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"Jonghwan Shin"

Original Articles

Critical Care

A quick Sequential Organ Failure Assessment–negative result at triage is associated with low compliance with sepsis bundles: a retrospective analysis of a multicenter prospective registry
Heesu Park, Tae Gun Shin, Won Young Kim, You Hwan Jo, Yoon Jung Hwang, Sung-Hyuk Choi, Tae Ho Lim, Kap Su Han, Jonghwan Shin, Gil Joon Suh, Gu Hyun Kang, Kyung Su Kim, Korean Shock Society investigators
Clin Exp Emerg Med 2022;9(2):84-92.   Published online June 30, 2022
DOI: https://doi.org/10.15441/ceem.22.230

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A quick Sequential Organ Failure Assessment–negative result at triage is associated with low compliance with sepsis bundles: a retrospective analysis of a multicenter prospective registry
Clin Exp Emerg Med. 2022;9(2):84-92.   Published online June 30, 2022
DOI: https://doi.org/10.15441/ceem.22.230
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A quick Sequential Organ Failure Assessment–negative result at triage is associated with low compliance with sepsis bundles: a retrospective analysis of a multicenter prospective registry
Clin Exp Emerg Med. 2022;9(2):84-92.   Published online June 30, 2022
DOI: https://doi.org/10.15441/ceem.22.230
Close
Objective
We investigated the effects of a quick Sequential Organ Failure Assessment (qSOFA)–negative result (qSOFA score <2 points) at triage on the compliance with sepsis bundles among patients with sepsis who presented to the emergency department (ED).
Methods
Prospective sepsis registry data from 11 urban tertiary hospital EDs between October 2015 and April 2018 were retrospectively reviewed. Patients who met the Third International Consensus Definitions for Sepsis and Septic Shock criteria were included. Primary exposure was defined as a qSOFA score ≥2 points at ED triage. The primary outcome was defined as 3-hour bundle compliance, including lactate measurement, blood culture, broad-spectrum antibiotics administration, and 30 mL/kg crystalloid administration. Multivariate logistic regression analysis to predict 3-hour bundle compliance was performed.
Results
Among the 2,250 patients enrolled in the registry, 2,087 fulfilled the sepsis criteria. Only 31.4% (656/2,087) of the sepsis patients had qSOFA scores ≥2 points at triage. Patients with qSOFA scores <2 points had lower lactate levels, lower SOFA scores, and a lower 28-day mortality rate. Rates of compliance with lactate measurement (adjusted odds ratio [aOR], 0.47; 95% confidence interval [CI], 0.29–0.75), antibiotics administration (aOR, 0.64; 95% CI, 0.52–0.78), and 30 mL/kg crystalloid administration (aOR, 0.62; 95% CI, 0.49–0.77) within 3 hours from triage were significantly lower in patients with qSOFA scores <2 points. However, the rate of compliance with blood culture within 3 hours from triage (aOR, 1.66; 95% CI, 1.33–2.08) was higher in patients with qSOFA scores <2 points.
Conclusion
A qSOFA-negative result at ED triage is associated with low compliance with lactate measurement, broad-spectrum antibiotics administration, and 30 mL/kg crystalloid administration within 3 hours in sepsis patients.

Citations

Citations to this article as recorded by  Crossref logo
  • Red Blood Cell Transfusion Beyond Restrictive Thresholds in Patients With Septic Shock and an Elevated Lactate Level: A Multicenter Observational Study
    Kyung Hun Yoo, Gil Joon Suh, Woon Yong Kwon, Sung-Hyuk Choi, Sung Phil Chung, Won Young Kim, Kyuseok Kim, Yoo Seok Park, Tae Gun Shin, Byuk Sung Ko, Tae Ho Lim, Yongil Cho
    Journal of Korean Medical Science.2026;[Epub]     CrossRef
  • Clinical Risk Models in Emphysematous Pyelonephritis: Toward a Unified Prognostic Approach
    Erkan Arslan
    Ibnosina Journal of Medicine and Biomedical Sciences.2026; 18(01): 006.     CrossRef
  • Early prognostication of septic shock in Korean adults aged 80 years and over: serum albumin combined with Sequential Organ Failure Assessment score
    Sang-Min Kim, Seung Mok Ryoo, Woon Yong Kwon, Kyuseok Kim, Tae Ho Lim, Sung Pil Chung, Sung-Hyuk Choi, Won Young Kim
    Acute and Critical Care.2026; 41(2): 304.     CrossRef
  • Prognostic Value of the AST/ALT Ratio in Patients with Septic Shock: A Prospective, Multicenter, Registry-Based Observational Study
    Sungwoo Choi, Sangun Nah, Gil Joon Suh, Sung-Hyuk Choi, Sung Phil Chung, Won Young Kim, Tae Ho Lim, Sangchun Choi, Tae Gun Shin, Sangsoo Han
    Diagnostics.2025; 15(14): 1773.     CrossRef
  • The usefulness of lactate/albumin ratio, C-reactive protein/albumin ratio, procalcitonin/albumin ratio, SOFA, and qSOFA in predicting the prognosis of patients with sepsis who presented to EDs
    Kyung Hun Yoo, Sung-Hyuk Choi, Gil Joon Suh, Sung Phil Chung, Han Sung Choi, Yoo Seok Park, You Hwan Jo, Tae Gun Shin, Tae Ho Lim, Won Young Kim, Juncheol Lee
    The American Journal of Emergency Medicine.2024; 78: 1.     CrossRef
  • Diagnostic Accuracy of Plasma Renin Concentration and Renin Activity in Predicting Mortality and Kidney Outcomes in Patients With Septic Shock and Hypoperfusion or Hypotension: A Multicenter, Prospective, Observational Study
    Gun Tak Lee, Byuk Sung Ko, Da Seul Kim, Minha Kim, Jong Eun Park, Sung Yeon Hwang, Daun Jeong, Chi Ryang Chung, Hyunggoo Kang, Jaehoon Oh, Tae Ho Lim, Bora Chae, Won Young Kim, Tae Gun Shin
    Annals of Laboratory Medicine.2024; 44(6): 497.     CrossRef
  • Impact of Point-of-Care Lactate Testing for Sepsis on Bundle Adherence and Clinical Outcomes in the Emergency Department: A Pre–Post Observational Study
    Sukyo Lee, Juhyun Song, Sungwoo Lee, Su Jin Kim, Kap Su Han, Sijin Lee
    Journal of Clinical Medicine.2024; 13(18): 5389.     CrossRef
  • Early Mortality Stratification with Serum Albumin and the Sequential Organ Failure Assessment Score at Emergency Department Admission in Septic Shock Patients
    Sang-Min Kim, Seung-Mok Ryoo, Tae-Gun Shin, You-Hwan Jo, Kyuseok Kim, Tae-Ho Lim, Sung-Phil Chung, Sung-Hyuk Choi, Gil-Joon Suh, Won-Young Kim
    Life.2024; 14(10): 1257.     CrossRef
  • Development and derivation of bacteremia prediction model in patients with hepatobiliary infection
    Jung Won Choi, Sung-Bin Chon, Sung Yeon Hwang, Tae Gun Shin, Jong Eun Park, Kyuseok Kim
    The American Journal of Emergency Medicine.2023; 73: 102.     CrossRef
  • Prognostic accuracy of initial and 24-h maximum SOFA scores of septic shock patients in the emergency department
    Tae Han Kim, Daun Jeong, Jong Eun Park, Sung Yeon Hwang, Gil Joon Suh, Sung-Hyuk Choi, Sung Phil Chung, Won Young Kim, Gun Tak Lee, Tae Gun Shin
    Heliyon.2023; 9(9): e19480.     CrossRef
  • EARLY PREDICTION OF UNEXPECTED LATENT SHOCK IN THE EMERGENCY DEPARTMENT USING VITAL SIGNS
    Hansol Chang, Weon Jung, Juhyung Ha, Jae Yong Yu, Sejin Heo, Gun Tak Lee, Jong Eun Park, Se Uk Lee, Sung Yeon Hwang, Hee Yoon, Won Chul Cha, Tae Gun Shin, Taerim Kim
    Shock.2023; 60(3): 373.     CrossRef
  • A Simple Bacteremia Score for Predicting Bacteremia in Patients with Suspected Infection in the Emergency Department: A Cohort Study
    Hyelin Han, Da Seul Kim, Minha Kim, Sejin Heo, Hansol Chang, Gun Tak Lee, Se Uk Lee, Taerim Kim, Hee Yoon, Sung Yeon Hwang, Won Chul Cha, Min Sub Sim, Ik Joon Jo, Jong Eun Park, Tae Gun Shin
    Journal of Personalized Medicine.2023; 14(1): 57.     CrossRef
  • 9,400 View
  • 236 Download
  • 13 Web of Science
  • 12 Crossref

