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Commentary

Critical Care

Epidemiology of sepsis in emergency departments: insights from the National Emergency Department Information System (NEDIS) database in Korea, 2020–2024
Sung Yeon Hwang, Taehui Kim, Borami Lim, Sung-keun Ko, Seung Joon Lee
In Press, Received January 15, 2026  Accepted March 16, 2026  Available online April 8, 2026  
DOI: https://doi.org/10.15441/ceem.26.017    [Accepted]

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Epidemiology of sepsis in emergency departments: insights from the National Emergency Department Information System (NEDIS) database in Korea, 2020–2024
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Epidemiology of sepsis in emergency departments: insights from the National Emergency Department Information System (NEDIS) database in Korea, 2020–2024
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Original Articles

Emergency Medicine Practice and Administration | Education & Simulation

Assessing emergency department physician workload: A NASA-TLX analysis by experience and care type
Donghyun Kim, Junsang Yoo, Ye Rim Lee, Ji Sim Yoon, Seung Jin Maeng, Minha Kim, Sejin Heo, Jong Eun Park, Gun Tak Lee, Se Uk Lee, Taerim Kim, Sung Yeon Hwang, Hee Yoon, Won Chul Cha, Hansol Chang
In Press, Received September 23, 2025  Accepted December 29, 2025  Available online February 27, 2026  
DOI: https://doi.org/10.15441/ceem.25.219    [Accepted]

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Assessing emergency department physician workload: A NASA-TLX analysis by experience and care type
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Assessing emergency department physician workload: A NASA-TLX analysis by experience and care type
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Objective
Emergency department (ED) physicians face substantial cognitive and physical demands, yet workload data applicable to real-world staffing and operational decisions remain limited. This study aimed to quantify perceived workload across diverse ED tasks using the NASA Task Load Index (NASA-TLX) and to determine how workload varies by physician experience, patient acuity, and clinical context. A secondary aim was to generate practical insights that may inform resource allocation and experience-based task distribution in the ED.
Methods
We conducted an observational survey of interns, residents, and specialists working in the ED of a tertiary hospital between June and July 2022. NASA-TLX questionnaires were administered to assess workload across common procedures and patient-care tasks. Analyses were stratified by physician experience, Korean Triage and Acuity Scale (KTAS) level, and chief complaint. Nonparametric methods were used to evaluate differences in workload patterns.
Results
Sixty physicians participated (30 interns, 30 residents/specialists). Procedures with high technical complexity, such as thoracentesis and lumbar puncture, showed the highest workload among interns. Among residents, workload decreased from postgraduate year 1 to 3 but rose again in year 4, reflecting increased supervisory responsibilities. Higher patient acuity (KTAS 1–2) and neurological chief complaints were consistently associated with elevated workload across all experience levels.
Conclusion
Perceived workload in the ED varies significantly by task type, experience level, and patient acuity. These findings provide actionable data that may support evidence-based staffing decisions, workload redistribution, and training strategies to optimize physician performance and mitigate cognitive overload in resource-limited emergency departments.
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  • 9 Download

Critical Care

Machine Learning-Based Clusters of Vital Signs and Lactate Levels Predict Vasopressor Use in Sepsis
Daun Jeong, Minyoung Choi, Seung Jin Maeng, Hanbeom Yoon, Jong Eun Park, Gun Tak Lee, Sung Yeon Hwang, Tae Gun Shin, Sung Phil Chung, Tae Ho Lim, on behalf of the Korean Shock Society
In Press, Received October 15, 2025  Accepted December 29, 2025  Available online January 14, 2026  
DOI: https://doi.org/10.15441/ceem.25.247    [Accepted]

