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"Joonghee Kim"

Original Articles

Cardiovascular | AI & Digital Health

Interethnic validation of electrocardiogram image analysis software for detecting left ventricular dysfunction in an emergency department population
Haemin Lee, Woon Yong Kwon, Kyoung Jun Song, You Hwan Jo, Joonghee Kim, Youngjin Cho, Ji Eun Hwang, Yeongho Choi
Clin Exp Emerg Med 2025;12(3):235-241.   Published online April 30, 2025
DOI: https://doi.org/10.15441/ceem.24.342

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Interethnic validation of electrocardiogram image analysis software for detecting left ventricular dysfunction in an emergency department population
Clin Exp Emerg Med. 2025;12(3):235-241.   Published online April 30, 2025
DOI: https://doi.org/10.15441/ceem.24.342
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Interethnic validation of electrocardiogram image analysis software for detecting left ventricular dysfunction in an emergency department population
Clin Exp Emerg Med. 2025;12(3):235-241.   Published online April 30, 2025
DOI: https://doi.org/10.15441/ceem.24.342
Close
Objective
We previously developed and validated an artificial intelligence-based electrocardiogram (ECG) analysis tool (ECG Buddy) in a Korean population. This study investigated the performance of this tool in a US population, specifically assessing the left ventricular (LV) dysfunction score and LV ejection fraction (LVEF)-ECG feature for predicting LVEF <40%. The study used N-terminal pro-B-type natriuretic peptide (NT-ProBNP) as a comparator.
Methods
We identified emergency department (ED) visits from the MIMIC-IV dataset with information on LVEF <40% or ≥40% and matched 12-lead ECG data recorded within 48 hours of the ED visit. The performance of ECG Buddy’s LV dysfunction score and the LVEF-ECG feature was compared with those of NT-ProBNP using area under the receiver operating characteristic curve (AUC) analysis.
Results
A total of 22,599 ED visits was analyzed. The LV dysfunction score had an AUC of 0.905 (95% confidence interval [CI], 0.899–0.910), with a sensitivity of 85.4% and specificity of 80.8%. The LVEF-ECG feature had an AUC of 0.908 (95% CI, 0.902–0.913), sensitivity of 83.5%, and specificity of 83.0%. NT-ProBNP had an AUC of 0.740 (95% CI, 0.727–0.752), with a sensitivity of 74.8% and specificity of 62.0%. The ECG-based predictors demonstrated superior diagnostic performance compared to NT-ProBNP (all P<0.001). In the sinus rhythm subgroup, the LV dysfunction score achieved an AUC of 0.913 and LVEF-ECG had an AUC of 0.917, both outperforming NT-ProBNP (AUC, 0.748; 95% CI, 0.732–0.763; all P<0.001).
Conclusion
ECG Buddy demonstrated superior accuracy compared with NT-ProBNP in predicting LV systolic dysfunction, validating its utility in a US ED population.

Citations

Citations to this article as recorded by  Crossref logo
  • Screening for Left Ventricular Dysfunction in Sepsis Using a Smartphone ECG Analysis Application: A Multicenter Validation Study
    Yun Seong Park, Joonghee Kim, You Hwan Jo, Woon Yong Kwon, Kyoung Jun Song, Hui Jai Lee, Youngjin Cho, Ji Eun Hwang
    Journal of Korean Medical Science.2026;[Epub]     CrossRef
  • Emerging Artificial Intelligence Tools for the Screening of Structural and Valvular Heart Disease
    Yasmine Abbaoui, Alexis Nolin-Lapalme, Julianne Morisset, Ines El Adib, Philippe Genereux, Timothy J. Poterucha, Pierre Elias, Xioaxi Yao, Robert Avram
    Current Heart Failure Reports.2026;[Epub]     CrossRef
  • 3,715 View
  • 102 Download
  • 1 Web of Science
  • 2 Crossref

Neurology

Risk of injury after emergency department visit for acute peripheral vertigo: a matched-cohort study
Hayoung Kim, Sihyoung Lee, Joonghee Kim
Clin Exp Emerg Med 2020;7(3):176-182.   Published online September 30, 2020
DOI: https://doi.org/10.15441/ceem.19.064

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Risk of injury after emergency department visit for acute peripheral vertigo: a matched-cohort study
Clin Exp Emerg Med. 2020;7(3):176-182.   Published online September 30, 2020
DOI: https://doi.org/10.15441/ceem.19.064
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Risk of injury after emergency department visit for acute peripheral vertigo: a matched-cohort study
Clin Exp Emerg Med. 2020;7(3):176-182.   Published online September 30, 2020
DOI: https://doi.org/10.15441/ceem.19.064
Close
Objective
Peripheral vertigo is one of the most common causes of the emergency department (ED) visits. It can impair balance and might predispose patients to injuries after discharge. The purpose of this study was to determine whether peripheral vertigo is associated with an increased risk of trauma.
Methods
This matched-cohort study used the nationally representative dataset of de-identified claim information of 1 million randomly sampled individuals from a real Korean population, from 2002 to 2013. The exposure cohort included patients who visited EDs for new-onset peripheral vertigo without prior or concurrent injury. Each patient was randomly matched to five unexposed individuals (also without previous injury) by incidence density sampling. The primary outcome was a new injury within 1 year. The secondary outcomes were various injury subtypes. The time-dependent effect of the exposure was modeled using the extended Cox model. Age, sex, comorbidities, and household income level were included as covariates.
Results
A total of 776 and 3,880 individuals were included as the exposure and comparison cohorts, respectively. The risks of trunk injury and upper extremity injury were significantly higher in the exposure cohort. Extended Cox models with multivariable adjustment showed significantly increased risk for up to 1 year, with the first 1-month; 1 month to 3 months; and 3 months to 1 year hazard ratios of 5.23 (95% confidence interval [CI], 2.83–9.64); 1.50 (95% CI, 1.02–2.20); and 1.37 (95% CI, 1.11–1.68), respectively.
Conclusion
Patients visiting EDs for acute peripheral vertigo are at a higher risk of a new injury for up to a year.

Citations

Citations to this article as recorded by  Crossref logo
  • Association Between Sleep and Vertigo Severity in Benign Paroxysmal Positional Vertigo: Mediating Role of Psychological Factors
    Juanli Xing, Xinyu Xu, Hongying Shan, Jiaqian Wu, Peiyu Liu, Wenyan Shi, Peihua Ren, JinLing Liu, Yuge Huang, Baibing Mi
    Nature and Science of Sleep.2025; Volume 17: 1477.     CrossRef
  • Incidence of Subsequent Injuries Associated with a New Diagnosis of Benign Paroxysmal Positional Vertigo and Effects of Treatment: A Nationwide Cohort Study
    Jhen-Jie Mao, Hung-Che Lin, Shih-Tsang Lin, Po-Cheng Lin, Ching-Hsiang Chang, Wu-Chien Chien, Chi-Hsiang Chung, Ying-Jiin Chen, Jeng-Wen Chen
    Journal of Clinical Medicine.2024; 13(15): 4561.     CrossRef
  • Increased Risk of Injury in Ménière's Disease and Effects of Treatment: Population‐Based Retrospective Cohort Study
    Po‐Ling Wu, Hung‐Che Lin, Wu‐Chien Chien, Chi‐Hsiang Chung, Jeng‐Wen Chen
    Otolaryngology–Head and Neck Surgery.2023; 168(3): 443.     CrossRef
  • Use of Physical Therapy and Subsequent Falls Among Patients With Dizziness in the US
    Schelomo Marmor, Pinar Karaca-Mandic, Meredith E. Adams
    JAMA Otolaryngology–Head & Neck Surgery.2023; 149(12): 1083.     CrossRef
  • Effects of customized vestibular rehabilitation plus canalith repositioning maneuver on gait and balance in adults with Benign Paroxysmal Positional Vertigo: A Randomized Controlled Trial
    Phui Lin Se To, Devinder Kaur Ajit Singh, Susan L. Whitney
    Journal of Vestibular Research.2022; 32(1): 79.     CrossRef
  • Vestibular Rehabilitation for Peripheral Vestibular Hypofunction: An Updated Clinical Practice Guideline From the Academy of Neurologic Physical Therapy of the American Physical Therapy Association
    Courtney D. Hall, Susan J. Herdman, Susan L. Whitney, Eric R. Anson, Wendy J. Carender, Carrie W. Hoppes, Stephen P. Cass, Jennifer B. Christy, Helen S. Cohen, Terry D. Fife, Joseph M. Furman, Neil T. Shepard, Richard A. Clendaniel, J. Donald Dishman, Joe
    Journal of Neurologic Physical Therapy.2022; 46(2): 118.     CrossRef
  • Occlusion of two semicircular canals does not disrupt normal hearing in adult mice
    Tianying Wang, Huizhan Liu, David Z. He, Yi Li
    Frontiers in Neurology.2022;[Epub]     CrossRef
  • Immersive Technologies for Vestibular Rehabilitation
    Emanuel Pereira, Bruno Ferreira, Ana Margarida Amorim, Paulo Menezes
    International Journal of Creative Interfaces and Computer Graphics.2022; 13(1): 1.     CrossRef
  • 7,854 View
  • 136 Download
  • 7 Web of Science
  • 8 Crossref