Resuscitation

Outcome and status of postcardiac arrest care in Korea: results from the Korean Hypothermia Network prospective registry
Soo Hyun Kim, Kyu Nam Park, Chun Song Youn, Minjung Kathy Chae, Won Young Kim, Byung Kook Lee, Dong Hoon Lee, Tae Chang Jang, Jae Hoon Lee, Yoon Hee Choi, Je Sung You, In Soo Cho, Su Jin Kim, Jong-Seok Lee, Yong Hwan Kim, Min Seob Sim, Jonghwan Shin, Yoo Seok Park, Young Hwan Lee, HyungJun Moon, Won Jung Jeong, Joo Suk Oh, Seung Pill Choi, Kyoung-Chul Cha, Korean Hypothermia Network investigators
Clin Exp Emerg Med 2020;7(4):250-258.   Published online December 31, 2020
DOI: https://doi.org/10.15441/ceem.20.035

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Outcome and status of postcardiac arrest care in Korea: results from the Korean Hypothermia Network prospective registry
Clin Exp Emerg Med. 2020;7(4):250-258.   Published online December 31, 2020
DOI: https://doi.org/10.15441/ceem.20.035
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Outcome and status of postcardiac arrest care in Korea: results from the Korean Hypothermia Network prospective registry
Clin Exp Emerg Med. 2020;7(4):250-258.   Published online December 31, 2020
DOI: https://doi.org/10.15441/ceem.20.035
Close
Objective
High-quality intensive care, including targeted temperature management (TTM) for patients with postcardiac arrest syndrome, is a key element for improving outcomes after out-of-hospital cardiac arrest (OHCA). We aimed to assess the status of postcardiac arrest syndrome care, including TTM and 6-month survival with neurologically favorable outcomes, after adult OHCA patients were treated with TTM, using data from the Korean Hypothermia Network prospective registry.
Methods
We used the Korean Hypothermia Network prospective registry, a web-based multicenter registry that includes data from 22 participating hospitals throughout the Republic of Korea. Adult comatose OHCA survivors treated with TTM between October 2015 and December 2018 were included. The primary outcome was neurological outcome at 6 months.
Results
Of the 1,354 registered OHCA survivors treated with TTM, 550 (40.6%) survived 6 months, and 413 (30.5%) had good neurological outcomes. We identified 839 (62.0%) patients with preClinsumed cardiac etiology. A total of 937 (69.2%) collapses were witnessed, shockable rhythms were demonstrated in 482 (35.6%) patients, and 421 (31.1%) patients arrived at the emergency department with prehospital return of spontaneous circulation. The most common target temperature was 33°C, and the most common target duration was 24 hours.
Conclusion
The survival and good neurologic outcome rates of this prospective registry show great improvements compared with those of an earlier registry. While the optimal target temperature and duration are still unknown, the most common target temperature was 33°C, and the most common target duration was 24 hours.

