Predictive accuracy of biomarkers for survival among cardiac arrest patients with hypothermia: a prospective observational cohort study in Japan
Abstract Background There is limited information on the predictive accuracy of commonly used predictors, such as lactate, pH or serum potassium for the survival among out-of-hospital cardiac arrest (OHCA) patients with hypothermia. This study aimed to identify the predictive accuracy of these biomar...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2020-08-01
|
| Series: | Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13049-020-00765-2 |
| _version_ | 1818107992344625152 |
|---|---|
| author | Yohei Okada Takeyuki Kiguchi Taro Irisawa Kazuhisa Yoshiya Tomoki Yamada Koichi Hayakawa Kazuo Noguchi Tetsuro Nishimura Takuya Ishibe Yoshiki Yagi Masafumi Kishimoto Hiroshi Shintani Yasuyuki Hayashi Taku Sogabe Takaya Morooka Haruko Sakamoto Keitaro Suzuki Fumiko Nakamura Norihiro Nishioka Tasuku Matsuyama Satoshi Matsui Takeshi Shimazu Kaoru Koike Takashi Kawamura Tetsuhisa Kitamura Taku Iwami |
| author_facet | Yohei Okada Takeyuki Kiguchi Taro Irisawa Kazuhisa Yoshiya Tomoki Yamada Koichi Hayakawa Kazuo Noguchi Tetsuro Nishimura Takuya Ishibe Yoshiki Yagi Masafumi Kishimoto Hiroshi Shintani Yasuyuki Hayashi Taku Sogabe Takaya Morooka Haruko Sakamoto Keitaro Suzuki Fumiko Nakamura Norihiro Nishioka Tasuku Matsuyama Satoshi Matsui Takeshi Shimazu Kaoru Koike Takashi Kawamura Tetsuhisa Kitamura Taku Iwami |
| author_sort | Yohei Okada |
| collection | DOAJ |
| description | Abstract Background There is limited information on the predictive accuracy of commonly used predictors, such as lactate, pH or serum potassium for the survival among out-of-hospital cardiac arrest (OHCA) patients with hypothermia. This study aimed to identify the predictive accuracy of these biomarkers for survival among OHCA patients with hypothermia. Methods In this retrospective analysis, we analyzed the data from a multicenter, prospective nationwide registry among OHCA patients transported to emergency departments in Japan (the JAAM-OHCA Registry). We included all adult (≥18 years) OHCA patients with hypothermia (≤32.0 °C) who were registered from June 2014 to December 2017 and whose blood test results on hospital arrival were recorded. We calculated the predictive accuracy of pH, lactate, and potassium for 1-month survival. Results Of the 34,754 patients in the JAAM-OHCA database, we included 754 patients from 66 hospitals. The 1-month survival was 5.8% (44/754). The areas under the curve of the predictors and 95% confidence interval were as follows: pH 0.829 [0.767–0.877] and lactate 0.843 [0.793–0.882]. On setting the cutoff points of 6.9 in pH and 120 mg/dL (13.3 mmol/L) in lactate, the predictors had a high sensitivity (lactate: 0.91; pH 0.91) and a low negative likelihood ratio (lactate: 0.14; pH 0.13), which are suitable to exclude survival to 1 month. Furthermore, in additional analysis that included only the patients with potassium values available, a cutoff point of 7.0 (mmol/L) for serum potassium had high sensitivity (0.96) and a low negative likelihood ratio (0.09). Conclusion This study indicated the predictive accuracy of serum lactate, pH, and potassium for 1-month survival among adult OHCA patients with hypothermia. These biomarkers may help define a more appropriate resuscitation strategy. |
| first_indexed | 2024-12-11T02:08:16Z |
| format | Article |
| id | doaj.art-c36489880d164244b526a42ebcc4aa11 |
| institution | Directory Open Access Journal |
| issn | 1757-7241 |
| language | English |
| last_indexed | 2024-12-11T02:08:16Z |
| publishDate | 2020-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine |
| spelling | doaj.art-c36489880d164244b526a42ebcc4aa112022-12-22T01:24:20ZengBMCScandinavian Journal of Trauma, Resuscitation and Emergency Medicine1757-72412020-08-012811910.1186/s13049-020-00765-2Predictive accuracy of biomarkers for survival among cardiac arrest patients with hypothermia: a prospective observational cohort study in JapanYohei Okada0Takeyuki Kiguchi1Taro Irisawa2Kazuhisa Yoshiya3Tomoki Yamada4Koichi Hayakawa5Kazuo Noguchi6Tetsuro Nishimura7Takuya Ishibe8Yoshiki Yagi9Masafumi Kishimoto10Hiroshi Shintani11Yasuyuki Hayashi12Taku Sogabe13Takaya Morooka14Haruko Sakamoto15Keitaro Suzuki16Fumiko Nakamura17Norihiro Nishioka18Tasuku Matsuyama19Satoshi Matsui20Takeshi Shimazu21Kaoru Koike22Takashi Kawamura23Tetsuhisa Kitamura24Taku Iwami25Department of Preventive Services, School of Public HealthKyoto University Health ServicesDepartment of Traumatology and Acute Critical Medicine, Osaka