, 1.1-14.8) for those with prehospital time ≤20 minutes, and 9.1 (95% CI, 2.3-35.2) for those without NaHCO3 administration during resuscitation, respectively. Conclusion: A cut-off value of an initial blood pH of 7.068 can serve as a predictor for survival among NTOHCA patients. In addition, patients whose initial blood pH is lower than 6.85 in the ED may not survive until hospital discharge.

Original languageEnglish
Pages (from-to)171-175
Number of pages5
JournalInternational Journal of Gerontology
Volume4
Issue number4
DOIs
Publication statusPublished - Dec 2010

Fingerprint

Out-of-Hospital Cardiac Arrest
Hospital Emergency Service
Survival
Confidence Intervals
Cardiopulmonary Resuscitation
Resuscitation
Logistic Models
Emergency Medical Services
Taiwan
ROC Curve
Survivors
Retrospective Studies
Odds Ratio
Regression Analysis

Keywords

  • emergency department
  • initial blood pH
  • nontraumatic out-of-hospital cardiac arrest (NTOHCA)
  • resuscitation
  • survival rate

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

Survival prediction of initial blood pH for nontraumatic out-of-hospital cardiac arrest patients in the emergency department. / Chien, Ding Kuo; Lin, Mau-Roung; Tsai, Shin-Han; Sun, Fang Ju; Liu, Te Chu; Chang, Wen Han.

In: International Journal of Gerontology, Vol. 4, No. 4, 12.2010, p. 171-175.

Research output: Contribution to journalArticle

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abstract = "Background: Most nontraumatic out-of-hospital cardiac arrest (NTOHCA) patients who fail in prehospital resuscitation receive continued cardiopulmonary resuscitation in the emergency department (ED). Initial blood pH, which can be assessed rapidly in the ED, was examined to see whether it is a strong survival predictor for these patients. Methods: A 1-year retrospective study included consecutive 225 NTOHCA patients at a medical center in northern Taiwan who presented through the emergency medical services system. On arrival at the ED, these patients received continued cardiopulmonary resuscitation, and their initial blood pH data were assessed. Results: The pH value was positively correlated with variables such as return of spontaneous circulation, witnessed arrest, short prehospital time (≤20 minutes), and survival. The best cut-off value of initial blood pH, revealed by the receiver operating characteristic curve, was 7.068. The lowest pH value of the survivors was 6.856. The results of logistic regression model analysis shows that the odds ratios of survival was 10.0 (95{\%} confidence interval [CI], 2.1-47.7) for patients with initial blood pH ≥ 7.068, 5.3 (95{\%} CI, 1.48-18.9) for those with nonasystole rhythm, 4.0 (95{\%} CI, 1.1-14.8) for those with prehospital time ≤20 minutes, and 9.1 (95{\%} CI, 2.3-35.2) for those without NaHCO3 administration during resuscitation, respectively. Conclusion: A cut-off value of an initial blood pH of 7.068 can serve as a predictor for survival among NTOHCA patients. In addition, patients whose initial blood pH is lower than 6.85 in the ED may not survive until hospital discharge.",
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N2 - Background: Most nontraumatic out-of-hospital cardiac arrest (NTOHCA) patients who fail in prehospital resuscitation receive continued cardiopulmonary resuscitation in the emergency department (ED). Initial blood pH, which can be assessed rapidly in the ED, was examined to see whether it is a strong survival predictor for these patients. Methods: A 1-year retrospective study included consecutive 225 NTOHCA patients at a medical center in northern Taiwan who presented through the emergency medical services system. On arrival at the ED, these patients received continued cardiopulmonary resuscitation, and their initial blood pH data were assessed. Results: The pH value was positively correlated with variables such as return of spontaneous circulation, witnessed arrest, short prehospital time (≤20 minutes), and survival. The best cut-off value of initial blood pH, revealed by the receiver operating characteristic curve, was 7.068. The lowest pH value of the survivors was 6.856. The results of logistic regression model analysis shows that the odds ratios of survival was 10.0 (95% confidence interval [CI], 2.1-47.7) for patients with initial blood pH ≥ 7.068, 5.3 (95% CI, 1.48-18.9) for those with nonasystole rhythm, 4.0 (95% CI, 1.1-14.8) for those with prehospital time ≤20 minutes, and 9.1 (95% CI, 2.3-35.2) for those without NaHCO3 administration during resuscitation, respectively. Conclusion: A cut-off value of an initial blood pH of 7.068 can serve as a predictor for survival among NTOHCA patients. In addition, patients whose initial blood pH is lower than 6.85 in the ED may not survive until hospital discharge.

AB - Background: Most nontraumatic out-of-hospital cardiac arrest (NTOHCA) patients who fail in prehospital resuscitation receive continued cardiopulmonary resuscitation in the emergency department (ED). Initial blood pH, which can be assessed rapidly in the ED, was examined to see whether it is a strong survival predictor for these patients. Methods: A 1-year retrospective study included consecutive 225 NTOHCA patients at a medical center in northern Taiwan who presented through the emergency medical services system. On arrival at the ED, these patients received continued cardiopulmonary resuscitation, and their initial blood pH data were assessed. Results: The pH value was positively correlated with variables such as return of spontaneous circulation, witnessed arrest, short prehospital time (≤20 minutes), and survival. The best cut-off value of initial blood pH, revealed by the receiver operating characteristic curve, was 7.068. The lowest pH value of the survivors was 6.856. The results of logistic regression model analysis shows that the odds ratios of survival was 10.0 (95% confidence interval [CI], 2.1-47.7) for patients with initial blood pH ≥ 7.068, 5.3 (95% CI, 1.48-18.9) for those with nonasystole rhythm, 4.0 (95% CI, 1.1-14.8) for those with prehospital time ≤20 minutes, and 9.1 (95% CI, 2.3-35.2) for those without NaHCO3 administration during resuscitation, respectively. Conclusion: A cut-off value of an initial blood pH of 7.068 can serve as a predictor for survival among NTOHCA patients. In addition, patients whose initial blood pH is lower than 6.85 in the ED may not survive until hospital discharge.

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