Citations

Citations to this article as recorded by  Crossref logo
  • Effects of Intrathecal Magnesium Administration on Neurologic Outcomes in a Porcine Model of Asphyxial Cardiac Arrest
    Hyoung Youn Lee, Najmiddin Mamadjonov, Wan Young Heo, Yeon Heo, Hussain Ahmad, Yong Hun Jung, Dong Hun Lee, Byung Kook Lee, Kyung Woon Jeung
    Journal of the American Heart Association.2026;[Epub]     CrossRef
  • Impact of Magnetic Field Strength (1.5 T vs. 3.0 T) on the Prognostic Value of Quantitative ADC Indices in Patients After Out-of-Hospital Cardiac Arrest: A Prospective Multicenter Observational Study in Korea (The KORHN-PRO Registry)
    Jae Hun Oh, Soo Hyun Kim, Seung Pill Choi, Se Won Oh, In Soo Cho, Yong Hwan Kim, Kyung Woon Jeung
    Journal of Clinical Medicine.2026; 15(14): 5411.     CrossRef
  • Multimodal Prediction of Progression Toward Brain Death After Out-of-Hospital Cardiac Arrest
    Jae Hun Oh, Jisu Kim, Jong Ho Zhu, Mi Kyong Kwon, Seung Pill Choi, Hyo Joon Kim, Kiwook Kim, Hwan Song, Soo Hyun Kim
    Journal of Clinical Medicine.2026; 15(14): 5751.     CrossRef
  • Relationships of Jugular Bulb Parameters with Cerebral Perfusion and Metabolism After Resuscitation from Cardiac Arrest: A Post-Hoc Analysis of Experimental Studies Using a Minipig Model
    Hyoung Youn Lee, Najmiddin Mamadjonov, Yong Hun Jung, Kyung Woon Jeung, Tae-Hoon Kim, Jin Woong Kim, Hyung Joong Kim, Jorge Antonio Gumucio, David D. Salcido
    Neurocritical Care.2025; 42(1): 261.     CrossRef
  • Prediction of good functional outcome decreases diagnostic uncertainty in unconscious survivors after out-of-hospital cardiac arrest
    Alice Lagebrant, Claudio Sandroni, Jerry P. Nolan, Jan Bělohlávek, Alain Cariou, Riccardo Carrai, Josef Dankiewicz, Anders Morten Grejs, Antonello Grippo, Christian Hassager, Janneke Horn, Matthias Haenggi, Janus C. Jakobsen, Thomas R. Keeble, Hans Kirkeg
    Resuscitation.2025; 214: 110686.     CrossRef
  • Withdrawal of life-sustaining therapies after cardiac arrest
    Jonathan Tam, Jonathan Elmer
    Current Opinion in Critical Care.2025; 31(6): 735.     CrossRef
  • Effects of withdrawal of life-sustaining therapy on long-term neurological outcome after cardiac arrest − A multicentre matched cohort study
    Alice Lagebrant, Byung Kook Lee, Chun Song Youn, Claudio Sandroni, Jan Bělohlávek, Alain Cariou, Riccardo Carrai, Josef Dankiewicz, Hans Friberg, Anders M. Grejs, Antonello Grippo, Christian Hassager, Janneke Horn, Matthias Haenggi, Janus C. Jakobsen, Tho
    Resuscitation.2025; 215: 110747.     CrossRef
  • What can we learn from international variations in withdrawal of life-sustaining therapy?
    Jonathan Tam, Jonathan Elmer
    Resuscitation.2025; 215: 110779.     CrossRef
  • High-Quality Targeted Temperature Management After Cardiac Arrest; Results from the Korean Hypothermia Network Prospective Registry
    Hyo Jin Bang, Chun Song Youn, Byung Kook Lee, Sang Hoon Oh, Hyo Joon Kim, Ae Kyung Gong, Ji-Sook Lee, Soo Hyun Kim, Kyu Nam Park, In Soo Cho
    Journal of Clinical Medicine.2025; 14(16): 5898.     CrossRef
  • Stress hyperglycemia ratio is associated with neurological outcome after cardiac arrest
    Dong Hun Lee, Byung Kook Lee, Seok Jin Ryu, Yong Hun Jung, Hyoung Youn Lee, Soo Hyun Kim, Chun Song Youn, Youn-Jung Kim, Won Young Kim, Kyung Woon Jeung
    Scientific Reports.2025;[Epub]     CrossRef
  • Explainable machine learning for neurological outcome prediction in out-of-hospital cardiac arrest survivors undergoing targeted temperature management: a multi-cohort validation study
    Oluwaseun Adebayo Bamodu, Yu-Xin Goh, Chien-Tai Hong, Po-Chih Chen, Wei-Ting Chiu, Lung Chan, Chen-Chih Chung
    Journal of NeuroEngineering and Rehabilitation.2025;[Epub]     CrossRef
  • A Systematic Literature Review to Assess Fever Management and the Quality of Targeted Temperature Management in Critically Ill Patients
    Benjamin Miao, Jeffrey R. Skaar, Matthew O'Hara, Andrew Post, Tim Kelly, Benjamin S. Abella
    Therapeutic Hypothermia and Temperature Management.2024; 14(2): 68.     CrossRef
  • Association Between Procalcitonin Level at 72 Hours After Cardiac Arrest and Neurological Outcomes in Cardiac Arrest Survivors
    Ji Ho Lee, Dong Hun Lee, Byung Kook Lee, Dong Ki Kim, Seok Jin Ryu
    Therapeutic Hypothermia and Temperature Management.2023; 13(1): 23.     CrossRef
  • A novel cardiac arrest severity score for the early prediction of hypoxic-ischemic brain injury and in-hospital death
    Hyo Jin Bang, Sang Hoon Oh, Won Jung Jeong, Kyungman Cha, Kyu Nam Park, Chun Song Youn, Han Joon Kim, Jee Yong Lim, Hyo Joon Kim, Hwan Song
    The American Journal of Emergency Medicine.2023; 66: 22.     CrossRef
  • Are serial neuron-specific enolase levels associated with neurologic outcome of ECPR patients: A retrospective multicenter observational study
    Han Bit Kim, Jeong Hoon Yang, Young Hwan Lee
    The American Journal of Emergency Medicine.2023; 69: 58.     CrossRef
  • Association between the number of prehospital defibrillation attempts and a sustained return of spontaneous circulation: a retrospective, multicentre, registry-based study
    Byuk Sung Ko, Youn-Jung Kim, Kap Su Han, You Hwan Jo, JongHwan Shin, Incheol Park, Hyunggoo Kang, Tae Ho Lim, SO Hwang, Won Young Kim