University Graduate School of MedicineDepartment of Traumatology and Acute Critical Medicine, Osaka University Graduate School of MedicineEmergency and Critical Care Medical Center, Osaka Police HospitalDepartment of Emergency and Critical Care Medicine, Kansai Medical University, Takii HospitalDepartment of Emergency Medicine, Tane General HospitalDepartment of Critical Care Medicine, Osaka City UniversityDepartment of Emergency and Critical Care Medicine, Kinki University School of MedicineOsaka Mishima Emergency Critical Care CenterOsaka Prefectural Nakakawachi Medical Center of Acute MedicineSenshu Trauma and Critical Care CenterSenri Critical Care Medical Center, Saiseikai Senri HospitalTraumatology and Critical Care Medical Center, National Hospital Organization Osaka National HospitalEmergency and Critical Care Medical Center, Osaka City General HospitalDepartment of Pediatrics, Osaka Red Cross HospitalEmergency and Critical Care Medical Center, Kishiwada Tokushukai HospitalDepartment of Emergency and Critical Care Medicine, Kansai Medical UniversityDepartment of Preventive Services, School of Public HealthDepartment of Emergency Medicine, Kyoto Prefectural University of MedicineDivision of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka UniversityDepartment of Traumatology and Acute Critical Medicine, Osaka University Graduate School of MedicineDepartment of Primary care and Emergency Medicine, Graduate School of Medicine, Kyoto UniversityDepartment of Preventive Services, School of Public HealthDivision of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka UniversityDepartment of Preventive Services, School of Public HealthAbstract Background There is limited information on the predictive accuracy of commonly used predictors, such as lactate, pH or serum potassium for the survival among out-of-hospital cardiac arrest (OHCA) patients with hypothermia. This study aimed to identify the predictive accuracy of these biomarkers for survival among OHCA patients with hypothermia. Methods In this retrospective analysis, we analyzed the data from a multicenter, prospective nationwide registry among OHCA patients transported to emergency departments in Japan (the JAAM-OHCA Registry). We included all adult (≥18 years) OHCA patients with hypothermia (≤32.0 °C) who were registered from June 2014 to December 2017 and whose blood test results on hospital arrival were recorded. We calculated the predictive accuracy of pH, lactate, and potassium for 1-month survival. Results Of the 34,754 patients in the JAAM-OHCA database, we included 754 patients from 66 hospitals. The 1-month survival was 5.8% (44/754). The areas under the curve of the predictors and 95% confidence interval were as follows: pH 0.829 [0.767–0.877] and lactate 0.843 [0.793–0.882]. On setting the cutoff points of 6.9 in pH and 120 mg/dL (13.3 mmol/L) in lactate, the predictors had a high sensitivity (lactate: 0.91; pH 0.91) and a low negative likelihood ratio (lactate: 0.14; pH 0.13), which are suitable to exclude survival to 1 month. Furthermore, in additional analysis that included only the patients with potassium values available, a cutoff point of 7.0 (mmol/L) for serum potassium had high sensitivity (0.96) and a low negative likelihood ratio (0.09). Conclusion This study indicated the predictive accuracy of serum lactate, pH, and potassium for 1-month survival among adult OHCA patients with hypothermia. These biomarkers may help define a more appropriate resuscitation strategy.http://link.springer.com/article/10.1186/s13049-020-00765-2Out-of-hospital cardiac arrestHypothermiaDiagnosisPredictionPrognosis |
| spellingShingle | Yohei Okada Takeyuki Kiguchi Taro Irisawa Kazuhisa Yoshiya Tomoki Yamada Koichi Hayakawa Kazuo Noguchi Tetsuro Nishimura Takuya Ishibe Yoshiki Yagi Masafumi Kishimoto Hiroshi Shintani Yasuyuki Hayashi Taku Sogabe Takaya Morooka Haruko Sakamoto Keitaro Suzuki Fumiko Nakamura Norihiro Nishioka Tasuku Matsuyama Satoshi Matsui Takeshi Shimazu Kaoru Koike Takashi Kawamura Tetsuhisa Kitamura Taku Iwami Predictive accuracy of biomarkers for survival among cardiac arrest patients with hypothermia: a prospective observational cohort study in Japan Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine Out-of-hospital cardiac arrest Hypothermia Diagnosis Prediction Prognosis |
| title | Predictive accuracy of biomarkers for survival among cardiac arrest patients with hypothermia: a prospective observational cohort study in Japan |
| title_full | Predictive accuracy of biomarkers for survival among cardiac arrest patients with hypothermia: a prospective observational cohort study in Japan |
