The development and validation of a “5A” severity scale for predicting in-hospital mortality after accidental hypothermia from J-point registry data
Abstract Background Accidental hypothermia is a serious condition that requires immediate and accurate assessment to determine severity and treatment. Currently, accidental hypothermia is evaluated using the Swiss grading system which uses core body temperature and clinical findings; however, resear...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2019-05-01
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| Series: | Journal of Intensive Care |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s40560-019-0384-2 |
| _version_ | 1818776325719064576 |
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| author | Yohei Okada Tasuku Matsuyama Sachiko Morita Naoki Ehara Nobuhiro Miyamae Takaaki Jo Yasuyuki Sumida Nobunaga Okada Makoto Watanabe Masahiro Nozawa Ayumu Tsuruoka Yoshihiro Fujimoto Yoshiki Okumura Tetsuhisa Kitamura Shungo Yamamoto Ryoji Iiduka Kaoru Koike |
| author_facet | Yohei Okada Tasuku Matsuyama Sachiko Morita Naoki Ehara Nobuhiro Miyamae Takaaki Jo Yasuyuki Sumida Nobunaga Okada Makoto Watanabe Masahiro Nozawa Ayumu Tsuruoka Yoshihiro Fujimoto Yoshiki Okumura Tetsuhisa Kitamura Shungo Yamamoto Ryoji Iiduka Kaoru Koike |
| author_sort | Yohei Okada |
| collection | DOAJ |
| description | Abstract Background Accidental hypothermia is a serious condition that requires immediate and accurate assessment to determine severity and treatment. Currently, accidental hypothermia is evaluated using the Swiss grading system which uses core body temperature and clinical findings; however, research has shown that core body temperature is not associated with in-hospital mortality in urban settings. Therefore, we developed and validated a severity scale for predicting in-hospital mortality among urban Japanese patients with accidental hypothermia. Methods Data for this multi-center retrospective cohort study were obtained from the J-point registry. We included patients with accidental hypothermia who were admitted to an emergency department. The total cohort was divided into a development cohort and validation cohort, based on the location of each institution. We developed a logistic regression model for predicting in-hospital mortality using the development cohort and assessed its internal validity using bootstrapping. The model was then subjected to external validation using the validation cohorts. Results Among the 572 patients in the J-point registry, 532 were ultimately included and divided into the development cohort (N = 288, six hospitals, in-hospital mortality 22.0%) and the validation cohort (N = 244, six hospitals, in-hospital mortality 27.0%). The 5 “A” scoring system based on age, activities-of-daily-living status, near arrest, acidemia, and serum albumin level was developed based on the variables’ coefficients in the development cohort. In the validation cohort, the prediction performance was validated. Conclusion Our “5A” severity scoring system could accurately predict the risk of in-hospital mortality among patients with accidental hypothermia. |
| first_indexed | 2024-12-18T11:11:09Z |
| format | Article |
| id | doaj.art-1d56175f3065430e9f434a15d1829ad2 |
| institution | Directory Open Access Journal |
| issn | 2052-0492 |
| language | English |
| last_indexed | 2024-12-18T11:11:09Z |
| publishDate | 2019-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Intensive Care |
| spelling | doaj.art-1d56175f3065430e9f434a15d1829ad22022-12-21T21:10:00ZengBMCJournal of Intensive Care2052-04922019-05-01711910.1186/s40560-019-0384-2The development and validation of a “5A” severity scale for predicting in-hospital mortality after accidental hypothermia from J-point registry dataYohei Okada0Tasuku Matsuyama1Sachiko Morita2Naoki Ehara3Nobuhiro Miyamae4Takaaki Jo5Yasuyuki Sumida6Nobunaga Okada7Makoto Watanabe8Masahiro Nozawa9Ayumu Tsuruoka10Yoshihiro Fujimoto11Yoshiki Okumura12Tetsuhisa Kitamura13Shungo Yamamoto14Ryoji Iiduka15Kaoru Koike16Department of Primary Care and Emergency Medicine, Graduate School of Medicine, Kyoto UniversityDepartment of Emergency Medicine, Kyoto Prefectural University of MedicineSenri Critical Care Medical Center, Saiseikai Senri HospitalDepartment of Emergency, Japanese Red Cross Society, Kyoto Daiichi Red Cross HospitalDepartment of Emergency Medicine, Rakuwa-kai Otowa HospitalDepartment of Emergency Medicine, Uji-Tokushukai