    Emergency Medicine Journal.2023; 40(6): 424.     CrossRef
  • Preliminary Prognostication for Good Neurological Outcomes in the Early Stage of Post-Cardiac Arrest Care
    Sunghyuk Lee, Jung Soo Park, Yeonho You, Jin Hong Min, Wonjoon Jeong, Hong Joon Ahn, Yong Nam In, Yong Chul Cho, In Ho Lee, Jae Kwang Lee, Changshin Kang
    Diagnostics.2023; 13(13): 2174.     CrossRef
  • Sex Difference on Neurological Outcomes and Post-Cardiac Arrest Care in Out-of-Hospital Cardiac Arrest Patients Treated with Targeted Temperature Management: Post-Hoc Study of a Prospective, Multicenter, Observational Cohort Study
    Seon Yeong Park, Sang Hoon Oh, Sang Hyun Park, Jae Hun Oh, Soo Hyun Kim
    Journal of Clinical Medicine.2023; 12(16): 5297.     CrossRef
  • Different neuroprognostication thresholds of neuron-specific enolase in shockable and non-shockable out-of-hospital cardiac arrest: a prospective multicenter observational study in Korea (the KORHN-PRO registry)
    Youn-Jung Kim, Yong Hwan Kim, Chun Song Youn, In Soo Cho, Su Jin Kim, Jung Hee Wee, Yoo Seok Park, Joo Suk Oh, Byung Kook Lee, Won Young Kim
    Critical Care.2023;[Epub]     CrossRef
  • Assessment of the Effects of Sodium Nitroprusside Administered Via Intracranial Subdural Catheters on the Cerebral Blood Flow and Lactate Using Dynamic Susceptibility Contrast Magnetic Resonance Imaging and Proton Magnetic Resonance Spectroscopy in a Pig
    Hyoung Youn Lee, Yong Hun Jung, Najmiddin Mamadjonov, Kyung Woon Jeung, Byung Kook Lee, Tae‐Hoon Kim, Hyung Joong Kim, Jorge Antonio Gumucio, David D. Salcido
    Journal of the American Heart Association.2023;[Epub]     CrossRef
  • Effect of adjuvant thiamine and ascorbic acid administration on the neurologic outcomes of out-of-hospital cardiac arrest patients: A before-and-after study
    Youn-Jung Kim, You Jin Lee, Yong Hwan Kim, Won Young Kim
    Resuscitation.2023; 193: 110018.     CrossRef
  • Rearrest during hospitalisation in adult comatose out-of-hospital cardiac arrest patients: Risk factors and prognostic impact, and predictors of favourable long-term outcomes
    Yong Hun Jung, Kyung Woon Jeung, Hyoung Youn Lee, Byung Kook Lee, Dong Hun Lee, Jonghwan Shin, Hui Jai Lee, In Soo Cho, Young-Min Kim
    Resuscitation.2022; 170: 150.     CrossRef
  • Late Awakening Is Common in Settings Without Withdrawal of Life-Sustaining Therapy in Out-of-Hospital Cardiac Arrest Survivors Who Undergo Targeted Temperature Management*
    Dong Hun Lee, Yong Soo Cho, Byung Kook Lee, Hyoung Youn Lee, Kyung Woon Jeung, Yong Hun Jung, Kyu Nam Park, Youn-Jung Kim, Minjung Kathy Chae, Dong-Woo Seo
    Critical Care Medicine.2022; 50(2): 235.     CrossRef
  • External validation of cardiac arrest-specific prognostication scores developed for early prognosis estimation after out-of-hospital cardiac arrest in a Korean multicenter cohort
    Wan Young Heo, Yong Hun Jung, Hyoung Youn Lee, Kyung Woon Jeung, Byung Kook Lee, Chun Song Youn, Seung Pill Choi, Kyu Nam Park, Yong Il Min, Muhammad Tarek Abdel Ghafar
    PLOS ONE.2022; 17(4): e0265275.     CrossRef
  • External validation of the 2020 ERC/ESICM prognostication strategy algorithm after cardiac arrest
    Chun Song Youn, Kyu Nam Park, Soo Hyun Kim, Byung Kook Lee, Tobias Cronberg, Sang Hoon Oh, Kyung Woon Jeung, In Soo Cho, Seung Pill Choi
    Critical Care.2022;[Epub]     CrossRef
  • Effects of Sodium Nitroprusside Administered Via a Subdural Intracranial Catheter on the Microcirculation, Oxygenation, and Electrocortical Activity of the Cerebral Cortex in a Pig Cardiac Arrest Model
    Hyoung Youn Lee, Yong Hun Jung, Najmiddin Mamadjonov, Kyung Woon Jeung, Min Chul Kim, Kyung Seob Lim, Chang‐Yeop Jeon, Youngjeon Lee, Hyung Joong Kim
    Journal of the American Heart Association.2022;[Epub]     CrossRef
  • The association of different target temperatures in targeted temperature management with neurological outcome after out-of-hospital cardiac arrest based on a prospective multicenter observational study in Korea (the KORHN-PRO registry): IPTW analysis
    Hyo Joon Kim, Chun Song Youn, Kyu Nam Park, Young-Min Kim, Byung Kook Lee, Kyung Woon Jeung, Won Young Kim, Seung Pill Choi, Soo Hyun Kim, Jignesh K. Patel
    PLOS ONE.2022; 17(7): e0271605.     CrossRef
  • Association between insulin administration method and six-month neurological outcome in survivors of out-of-hospital cardiac arrest who underwent targeted temperature management
    Dong Hun Lee, Byung Kook Lee, Yong Soo Cho, Yong Hun Jung, Hyoung Youn Lee, Kyung Woon Jeung, Chun Song Youn, Soo Hyun Kim, Simone Savastano
    PLOS ONE.2022; 17(12): e0279776.     CrossRef
  • Augmented-Medication CardioPulmonary Resuscitation (AMCPR) trial: a study protocol for a randomized controlled trial
    Dong Kun Oh, June-sung Kim, Seung Mok Ryoo, Youn-Jung Kim, Sang Min Kim, Seok In Hong, Bora Chae, Won Young Kim
    Clinical and Experimental Emergency Medicine.2022; 9(4): 361.     CrossRef
  • Cardiopulmonary Resuscitation and Rescue Therapies
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    Critical Care Medicine.2021; 49(9): 1375.     CrossRef
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  • 221 Download
  • 30 Web of Science
  • 30 Crossref

