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

研究成果: 雜誌貢獻文章

4 引文 (Scopus)

摘要

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.
原文英語
頁(從 - 到)171-175
頁數5
期刊International Journal of Gerontology
4
發行號4
DOIs
出版狀態已發佈 - 十二月 2010

指紋

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

ASJC Scopus subject areas

  • Geriatrics and Gerontology

引用此文

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.

於: International Journal of Gerontology, 卷 4, 編號 4, 12.2010, p. 171-175.

研究成果: 雜誌貢獻文章

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title = "Survival prediction of initial blood pH for nontraumatic out-of-hospital cardiac arrest patients in the emergency department",
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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T1 - Survival prediction of initial blood pH for nontraumatic out-of-hospital cardiac arrest patients in the emergency department

AU - Chien, Ding Kuo

AU - Lin, Mau-Roung

AU - Tsai, Shin-Han

AU - Sun, Fang Ju

AU - Liu, Te Chu

AU - Chang, Wen Han

PY - 2010/12

Y1 - 2010/12

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.

KW - emergency department

KW - initial blood pH

KW - nontraumatic out-of-hospital cardiac arrest (NTOHCA)

KW - resuscitation

KW - survival rate

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