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Machine Learning-Based Clusters of Vital Signs and Lactate Levels Predict Vasopressor Use in Sepsis
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Machine Learning-Based Clusters of Vital Signs and Lactate Levels Predict Vasopressor Use in Sepsis
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Objective
Sepsis remains a major clinical challenge because of its complex, heterogeneous, and multidimensional clustering patterns. This study aimed to investigate the association between vasopressor administration and machine learning–derived clusters based on initial vital signs and lactate measurements obtained in emergency department (ED) and intensive care unit (ICU) settings.
Methods
A retrospective cohort analysis was performed using data from the Korean Shock Society Septic Shock (KOSS) Registry (septic shock in the ED) and the Marketplace for Medical Information in Intensive Care (MIMIC)-IV database (ICU patients with suspected infection). To derive clusters, k-means clustering was applied to six initial vital signs and serum lactate measurements. The primary outcome was vasopressor administration. Secondary outcomes included second vasopressor administration and 28-day mortality.
Results
A total of 17,500 patients were included in the analysis (KOSS cohort, n=7,130; MIMIC-IV cohort, n=10,370). K-means clustering identified three distinct clusters in each cohort. In the KOSS cohort, Cluster 3 was characterized by the lowest mean arterial pressure (MAP) (62 mmHg [IQR, 53–71]) and the highest diastolic shock index (DSI) (2.6 [2.3–3.0]). This cluster was associated with the highest rates of vasopressor administration (93.9%), second vasopressor administration (33.5%), and 28-day mortality (25.3%) (all p<0.001). Comparable physiological and clinical patterns were observed in the MIMIC-IV cohort, in which Cluster 3 likewise demonstrated the lowest MAP (68 mmHg [60–76]) and highest DSI (2.0 [1.8–2.3]). This group similarly exhibited the poorest outcomes, including vasopressor administration (41.0%), second vasopressor administration (16.7%), and 28-day mortality (29.0%).
Conclusion
Machine learning–derived clusters based on initial vital signs and serum lactate levels demonstrated different patterns of vasopressor use and mortality. The clinical utility of this approach for guiding timely or targeted vasopressor therapy requires prospective validation.
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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
Clin Exp Emerg Med 2022;9(3):176-186.   Published online September 30, 2022
DOI: https://doi.org/10.15441/ceem.22.324

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Prediction of vasopressor requirement among hypotensive patients with suspected infection: usefulness of diastolic shock index and lactate
Clin Exp Emerg Med. 2022;9(3):176-186.   Published online September 30, 2022
DOI: https://doi.org/10.15441/ceem.22.324
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Prediction of vasopressor requirement among hypotensive patients with suspected infection: usefulness of diastolic shock index and lactate
Clin Exp Emerg Med. 2022;9(3):176-186.   Published online September 30, 2022
DOI: https://doi.org/10.15441/ceem.22.324
Close
Objective
We evaluated the performance of diastolic shock index (DSI) and lactate in predicting vasopressor requirement among hypotensive patients with suspected infection in an emergency department.
Methods
This was a single-center, retrospective observational study for adult patients with suspected infection and hypotension in the emergency department from 2018 to 2019. The study population was split into derivation and validation cohorts (70/30). We derived a simple risk score to predict vasopressor requirement using DSI and lactate cutoff values determined by Youden index. We tested the score by the area under the receiver operating characteristic curve (AUC). We performed a multivariable regression analysis to evaluate the association between the timing of vasopressor treatment and 28-day mortality.
Results
A total of 1,917 patients were included. We developed a score, assigning 1 point each for the high DSI (≥2.0) and high lactate (≥2.5 mmol/L) criteria. The AUCs of the score were 0.741 (95% confidence interval [CI], 0.715–0.768) at hypotension and 0.736 (95% CI, 0.708–0.763) after initial fluid challenge in the derivation cohort and 0.676 (95% CI, 0.631–0.719) at hypotension and 0.688 (95% CI, 0.642–0.733) after initial fluid challenge in the validation cohort, respectively. In patients with scores of 2 points, early vasopressor therapy initiation was significantly associated with decreased 28-day mortality (adjusted odds ratio, 0.37; 95% CI, 0.14–0.94).
Conclusion
A prediction model with DSI and lactate levels might be useful to identify patients who are more likely to need vasopressor administration among hypotensive patients with suspected infection.