| title_fullStr | Predictive accuracy of biomarkers for survival among cardiac arrest patients with hypothermia: a prospective observational cohort study in Japan |
| title_full_unstemmed | Predictive accuracy of biomarkers for survival among cardiac arrest patients with hypothermia: a prospective observational cohort study in Japan |
| title_short | Predictive accuracy of biomarkers for survival among cardiac arrest patients with hypothermia: a prospective observational cohort study in Japan |
| title_sort | predictive accuracy of biomarkers for survival among cardiac arrest patients with hypothermia a prospective observational cohort study in japan |
| topic | Out-of-hospital cardiac arrest Hypothermia Diagnosis Prediction Prognosis |
| url | http://link.springer.com/article/10.1186/s13049-020-00765-2 |
| work_keys_str_mv | AT yoheiokada predictiveaccuracyofbiomarkersforsurvivalamongcardiacarrestpatientswithhypothermiaaprospectiveobservationalcohortstudyinjapan AT takeyukikiguchi predictiveaccuracyofbiomarkersforsurvivalamongcardiacarrestpatientswithhypothermiaaprospectiveobservationalcohortstudyinjapan AT taroirisawa predictiveaccuracyofbiomarkersforsurvivalamongcardiacarrestpatientswithhypothermiaaprospectiveobservationalcohortstudyinjapan AT kazuhisayoshiya predictiveaccuracyofbiomarkersforsurvivalamongcardiacarrestpatientswithhypothermiaaprospectiveobservationalcohortstudyinjapan AT tomokiyamada predictiveaccuracyofbiomarkersforsurvivalamongcardiacarrestpatientswithhypothermiaaprospectiveobservationalcohortstudyinjapan AT koichihayakawa predictiveaccuracyofbiomarkersforsurvivalamongcardiacarrestpatientswithhypothermiaaprospectiveobservationalcohortstudyinjapan AT kazuonoguchi predictiveaccuracyofbiomarkersforsurvivalamongcardiacarrestpatientswithhypothermiaaprospectiveobservationalcohortstudyinjapan AT tetsuronishimura predictiveaccuracyofbiomarkersforsurvivalamongcardiacarrestpatientswithhypothermiaaprospectiveobservationalcohortstudyinjapan AT takuyaishibe predictiveaccuracyofbiomarkersforsurvivalamongcardiacarrestpatientswithhypothermiaaprospectiveobservationalcohortstudyinjapan AT yoshikiyagi predictiveaccuracyofbiomarkersforsurvivalamongcardiacarrestpatientswithhypothermiaaprospectiveobservationalcohortstudyinjapan AT masafumikishimoto predictiveaccuracyofbiomarkersforsurvivalamongcardiacarrestpatientswithhypothermiaaprospectiveobservationalcohortstudyinjapan AT hiroshishintani predictiveaccuracyofbiomarkersforsurvivalamongcardiacarrestpatientswithhypothermiaaprospectiveobservationalcohortstudyinjapan AT yasuyukihayashi predictiveaccuracyofbiomarkersforsurvivalamongcardiacarrestpatientswithhypothermiaaprospectiveobservationalcohortstudyinjapan AT takusogabe predictiveaccuracyofbiomarkersforsurvivalamongcardiacarrestpatientswithhypothermiaaprospectiveobservationalcohortstudyinjapan AT takayamorooka predictiveaccuracyofbiomarkersforsurvivalamongcardiacarrestpatientswithhypothermiaaprospectiveobservationalcohortstudyinjapan AT harukosakamoto predictiveaccuracyofbiomarkersforsurvivalamongcardiacarrestpatientswithhypothermiaaprospectiveobservationalcohortstudyinjapan AT keitarosuzuki predictiveaccuracyofbiomarkersforsurvivalamongcardiacarrestpatientswithhypothermiaaprospectiveobservationalcohortstudyinjapan AT fumikonakamura predictiveaccuracyofbiomarkersforsurvivalamongcardiacarrestpatientswithhypothermiaaprospectiveobservationalcohortstudyinjapan AT norihironishioka predictiveaccuracyofbiomarkersforsurvivalamongcardiacarrestpatientswithhypothermiaaprospectiveobservationalcohortstudyinjapan AT tasukumatsuyama predictiveaccuracyofbiomarkersforsurvivalamongcardiacarrestpatientswithhypothermiaaprospectiveobservationalcohortstudyinjapan AT satoshimatsui predictiveaccuracyofbiomarkersforsurvivalamongcardiacarrestpatientswithhypothermiaaprospectiveobservationalcohortstudyinjapan AT takeshishimazu predictiveaccuracyofbiomarkersforsurvivalamongcardiacarrestpatientswithhypothermiaaprospectiveobservationalcohortstudyinjapan AT kaorukoike predictiveaccuracyofbiomarkersforsurvivalamongcardiacarrestpatientswithhypothermiaaprospectiveobservationalcohortstudyinjapan AT takashikawamura predictiveaccuracyofbiomarkersforsurvivalamongcardiacarrestpatientswithhypothermiaaprospectiveobservationalcohortstudyinjapan AT tetsuhisakitamura predictiveaccuracyofbiomarkersforsurvivalamongcardiacarrestpatientswithhypothermiaaprospectiveobservationalcohortstudyinjapan AT takuiwami predictiveaccuracyofbiomarkersforsurvivalamongcardiacarrestpatientswithhypothermiaaprospectiveobservationalcohortstudyinjapan |