Critical Care | Epidemiology

Epidemiology of sepsis in Korea: a population-based study of incidence, mortality, cost and risk factors for death in sepsis
Joonghee Kim, Kyuseok Kim, Heeyoung Lee, Soyeon Ahn
Clin Exp Emerg Med 2019;6(1):49-63.   Published online February 20, 2019
DOI: https://doi.org/10.15441/ceem.18.007

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Epidemiology of sepsis in Korea: a population-based study of incidence, mortality, cost and risk factors for death in sepsis
Clin Exp Emerg Med. 2019;6(1):49-63.   Published online February 20, 2019
DOI: https://doi.org/10.15441/ceem.18.007
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Epidemiology of sepsis in Korea: a population-based study of incidence, mortality, cost and risk factors for death in sepsis
Clin Exp Emerg Med. 2019;6(1):49-63.   Published online February 20, 2019
DOI: https://doi.org/10.15441/ceem.18.007
Close
Objective
To investigate the epidemiology of sepsis in Korea and identify risk factors for death in sepsis.
Methods
We conducted a longitudinal, population-based epidemiological study of sepsis in Korea from 2005 to 2012 using the National Health Insurance Service-National Sample Cohort, a population-based cohort representing 2.2% of the Korean population. The primary objective was to assess the incidence, mortality and cost of sepsis. The secondary objective was to identify the risk factors for death in sepsis. Claim records of admitted adult patients (aged ≥15 years) were analyzed. Sepsis was defined as 1) bacterial or fungal infection or the conditions they often complicate, 2) prescription of intravenous antibiotics, and 3) presence of any organ dysfunction. Comorbidities were defined using the Charlson/Deyo method. Risk factors for 6-month mortality were assessed using multivariable logistic regression.
Results
A total of 22,882 cases were identified. Both incidence and 6-month mortality increased from 265.7 (95% confidence interval [CI], 254.7 to 277.1) to 453.1 (95% CI, 439.0 to 467.5) per 100,000 person-years (P-trend <0.001) and from 26.5% (95% CI, 24.4% to 28.8%) to 30.1% (95% CI, 28.4% to 31.9%), respectively. After standardization, the increasing trend of incidence was slower but still significant (P-trend <0.001), while that for mortality was not (P-trend 0.883). The average cost increased by 75.5% (P-trend <0.001). Multivariable logistic regression identified various risk factors for mortality.
Conclusion
The burden of sepsis in Korea was high and is expected to increase considering the aging population. Proactive measures to curtail this increase should be sought and implemented.

