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
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
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
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
Objective We aimed to compare the multi-marker strategy (copeptin and high-sensitivity cardiac troponin I [hs-cTnI]) with serial hs-cTnI measurements to rule out acute myocardial infarction (AMI) in patients with chest pain.
Methods This prospective observational study was performed in a single emergency department. To test the non-inferiority margin of 4% in terms of negative predictive value (NPV) between the multi-marker strategy (0 hour) and serial hs-cTnI measurements (0 and 2 hours), 262 participants were required. Samples for copeptin and hs-cTnI assays were collected at presentation (0 hour) and after 2 hours. The measured biomarkers were considered abnormal when hs-cTnI was >26.2 ng/L and when copeptin was >10 pmol/L.
Results AMI was diagnosed in 28 patients (10.7%). The NPV of the multi-marker strategy was 100% (160/160; 95% confidence interval [CI], 97.7% to 100%), which was not inferior to that of serial hs-cTnI measurements (201/201; 100%; 95% CI, 98.2% to 100%). The sensitivity, specificity, and positive predictive value of the multi-marker strategy were 100% (95% CI, 87.7% to 100%), 68.1% (95% CI, 61.7% to 74.0%), and 27.2% (95% CI, 18.9% to 36.8%), respectively. The sensitivity, specificity, and positive predictive value of serial hs-cTnI measurements were 100% (95% CI, 87.7% to 100%), 85.5% (95% CI, 80.4% to 89.8%), and 45.2% (95% CI, 32.5% to 58.3%), respectively.
Conclusion The multi-marker strategy (copeptin and hs-cTnI measurement) was not inferior to serial hs-cTnI measurements in terms of NPV for AMI diagnosis, with a sensitivity and NPV of 100%. Copeptin may help in the early rule-out of AMI in patients with chest pain.
Citations
Citations to this article as recorded by
Copeptin in Acute Myocardial Infarction: Is There a Role in the Era of High-Sensitivity Troponins? Sofia Bezati, Ioannis Ventoulis, Vasiliki Bistola, Christos Verras, Dionysis Matsiras, Effie Polyzogopoulou, John Parissis Journal of Cardiovascular Development and Disease.2025; 12(4): 144. CrossRef
ATUALIZAÇÃO SOBRE OS BIOMARCADORES PRECOCES DO INFARTO AGUDO DO MIOCÁRDIO E SUAS RELAÇÕES COM A TROPONINA CARDÍACA: UMA REVISÃO DE LITERATURA Paula Rayssa Rodrigues, Gabriel Santiago De Faria, Alessandra Cristina Pupin Silvério RECIMA21 - Revista Científica Multidisciplinar - ISSN 2675-6218.2024; 5(8): e585497. CrossRef
Copeptin plus troponin in the rapid rule out of acute myocardial infarction and prognostic value on post-myocardial infarction outcomes: a systematic review and diagnostic accuracy study Sheref A. Elseidy, Ahmed K. Awad, Debvarsha Mandal, Mounika Vorla, Ahmed Elkheshen, Tamam Mohamad Heart and Vessels.2023; 38(1): 1. CrossRef
Copeptin with high-sensitivity cardiac troponin to rule out non-ST-elevation myocardial infarction early on: A systematic review and meta-analysis Danni Mu, Jian Zhong, Lei Li, Jin Cheng, Yutong Zou, Ling Qiu, Xinqi Cheng Clinical Biochemistry.2023; 112: 24. CrossRef
Acute coronary syndrome as a current issue of pediatric cardiology. Outcomes and prognosis: Clinical case N. V. Tomchik, T. A. Lashkovskaya, A. I. Kizilevich, A. I. Matveichyk Kuban Scientific Medical Bulletin.2023; 30(5): 113. CrossRef
Copeptin as a Diagnostic and Prognostic Biomarker in Cardiovascular Diseases Danni Mu, Jin Cheng, Ling Qiu, Xinqi Cheng Frontiers in Cardiovascular Medicine.2022;[Epub] CrossRef
Performance of Copeptin for Early Diagnosis of Acute Coronary Syndromes: A Systematic Review and Meta-Analysis of 14,139 Patients Lukasz Szarpak, Marcin Lapinski, Aleksandra Gasecka, Michal Pruc, Wiktoria L. Drela, Mariusz Koda, Andrea Denegri, Frank W. Peacock, Miłosz J. Jaguszewski, Krzysztof J. Filipiak Journal of Cardiovascular Development and Disease.2021; 9(1): 6. CrossRef
Serum exosomal miR-122-5p is a new biomarker for both acute coronary syndrome and underlying coronary artery stenosis Hao Ling, Ziyuan Guo, Shuangshuang Du, Yinghong Liao, Yunyan Li, Chao Ding, Chunli Song Biomarkers.2020; 25(7): 539. CrossRef
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
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
Objective This study aimed to determine whether simultaneous decreases in the serum levels of cell adhesion molecules (intracellular cell adhesion molecule-1 [ICAM-1], vascular cell adhesion molecule-1 [VCAM-1], and E-selectin) and S100 proteins within the first 24 hours after the return of spontaneous circulation were associated with good neurological outcomes in cardiac arrest survivors.