Citations

Citations to this article as recorded by  Crossref logo
  • Utility of Shock Index and Pediatric Age-Adjusted Shock Index in Predicting Severe Sepsis and Septic Shock
    Raziye Merve Yaradilmiş, Aytaç Göktuğ, İlknur Bodur, Betül Öztürk, Orkun Aydin, Muhammed M. Güneylioğlu, Bilge Akkaya, Fatma Şule Erdem, Ahmet S. Özcan, Ali Güngör, Can Demir Karacan, Nilden Tuygun
    Pediatric Emergency Care.2026; 42(1): e1.     CrossRef
  • Predicting Cardiovascular Collapse in Critically Ill Patients During Intubation Induction: A Prospective Observational Study
    Ömer Emgin, Gamze Taşkan, Aytuğ Yıldız, İmren Taşkıran, Engin Haftacı, Adnan Ata, Mehmet Yılmaz
    Medicina.2026; 62(1): 177.     CrossRef
  • Effect of norepinephrine initiation timing on mortality in septic shock: a multicenter cohort study
    Jung Won Choi, Tae Gun Shin, Seung Jin Maeng, Sung Yeon Hwang, Sang-Min Kim, Won Young Kim, Kyuseok Kim, Sung-Joon Park, Sung-Hyuk Choi, Sejoong Ahn, Woon Yong Kwon, Taeyoung Kong, Sung Phil Chung, Byuk Sung Ko, Tae Ho Lim
    BMC Anesthesiology.2026;[Epub]     CrossRef
  • The Application of Scoring Systems in Pediatric Intensive Care Unit for Onco-Hematological Patients Who Have Not Undergone Stem Cell Transplantation: A Cross-Sectional Study
    Shereen Abdelmonem Mohamed Mohamed, Hanaa Ibrahim Abdel Fattah Rady, Eman Hany Ahmed Elsebaie, Rana Saber Bastawy Mahmoud
    Indian Journal of Medical and Paediatric Oncology.2026;[Epub]     CrossRef
  • Beyond the Mean: The Dynamic Fingerprint of Vasoplegia in Septic Shock
    Abhishek P Singh, Deepak Govil
    Indian Journal of Critical Care Medicine.2026; 30(2): 85.     CrossRef
  • Temporal Analysis of Diastolic Shock Index in Patients with Septic Shock and Its Correlation with Clinical Outcomes in an Indian Setting: A Prospective Observational Study
    Soumya Sarkar, Ashish K Sharma, Afzal Azim, Jitendra S Chahar, Sangam Yadav, PV Sai Saran, Prabhakar Mishra, Mohan Gurjar, Banani Poddar
    Indian Journal of Critical Care Medicine.2026; 30(2): 99.     CrossRef
  • The clinical utility of shock index in hospitalised patients requiring activation of the rapid response team
    Hasan M. Al-Dorzi, Yasser A. AlRumih, Mohammed Alqahtani, Mutaz H. Althobaiti, Thamer T. Alanazi, Kenana Owaidah, Saud N. Alotaibi, Monirah Alnasser, Abdulaziz M. Abdulaal, Turki Z. Al Harbi, Ahmad O. AlBalbisi, Saad Al-Qahtani, Yaseen M. Arabi
    Australian Critical Care.2025; 38(3): 101150.     CrossRef
  • Diastolic shock index: Its importance and application in critically ill patients: A narrative review
    Natthida Owattanapanich, Natyada Boonchana
    Clinical Critical Care.2025;[Epub]     CrossRef
  • Assessment of the Ability of Shock Index to Predict Early Hemodynamic Collapse in Hypotensive Sepsis Patient in Emergency Department
    Aiesha Baloch, Waqas Farooq Ali, Rafia Shoukat, Dania Asghar, Aqsa Baloch, Mars Christian Aragon Sta Ines
    Indus Journal of Bioscience Research.2025; 3(3): 696.     CrossRef
  • Temporal Analysis of Diastolic Shock Index in Patients with Septic Shock and its Correlation with Clinical Outcomes in Indian Setting – A Prospective Observational Study
    Banani Poddar, Mohan Gurjar, Afzal Azim, Prabhakar Mishra, Jitendra Chahar, Soumya Sarkar
    Indian Journal of Critical Care Medicine.2025; 29(S1): S194.     CrossRef
  • A Novel Approach to Early Personalized Hemodynamic Resuscitation: Non‐Invasive Peripheral Photoplethysmography for Identifying Predominant Vasodilatory Shock in Sepsis
    Sanne Ter Horst, Anna D. Schoonhoven, Raymond J. van Wijk, Rick Weitering, Sanne W. van Loon, Jan C. ter Maaten, Hjalmar R. Bouma
    Acta Anaesthesiologica Scandinavica.2025;[Epub]     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
  • 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
  • Comparison of Early and Late Norepinephrine Administration in Patients With Septic Shock
    Chiwon Ahn, Gina Yu, Tae Gun Shin, Youngsuk Cho, Sunghoon Park, Gee Young Suh
    CHEST.2024; 166(6): 1417.     CrossRef
  • Early management of adult sepsis and septic shock: Korean clinical practice guidelines
    Chul Park, Nam Su Ku, Dae Won Park, Joo Hyun Park, Tae Sun Ha, Do Wan Kim, So Young Park, Youjin Chang, Kwang Wook Jo, Moon Seong Baek, Yijun Seo, Tae Gun Shin, Gina Yu, Jongmin Lee, Yong Jun Choi, Ji Young Jang, Yun Tae Jung, Inseok Jeong, Hwa Jin Cho, A
    Acute and Critical Care.2024; 39(4): 445.     CrossRef
  • Which haemodynamic monitoring should we chose for critically ill patients with acute circulatory failure?
    Xavier Monnet, Christopher Lai
    Current Opinion in Critical Care.2023; 29(3): 275.     CrossRef
  • DEVELOPMENT OF SCORE SYSTEM BASED ON POINT-OF-CARE ULTRASOUND TO PREDICT VASOPRESSOR REQUIREMENT FOR EMERGENCY PATIENTS WITH CARDIOPULMONARY SYMPTOMS
    Hayoung Kim, Ki Hong Kim, Yun Seong Park, Jin Hee Kim, Yun Ang Choi, Joong Wan Park, Yong Hee Lee, Jae Yun Jung
    Shock.2023; 60(1): 34.     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
  • Hemodynamic management of septic shock: beyond the Surviving Sepsis Campaign guidelines
    Gil Joon Suh, Tae Gun shin, Woon Yong Kwon, Kyuseok Kim, You Hwan Jo, Sung-Hyuk Choi, Sung Phil Chung, Won Young Kim
    Clinical and Experimental Emergency Medicine.2023; 10(3): 255.     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
  • Modified Cardiovascular Sequential Organ Failure Assessment Score in Sepsis: External Validation in Intensive Care Unit Patients
    Byuk Sung Ko, Seung Mok Ryoo, Eunah Han, Hyunglan Chang, Chang June Yune, Hui Jai Lee, Gil Joon Suh, Sung-Hyuk Choi, Sung Phil Chung, Tae Ho Lim, Won Young Kim, Jang Won Sohn, Mi Ae Jeong, Sung Yeon Hwang, Tae Gun Shin, Kyuseok Kim
    Journal of Korean Medical Science.2023;[Epub]     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
  • Using the diastolic shock index to determine when to promptly administer vasopressors in patients with septic shock
    Gustavo A. Ospina-Tascón, Gustavo García-Gallardo, Nicolás Orozco
    Clinical and Experimental Emergency Medicine.2022; 9(4): 367.     CrossRef
  • 11,150 View
  • 478 Download
  • 23 Web of Science
  • 23 Crossref