Citations

Citations to this article as recorded by  Crossref logo
  • Age–Comorbidity Interactions and Clinical Outcomes in Septic Shock: An Emergency Department-Based Multicenter Cohort Study
    Seung Jin Maeng, Jong Eun Park, Gun Tak Lee, Sung Yeon Hwang, Minha Kim, Sejin Heo, Tae Ho Lim, Sung Phil Chung, Sung-Hyuk Choi, Tae Gun Shin
    Healthcare.2026; 14(6): 722.     CrossRef
  • Evaluation of serum amyloid A as a biomarker for sepsis diagnosis compared with C-reactive protein, procalcitonin, and presepsin
    Myeong Hee Kim, So Young Kang, Woo-In Lee, Min Young Lee
    Laboratory Medicine.2026;[Epub]     CrossRef
  • Urinary biomarkers for diagnosing acute kidney injury in sepsis in the emergency department
    Sumin Baek, Inwon Park, Seonghye Kim, Young Woo Um, Hee Eun Kim, Kyunghoon Lee, Jae Hyuk Lee, You Hwan Jo
    Heliyon.2025; 11(1): e41252.     CrossRef
  • Population Sepsis Incidence, Mortality, and Trends in Hong Kong Between 2009 and 2018 Using Clinical and Administrative Data
    Lowell Ling, Jack Zhenhe Zhang, Lok Ching Chang, Lok Ching Sandra Chiu, Samantha Ho, Pauline Yeung Ng, Manimala Dharmangadan, Chi Ho Lau, Steven Ling, Man Yee Man, Ka Man Fong, Ting Liong, Alwin Wai Tak Yeung, Gary Ka Fai Au, Jacky Ka Hing Chan, Michele T
    Clinical Infectious Diseases.2025; 80(1): 91.     CrossRef
  • The impact of withholding and withdrawal life-sustaining treatment issues on patients with sepsis: a prospective, nationwide, multicenter cohort study
    So-yun Kim, Da Hyun Kang, Hyekyeong Ju, Dong Kyu Oh, Su Yeon Lee, Mi Hyeon Park, Chae-Man Lim, Song I Lee, Chae-Man Lim, Sang-Bum Hong, Dong Kyu Oh, Su Yeon Lee, Gee Young Suh, Kyeongman Jeon, Ryoung-Eun Ko, Young-Jae Cho, Yeon Joo Lee, Sung Yoon Lim, Sun
    Scientific Reports.2025;[Epub]     CrossRef
  • Epidemiology of sepsis in emergency departments: insights from the National Emergency Department Information System (NEDIS) database in Korea, 2018–2022
    Tae Gun Shin, Eunsil Ko, So-hyun Han, Taehui Kim, Dai Hai Choi
    Clinical and Experimental Emergency Medicine.2025; 12(3): 185.     CrossRef
  • C-reactive protein and procalcitonin during course of sepsis and septic shock
    Tobias Schupp, Kathrin Weidner, Jonas Rusnak, Schanas Jawhar, Jan Forner, Floriana Dulatahu, Jonas Dudda, Lea Marie Brück, Ursula Hoffmann, Thomas Bertsch, Ibrahim Akin, Michael Behnes
    Irish Journal of Medical Science (1971 -).2024; 193(1): 457.     CrossRef
  • Previously healthy adults among septic patients: Population-level epidemiology and outcomes
    Lavi Oud, John Garza
    Journal of Critical Care.2024; 79: 154427.     CrossRef
  • Predicting septic shock in patients with sepsis at emergency department triage using systolic and diastolic shock index
    Yumin Jeon, Sungjin Kim, Sejoong Ahn, Jong-Hak Park, Hanjin Cho, Sungwoo Moon, Sukyo Lee
    The American Journal of Emergency Medicine.2024; 78: 196.     CrossRef
  • Sepsis in Latvia—Incidence, Outcomes, and Healthcare Utilization: A Retrospective, Observational Study
    Laura Puceta, Artis Luguzis, Uga Dumpis, Guna Dansone, Natalija Aleksandrova, Juris Barzdins
    Healthcare.2024; 12(2): 272.     CrossRef
  • The Relation Between Cigarette Smoking and Development of Sepsis: A 10-Year Follow-Up Study of Four Million Adults from the National Health Screening Program
    Eun Hwa Lee, Kyoung Hwa Lee, Kyu-na Lee, Yebin Park, Kyung Do Han, Sang Hoon Han
    Journal of Epidemiology and Global Health.2024; 14(2): 444.     CrossRef
  • Sex or gender differences in treatment outcomes of sepsis and septic shock
    Seung Yeon Min, Ho Jin Yong, Dohhyung Kim
    Acute and Critical Care.2024; 39(2): 207.     CrossRef
  • Sex differences in in-hospital management in patients with sepsis and septic shock: a prospective multicenter observational study
    Sejoong Ahn, Bo-Yeong Jin, Sukyo Lee, Sungjin Kim, Sungwoo Moon, Hanjin Cho, Kap Su Han, You Hwan Jo, Kyuseok Kim, Jonghwan Shin, Gil Joon Suh, Woon Yong Kwon, Tae Gun Shin, Han Sung Choi, Sangchun Choi, Yoo Seok Park, Sung Phil Chung, Won Young Kim, Hong
    Scientific Reports.2024;[Epub]     CrossRef
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    Scientific Reports.2024;[Epub]     CrossRef
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    American Journal of Critical Care.2024; 33(5): 347.     CrossRef
  • The mortality of patients with sepsis increases in the first month of a new academic year
    Sukyo Lee, Sungjin Kim, Sejoong Ahn, Hanjin Cho, Sungwoo Moon, Young Duck Cho, Jong-Hak Park
    Clinical and Experimental Emergency Medicine.2024; 11(2): 161.     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
  • The Usefulness of Carotid Artery Doppler Measurement as a Predictor of Early Death in Sepsis Patients Admitted to the Emergency Department
    Su-Il Kim, Yun-Deok Jang, Jae-Gu Ji, Yong-Seok Kim, In-Hye Kang, Seong-Ju Kim, Seong-Min Han, Min-Seok Choi
    Journal of Clinical Medicine.2024; 13(22): 6912.     CrossRef
  • Targeted literature review of the burden of extraintestinal pathogenic Escherichia Coli among elderly patients in Asia Pacific regions
    Norio Ohmagari, Won Suk Choi, Hung-Jen Tang, Petar Atanasov, Xiaobin Jiang, Luis Hernandez Pastor, Yoshikazu Nakayama, Jason Chiang, Kyunghwa Lim, Maria Carmen Nievera
    Journal of Medical Economics.2023; 26(1): 168.     CrossRef
  • Clinical and Economic Evaluation of the Blood Purification with Selective Sorption Techniques in ICU Patients
    Yu. S. Polushin, D. V. Sokolov, R. O. Dreval, A. N. Zabotina
    Messenger of ANESTHESIOLOGY AND RESUSCITATION.2023; 20(1): 6.     CrossRef
  • Sepsis and management: how to improve the outcomes of treatment of patients with sepsis
    Yu. S. Polushin
    Grekov's Bulletin of Surgery.2023; 181(5): 38.     CrossRef
  • Mortality among adult patients with sepsis and septic shock in Korea: a systematic review and meta-analysis
    Myeong Namgung, Chiwon Ahn, Yeonkyung Park, Il-Youp Kwak, Jungguk Lee, Moonho Won
    Clinical and Experimental Emergency Medicine.2023; 10(2): 157.     CrossRef
  • The Significance of FilmArray Blood Culture Identification Panel (FA-BCID) for Managing Patients with Positive Blood Cultures
    Kristin Widyasari, Seungjun Lee, Oh-Hyun Cho, Sun-In Hong, Byung-Han Ryu, Sunjoo Kim
    Diagnostics.2023; 13(21): 3335.     CrossRef
  • Identification of the robust predictor for sepsis based on clustering analysis
    Jae Yeon Jang, Gilsung Yoo, Taesic Lee, Young Uh, Juwon Kim
    Scientific Reports.2022;[Epub]     CrossRef
  • Effects of Glucocorticoid Therapy on Sepsis Depend Both on the Dose of Steroids and on the Severity and Phase of the Animal Sepsis Model
    Ye Jin Park, Min Ji Lee, Jinkun Bae, Jung Ho Lee, Han A Reum Lee, Sehwan Mun, Yun-seok Kim, Chang June Yune, Tae Nyoung Chung, Kyuseok Kim
    Life.2022; 12(3): 421.     CrossRef
  • Neutrophil-to-Albumin Ratio as A Novel Predictor of Mortality in Patients with Sepsis
    Naser Gharebaghi, Mohammad Amin Valizade Hasanloei, Mohammad Fromandi, Mohammad Reza Pashaei
    Avicenna Journal of Clinical Medicine.2022; 29(1): 12.     CrossRef
  • Association between Vitamin C Deficiency and Mortality in Patients with Septic Shock
    Jong Eun Park, Tae Gun Shin, Daun Jeong, Gun Tak Lee, Seung Mok Ryoo, Won Young Kim, You Hwan Jo, Gil Joon Suh, Sung Yeon Hwang
    Biomedicines.2022; 10(9): 2090.     CrossRef
  • The DEXA-SEPSIS study protocol: a phase II randomized double-blinded controlled trial of the effect of early dexamethasone in high-risk sepsis patients
    Kihwan Choi, Jong Eun Park, Anhye Kim, Sojung Hwang, Jinkun Bae, Tae Gun Shin, Kyuseok Kim
    Clinical and Experimental Emergency Medicine.2022; 9(3): 246.     CrossRef
  • Prediction of vasopressor requirement among hypotensive patients with suspected infection: usefulness of diastolic shock index and lactate
    Da Seul Kim, Jong Eun Park, Sung Yeon Hwang, Daun Jeong, Gun Tak Lee, Taerim Kim, Se Uk Lee, Hee Yoon, Won Chul Cha, Min Seob Sim, Ik Joon Jo, Tae Gun Shin
    Clinical and Experimental Emergency Medicine.2022; 9(3): 176.     CrossRef
  • The Value of Neutrophil/Lymphocyte Ratio Combined with Red Blood Cell Distribution Width in Evaluating the Prognosis of Emergency Patients with Sepsis
    Maosheng Lin, Louwei Zhang, Xuhua Tang, Yejiang Tang, Weiguo Li
    Emergency Medicine International.2022; 2022: 1.     CrossRef
  • Clinical outcomes and prognostic factors of patients with sepsis caused by intra-abdominal infection in the intensive care unit: a post-hoc analysis of a prospective cohort study in Korea
    Chan Hee Park, Jeong Woo Lee, Hak Jae Lee, Dong Kyu Oh, Mi Hyeon Park, Chae-Man Lim, Suk-Kyung Hong, Chae-Man Lim, Sang-Bum Hong, Dong Kyu Oh, Gee Young Suh, Kyeongman Jeon, Ryoung-Eun Ko, Young-Jae Cho, Yeon Joo Lee, Sung Yoon Lim, Sunghoon Park, Chae-Ma
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    Clinical and Experimental Emergency Medicine.2022; 9(4): 269.     CrossRef
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    Journal of Clinical Medicine.2020; 9(6): 1607.     CrossRef
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    C. Fleischmann-Struzek, L. Mellhammar, N. Rose, A. Cassini, K. E. Rudd, P. Schlattmann, B. Allegranzi, K. Reinhart
    Intensive Care Medicine.2020; 46(8): 1552.     CrossRef
  • Association between right ventricle dysfunction and poor outcome in patients with septic shock
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    Hyung Jun Park, Dae Yon Jung, Wonjun Ji, Chang-Min Choi
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    Seung-Young Oh, Songhee Cho, Ga Hee Kim, Eun Jin Jang, Seongmi Choi, Hannah Lee, Ho Geol Ryu
    Critical Care Medicine.2019; 47(12): e993.     CrossRef
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    Hyeri Seok, Dae Won Park
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    BMJ Open.2019; 9(10): e032692.     CrossRef
  • 14,183 View
  • 210 Download
  • 42 Web of Science
  • 47 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.
  • 10,418 View
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Original Article