Methods This retrospective observational study was based on prospectively collected data from a single emergency intensive care unit (ICU). Twenty-nine out-of-hospital cardiac arrest survivors who were admitted to the ICU for post-resuscitation care were enrolled. Blood samples were collected at 0 and 24 hours after ICU admission. According to the 6-month cerebral performance category (CPC) scale, the patients were divided into good (CPC 1 and 2, n=12) and poor (CPC 3 to 5, n=17) outcome groups.
Results No difference was observed between the two groups in terms of the serum levels of ICAM-1, VCAM-1, E-selectin, and S100 at 0 and 24 hours. A simultaneous decrease in the serum levels of VCAM-1 and S100 as well as E-selectin and S100 was associated with good neurological outcomes. When other variables were adjusted, a simultaneous decrease in the serum levels of VCAM-1 and S100 was independently associated with good neurological outcomes (odds ratio, 9.285; 95% confidence interval, 1.073 to 80.318; P=0.043).
Conclusion A simultaneous decrease in the serum levels of soluble VCAM-1 and S100 within the first 24 hours after the return of spontaneous circulation was associated with a good neurological outcome in out-of-hospital cardiac arrest survivors.
Citations
Citations to this article as recorded by
Inflammation and Neurological Outcomes in Cardiac Arrest – a Narrative Review of Serum Biomarker Investigations Sergio L. Angulo, Thomas W. Johnson, Lilly Hutchinson, Bhagyashri Bhende, Yama Akbari, Sung-Min Cho, Imad R. Khan Journal of Intensive Care Medicine.2025;[Epub] CrossRef
Prognostic Value of Serum S100B Protein for Neurological Outcomes After Cardiac Arrest: A Systematic Review and Meta-Analysis Łukasz Szpinda, Michal Lis, Michal Pruc, Weronika Goraj, Iwona Niewiadomska, Maciej Maslyk, Katarzyna Kotfis, Hanno L. Tan, Enrico Baldi, Lukasz Szarpak Journal of Clinical Medicine.2025; 15(1): 238. CrossRef
Recovery and Survival of Patients After Out-of-Hospital Cardiac Arrest: A Literature Review Showcasing the Big Picture of Intensive Care Unit-Related Factors Srdjan S Nikolovski, Aleksandra D Lazic, Zoran Z Fiser, Ivana A Obradovic, Jelena Z Tijanic, Violetta Raffay Cureus.2024;[Epub] CrossRef
Predicting neurological outcome after out-of-hospital cardiac arrest with cumulative information; development and internal validation of an artificial neural network algorithm Peder Andersson, Jesper Johnsson, Ola Björnsson, Tobias Cronberg, Christian Hassager, Henrik Zetterberg, Pascal Stammet, Johan Undén, Jesper Kjaergaard, Hans Friberg, Kaj Blennow, Gisela Lilja, Matt P. Wise, Josef Dankiewicz, Niklas Nielsen, Attila Frigye Critical Care.2021;[Epub] CrossRef
Regional cerebral oxygen saturation in cardiac arrest survivors undergoing targeted temperature management 36 °C versus 33 °C: A randomized clinical trial Woon Yong Kwon, Yoon Sun Jung, Gil Joon Suh, Taekyun Kim, Hyeongkyu Kwak, Taekwon Kim, Jeong Yeon Kim, Min Sung Lee, Kyung Su Kim, Jonghwan Shin, Hui Jai Lee, Kyung Min You Resuscitation.2021; 167: 362. CrossRef
Atazanavir is a protease inhibitor approved for use in combination with other antiretroviral drugs for the treatment of human immunodeficiency virus infection. Atazanavir and other protease inhibitors can sometimes induce corrected QT prolongation and ventricular arrhythmia. A 40-year-old man with no comorbidities, except human immunodeficiency virus 1 infection, presented with palpitations 3 days after an overdose of 150 caps of atazanavir, with suicidal intent. His initial electrocardiogram showed monomorphic ventricular tachycardia, and hyperbilirubinemia was observed in his initial blood test. Immediately after magnesium sulfate infusion, his ventricular tachycardia was converted into junctional bradycardia with prolonged corrected QT. After 3 days of close observation in the intensive care unit, the corrected QT prolongation and hyperbilirubinemia were normalized.