COVID-19

Effect of fever or respiratory symptoms on leaving without being seen during the COVID-19 pandemic in South Korea
Dohyung Kim, Weon Jung, Jae Yong Yu, Hansol Chang, Se Uk Lee, Taerim Kim, Sung Yeon Hwang, Hee Yoon, Tae Gun Shin, Min Seob Sim, Ik Joon Jo, Won Chul Cha
Clin Exp Emerg Med 2022;9(1):1-9.   Published online March 31, 2022
DOI: https://doi.org/10.15441/ceem.21.105

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Effect of fever or respiratory symptoms on leaving without being seen during the COVID-19 pandemic in South Korea
Clin Exp Emerg Med. 2022;9(1):1-9.   Published online March 31, 2022
DOI: https://doi.org/10.15441/ceem.21.105
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Effect of fever or respiratory symptoms on leaving without being seen during the COVID-19 pandemic in South Korea
Clin Exp Emerg Med. 2022;9(1):1-9.   Published online March 31, 2022
DOI: https://doi.org/10.15441/ceem.21.105
Close
Objective
Coronavirus disease 2019 (COVID-19) has notably altered the emergency department isolation protocol, imposing stricter requirements on probable infectious disease patients that enter the department. This has caused adverse effects, such as an increased rate of leave without being seen (LWBS). This study describes the effect of fever/respiratory symptoms as the main cause of isolation regarding LWBS after the COVID-19 pandemic.
Methods
We retrospectively analyzed emergency department visits before (March to July 2019) and after (March to July 2020) the COVID-19 pandemic. Patients were grouped based on existing fever or respiratory symptoms, with the LWBS rate as the primary outcome. Logistic regression analysis was used to identify the risk factors of LWBS. Logistic regression was performed using interaction terminology (fever/respiratory symptom patient [FRP]×post–COVID-19) to determine the interaction between patients with FRPs and the COVID-19 pandemic period.
Results
A total of 60,290 patients were included (34,492 in the pre–COVID-19, and 25,298 in the post–COVID-19 group). The proportion of FRPs decreased significantly after the pandemic (P<0.001), while the LWBS rate in FRPs significantly increased from 2.8% to 19.2% (P<0.001). Both FRPs (odds ratio, 1.76; 95% confidence interval, 1.59–1.84 (P<0.001) and the COVID-19 period (odds ratio, 2.29; 95% confidence interval, 2.15–2.44; P<0.001) were significantly associated with increased LWBS. Additionally, there was a significant interaction between the incidence of LWBS in FRPs and the COVID-19 pandemic period (P<0.001).
Conclusion
The LWBS rate has increased in FRPs after the COVID-19 pandemic; additionally, the effect observed was disproportionate compared with that of nonfever/respiratory symptom patients.