Pulmonary | Clinical Laboratory

The clinical significance of changes in red blood cell distribution width in patients with community-acquired pneumonia
Sang-Min Lee, Jae Hyuk Lee, Kyuseok Kim, You Hwan Jo, Jungyoup Lee, Joonghee Kim, Ji Eun Hwang, Young Sang Ko, Chulmin Ha, Sujin Jang, Hyunmi Park
Clin Exp Emerg Med 2016;3(3):139-147.   Published online September 30, 2016
DOI: https://doi.org/10.15441/ceem.15.081

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The clinical significance of changes in red blood cell distribution width in patients with community-acquired pneumonia
Clin Exp Emerg Med. 2016;3(3):139-147.   Published online September 30, 2016
DOI: https://doi.org/10.15441/ceem.15.081
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The clinical significance of changes in red blood cell distribution width in patients with community-acquired pneumonia
Clin Exp Emerg Med. 2016;3(3):139-147.   Published online September 30, 2016
DOI: https://doi.org/10.15441/ceem.15.081
Close
Objective
Red cell distribution width (RDW) is associated with mortality in patients with community-acquired pneumonia (CAP). However, little is known about the effect of changes in RDW during treatment on mortality. Thus, the objective of this study was to evaluate the association between RDW changes and mortality in hospitalized patients with CAP.
Methods
Retrospective analyses were performed using medical records of patients hospitalized for CAP from April 2008 to February 2014. The abstracted laboratory values included RDW (from days one to four), clinical variables, and pneumonia severity index (PSI) scores. The ΔRDWn-1 was defined as the change in RDW calculated as: (RDWday1-RDWday-n)/RDWday1×100 (%), where ‘day n’ refers to hospital day.
Results
During the study period, a total of 1,069 patients were hospitalized for CAP. The 30-day mortality was 100/1,069 (9.4%). The median RDW at baseline was 14.1% (range, 11.1 to 30.2) and differed significantly between survivors and non-survivors (P<0.05). There were 470 patients with available serial RDW data (30-day mortality 58/470 [12.3%]). Of those, age, PSI score, blood urea nitrogen level, total protein concentration, albumin level, RDW at day 1, and the ΔRDW4-1 differed significantly between survivors and non-survivors. Multivariate Cox regression analysis showed that the significance of the relationship between ΔRDW4-1 and 30-day mortality risk remained after adjusting for age, PSI score, RDW at day 1, total protein concentration, and initial albumin level.
Conclusion
RDW change from day 1 to day 4 was an independent predictor of mortality in patients with CAP.

Citations

Citations to this article as recorded by  Crossref logo
  • Association Between the Red Cell Distribution Width‐to‐Albumin Ratio and Pediatric Community‐Acquired Pneumonia
    Zühal Örnek
    Pediatrics International.2026;[Epub]     CrossRef
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    Seohyun Choi, Young Jae Kim, Seon Min Lee, Kwang Gi Kim
    DIGITAL HEALTH.2025;[Epub]     CrossRef
  • Association of mean RDW values and changes in RDW with in‐hospital mortality in ventilator‐associated pneumonia (VAP): Evidence from MIMIC‐IV database
    Wenbin Nan, Siqi Li, Jinfa Wan, Zhenyu Peng
    International Journal of Laboratory Hematology.2024; 46(1): 99.     CrossRef
  • Mean platelet volume (MPV) and red blood cell distribution width coefficient of variation (RDW_CV) as prognostic markers in community-acquired pneumonia in children: a cross-sectional study
    Masoud Kiani, Hengameh Shahnouri, Hasan Mahmoodi, Mohammad Pournasrollah, Hemmat Gholinia Ahangar, Mohsen Mohammadi
    Egyptian Pediatric Association Gazette.2024;[Epub]     CrossRef
  • Development and validation of a survival prediction model in elder patients with community-acquired pneumonia: a MIMIC-population-based study
    Na Li, Wenli Chu
    BMC Pulmonary Medicine.2023;[Epub]     CrossRef
  • Evaluation of red blood cell distribution width, neutrophil‐to‐lymphocyte ratio, and other hematologic parameters in canine acute pancreatitis
    Meghan M. Johnson, John C. Gicking, Deborah A. Keys
    Journal of Veterinary Emergency and Critical Care.2023; 33(5): 587.     CrossRef
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    Qiujing Li, Na Shang, Tiecheng Yang, Qian Gao, Shubin Guo
    Aging Clinical and Experimental Research.2023; 35(11): 2593.     CrossRef
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    瑞 杨
    Advances in Clinical Medicine.2023; 13(12): 19321.     CrossRef
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    Jaclyn Lee, Yuwei Zhu, Derek J. Williams, Wesley H. Self, Sandra R. Arnold, Jonathan A. McCullers, Krow Ampofo, Andrew T. Pavia, Evan J. Anderson, Seema Jain, Kathryn M. Edwards, Carlos G. Grijalva
    Hospital Pediatrics.2022; 12(9): 798.     CrossRef
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    Yanyan Jiang, Chuancheng Ren, Aydos Alimujiang, Yuncheng Wu, Dongya Huang, Weiting Yang
    Frontiers in Neurology.2022;[Epub]     CrossRef
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    Deniz GÜVEN, Fatih Mehmet KIŞLAL
    Journal of Health Sciences and Medicine.2022; 5(6): 1592.     CrossRef
  • RDW-based clinical score to predict long-term survival in community-acquired pneumonia: a European derivation and validation study
    Remo Melchio, Jacopo Davide Giamello, Elisa Testa, Luis Alberto Ruiz Iturriaga, Andrea Falcetta, Cristina Serraino, Piero Riva, Christian Bracco, Leyre Serrano Fernandez, Salvatore D’Agnano, Stefano Leccardi, Massimo Porta, Luigi Maria Fenoglio
    Internal and Emergency Medicine.2021; 16(6): 1547.     CrossRef
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    Mandana Pouladzadeh, Mehdi Safdarian, Parastoo Moradi Choghakabodi, Fatemeh Amini, Alireza Sokooti
    Future Science OA.2021;[Epub]     CrossRef
  • The Role of Red Blood Cell Distribution Width in the Severity and Prognosis of Community-Acquired Pneumonia
    Qiang Ren, Hebing Liu, Ying Wang, Deyu Dai, Zhennan Tian, Guiwei Jiao, Xiaomin Liu, Haiyan Yin
    Canadian Respiratory Journal.2021; 2021: 1.     CrossRef
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    Human Vaccines & Immunotherapeutics.2021; 17(12): 5460.     CrossRef
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    Yousef A. Yousef, Mahmoud A. Manal
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    Cristina Represas-Represas, Maribel Botana-Rial, Alberto Fernández-Villar
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    Cristina Represas, Maribel Botana, Alberto Fernández-Villar
    Archivos de Bronconeumología.2017; 53(3): 93.     CrossRef
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    Min Woo Kim, Jee Yong Lim, Sang Hoon Oh
    Scandinavian Journal of Clinical and Laboratory Investigation.2017; 77(7): 486.     CrossRef
  • 16,708 View
  • 186 Download
  • 24 Web of Science
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Case Report

Gastrointestinal

Use of resuscitative endovascular balloon occlusion of the aorta in a patient with gastrointestinal bleeding
Jungyoup Lee, Kyuseok Kim, You Hwan Jo, Jae Hyuk Lee, Joonghee Kim, Heajin Chung, Ji Eun Hwang
Clin Exp Emerg Med 2016;3(1):55-58.   Published online March 31, 2016
DOI: https://doi.org/10.15441/ceem.15.006

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Use of resuscitative endovascular balloon occlusion of the aorta in a patient with gastrointestinal bleeding
Clin Exp Emerg Med. 2016;3(1):55-58.   Published online March 31, 2016
DOI: https://doi.org/10.15441/ceem.15.006
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Use of resuscitative endovascular balloon occlusion of the aorta in a patient with gastrointestinal bleeding
Clin Exp Emerg Med. 2016;3(1):55-58.   Published online March 31, 2016
DOI: https://doi.org/10.15441/ceem.15.006
Close
Resuscitative endovascular balloon occlusion of the aorta (REBOA) was developed for controlling intra-abdominal arterial bleeding before definitive bleeding control, and is commonly used in patients with ruptured abdominal aortic aneurysms. Although there is limited evidence for other uses of REBOA, we used REBOA in a patient with massive gastrointestinal bleeding. A 53-year-old man with hematochezia was admitted to our emergency department with an initial systolic blood pressure (SBP) of 83 mmHg. His SBP decreased to 40 mmHg in 10 minutes despite rapid fluid infusion. We decided to resuscitate the patient with REBOA in the emergency department and then move him to an intervention room after stabilization. After aortic occlusion, SBP abruptly increased from 57 to 108 mmHg, and the patient could be transferred to an intervention room. The patient was admitted to intensive care, but died of massive rebleeding 24 hours after admission to the emergency department.