Critical Care

Quick Sepsis-related Organ Failure Assessment score is not sensitive enough to predict 28-day mortality in emergency department patients with sepsis: a retrospective review
Kyung Su Kim, Gil Joon Suh, Kyuseok Kim, Woon Yong Kwon, Jonghwan Shin, You Hwan Jo, Jae Hyuk Lee, Huijai Lee
Clin Exp Emerg Med 2019;6(1):77-83.   Published online March 28, 2019
DOI: https://doi.org/10.15441/ceem.17.294

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Quick Sepsis-related Organ Failure Assessment score is not sensitive enough to predict 28-day mortality in emergency department patients with sepsis: a retrospective review
Clin Exp Emerg Med. 2019;6(1):77-83.   Published online March 28, 2019
DOI: https://doi.org/10.15441/ceem.17.294
Download Citation

Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.
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Quick Sepsis-related Organ Failure Assessment score is not sensitive enough to predict 28-day mortality in emergency department patients with sepsis: a retrospective review
Clin Exp Emerg Med. 2019;6(1):77-83.   Published online March 28, 2019
DOI: https://doi.org/10.15441/ceem.17.294
Close
Objective
To test the hypothesis that the quick Sepsis-related Organ Failure Assessment (qSOFA) score, derived from vital signs taken during triage and recommended by current sepsis guidelines for screening patients with infections for organ dysfunction, is not sensitive enough to predict the risk of mortality in emergency department (ED) sepsis patients.
Methods
Patients diagnosed with severe sepsis and septic shock using the old definition between May 2014 and April 2015 were retrospectively reviewed in three urban tertiary hospital EDs. The sensitivities of systemic inflammatory response syndrome (SIRS) criteria, qSOFA, and Sequential Organ Failure Assessment (SOFA) scores ≥2 were compared using McNemar’s test. Diagnostic performances were evaluated using specificity, positive predictive value, and negative predictive value.
Results
Among the 928 patients diagnosed with severe sepsis or septic shock using the old definition, 231 (24.9%) died within 28 days. More than half of the sepsis patients (493/928, 53.1%) and more than one-third of the mortality cases (88/231, 38.1%) had a qSOFA score <2. The sensitivity of a qSOFA score ≥2 was 61.9%, which was significantly lower than the sensitivity of SIRS ≥2 (82.7%, P<0.001) and SOFA ≥2 (99.1%, P<0.001). The specificity, positive predictive value, and negative predictive value of a qSOFA score ≥2 for 28-day mortality were 58.1%, 32.9%, and 82.2%, respectively.
Conclusion
The current clinical criteria of the qSOFA are less sensitive than the SIRS assessment and SOFA to predict 28-day mortality in ED patients with sepsis.

Citations

Citations to this article as recorded by  Crossref logo
  • Performance of early warning assessment tools in predicting mortality among patients with sepsis: a systematic review and network meta-analysis
    Duo Li, Zhu Yue, Genshen Zhen
    Critical Public Health.2026;[Epub]     CrossRef
  • Assessment of the performance of early warning scores in patients with COVID-19
    Victoria Castilho Bartolomeu, Luiz Humberto Vieri Piacezzi, Karina Aparecida Lopes da Costa, Ruth Ester Assayag Batista, Cássia Regina Vancini Campanharo, Maria Carolina Barbosa Teixeira Lopes
    Revista da Escola de Enfermagem da USP.2025;[Epub]     CrossRef
  • Evaluación del desempeño de puntajes de alerta temprana en pacientes con COVID-19
    Victoria Castilho Bartolomeu, Luiz Humberto Vieri Piacezzi, Karina Aparecida Lopes da Costa, Ruth Ester Assayag Batista, Cássia Regina Vancini Campanharo, Maria Carolina Barbosa Teixeira Lopes
    Revista da Escola de Enfermagem da USP.2025;[Epub]     CrossRef
  • Avaliação do desempenho dos escores de alerta precoce em pacientes com COVID-19
    Victoria Castilho Bartolomeu, Luiz Humberto Vieri Piacezzi, Karina Aparecida Lopes da Costa, Ruth Ester Assayag Batista, Cássia Regina Vancini Campanharo, Maria Carolina Barbosa Teixeira Lopes
    Revista da Escola de Enfermagem da USP.2025;[Epub]     CrossRef
  • C-reactive Protein/Albumin Ratio as a Predictive Inflammatory Marker for Postoperative Systemic Inflammatory Response Syndrome and/or Sepsis in Polytraumatized Patients in ICU
    Ahmed S Salem, Mohamed A Zaghloul, Alfred M Boctor, Mohamed Maher Abd Elfattah, Oliver M Shehata
    Indian Journal of Critical Care Medicine.2025; 29(12): 1002.     CrossRef
  • Comparison of early warning and sepsis scores for mortality prediction in patients with suspected infection admitted to medical intensive care units
    Batuhan Başpınar, Efe Cem Erdat, Ebru Ersoy Ortaç, Arzu Topeli
    Journal of Health Sciences and Medicine.2024; 7(1): 73.     CrossRef
  • Corticosteroid sensitivity detection in sepsis patients using a personalized data mining approach: A clinical investigation
    Rahma Hellali, Zaineb Chelly Dagdia, Ahmed Ktaish, Karine Zeitouni, Djillali Annane
    Computer Methods and Programs in Biomedicine.2024; 245: 108017.     CrossRef
  • Navigating the Complexity of Scoring Systems in Sepsis Management: A Comprehensive Review
    Venkat Reddy, Harshitha Reddy, Rinkle Gemnani, Sunil Kumar, Sourya Acharya
    Cureus.2024;[Epub]     CrossRef
  • Performance of point‐of‐care severity scores to predict prognosis in patients admitted through the emergency department with COVID‐19
    Priya A. Prasad, Jessica Correia, Margaret C. Fang, Arielle Fisher, Mick Correll, Sandra Oreper, Andrew Auerbach
    Journal of Hospital Medicine.2023; 18(5): 413.     CrossRef
  • End-to-End Sepsis Solution Incorporating Expert Telemedicine Consultation
    David F. Gaieski, Brendan Carr, Melanie Toolan, Kim Ciotti, Amy Kidane, Joseph Christina, Rajesh Aggarwal
    Telemedicine and e-Health.2023; 29(11): 1679.     CrossRef
  • SIRS, SOFA, qSOFA, and NEWS in the diagnosis of sepsis and prediction of adverse outcomes: a systematic review and meta-analysis
    Xia Qiu, Yu-Peng Lei, Rui-Xi Zhou
    Expert Review of Anti-infective Therapy.2023; 21(8): 891.     CrossRef
  • Using qSOFA and SIRS scores in predicting the outcomes of patients with sepsis in Emergency Department of Menoufia University Hospitals
    Athar Fekry Lasheen, Tarek Mohey Rageh, Mahmoud Magdy Al-Abassy, Ahmed Ragab Abdo Selima
    The Egyptian Journal of Surgery.2023; 42(3): 801.     CrossRef
  • A comparison of qSOFA, SIRS and NEWS in predicting the accuracy of mortality in patients with suspected sepsis: A meta-analysis
    Can Wang, Rufu Xu, Yuerong Zeng, Yu Zhao, Xuelian Hu, Ali Rostami
    PLOS ONE.2022; 17(4): e0266755.     CrossRef
  • A quick Sequential Organ Failure Assessment–negative result at triage is associated with low compliance with sepsis bundles: a retrospective analysis of a multicenter prospective registry
    Heesu Park, Tae Gun Shin, Won Young Kim, You Hwan Jo, Yoon Jung Hwang, Sung-Hyuk Choi, Tae Ho Lim, Kap Su Han, Jonghwan Shin, Gil Joon Suh, Gu Hyun Kang, Kyung Su Kim
    Clinical and Experimental Emergency Medicine.2022; 9(2): 84.     CrossRef
  • Serum total carbon dioxide as a prognostic factor for 28-day mortality in patients with sepsis
    Jin Hee Kim, Dong-Hyun Jang, You Hwan Jo, Gil Joon Suh, Woon Yong Kwon, Jae Hyuk Lee, Jonghwan Shin, Inwon Park, Che Uk Lee, Sang-Min Lee
    The American Journal of Emergency Medicine.2021; 44: 277.     CrossRef
  • Identifying the Sickest During Triage: Using Point‐of‐Care Severity Scores to Predict Prognosis in Emergency Department Patients With Suspected Sepsis
    Priya A Prasad, Margaret C Fang, Sandra P Martinez, Kathleen D Liu, Kirsten N Kangelaris
    Journal of Hospital Medicine.2021; 16(8): 453.     CrossRef
  • Thrombo-inflammatory prognostic score improves qSOFA for risk stratification in patients with sepsis: a retrospective cohort study
    Dongze Li, Yisong Cheng, Jing Yu, Yu Jia, Bofu Liu, Yiqin Xia, Qin Zhang, Yanmei Liu, Yan Ma, Rong Yao, Zhi Zeng, Yu Cao, Shuyun Xu
    Clinical Chemistry and Laboratory Medicine (CCLM).2020; 58(4): 625.     CrossRef
  • Accuracy of the qSOFA Score and RED Sign in Predicting Critical Care Requirements in Patients with Suspected Infection in the Emergency Department: A Retrospective Observational Study
    Jong Eun Park, Sung Yeon Hwang, Ik Joon Jo, Min Seob Sim, Won Chul Cha, Hee Yoon, Tae Rim Kim, Gun Tak Lee, Hye Seung Kim, InSuk Sohn, Tae Gun Shin
    Medicina.2020; 56(1): 42.     CrossRef
  • The sensitivity of qSOFA calculated at triage and during emergency department treatment to rapidly identify sepsis patients
    Sarah M. Perman, Mark E. Mikkelsen, Munish Goyal, Adit Ginde, Abhishek Bhardwaj, Byron Drumheller, S. Cham Sante, Anish K. Agarwal, David F. Gaieski
    Scientific Reports.2020;[Epub]     CrossRef
  • Effect of propofol, midazolam and dexmedetomidine on ICU patients with sepsis and on arterial blood gas
    Jia Ding, Yuwen Chen, Yuan Gao
    Experimental and Therapeutic Medicine.2019;[Epub]     CrossRef
  • 14,765 View
  • 208 Download
  • 20 Web of Science
  • 20 Crossref