Objective To investigate whether serum levels of high-density lipoprotein (HDL) and apolipoprotein A-1 (ApoA1), after the return of spontaneous circulation, can predict the neurologic outcome in patients with out-of-hospital cardiac arrest (OHCA).
Methods This was a retrospective observational study conducted in a single tertiary hospital intensive care unit. All adult OHCA survivors with admission lipid profiles were enrolled from March 2013 to December 2015. Good neurologic outcome was defined as discharge cerebral performance categories 1 and 2.
Results Among 59 patients enrolled, 13 (22.0%) had a good neurologic outcome. Serum levels of HDL (56.7 vs. 40 mg/dL) and ApoA1 (117 vs. 91.6 mg/dL) were significantly higher in patients with a good outcome. Areas under the HDL and ApoA1 receiver operating curves to predict good outcomes were 0.799 and 0.759, respectively. The proportion of good outcome was significantly higher in patients in higher tertiles of HDL and ApoA1 (test for trend, both P=0.003). HDL (P=0.018) was an independent predictor in the multivariate logistic regression model.
Conclusion Admission levels of HDL and ApoA1 are associated with neurologic outcome in patients with OHCA. Prognostic and potential therapeutic values of HDL and ApoA1 merit further evaluation in the post-cardiac arrest state, as in other systemic inflammatory conditions such as sepsis.
Citations
Citations to this article as recorded by
Total cholesterol and bilirubin levels are associated with neurologic outcomes in patients with out-of-hospital cardiac arrest Sang Hwan Lee, Yongil Cho, Jaehoon Oh, Hyunggoo Kang, Tae Ho Lim, Byuk Sung Ko, Kyung Hun Yoo, Juncheol Lee Internal and Emergency Medicine.2025; 20(4): 1185. CrossRef
Neutrophil to high-density lipoprotein cholesterol ratio as a potential inflammatory marker for predicting all-cause mortality in out-of-hospital cardiac arrest survivors Da-Long Chen, Yu-Kai Lin, Guei-Jane Wang, Kuan-Cheng Chang Scientific Reports.2025;[Epub] CrossRef
Lactate-to-albumin ratio and cholesterol levels predict neurological outcome in cardiac arrest survivors Da-Long Chen, Chia-Min Chung, Guei-Jane Wang, Kuan-Cheng Chang The American Journal of Emergency Medicine.2024; 83: 9. CrossRef
Association between Early Phase Serum Albumin Levels and Outcomes of Post-Cardiac Arrest Patients: A Systematic Review and Meta-Analysis Heekyung Lee, Juncheol Lee, Hyungoo Shin, Tae-Ho Lim, Bo-Hyoung Jang, Youngsuk Cho, Wonhee Kim, Jae-Guk Kim, Kyu-Sun Choi, Min-Kyun Na, Chiwon Ahn, Sae-Min Kwon Journal of Personalized Medicine.2022; 12(11): 1787. CrossRef
Serum total cholesterol level as a potential predictive biomarker for neurological outcomes in cardiac arrest survivors who underwent target temperature management Changjoo Ahn, Changshin Kang, Hong Joon Ahn, Yeonho You, Jung Soo Park, Jin Hong Min, Wonjoon Jeong, Yongchul Cho, Seung Ryu, Yong Nam In Medicine.2022; 101(46): e31909. CrossRef
Persistence of Lipoproteins and Cholesterol Alterations after Sepsis: Implication for Atherosclerosis Progression Krzysztof Laudanski International Journal of Molecular Sciences.2021; 22(19): 10517. CrossRef
Low serum cholesterol level as a risk factor for out-of-hospital cardiac arrest: a case-control study Jae Kwang Yang, Yu Jin Kim, Joo Jeong, Jungeun Kim, Jeong Ho Park, Young Sun Ro, Sang Do Shin Clinical and Experimental Emergency Medicine.2021; 8(4): 296. CrossRef