Citations

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  • Is REBOA the Last Card to Control a Massive Gastrointestinal Bleeding?
    Fernando Rodríguez-Holguín, Alexander Salcedo, Philip Leib, Yaset Caicedo, José Julián Serna, Luis Toro, Sandra Carvajal, Manolo Riascos, Michael W. Parra, Alberto García, Carlos A. Ordoñez
    Journal of Surgical Research.2024; 296: 735.     CrossRef
  • Computational study of haemodynamic change induced by the resuscitative endovascular balloon aortic occlusion
    Jiade Qiu, Xiaomei Tian, Hongjun Yuan, Junyang Cao, Xin Chen, Xin Li, Dengfeng Wu, Daojian Cheng, Xianren Zhang, Fengyong Liu
    Molecular Simulation.2024; 50(12): 743.     CrossRef
  • Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) as a strategy for postpartum haemorrhage management: A narrative review
    Michele Salvagno, Marta Grinza, Giacomo Coppalini, Alessandro de Cassai, Rossana Soloperto, Alessia Degrassi, Andrew Carlin, Filippo Annoni, Fabrizia Calabrese, Fabio Silvio Taccone
    International Journal of Obstetric Anesthesia.2024; 60: 104260.     CrossRef
  • One-dimensional analysis method of pulsatile blood flow in arterial network for REBOA operations
    Jiade Qiu, Xin Chen, Dengfeng Wu, Xianren Zhang, Daojian Cheng
    Computers in Biology and Medicine.2023; 159: 106898.     CrossRef
  • Die aortoösophageale Fistel – Eine seltene Differenzialdiagnose der oberen Gastrointestinalblutung
    Julia Johanna Grannemann, Achim Röper, Sebastian Rehberg, Gerrit Jansen
    Der Anaesthesist.2021; 70(10): 866.     CrossRef
  • Safe balloon inflation parameters for resuscitative endovascular balloon occlusion of the aorta
    Kaspars Maleckis, Courtney Keiser, Majid Jadidi, Eric Anttila, Anastasia Desyatova, Jason MacTaggart, Alexey Kamenskiy
    Journal of Trauma and Acute Care Surgery.2021; 91(2): 302.     CrossRef
  • Resuscitative Endovascular Balloon Occlusion of the Aorta for Hemorrhagic Shock Due to a Gastric Ulcer: A Case Report
    Shigeto ISHIKAWA, Masao NARITA, Makiko TAMUNE, Koki UMEDA, Michiaki KAKU, Toshihiko MAYUMI
    Journal of UOEH.2021; 43(3): 363.     CrossRef
  • Indicações e resultados para o uso expandido da oclusão ressuscitativa por balão endovascular da aorta - REBOA.
    Marcelo Augusto Fontenelle Ribeiro Júnior, Andressa Daniel Maurício, Cassia Tieni Kawase Costa, Paola Rezende Néder, Samara de Souza Augusto, Salomone Di-Saverio, Megan Brenner
    Revista do Colégio Brasileiro de Cirurgiões.2019;[Epub]     CrossRef
  • Resuscitative endovascular balloon occlusion of the aorta (REBOA): an updated review
    MARCELO AUGUSTO FONTENELLE RIBEIRO JÚNIOR, MEGAN BRENNER, ALEXANDER T. M. NGUYEN, CÉLIA Y. D. FENG, RAÍSSA REIS DE-MOURA, VINICIUS C. RODRIGUES, RENATA L. PRADO
    Revista do Colégio Brasileiro de Cirurgiões.2018;[Epub]     CrossRef
  • A systematic review and meta-analysis of the use of resuscitative endovascular balloon occlusion of the aorta in the management of major exsanguination
    B. L. S. Borger van der Burg, Thijs T. C. F. van Dongen, J. J. Morrison, P. P. A. Hedeman Joosten, J. J. DuBose, T. M. Hörer, R. Hoencamp
    European Journal of Trauma and Emergency Surgery.2018; 44(4): 535.     CrossRef
  • 12,780 View
  • 119 Download
  • 12 Web of Science
  • 10 Crossref
Original Articles

Imaging

Change in guardians’ preference for computed tomography after explanation by emergency physicians in pediatric head injury
Jin Hee Jeong, Jin Hee Lee, Kyuseok Kim, Joong Eui Rhee, Tae Yun Kim, You Hwan Jo, Yu Jin Kim, Jae Hyuk Lee, Changwoo Kang, Soo Hoon Lee, Joonghee Kim, Chan Jong Park, Hyuksool Kwon
Clin Exp Emerg Med 2015;2(4):226-235.   Published online December 28, 2015
DOI: https://doi.org/10.15441/ceem.14.039

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Change in guardians’ preference for computed tomography after explanation by emergency physicians in pediatric head injury
Clin Exp Emerg Med. 2015;2(4):226-235.   Published online December 28, 2015
DOI: https://doi.org/10.15441/ceem.14.039
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Change in guardians’ preference for computed tomography after explanation by emergency physicians in pediatric head injury
Clin Exp Emerg Med. 2015;2(4):226-235.   Published online December 28, 2015
DOI: https://doi.org/10.15441/ceem.14.039
Close
Objective
Head injury in children is a common problem presenting to emergency departments, and cranial computed tomography scanning is the diagnostic standard for these patients. Several decision rules are used to determine whether computed tomography scans should be used; however, the use of computed tomography scans is often influenced by guardians’ preference toward the scans. The objective of this study was to identify changes in guardian preference for minor head injuries after receiving an explanation based on the institutional clinical practice guideline.
Methods
A survey was conducted between July 2010 and June 2012. Patients younger than 16 years with a Glasgow Coma Scale score of 15 after a head injury and their guardians were included. Pre- and post-explanation questionnaires were given to guardians to assess their preference for computed tomography scans and factors related to the degree of preference. Treating physicians explained the risks and benefits of cranial computed tomography scanning using the institutional clinical practice guideline. Guardian preference for a computed tomography scan was examined using a 100-mm visual analog scale.
Results
In total, 208 patients and their guardians were included in this survey. Guardian preference for computed tomography scans was significantly reduced after explanation (46.7 vs. 17.4, P<0.01). Pre-explanation preference and the strength of the physician recommendation to get a computed tomography were the most important factors affecting pre- and post-explanation changes in preferences.
Conclusion
Explanation of the risks and benefits of cranial computed tomography scans using the institutional clinical practice guideline may significantly reduce guardian preference for computed tomography scans.