Pain Management & Sedation

Quality improvement activity for improving pain management in acute extremity injuries in the emergency department
Hyung Lan Chang, Jin Hee Jung, Young Ho Kwak, Do Kyun Kim, Jin Hee Lee, Jae Yun Jung, Hyuksool Kwon, So Hyun Paek, Joong Wan Park, Jonghwan Shin
Clin Exp Emerg Med 2018;5(1):51-59.   Published online March 30, 2018
DOI: https://doi.org/10.15441/ceem.17.260

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Quality improvement activity for improving pain management in acute extremity injuries in the emergency department
Clin Exp Emerg Med. 2018;5(1):51-59.   Published online March 30, 2018
DOI: https://doi.org/10.15441/ceem.17.260
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Quality improvement activity for improving pain management in acute extremity injuries in the emergency department
Clin Exp Emerg Med. 2018;5(1):51-59.   Published online March 30, 2018
DOI: https://doi.org/10.15441/ceem.17.260
Close
Objective
The aim of this study was to investigate the effectiveness of a quality improvement activity for pain management in patients with extremity injury in the emergency department (ED).
Methods
This was a retrospective interventional study. The patient group consisted of those at least 19 years of age who visited the ED and were diagnosed with International Classification of Diseases codes S40–S99 (extremity injuries). The quality improvement activity consisted of three measures: a survey regarding activities, education, and the triage nurse’s pain assessment, including change of pain documentation on electronic medical records. The intervention was conducted from January to April in 2014 and outcome was compared between May and August in 2013 and 2014. The primary outcome was the rate of analgesic prescription, and the secondary outcome was the time to analgesic prescription.
Results
A total of 1,739 patients were included, and 20.3% of 867 patients in the pre-intervention period, and 28.8% of 872 patients in the post-intervention period received analgesics (P< 0.001). The prescription rate of analgesics for moderate-to-severe injuries was 36.4% in 2013 and 44.5% in 2014 (P=0.026). The time to analgesics prescription was 116.6 minutes (standard deviation 225.6) in 2013 and 64 minutes (standard deviation 75.5) in 2014 for all extremity injuries. The pain scoring increased from 1.4% to 51.6%.
Conclusion
ED-based quality improvement activities including education and change of pain score documentation can improve the rate of analgesic prescription and time to prescription for patients with extremity injury in the ED.

