J Korean Soc Emerg Med.
2017 Oct;28(5):475-483. 10.0000/jksem.2017.28.5.475.
Early Predictors of Critical Cases for the Patients Who Visited Emergency Department due to Gas Inhalation: Early Predictors of Severity in Gas Inhalation
- Affiliations
-
- 1Department of Emergency Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea. uuh0729166@hanmail.net
- KMID: 2394396
- DOI: http://doi.org/10.0000/jksem.2017.28.5.475
Abstract
- PURPOSE
To define early predictors of critical cases involving patients who visited the emergency department (ED) due to gas inhalation, with the goal of identifying patients who require intensive monitoring and treatment.
METHODS
The retrospective study was carried out for patients who visited the ED at Ulsan University Hospital due to gas inhalation from March 2014 to February 2016. General demographics, mechanism of accident, critical symptoms, vital signs, blood lab test results, severity, and clinical manifestation were investigated. Patients were divided into a critical group and non-critical group, and predictors of critical cases were investigated by comparing both groups.
RESULTS
Of the 180 patients, 26 patients were in the critical group. In this group, more patients displayed altered mentality and cardiac arrest (both p<0.001). The critical group also showed significantly higher fractions for low-blood pressure (systolic blood pressure<90 mmHg; p<0.001), number of critical symptoms (p<0.001), transport by emergency medical services (p=0.003), and consultation involving other departments (p<0.001). Patients in the critical group showed higher Korean Triage and Acuity Scale (KTAS) level (p<0.001), lactate value (p=0.001), and carboxy-hemoglobin value (p=0.017) as well as older age (p=0.001), lower pH (p=0.001), and HCO₃⻠value (p<0.001). Multiple regression analysis revealed that predictors of critical cases were older age and higher KTAS level (both p<0.001).
CONCLUSION
Patients admitted to the ED for treatment of gas inhalation, who were older and had a higher KTAS level, require intensive monitoring and treatment.