Citations

Citations to this article as recorded by  Crossref logo
  • Optimizing Advanced Imaging of the Pediatric Patient in the Emergency Department: Technical Report
    Jennifer R. Marin, Todd W. Lyons, Ilene Claudius, Mary E. Fallat, Michael Aquino, Timothy Ruttan, Reza J. Daugherty
    Journal of the American College of Radiology.2024; 21(7): e37.     CrossRef
  • Optimizing Advanced Imaging of the Pediatric Patient in the Emergency Department: Technical Report
    Jennifer R. Marin, Todd W. Lyons, Ilene Claudius, Mary E. Fallat, Michael Aquino, Timothy Ruttan, Reza J. Daugherty, Gregory P. Conners, Sylvia Owusu-Ansah, Kerry S. Caperell, Jennifer Hoffmann, Benson Hsu, Deborah Hsu, Jennifer E. McCain, Mohsen Saidinej
    Pediatrics.2024;[Epub]     CrossRef
  • Risk stratification of intermediate-risk children with minor head injury: a secondary publication translated into Korean
    Jung Heon Kim
    Pediatric Emergency Medicine Journal.2022; 9(1): 1.     CrossRef
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    So Hyun Paek, Jin Hee Jung, Young Ho Kwak, Do Kyun Kim, Jin Hee Lee, Jae Yun Jung, Sohee Oh
    Pediatric Emergency Care.2020; 36(5): e280.     CrossRef
  • Risk Stratification of Intermediate-Risk Children With Minor Head Injury
    Yura Ko, Ji Sook Lee, Minjung Kathy Chae, Jung Hwan Ahn, Hyuk-Hoon Kim, Eun Jung Park, Jung Heon Kim
    Pediatric Emergency Care.2020; 36(11): e659.     CrossRef
  • Is cranial computed tomography unnecessary in children with a head injury and isolated vomiting?
    Simon Hardman, Ola Rominiyi, David King, Edward Snelson
    BMJ.2019; : l1875.     CrossRef
  • 10,699 View
  • 117 Download
  • 4 Web of Science
  • 6 Crossref

Resuscitation

The risk factors and prognostic implication of acute pulmonary edema in resuscitated cardiac arrest patients
Dae-hyun Kang, Joonghee Kim, Joong Eui Rhee, Taeyun Kim, Kyuseok Kim, You Hwan Jo, Jin Hee Lee, Jae Hyuk Lee, Yu Jin Kim, Seung Sik Hwang
Clin Exp Emerg Med 2015;2(2):110-116.   Published online June 30, 2015
DOI: https://doi.org/10.15441/ceem.14.016

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The risk factors and prognostic implication of acute pulmonary edema in resuscitated cardiac arrest patients
Clin Exp Emerg Med. 2015;2(2):110-116.   Published online June 30, 2015
DOI: https://doi.org/10.15441/ceem.14.016
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The risk factors and prognostic implication of acute pulmonary edema in resuscitated cardiac arrest patients
Clin Exp Emerg Med. 2015;2(2):110-116.   Published online June 30, 2015
DOI: https://doi.org/10.15441/ceem.14.016
Close
Objective
Pulmonary edema is frequently observed after a successful resuscitation in out-of hospital cardiac arrest (OHCA) patients. Currently, its risk factors and prognostic implications are mostly unknown.
Methods
Adult OHCA patients with a presumed cardiac etiology who achieved sustained return of spontaneous circulation (ROSC) in emergency department were retrospectively analyzed. The patients were grouped according to the severity of consolidation on their initial chest X-ray (group I, no consolidation; group II, patchy consolidations; group III, consolidation involving an entire lobe; group IV, total white-out of any lung). The primary objective was to identify the risk factors of developing severe pulmonary edema (group III or IV). The secondary objective was to evaluate the association between long-term prognosis and the severity of pulmonary edema.
Results
One hundred and seven patients were included. Total duration of cardiopulmonary resuscitation (CPR) and initial pCO2 level were both independent predictors of developing severe pulmonary edema with their odds ratio (OR) being 1.02 (95% confidence interval [CI], 1.00 to 1.04; per 1 minute) and 1.04 (95% CI, 1.01 to 1.07; per 1 mmHg), respectively. The long term prognosis was significantly poor in patients with severe pulmonary edema with a OR for good outcome (6-month cerebral performance category 1 or 2) being 0.22 (95% CI, 0.06 to 0.79) in group III and 0.16 (95% CI, 0.04 to 0.63) in group IV compared to group I.
Conclusion
The duration of CPR and initial pCO2 level were both independent predictors for the development of severe pulmonary edema after resuscitation in emergency department. The severity of the pulmonary edema was significantly associated with long-term outcome.

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    Willard W. Sharp, Lin Piao
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    Ingo Voigt, Marco Mighali, Heinrich Wieneke, Oliver Bruder
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    Maranda Newton, Jane Hall, Catherine R. Counts, Navya Gunaje, Basar Sarikaya, Vasisht Srinivasan, Kelley R.H. Branch, Nicholas J. Johnson
    Resuscitation.2024; 205: 110446.     CrossRef
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    Manoj Khokhar, Purvi Purohit, Dipayan Roy, Sojit Tomo, Ashita Gadwal, Anupama Modi, Mithu Banerjee, Praveen Sharma
    Archives of Physiology and Biochemistry.2023; 129(3): 626.     CrossRef
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    Olga Lender
    JAAPA.2023; 36(7): 46.     CrossRef
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    Ingo Voigt, Marco Mighali, Daniela Manda, Phillip Aurich, Oliver Bruder
    Internal and Emergency Medicine.2022; 17(5): 1463.     CrossRef
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    Ruijian Li, Sang Jae Rhee, Soochan Bae, Shi Su, Chang-Sun Kang, Qingen Ke, Ye Eun Koo, Chloe Ryu, Chul Gyu Song, Dongwon Lee, Peter M. Kang
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    Cheng-Chieh Huang, Kuan-Chih Chen, Zih-Yang Lin, Yu-Hsuan Chou, Wen-Liang Chen, Tsung-Han Lee, Kun-Te Lin, Pei-You Hsieh, Cheng Hsu Chen, Chu-Chung Chou, Yan-Ren Lin
    Critical Care.2021;[Epub]     CrossRef
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    Khaled El-Khawas, Danielle Richmond, Lara Zwakman-Hessels, Salvatore L. Cutuli, Alessandro Belletti, Thummaporn Naorungroj, Hussam Abdelkarim, Natalie Yang, Rinaldo Bellomo
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    Yong Won Kim, Sung Oh Hwang, Hee Seung Kang, Kyoung-Chul Cha
    The American Journal of Emergency Medicine.2019; 37(1): 1.     CrossRef
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    Chunshuang Wu, Jiefeng Xu, Xiaohong Jin, Qijiang Chen, Zilong Li, Mao Zhang
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    Yoonsoo Park, Hyun-Jin Tae, Jeong Hwi Cho, In-Shik Kim, Taek Geun Ohk, Chan Woo Park, Joong Bum Moon, Myoung Cheol Shin, Tae-Kyeong Lee, Jae-Chul Lee, Joon Ha Park, Ji Hyeon Ahn, Seok Hoon Kang, Moo-Ho Won, Jun Hwi Cho
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    Jian Wei, Peng Wang, Yi Li, Qingli Dou, Jiali Lin, Wuyuan Tao, Jinle Lin, Xuan Fu, Zitong Huang, Wenwu Zhang
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    Joonghee Kim, Kyuseok Kim, Jongdae Park, You Hwan Jo, Jae Hyuk Lee, Ji Eun Hwang, Chulmin Ha, Young-sang Ko, Euigi Jung
    The American Journal of Emergency Medicine.2016; 34(2): 225.     CrossRef
  • ED crowding and the outcomes of out-of-hospital cardiac arrest
    Jiwon Kang, Joonghee Kim, You Hwan Jo, Kyuseok Kim, Jae Hyuk Lee, Taeyun Kim, Jungyoup Lee, Ji Eun Hwang, Euigi Jung
    The American Journal of Emergency Medicine.2015; 33(11): 1659.     CrossRef
  • 17,138 View
  • 137 Download
  • 20 Web of Science
  • 16 Crossref

Imaging

Can emergency physicians reliably interpret cardiac CT images? A prospective observational study
Joon-myoung Kwon, Joonghee Kim, Kyuseok Kim, Taeyun Kim, You Hwan Jo, Jin Hee Lee, Jae Hyuk Lee, Yu Jin Kim, Jae Yun Jung
Clin Exp Emerg Med 2015;2(1):38-43.   Published online March 31, 2015
DOI: https://doi.org/10.15441/ceem.14.013

