Korean J Crit Care Med.  2011 Jun;26(2):57-63. 10.4266/kjccm.2011.26.2.57.

Prognostic Factors for Mortality in Emergency Department Patients with Hypotension

Affiliations
  • 1Department of Emergency Medicine, Pusan Paik Hospital, Inje University, Busan, Korea.
  • 2Department of Emergency Medicine, Bundang Jesaeng General Hospital, Seongnam, Korea. rocky66@dmc.or.kr
  • 3Department of Neuro-surgery, Bundang Jesaeng General Hospital, Seongnam, Korea.
  • 4Department of Thoracic-surgery, Bundang Jesaeng General Hospital, Seongnam, Korea.
  • 5Department of Neurology, Bundang Jesaeng General Hospital, Seongnam, Korea.

Abstract

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.

Keyword

anion gap; central venous oxygen saturation; corrected anion gap; lactate

MeSH Terms

Acid-Base Equilibrium
Area Under Curve
Arterial Pressure
Blood Gas Analysis
Blood Pressure
Body Temperature
Electrolytes
Emergencies
Follow-Up Studies
Heart Rate
Humans
Hypotension
Lactic Acid
Oxygen
Respiratory Rate
Electrolytes
Lactic Acid
Oxygen
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