Citations

Citations to this article as recorded by  Crossref logo
  • Time from pain assessment to opioid treatment in the Danish emergency departments—A multicenter cohort study
    Katrine H. Gull, Marianne Lisby, Sara V. Leth, Stine F. Galili
    Acta Anaesthesiologica Scandinavica.2025;[Epub]     CrossRef
  • Improving door-to-analgesia timing in musculoskeletal injuries in an academic emergency department in India: a quality improvement project
    Anuusha Sadasivam S, Aswin Kumaran, S Manu Ayyan, S N Sindujaa
    BMJ Open Quality.2024; 13(2): e002815.     CrossRef
  • Assessment of the implementation of a nurse-initiated pain management protocol in the emergency department
    Marcia Boessio dos Santos, Cristiana Maria Toscano, Ruth Ester Assayag Batista, Elena Bohomol
    Revista Brasileira de Enfermagem.2021;[Epub]     CrossRef
  • The investigation of open hand injury patients presenting to emergency department
    İsa Gökhan YALÇIN, Cihan BEDEL, Önder TOMRUK, Nesrin Gökben BECEREN, Hamit Hakan ARMAĞAN
    Journal of Health Sciences and Medicine.2018; 1(4): 75.     CrossRef
  • 11,283 View
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  • 4 Web of Science
  • 4 Crossref

Study protocol

Cardiovascular

SEALONE (Safety and Efficacy of Coronary Computed Tomography Angiography with Low Dose in Patients Visiting Emergency Room) trial: study protocol for a randomized controlled trial
Joonghee Kim, Joon-Won Kang, Kyuseok Kim, Sang Il Choi, Eun Ju Chun, Yeo Goon Kim, Won Young Kim, Dong Woo Seo, Jonghwan Shin, Huijai Lee, Kwang-Nam Jin, Soyeon Ahn, Seung Sik Hwang, Kwang Pyo Kim, Ru-Bi Jeong, Sang Ook Ha, Byungho Choi, Chang-Hwan Yoon, Jung-Won Suh, Hack-Lyoung Kim, Ju Kyoung Kim, Sujin Jang, Ji Seon Seo
Clin Exp Emerg Med 2017;4(4):208-213.   Published online December 30, 2017
DOI: https://doi.org/10.15441/ceem.17.245

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SEALONE (Safety and Efficacy of Coronary Computed Tomography Angiography with Low Dose in Patients Visiting Emergency Room) trial: study protocol for a randomized controlled trial
Clin Exp Emerg Med. 2017;4(4):208-213.   Published online December 30, 2017
DOI: https://doi.org/10.15441/ceem.17.245
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SEALONE (Safety and Efficacy of Coronary Computed Tomography Angiography with Low Dose in Patients Visiting Emergency Room) trial: study protocol for a randomized controlled trial
Clin Exp Emerg Med. 2017;4(4):208-213.   Published online December 30, 2017
DOI: https://doi.org/10.15441/ceem.17.245
Close
Objective
Chest pain is one of the most common complaints in the emergency department (ED). Cardiac computed tomography angiography (CCTA) is a frequently used tool for the early triage of patients with low- to intermediate-risk acute chest pain. We present a study protocol for a multicenter prospective randomized controlled clinical trial testing the hypothesis that a low-dose CCTA protocol using prospective electrocardiogram (ECG)-triggering and limited-scan range can provide sufficient diagnostic safety for early triage of patients with acute chest pain.
Methods
The trial will include 681 younger adult (aged 20 to 55) patients visiting EDs of three academic hospitals for acute chest pain or equivalent symptoms who require further evaluation to rule out acute coronary syndrome. Participants will be randomly allocated to either low-dose or conventional CCTA protocol at a 2:1 ratio. The low-dose group will undergo CCTA with prospective ECG-triggering and restricted scan range from sub-carina to heart base. The conventional protocol group will undergo CCTA with retrospective ECG-gating covering the entire chest. Patient disposition is determined based on computed tomography findings and clinical progression and all patients are followed for a month. The primary objective is to prove that the chance of experiencing any hard event within 30 days after a negative low-dose CCTA is less than 1%. The secondary objectives are comparisons of the amount of radiation exposure, ED length of stay and overall cost.
Results
and Conclusion Our low-dose protocol is readily applicable to current multi-detector computed tomography devices. If this study proves its safety and efficacy, dose-reduction without purchasing of expensive newer devices would be possible.
  • 10,673 View
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Original Article

Resuscitation

Outcome and current status of therapeutic hypothermia after out-of-hospital cardiac arrest in Korea using data from the Korea Hypothermia Network registry
Byung Kook Lee, Kyu Nam Park, Gu Hyun Kang, Kyung Hwan Kim, Giwoon Kim, Won Young Kim, Jin Hong Min, Yooseok Park, Jung Bae Park, Gil Joon Suh, Yoo Dong Son, Jonghwan Shin, Joo Suk Oh, Yeon Ho You, Dong Hoon Lee, Jong Seok Lee, Hoon Lim, Tae Chang Jang, Gyu Chong Cho, In Soo Cho, Kyoung Chul Cha, Seung Pill Choi, Wook Jin Choi, Chul Han, The Korean Hypothermia Network Investigators
Clin Exp Emerg Med 2014;1(1):19-27.   Published online September 30, 2014
DOI: https://doi.org/10.15441/ceem.14.007

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Outcome and current status of therapeutic hypothermia after out-of-hospital cardiac arrest in Korea using data from the Korea Hypothermia Network registry
Clin Exp Emerg Med. 2014;1(1):19-27.   Published online September 30, 2014
DOI: https://doi.org/10.15441/ceem.14.007
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Outcome and current status of therapeutic hypothermia after out-of-hospital cardiac arrest in Korea using data from the Korea Hypothermia Network registry
Clin Exp Emerg Med. 2014;1(1):19-27.   Published online September 30, 2014
DOI: https://doi.org/10.15441/ceem.14.007
Close
Objective

Therapeutic hypothermia (TH) has become the standard strategy for reducing brain damage in the postresuscitation period. The aim of this study was to investigate current TH performance and outcomes in out-of-hospital cardiac arrest (OHCA) survivors using data from the Korean Hypothermia Network (KORHN) registry.

 Methods

We used the KORHN registry, a web-based multicenter registry that includes 24 participating hospitals throughout the Republic of Korea. Adult comatose OHCA survivors treated with TH between 2007 and 2012 were included. The primary outcomes were neurological outcome at hospital discharge and in-hospital mortality. The secondary outcomes were TH performance and adverse events during TH.

 Results

A total of 930 patients were included, of whom 556 (59.8%) survived to discharge and 249 (26.8%) were discharged with good neurologic outcomes. The median time from return of spontaneous circulation (ROSC) to the start of TH was 101 minutes (interquartile range [IQR], 46 to 200 minutes). The induction, maintenance, and rewarming durations were 150 minutes (IQR, 80 to 267 minutes), 1,440 minutes (IQR, 1,290 to 1,440 minutes), and 708 minutes (IQR, 420 to 900 minutes), respectively. The time from the ROSC to coronary angiography was 1,045 hours (IQR, 121 to 12,051 hours). Hyperglycemia (46.3%) was the most frequent adverse event.