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Can emergency physicians reliably interpret cardiac CT images? A prospective observational study
Clin Exp Emerg Med. 2015;2(1):38-43.   Published online March 31, 2015
DOI: https://doi.org/10.15441/ceem.14.013
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Can emergency physicians reliably interpret cardiac CT images? A prospective observational study
Clin Exp Emerg Med. 2015;2(1):38-43.   Published online March 31, 2015
DOI: https://doi.org/10.15441/ceem.14.013
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Objective
Cardiac computed tomography (CCT) is useful for evaluation of acute chest pain in the emergency department (ED). Though the test needs proper interpretation by someone with expertise in cardiovascular imaging, the critical nature of the information the test provides frequently lead emergency physicians (EPs) to act on their own interpretation. We performed this study to assess how often EPs’ interpretations are in agreement with radiologists’.
Methods
This study is a prospective observational study. The target population was patients assessed with CCT for acute chest pain or discomfort. EPs with at least one year CCT experience underwent a one-hour training session before study participation. The most significant lesion, if any, in each arterial segment was assessed for coronary stenosis and plaque calcification. The agreement between EPs’ and radiologists’ interpretation was assessed with Cohen’s kappa and Gwet’s AC1.
Results
One hundred and three patients were enrolled and 412 segments were analyzed. Stenosis grading was identical in 363 segments (88.1%) and the interrater agreement was good (kappa=0.6439, AC1=0.8810). Similarly, the plaque calcification grading was identical in 354 segments (86.6%) and the kappa and AC1 values were 0.5660 and 0.8501, respectively. EPs classified 6 of the 17 arterial segments with significant stenosis reported by radiologists as non-significant stenosis (n=5) or clear (n=2), all of which were proved to be significant by following subsequent invasive coronary angiography.
Conclusion
There was substantial discordance of CCT interpretation between EPs and radiologists. For now, EPs need more education prior to independent CCT reading.

Citations

Citations to this article as recorded by  Crossref logo
  • Comparison of abdominal ct interpretation levels of emergency physicians and radiologists
    Kasim Turgut
    Adıyaman Üniversitesi Sağlık Bilimleri Dergisi.2019; 5(2): 1482.     CrossRef
  • 12,850 View
  • 79 Download
  • 1 Crossref

Resuscitation

Resuscitation duration inequality by patient characteristics in emergency department out-of-hospital cardiac arrest: an observational study
Minoo Kang, Joonghee Kim, Kyuseok Kim
Clin Exp Emerg Med 2014;1(2):87-93.   Published online December 31, 2014
DOI: https://doi.org/10.15441/ceem.14.010

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Resuscitation duration inequality by patient characteristics in emergency department out-of-hospital cardiac arrest: an observational study
Clin Exp Emerg Med. 2014;1(2):87-93.   Published online December 31, 2014
DOI: https://doi.org/10.15441/ceem.14.010
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Resuscitation duration inequality by patient characteristics in emergency department out-of-hospital cardiac arrest: an observational study
Clin Exp Emerg Med. 2014;1(2):87-93.   Published online December 31, 2014
DOI: https://doi.org/10.15441/ceem.14.010
Close
Objective
Out-of-hospital cardiac arrest (OHCA) patients unresponsive to basic life support are frequently transferred to emergency departments (EDs) for further resuscitation. Although some survive with good neurologic outcomes, additional resuscitation in EDs is often futile. Without a dedicated termination of resuscitation (TOR) rule for ED resuscitation, the decision when to stop the resuscitation is up to emergency physicians. In this study, we assessed the association between patient characteristics and duration of resuscitation in EDs to understand how emergency physicians decide when to terminate cardiopulmonary resuscitation. Methods A retrospective analysis of the OHCA registry of a single ED was conducted. Adult (18 years or older) patients without any return of spontaneous circulation (ROSC) after unsuccessful ED advanced cardiac life support were included. The primary endpoint was duration of resuscitation attempts. Prehospital and demographic factors were assessed as independent variables. The relationship between these factors and duration of resuscitative attempts was analyzed with multivariable quantile regression.
Results
From January 2008 to August 2012, ED resuscitation was terminated without ROSC in 266 patients (53.5%). The duration of resuscitative attempts was significantly shorter if any of the currently recognized poor prognostic factors was present. Interestingly, controversial factors such as female sex and older age were significantly associated with shorter resuscitation duration, while factors definitively indicating poor prognosis, such as severe trauma and poor baseline neurological status, showed no significant association.
Conclusion
The results of this study suggest that physicians adjust the resuscitation duration according to their subjective prediction of futility despite the absence of evidence-based TOR guidelines.

Citations

Citations to this article as recorded by  Crossref logo
  • External validation of the Survival After ROSC in Cardiac Arrest (SARICA) score for predicting survival after return of spontaneous circulation using multinational pan-asian cohorts
    Maehanyi Frances Rajendram, Faraz Zarisfi, Feng Xie, Nur Shahidah, Pin Pin Pek, Jun Wei Yeo, Benjamin Yong-Qiang Tan, Matthew Ma, Sang Do Shin, Hideharu Tanaka, Marcus Eng Hock Ong, Nan Liu, Andrew Fu Wah Ho
    Frontiers in Medicine.2022;[Epub]     CrossRef
  • Survival and Rearrest in out-of-Hospital Cardiac Arrest Patients with Prehospital Return of Spontaneous Circulation: A Prospective Multi-Regional Observational Study
    Jae-Hyug Woo, Jin-Seong Cho, Choung Ah Lee, Gi Woon Kim, Yu Jin Kim, Hyung Jun Moon, Yong Jin Park, Kyoung Mi Lee, Won Jung Jeong, Il Kug Choi, Han Joo Choi, Hyuk Joong Choi
    Prehospital Emergency Care.2021; 25(1): 59.     CrossRef
  • European Resuscitation Council Guidelines 2021: Ethics of resuscitation and end of life decisions
    Spyros D. Mentzelopoulos, Keith Couper, Patrick Van de Voorde, Patrick Druwé, Marieke Blom, Gavin D. Perkins, Ileana Lulic, Jana Djakow, Violetta Raffay, Gisela Lilja, Leo Bossaert
    Resuscitation.2021; 161: 408.     CrossRef
  • Ethik der Reanimation und Entscheidungen am Lebensende
    Spyros D. Mentzelopoulos, Keith Couper, Patrick Van de Voorde, Patrick Druwé, Marieke Blom, Gavin D. Perkins, Ileana Lulic, Jana Djakow, Violetta Raffay, Gisela Lilja, Leo Bossaert
    Notfall + Rettungsmedizin.2021; 24(4): 720.     CrossRef
  • Factors associated with the decision to terminate resuscitation early for adult in-hospital cardiac arrest: Influence of family in an East Asian society
    Chih-Hung Wang, Wei-Tien Chang, Chien-Hua Huang, Min-Shan Tsai, Ping-Hsun Yu, Yen-Wen Wu, Wen-Jone Chen, Chiara Lazzeri
    PLOS ONE.2019; 14(3): e0213168.     CrossRef
  • ED crowding and the outcomes of out-of-hospital cardiac arrest
    Jiwon Kang, Joonghee Kim, You Hwan Jo, Kyuseok Kim, Jae Hyuk Lee, Taeyun Kim, Jungyoup Lee, Ji Eun Hwang, Euigi Jung
    The American Journal of Emergency Medicine.2015; 33(11): 1659.     CrossRef
  • 35,015 View
  • 71 Download
  • 6 Web of Science
  • 6 Crossref

Critical Care

Awareness and knowledge of sepsis in the general Korean population: comparison with the awareness and knowledge of acute myocardial infarction and stroke
Minji Park, Kyuseok Kim, Jae Hyuk Lee, Changwoo Kang, You Hwan Jo, Dong Hoon Kim, Kyeong Won Kang, Soo Hoon Lee, Chanjong Park, Joonghee Kim, Heajin Chung, Hyunmi Park, Sujin Jang
Clin Exp Emerg Med 2014;1(1):41-48.   Published online September 30, 2014
DOI: https://doi.org/10.15441/ceem.14.014

