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KMID : 0385920210320020103
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Journal of the Korean Society of Emergency Medicine
2021 Volume.32 No. 2 p.103 ~ p.111
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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
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Lim Hyun-Joon
Cho Jun-Hwi
Moon Joong-Bum
Park Chan-Woo
Shin Myoung-Cheol
Kim Ka-Eul
Park Yoon-Soo
Yang Go-Eun
Ohk Taek-Geun
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Abstract
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Objective: 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.
Methods: 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.
Results: 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).
Conclusion: 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.
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KEYWORD
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Out-of-hospital cardiac arrest, Blood gas analysis, Lactate
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