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KMID : 0604020110260020057
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Korean Journal of Critical Care Medicine
2011 Volume.26 No. 2 p.57 ~ p.63
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Prognostic Factors for Mortality in Emergency Department Patients with Hypotension
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Park Deuk-Hyun
Ha Young-Rock
Kim Young-Sik
Shin Tae-Yong
Oh Sung-Han
Choi Sung-Sil
Roh Sook-Young
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Abstract
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Background:This study was performed to analyze the effects of differences between initial and follow up amounts of central venous oxygen saturation (ScvO2), lactate, anion gap (AG), and corrected anion gap (CAG).
Methods: Patients with systolic blood pressure that was lower than 90 mmHg participated in this study. Along with Arterial Blood Gas Analysis (ABGA), the amounts of electrolytes, albumin, and Scvo2 were initially checked and then re-checked four hours later. The patients were divided into two groups, which were survived and expired, and the differences in initial and final values were compared in both groups.
Results:Out of a total of 36 patients, 29 patients survived and 7 patients died. The data showed almost no difference in mean age, mean arterial pressure, heart rate, respiratory rate, and body temperature between two groups. Comparing the initial amount, there was a statistically significant variation in lactate. Comparing the final values, lactate, AG, and CAG varied significantly. However, for both groups, the differences between the initial and final values were not significant. The area under curve (AUC) of follow up lactate and follow up CAG was 0.89 and 0.88. AUC of ED-APACHEII and original ICU APACHEII was 0.74 and 0.96.
Conclusions :There was no prognostic effect of ScvO2, lactate, AG, and CAG in hypotensive patients. The initial and final values of lactate and CAG were good prognostic factors for the expired group.
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KEYWORD
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anion gap, central venous oxygen saturation, corrected anion gap, Lactate
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