Citations

Citations to this article as recorded by  Crossref logo
  • Nationwide Age-Specific Changes in EMS-Transported Emergency Department Visits in Korea During the Pre-COVID-19 and Post-COVID-19 Periods
    Min-Jung Kim, Jae-Hyun Kwon, Soo Hyun Park, Young-Hoon Byun, Ho-Young Song, Jin Hee Kim, Sung-Ha Kim, So-Hyun Paek
    Journal of Clinical Medicine.2026; 15(7): 2552.     CrossRef
  • Impact of the Early COVID-19 Pandemic on Emergency Department Visits of Adult Cancer Patients With Fever or Respiratory Symptoms: A Korean Nationwide Population-Based Study, 2016–2020
    Kyung Shin Lee, Ho Kyung Sung, Youn Young Choi, Changwoo Han, Hye Sook Min
    Journal of Korean Medical Science.2024;[Epub]     CrossRef
  • Impact of COVID-19 outbreak on acute gallbladder disease in the emergency department
    Dal Sakong, Michael Sung Pil Choe, Woo Young Nho, Chang Won Park
    Clinical and Experimental Emergency Medicine.2023; 10(1): 84.     CrossRef
  • The impact of the COVID-19 pandemic on in-hospital mortality in patients admitted through the emergency department
    Changgyun Kim, Juncheol Lee, Yongil Cho, Jaehoon Oh, Hyunggoo Kang, Tae Ho Lim, Byuk Sung Ko
    Clinical and Experimental Emergency Medicine.2023; 10(1): 92.     CrossRef
  • Patient Anxiety and Communication Experience in the Emergency Department: A Mobile, Web-Based, Mixed-Methods Study on Patient Isolation During the COVID-19 Pandemic
    Sumin Kim, Hansol Chang, Taerim Kim, Won Chul Cha
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
  • Epidemiologic trends of patients who visited nationwide emergency departments: a report from the National Emergency Department Information System (NEDIS) of Korea, 2018–2022
    Hyun Ho Yoo, Young Sun Ro, Eunsil Ko, Jin-Hee Lee, So-hyun Han, Taerim Kim, Tae Gun Shin, Seongjung Kim, Hansol Chang
    Clinical and Experimental Emergency Medicine.2023; 10(S): S1.     CrossRef
  • Characteristics of pediatric emergency department visits before and during the COVID-19 pandemic: a report from the National Emergency Department Information System (NEDIS) of Korea, 2018–2022
    Jin Hyuck Hong, So Hyun Paek, Taerim Kim, Seongjung Kim, Eunsil Ko, Young Sun Ro, Jungeon Kim, Jae Hyun Kwon
    Clinical and Experimental Emergency Medicine.2023; 10(S): S13.     CrossRef
  • The effect of COVID-19 pandemic on the length of stay and outcomes in the emergency department
    Soh Yeon Chun, Ho Jung Kim, Han Bit Kim
    Clinical and Experimental Emergency Medicine.2022; 9(2): 128.     CrossRef
  • Emergency Transport Refusal during the Early Stages of the COVID-19 Pandemic in Gyeonggi Province, South Korea
    Min Young Ryu, Hang A. Park, Sangsoo Han, Hye Ji Park, Choung Ah Lee
    International Journal of Environmental Research and Public Health.2022; 19(14): 8444.     CrossRef
  • The impact of COVID-19 on cancer care in a tertiary hospital in Korea: possible collateral damage to emergency care
    Shin Hye Yoo, Jin-Ah Sim, Jeongmi Shin, Bhumsuk Keam, Jun-Bean Park, Aesun Shin
    Epidemiology and Health.2022; 44: e2022044.     CrossRef
  • Optimal diagnostic fever thresholds using non-contact infrared thermometers under COVID-19
    Fan Lai, Xin Li, Tianjiao Liu, Xin Wang, Qi Wang, Shan Chen, Sumei Wei, Ying Xiong, Qiannan Hou, Xiaoyan Zeng, Yang Yang, Yalan Li, Yonghong Lin, Xiao Yang
    Frontiers in Public Health.2022;[Epub]     CrossRef
  • Cause-specific mortality in Korea during the first year of the COVID-19 pandemic
    Jinwook Bahk, Kyunghee Jung-Choi
    Epidemiology and Health.2022; 44: e2022110.     CrossRef
  • 8,287 View
  • 252 Download
  • 11 Web of Science
  • 12 Crossref

