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Prognostic ability of the sequential organ failure assessment score in accidental hypothermia: a multi-institutional retrospective cohort study
BACKGROUND: Severe accidental hypothermia (AH) is life threatening. Thus, prognostic prediction in AH is essential to rapidly initiate intensive care. Several studies on prognostic factors for AH are known, but none have been established. We clarified the prognostic ability of the Sequential Organ F...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6849316/ https://www.ncbi.nlm.nih.gov/pubmed/31718708 http://dx.doi.org/10.1186/s13049-019-0681-8 |
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author | Kandori, Kenji Okada, Yohei Matsuyama, Tasuku Morita, Sachiko Ehara, Naoki Miyamae, Nobuhiro Jo, Takaaki Sumida, Yasuyuki Okada, Nobunaga Watanabe, Makoto Nozawa, Masahiro Tsuruoka, Ayumu Fujimoto, Yoshihiro Okumura, Yoshiki Kitamura, Tetsuhisa Iiduka, Ryoji |
author_facet | Kandori, Kenji Okada, Yohei Matsuyama, Tasuku Morita, Sachiko Ehara, Naoki Miyamae, Nobuhiro Jo, Takaaki Sumida, Yasuyuki Okada, Nobunaga Watanabe, Makoto Nozawa, Masahiro Tsuruoka, Ayumu Fujimoto, Yoshihiro Okumura, Yoshiki Kitamura, Tetsuhisa Iiduka, Ryoji |
author_sort | Kandori, Kenji |
collection | PubMed |
description | BACKGROUND: Severe accidental hypothermia (AH) is life threatening. Thus, prognostic prediction in AH is essential to rapidly initiate intensive care. Several studies on prognostic factors for AH are known, but none have been established. We clarified the prognostic ability of the Sequential Organ Failure Assessment (SOFA) score in comparison with previously reported prognostic factors among patients with AH. METHODS: The J-point registry database is a multi-institutional retrospective cohort study for AH in 12 Japanese emergency departments. From this registry, we enrolled patients who were treated at the intensive care unit (ICU) in various critical care medical centers. In-hospital mortality was the primary outcome. We investigated the discrimination ability of each candidate prognostic factor and the in-hospital mortality by applying the logistic regression models with areas under the receiver operating characteristic curve (AUROC) with 95% confidence interval (CI). RESULTS: Of the 572 patients with AH registered in the J-point registry, 220 were eligible for the analyses. The in-hospital mortality was 23.2%. The AUROC of the SOFA score (0.80; 95% CI: 0.72–0.86) was the highest among all factors. The other factors were serum potassium (0.65; 95% CI: 0.55–0.73), lactate (0.67; 95% CI: 0.57–0.75), quick SOFA (qSOFA) (0.55; 95% CI: 0.46–0.65), systemic inflammatory response syndrome (SIRS) (0.60; 95% CI: 0.50–0.69), and 5A severity scale (0.77; 95% CI: 0.68–0.84). DISCUSSION: Although serum potassium and lactate had relatively good discrimination ability as mortality predictors, the SOFA score had slightly better discrimination ability. The reason is that lactate and serum potassium were mainly reflected by the hemodynamic state; conversely, the SOFA score is a comprehensive score of organ failure, basing on six different scores from the respiratory, cardiovascular, hepatic, coagulation, renal, and neurological systems. Meanwhile, the qSOFA and SIRS scores underestimated the severity, with low discrimination abilities for mortality. CONCLUSIONS: The SOFA score demonstrated better discrimination ability as a mortality predictor among all known prognostic factors in patients with AH. |
format | Online Article Text |