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Awareness and knowledge of sepsis in the general Korean population: comparison with the awareness and knowledge of acute myocardial infarction and stroke
Clin Exp Emerg Med. 2014;1(1):41-48.   Published online September 30, 2014
DOI: https://doi.org/10.15441/ceem.14.014
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Awareness and knowledge of sepsis in the general Korean population: comparison with the awareness and knowledge of acute myocardial infarction and stroke
Clin Exp Emerg Med. 2014;1(1):41-48.   Published online September 30, 2014
DOI: https://doi.org/10.15441/ceem.14.014
Close
Objective

Patients with severe sepsis or septic shock require timely, aggressive management to improve their outcomes, and early presentation of patients to the hospital may also be important. Thus, public awareness about sepsis may be important for improved outcomes. However, there are no studies regarding the public awareness of sepsis in the general Korean population. Therefore, the objective of this survey was to gain insight into the public awareness of sepsis.

 Methods

Prospective paper-based and web-based surveys were issued between May and June 2013 to adults aged ≥18 years.

 Results

A total of 1,081 participants responded to the survey (394 paper-based and 687 web-based). Mean age was 38.7±11.4 years, and 541 participants (50%) were men. Of the 1,081 participants, 831 (76.9%) had heard of the term “sepsis.” Of these participants, only 295 (35%) responded correctly regarding the definition of sepsis. However, 1,019 participants (94.3%) had heard of acute myocardial infarction, and 817 of these (80%) correctly defined acute myocardial infarction. Regarding stroke, 1,047 (96.9%) had heard of stroke, and 975 of these responded (93.1%) correctly to the definition of stroke.

 Conclusion

There is poor public awareness about sepsis compared with that of acute myocardial infarction and stroke. This may limit the timely management of severe sepsis and septic shock.

Citations

Citations to this article as recorded by  Crossref logo
  • The Role of Perceived Urgency and Barriers in Using Emergency Medical Care for Sepsis: A German-Wide, Representative Survey Using Case Vignettes
    Sebastian Born, Norman Rose, Silke Piedmont, Daniel Schwarzkopf, Mathias W. Pletz, Wiltrud Abels, Konrad Reinhart, Carolin Fleischmann-Struzek
    Critical Care Medicine.2026; 54(2): 291.     CrossRef
  • Public knoweldge of sepsis in Saudi Arabia: A cross-sectional study
    Kadejh Abdulrahman Bashekah, Alla Hussain Felemban, Lubna Abdulrahman Hafiz, Abdulrahman Mauafaq Aljifri, Dalal Nasser Gaith Alsharif, Abdulaziz Ahmad Albarakati, Hind Mauafaq Aljifri, Sarah Mauafaq Aljifri, Hind Abdullah Ebrahim Abdullah, Hanan Ali Zurba
    Medicine.2025; 104(22): e42643.     CrossRef
  • Sepsis incidence, suspicion, prediction and mortality in emergency medical services: a cohort study related to the current international sepsis guideline
    Silke Piedmont, Ludwig Goldhahn, Enno Swart, Bernt-Peter Robra, Carolin Fleischmann-Struzek, Rajan Somasundaram, Wolfgang Bauer
    Infection.2024; 52(4): 1325.     CrossRef
  • Most patients with an increased risk for sepsis-related morbidity or death do not recognize sepsis as a medical emergency: results of a survey study using case vignettes
    Sebastian Born, Carolin Fleischmann-Struzek, Wiltrud Abels, Silke Piedmont, Edmund Neugebauer, Konrad Reinhart, Evjenia Toubekis, Odette Wegwarth, Daniel Schwarzkopf
    Critical Care.2023;[Epub]     CrossRef
  • Assessing Awareness and Actions Must Be Taken in Acute Myocardial Infarction: A Cross-Sectional Study on the General Population in Alahssa, Saudi Arabia
    Abdullah Almaqhawi, Abdullah Alkhalaf, Mohammed Al Qadhib, Ali M Alhashim, Norah S Alsaad, Mshari S Alqahtani, Mohammed Alqahtani, Osama F Alamri, Fatimah Buali, Ibraheem Alhusain
    Cureus.2023;[Epub]     CrossRef
  • Text-Based vs. Graphical Information Formats in Sepsis Prevention and Early Detection: A Randomized Controlled Trial on Informed Choice
    Luka Johanna Debbeler, Anne Pohrt, Carolin Fleischmann-Struzek, Daniel Schwarzkopf, Sebastian Born, Konrad Reinhart, Odette Wegwarth
    Journal of Clinical Medicine.2022; 11(13): 3659.     CrossRef
  • Public awareness and knowledge of sepsis: a cross-sectional survey of adults in Canada
    Jeanna Parsons Leigh, Rebecca Brundin-Mather, Stephana Julia Moss, Angie Nickel, Ariana Parolini, Deirdre Walsh, Blair L. Bigham, Alix J. E. Carter, Alison Fox-Robichaud, Kirsten M. Fiest
    Critical Care.2022;[Epub]     CrossRef
  • Public Awareness of Sepsis Compared to Acute Myocardial Infarction and Stroke in Jeddah, Saudi Arabia: Questionnaire Study
    Nourah Al-Orainan, Adel Mohamed EL-Shabasy, Khawlah Alamin Al-Shanqiti, Rawan Awad Al-Harbi, Hadeel Rajeh Alnashri, Raghad Ahmed Rezqallah, Alanoud Abdallah Mirghani
    Interactive Journal of Medical Research.2020; 9(2): e16195.     CrossRef
  • Korean Registry for Improving Sepsis Survival (KISS): Protocol for a Multicenter Cohort of Adult Patients with Sepsis or Septic Shock
    Jong Hun Kim, Nam Su Ku, Youn Jeong Kim, Hong Bin Kim, Hyeri Seok, Dong-Gun Lee, Jin Seo Lee, Su Jin Jeong, Jung-Hyun Choi, Jang Wook Sohn, Min Ja Kim, Dae Won Park
    Infection & Chemotherapy.2020; 52(1): 31.     CrossRef
  • Level of Knowledge on Stroke and Associated Factors: A Cross-Sectional Study at Primary Health Care Centers in Morocco
    Ahmed Kharbach, Majdouline Obtel, Abderrahmane Achbani, Youssef Bouchriti, Kenza Hassouni, Laila Lahlou, Rachid Razine
    Annals of Global Health.2020;[Epub]     CrossRef
  • Development of questionnaire on awareness and action towards symptoms and risk factors of heart attack and stroke among a Malaysian population
    Abdullah Abdulmajid Abdo Ahmed, Abdulkareem Mohammed AL-Shami, Shazia Jamshed, Abdul Rahman Fata Nahas
    BMC Public Health.2019;[Epub]     CrossRef
  • Determinants of sepsis knowledge: a representative survey of the elderly population in Germany
    Sarah Eitze, Carolin Fleischmann-Struzek, Cornelia Betsch, Konrad Reinhart
    Critical Care.2018;[Epub]     CrossRef
  • Assessment of the general public's knowledge of stroke: A cross-sectional study in Yaoundé, Cameroon
    Jobert Richie Nansseu, Cedric Paterson Atangana, Saint-Just N. Petnga, Joseph Kamtchum-Tatuene, Jean Jacques Noubiap
    Journal of the Neurological Sciences.2017; 378: 123.     CrossRef
  • Public Awareness of Sepsis Is Low in Sweden
    Lisa Mellhammar, Bertil Christensson, Adam Linder
    Open Forum Infectious Diseases.2015;[Epub]     CrossRef
  • 17,094 View
  • 166 Download
  • 14 Web of Science
  • 14 Crossref
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CEEM : Clinical and Experimental Emergency Medicine