 Conclusion

More than one-quarter of the OHCA survivors (26.8%) were discharged with good neurologic outcomes. TH performance was appropriately managed in terms of the factors related to its timing, including cooling start time and rewarming duration.

Citations

Citations to this article as recorded by  Crossref logo
  • Association Between the Timing of Coronary Angiography, Targeted Temperature Management, and Neurological Outcomes After Out‐of‐Hospital Cardiac Arrest: A Nationwide Population‐Based Registry Study in Korea
    Sang Hoon Oh, Han Joon Kim, Kyu Nam Park, Chun Song Youn, Jee Yong Lim, Hyo Joon Kim, Hyo Jin Bang
    Journal of the American Heart Association.2025;[Epub]     CrossRef
  • Feasibility of Magnetic Resonance-Based Conductivity Imaging as a Tool to Estimate the Severity of Hypoxic-Ischemic Brain Injury in the First Hours After Cardiac Arrest
    Yong Hun Jung, Hyoung Youn Lee, Byung Kook Lee, Bup Kyung Choi, Tae-Hoon Kim, Jin Woong Kim, Hyun Chul Kim, Hyung Joong Kim, Kyung Woon Jeung
    Neurocritical Care.2024; 40(2): 538.     CrossRef
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    Hwan Song, Sang Hoon Oh, Hye Rim Woo
    Diagnostics.2022; 12(5): 1190.     CrossRef
  • Ultra-early neurologic outcome prediction of out-of-hospital cardiac arrest survivors using combined diffusion-weighted imaging findings and quantitative analysis of apparent diffusion coefficient
    Jung Soo Park, Yong Nam In, Yeon Ho You, Jin Hong Min, Hong Joon Ahn, In Sool Yoo, Seung Whan Kim, Jin Woong Lee, Seung Ryu, Won Joon Jeong, Yong Chul Cho, Se Kwang Oh, Sung Uk Cho, Chang Shin Kang, In Ho Lee, Byung Kook Lee, Dong Hun Lee, Dong Hoon Lee
    Resuscitation.2020; 148: 39.     CrossRef
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    Wan Jing Tay, Huihua Li, Andrew FW Ho, Ching Hui Sia, Georgina GJ Kwek, Sohil Pothiawala, Nur Shahidah, Kenneth BK Tan, Aaron SL Aaron SL Wong, Duu Wen Sewa, Eric TS Lim, Chee Tang Chin, Marcus EH Marcus EH Ong
    Annals of the Academy of Medicine, Singapore.2020; 49(3): 127.     CrossRef
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    Soo Hyun Kim, Kyu Nam Park, Chun Song Youn, Minjung Kathy Chae, Won Young Kim, Byung Kook Lee, Dong Hoon Lee, Tae Chang Jang, Jae Hoon Lee, Yoon Hee Choi, Je Sung You, In Soo Cho, Su Jin Kim, Jong-Seok Lee, Yong Hwan Kim, Min Seob Sim, Jonghwan Shin, Yoo
    Clinical and Experimental Emergency Medicine.2020; 7(4): 250.     CrossRef
  • Factors Predicting Bacterial Infection in Out-of-Hospital Cardiac Arrest Patients Undergoing Targeted Temperature Management
    Seung Mok Ryoo, Seung Joon Yoo, Joon Sung Kim, Gina Yu, Sungmin Jung, Youn-Jung Kim, Chang Hwan Sohn, Won Young Kim
    Therapeutic Hypothermia and Temperature Management.2019; 9(3): 190.     CrossRef
  • Recovery from acute kidney injury as a potent predictor of survival and good neurological outcome at discharge after out-of-hospital cardiac arrest
    Yoo Seok Park, Yoon Hee Choi, Je Hyeok Oh, In Soo Cho, Kyoung-Chul Cha, Byung-Sun Choi, Je Sung You
    Critical Care.2019;[Epub]     CrossRef
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    Je Hyeok Oh, Dong Hoon Lee, In Soo Cho, Chun Song Youn, Byung Kook Lee, Jung Hee Wee, Kyoung-Chul Cha, Minjung Kathy Chae, Jonghwan Shin
    Journal of Critical Care.2019; 54: 197.     CrossRef
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    Seung Mok Ryoo, Dong Hun Lee, Byung Kook Lee, Chun Song Youn, Youn-Jung Kim, Su Jin Kim, Yong Hwan Kim, Won Young Kim
    Journal of Clinical Medicine.2019; 8(9): 1360.     CrossRef
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    Hyung Ki Moon, Jinhee Jang, Kyu Nam Park, Soo Hyun Kim, Byung Kook Lee, Sang Hoon Oh, Kyung Woon Jeung, Seung Pill Choi, In Soo Cho, Chun Song Youn
    Resuscitation.2018; 126: 36.     CrossRef
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    Dong Hoon Lee, Sun Hwa Lee, Je Hyeok Oh, In Soo Cho, Young Hwan Lee, Chul Han, Wook Jin Choi, You Dong Sohn
    Resuscitation.2018; 128: 144.     CrossRef
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    Jeong Ho Park, Jae Hun Oh, Seung Pill Choi, Jung Hee Wee
    Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine.2018;[Epub]     CrossRef
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    Byung Kook Lee, In Soo Cho, Joo Suk Oh, Wook Jin Choi, Jung Hee Wee, Chang Sun Kim, Won Young Kim, Chun Song Youn, Salvatore De Rosa
    PLOS ONE.2018; 13(12): e0209327.     CrossRef
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    Yong Hun Jung, Byung Kook Lee, Dong Hun Lee, Sung Min Lee, Yong Soo Cho, Kyung Woon Jeung
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    Young-Min Kim, Chun Song Youn, Soo Hyun Kim, Byung Kook Lee, In Soo Cho, Gyu Chong Cho, Kyung Woon Jeung, Sang Hoon Oh, Seung Pill Choi, Jong Hwan Shin, Kyoung-Chul Cha, Joo Suk Oh, Hyeon Woo Yim, Kyu Nam Park
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    Sang Hoon Oh, Kyu Nam Park, Young-Min Shon, Young-Min Kim, Han Joon Kim, Chun Song Youn, Soo Hyun Kim, Seung Pill Choi, Seok Chan Kim
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  • 190 Download
  • 21 Web of Science
  • 23 Crossref
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CEEM : Clinical and Experimental Emergency Medicine