id | pubmed-6849316 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-68493162019-11-15 Prognostic ability of the sequential organ failure assessment score in accidental hypothermia: a multi-institutional retrospective cohort study Kandori, Kenji Okada, Yohei Matsuyama, Tasuku Morita, Sachiko Ehara, Naoki Miyamae, Nobuhiro Jo, Takaaki Sumida, Yasuyuki Okada, Nobunaga Watanabe, Makoto Nozawa, Masahiro Tsuruoka, Ayumu Fujimoto, Yoshihiro Okumura, Yoshiki Kitamura, Tetsuhisa Iiduka, Ryoji Scand J Trauma Resusc Emerg Med Original Research BACKGROUND: Severe accidental hypothermia (AH) is life threatening. Thus, prognostic prediction in AH is essential to rapidly initiate intensive care. Several studies on prognostic factors for AH are known, but none have been established. We clarified the prognostic ability of the Sequential Organ Failure Assessment (SOFA) score in comparison with previously reported prognostic factors among patients with AH. METHODS: The J-point registry database is a multi-institutional retrospective cohort study for AH in 12 Japanese emergency departments. From this registry, we enrolled patients who were treated at the intensive care unit (ICU) in various critical care medical centers. In-hospital mortality was the primary outcome. We investigated the discrimination ability of each candidate prognostic factor and the in-hospital mortality by applying the logistic regression models with areas under the receiver operating characteristic curve (AUROC) with 95% confidence interval (CI). RESULTS: Of the 572 patients with AH registered in the J-point registry, 220 were eligible for the analyses. The in-hospital mortality was 23.2%. The AUROC of the SOFA score (0.80; 95% CI: 0.72–0.86) was the highest among all factors. The other factors were serum potassium (0.65; 95% CI: 0.55–0.73), lactate (0.67; 95% CI: 0.57–0.75), quick SOFA (qSOFA) (0.55; 95% CI: 0.46–0.65), systemic inflammatory response syndrome (SIRS) (0.60; 95% CI: 0.50–0.69), and 5A severity scale (0.77; 95% CI: 0.68–0.84). DISCUSSION: Although serum potassium and lactate had relatively good discrimination ability as mortality predictors, the SOFA score had slightly better discrimination ability. The reason is that lactate and serum potassium were mainly reflected by the hemodynamic state; conversely, the SOFA score is a comprehensive score of organ failure, basing on six different scores from the respiratory, cardiovascular, hepatic, coagulation, renal, and neurological systems. Meanwhile, the qSOFA and SIRS scores underestimated the severity, with low discrimination abilities for mortality. CONCLUSIONS: The SOFA score demonstrated better discrimination ability as a mortality predictor among all known prognostic factors in patients with AH. BioMed Central 2019-11-12 /pmc/articles/PMC6849316/ /pubmed/31718708 http://dx.doi.org/10.1186/s13049-019-0681-8 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Original Research Kandori, Kenji Okada, Yohei Matsuyama, Tasuku Morita, Sachiko Ehara, Naoki Miyamae, Nobuhiro Jo, Takaaki Sumida, Yasuyuki Okada, Nobunaga Watanabe, Makoto Nozawa, Masahiro Tsuruoka, Ayumu Fujimoto, Yoshihiro Okumura, Yoshiki Kitamura, Tetsuhisa Iiduka, Ryoji Prognostic ability of the sequential organ failure assessment score in accidental hypothermia: a multi-institutional retrospective cohort study |
title | Prognostic ability of the sequential organ failure assessment score in accidental hypothermia: a multi-institutional retrospective cohort study |
title_full | Prognostic ability of the sequential organ failure assessment score in accidental hypothermia: a multi-institutional retrospective cohort study |
title_fullStr | Prognostic ability of the sequential organ failure assessment score in accidental hypothermia: a multi-institutional retrospective cohort study |
title_full_unstemmed | Prognostic ability of the sequential organ failure assessment score in accidental hypothermia: a multi-institutional retrospective cohort study |
title_short | Prognostic ability of the sequential organ failure assessment score in accidental hypothermia: a multi-institutional retrospective cohort study |
title_sort | prognostic ability of the sequential organ failure assessment score in accidental hypothermia: a multi-institutional retrospective cohort study |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6849316/ https://www.ncbi.nlm.nih.gov/pubmed/31718708 http://dx.doi.org/10.1186/s13049-019-0681-8 |
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