Initial serum cholesterol level as a potential marker for post cardiac arrest patient outcomes Minjung Kathy Chae, Sung Eun Lee, Young Gi Min, Eun Jung Park Resuscitation.2020; 146: 50. CrossRef
The association between lipid profiles and the neurologic outcome in patients with out-of-hospital cardiac arrest Hyoung Youn Lee, Dong Hun Lee, Byung Kook Lee, Kyung Woon Jeung, Yong Hun Jung, Jung Soo Park, Jin Hong Min, Yong Il Min Resuscitation.2019; 145: 26. CrossRef
Objective This study compared the diagnostic accuracy of computed tomography (CT) angiography in patients with various severities of gastrointestinal hemorrhage (GIH).
Methods We retrospectively enrolled adult patients (n=262) with GIH who had undergone CT angiography from January 2012 to December 2013. Age, sex, comorbidities, presenting symptoms, initial vital signs, laboratory results, transfusion volume, emergency department disposition, and hospital mortality were abstracted from patient records. CT angiography findings were reviewed and compared to reference standards consisting of endoscopy, conventional angiography, bleeding scan, capsule endoscopy, and surgery, either alone or in combination. Clinical severity was stratified according to the number of packed red blood cell units transfused during the first two days: the first quartile was categorized as mild severity, while the second and third quartiles were categorized as moderate severity. The fourth quartile was categorized as severe.
Results Patients were categorized into the mild (n=75, 28.6%), moderate (n=139, 53.1%), and severe (n=48, 18.3%) groups. The mean number of transfused packed red blood cell units was 0, 3, and 9.6 in the mild, moderate, and severe groups, respectively. The overall sensitivity, specificity, positive predictive value, and negative predictive value of CT angiography were 73.8%, 94.0%, 97.3%, and 55.3%, respectively. The area under the receiver operating characteristics curve for the diagnostic performance of CT angiography was 0.780, 0.841, and 0.930 in the mild, moderate, and severe groups, respectively, which significantly differed among groups (P=0.006).
Conclusion The diagnostic accuracy of CT angiography is better in patients with more severe GIH.
Citations
Citations to this article as recorded by
The Accuracy of Computed Tomography Angiography Compared With Technetium-99m Labelled Red Blood Cell Scintigraphy for the Diagnosis and Localization of Acute Gastrointestinal Bleeding: A Systematic Review and Meta-Analysis Kaspar L. Yaxley, Ali Mulhem, Sean Godfrey, Jason L. Oke Current Problems in Diagnostic Radiology.2023; 52(6): 546. CrossRef
Delayed endoscopy is associated with increased mortality in upper gastrointestinal hemorrhage Namkyung Jeong, Kyung Su Kim, Yoon Sun Jung, Taegyun Kim, So Mi Shin The American Journal of Emergency Medicine.2019; 37(2): 277. CrossRef
Comparison of the National Early Warning Score+Lactate score with the pre-endoscopic Rockall, Glasgow-Blatchford, and AIMS65 scores in patients with upper gastrointestinal bleeding Daejin Kim, Sion Jo, Jae Baek Lee, Youngho Jin, Taeoh Jeong, Jaechol Yoon, Boyoung Park Clinical and Experimental Emergency Medicine.2018; 5(4): 219. CrossRef
First
Prev