Medical CenterDepartment of Emergency Medicine, North Medical Center, Kyoto Prefectural University of MedicineDepartment of Emergency Medicine, Kyoto Prefectural University of MedicineDepartment of Emergency Medicine, Kyoto Prefectural University of MedicineDepartment of Emergency and Critical Care Medicine, Saiseikai Shiga HospitalDepartment of Emergency and Critical Care Medicine, Kyoto Min-Iren Chuo HospitalDepartment of Emergency Medicine, Yodogawa Christian HospitalDepartment of Emergency Medicine, Fukuchiyama City HospitalDivision of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka UniversityDepartment of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto UniversityDepartment of Emergency and Critical Care Medicine, Japanese Red Cross Society, Kyoto Daini HospitalDepartment of Primary Care and Emergency Medicine, Graduate School of Medicine, Kyoto UniversityAbstract Background Accidental hypothermia is a serious condition that requires immediate and accurate assessment to determine severity and treatment. Currently, accidental hypothermia is evaluated using the Swiss grading system which uses core body temperature and clinical findings; however, research has shown that core body temperature is not associated with in-hospital mortality in urban settings. Therefore, we developed and validated a severity scale for predicting in-hospital mortality among urban Japanese patients with accidental hypothermia. Methods Data for this multi-center retrospective cohort study were obtained from the J-point registry. We included patients with accidental hypothermia who were admitted to an emergency department. The total cohort was divided into a development cohort and validation cohort, based on the location of each institution. We developed a logistic regression model for predicting in-hospital mortality using the development cohort and assessed its internal validity using bootstrapping. The model was then subjected to external validation using the validation cohorts. Results Among the 572 patients in the J-point registry, 532 were ultimately included and divided into the development cohort (N = 288, six hospitals, in-hospital mortality 22.0%) and the validation cohort (N = 244, six hospitals, in-hospital mortality 27.0%). The 5 “A” scoring system based on age, activities-of-daily-living status, near arrest, acidemia, and serum albumin level was developed based on the variables’ coefficients in the development cohort. In the validation cohort, the prediction performance was validated. Conclusion Our “5A” severity scoring system could accurately predict the risk of in-hospital mortality among patients with accidental hypothermia.http://link.springer.com/article/10.1186/s40560-019-0384-2Environmental emergencyAccidental hypothermiaCardiac arrest |
| spellingShingle | Yohei Okada Tasuku Matsuyama Sachiko Morita Naoki Ehara Nobuhiro Miyamae Takaaki Jo Yasuyuki Sumida Nobunaga Okada Makoto Watanabe Masahiro Nozawa Ayumu Tsuruoka Yoshihiro Fujimoto Yoshiki Okumura Tetsuhisa Kitamura Shungo Yamamoto Ryoji Iiduka Kaoru Koike The development and validation of a “5A” severity scale for predicting in-hospital mortality after accidental hypothermia from J-point registry data Journal of Intensive Care Environmental emergency Accidental hypothermia Cardiac arrest |
| title | The development and validation of a “5A” severity scale for predicting in-hospital mortality after accidental hypothermia from J-point registry data |
| title_full | The development and validation of a “5A” severity scale for predicting in-hospital mortality after accidental hypothermia from J-point registry data |
| title_fullStr | The development and validation of a “5A” severity scale for predicting in-hospital mortality after accidental hypothermia from J-point registry data |
| title_full_unstemmed | The development and validation of a “5A” severity scale for predicting in-hospital mortality after accidental hypothermia from J-point registry data |
| title_short | The development and validation of a “5A” severity scale for predicting in-hospital mortality after accidental hypothermia from J-point registry data |
| title_sort | development and validation of a 5a severity scale for predicting in hospital mortality after accidental hypothermia from j point registry data |
| topic | Environmental emergency Accidental hypothermia Cardiac arrest |
| url | http://link.springer.com/article/10.1186/s40560-019-0384-2 |
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