Pulmonary

Predicting 30-day mortality of patients with pneumonia in an emergency department setting using machine-learning models
Soo Yeon Kang, Won Chul Cha, Junsang Yoo, Taerim Kim, Joo Hyun Park, Hee Yoon, Sung Yeon Hwang, Min Seob Sim, Ik Joon Jo, Tae Gun Shin
Clin Exp Emerg Med 2020;7(3):197-205.   Published online September 30, 2020
DOI: https://doi.org/10.15441/ceem.19.052

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Predicting 30-day mortality of patients with pneumonia in an emergency department setting using machine-learning models
Clin Exp Emerg Med. 2020;7(3):197-205.   Published online September 30, 2020
DOI: https://doi.org/10.15441/ceem.19.052
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Predicting 30-day mortality of patients with pneumonia in an emergency department setting using machine-learning models
Clin Exp Emerg Med. 2020;7(3):197-205.   Published online September 30, 2020
DOI: https://doi.org/10.15441/ceem.19.052
Close
Objective
This study aimed to confirm the accuracy of a machine-learning-based model in predicting the 30-day mortality of patients with pneumonia and evaluating whether they were required to be admitted to the intensive care unit (ICU).
Methods
The study conducted a retrospective analysis of pneumonia patients at an emergency department (ED) in Seoul, Korea, from January 1, 2016 to December 31, 2017. Patients aged 18 years or older with a pneumonia registry designation on their electronic medical record were enrolled. We collected their demographic information, mental status, and laboratory findings. Three models were used: the pre-existing CURB-65 model, and the CURB-RF and Extensive CURB-RF models, which were machine-learning models that used a random forest algorithm. The primary outcomes were ICU admission from the ED or 30-day mortality. Receiver operating characteristic curves were constructed for the models, and the areas under these curves were compared.
Results
Out of the 1,974 pneumonia patients, 1,732 patients were eligible to be included in the study; from these, 473 patients died within 30 days or were initially admitted to the ICU from the ED. The area under receiver operating characteristic curves of CURB-65, CURB-RF, and extensive-CURB-RF were 0.615 (0.614–0.616), 0.701 (0.700–0.702), and 0.844 (0.843–0.845), respectively.
Conclusion
The proposed machine-learning models could predict the mortality of patients with pneumonia more accurately than the pre-existing CURB-65 model and can help decide whether the patient should be admitted to the ICU.

Citations

Citations to this article as recorded by  Crossref logo
  • Implementation of machine learning in emergency departments: A systematic review
    Banafshe Hosseini, Atushi Patel, Megan Landes, Samuel Vaillancourt, Muhammad Mamdani, Kevin Maruthananth, Neha Matharu, Zuha Pathan, Krishihan Sivapragasam, Onlak Ruangsomboon, Becky Skidmore, Andrew D Pinto
    DIGITAL HEALTH.2026;[Epub]     CrossRef
  • Multimodal AI-based 28-day mortality prediction of pneumonia patients at ED discharge: a multicenter study
    Sunjin Hwang, Sejin Heo, Sungjun Hong, Kyu-Hwan Jung, Won Chul Cha, Junsang Yoo
    Scientific Reports.2026;[Epub]     CrossRef
  • Comparison of Predictive Models for Keloid Recurrence Based on Machine Learning
    Yan Hao, Mengjie Shan, Hao Liu, Yijun Xia, Xinwen Kuang, Kexin Song, Youbin Wang
    Journal of Cosmetic Dermatology.2025;[Epub]     CrossRef
  • Machine learning-based model for predicting all-cause mortality in severe pneumonia
    Weichao Zhao, Xuyan Li, Lianjun Gao, Zhuang Ai, Yaping Lu, Jiachen Li, Dong Wang, Xinlou Li, Nan Song, Xuan Huang, Zhao-hui Tong
    BMJ Open Respiratory Research.2025; 12(1): e001983.     CrossRef
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    Tapan Kumar, R. L. Ujjwal
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Emergency Medical Services | Disaster

Effect of typhoons on the Korean national emergency medical service system
Soo Hyun Park, Won Chul Cha, Giwoon Kim, Tae Rim Lee, Sung Yeon Hwang, Tae Gun Shin, Min Seob Sim, Ik Joon Jo
Clin Exp Emerg Med 2018;5(4):272-277.   Published online December 31, 2018
DOI: https://doi.org/10.15441/ceem.17.255

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Effect of typhoons on the Korean national emergency medical service system
Clin Exp Emerg Med. 2018;5(4):272-277.   Published online December 31, 2018
DOI: https://doi.org/10.15441/ceem.17.255
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Effect of typhoons on the Korean national emergency medical service system
Clin Exp Emerg Med. 2018;5(4):272-277.   Published online December 31, 2018
DOI: https://doi.org/10.15441/ceem.17.255
Close
Objective
While the effect of typhoons on emergency medicine has been evaluated, data are scarce on their effects on the emergency medical service (EMS). This study evaluated the effect of typhoons on EMS patients and performance.
Methods
The study period was January 2010 to December 2012. Meteorological data regarding typhoons were provided by the Korean Meteorological Administration. EMS data were retrieved from the EMS database of the national emergency management agency. The database includes ambulance run sheets, which contain clinical and operational data. In this case-crossover study, the cases and controls were EMS calls on the day of typhoon warnings and calls one week prior to the typhoon warnings, respectively.
Results
During the study period, 11 typhoons affected Korea. A total of 14,521 cases were selected for analysis. Overall, there were no obvious differences between the case and control groups. However, there were statistically significant differences in age, place, and time requests. There were fewer patients between 0 and 15 years of age (P=0.01) and more unconscious patients (P=0.01) in the case group. The EMS operational performance, as measured by the times elapsed between call to start, call to field, and call to hospital did not differ significantly. There was also no significant difference in the time from hospital arrival between the cases (28.67, standard deviation 16.37) and controls (28.97, standard deviation 28.91) (P=0.39).
Conclusion
Typhoons did not significantly affect the EMS system in this study. Further study is necessary to understand the reasons for this finding.
  • 7,916 View
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Critical Care

Korean Shock Society septic shock registry: a preliminary report
Tae Gun Shin, Sung Yeon Hwang, Gu Hyun Kang, Won Young Kim, Seung Mok Ryoo, Kyuseok Kim, You Hwan Jo, Sung Phil Chung, Young Seon Joo, Jin Ho Beom, Sung-Hyuk Choi, Young Hoon Yoon, Woon Yong Kwon, Tae Ho Lim, Kap Su Han, Han Sung Choi, Gil Joon Suh
Clin Exp Emerg Med 2017;4(3):146-153.   Published online September 30, 2017
DOI: https://doi.org/10.15441/ceem.17.204

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Korean Shock Society septic shock registry: a preliminary report
Clin Exp Emerg Med. 2017;4(3):146-153.   Published online September 30, 2017
DOI: https://doi.org/10.15441/ceem.17.204
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Korean Shock Society septic shock registry: a preliminary report
Clin Exp Emerg Med. 2017;4(3):146-153.   Published online September 30, 2017
DOI: https://doi.org/10.15441/ceem.17.204
Close
Objective
To evaluate the clinical characteristics, therapeutic interventions, and outcomes of patients with septic shock admitted to the emergency department (ED). Methods This study was a preliminary, descriptive analysis of a prospective, multi-center, observational registry of the EDs of 10 hospitals participating in the Korean Shock Society. Patients aged 19 years or older who had a suspected or confirmed infection and evidence of refractory hypotension or hypoperfusion were included. Results A total of 468 patients were enrolled (median age, 71.3 years; male, 55.1%; refractory hypotension, 82.9%; hyperlactatemia without hypotension, 17.1%). Respiratory infection was the most common source of infection (31.0%). The median Sepsis-related Organ Failure Assessment score was 7.5. The sepsis bundle compliance was 91.2% for lactate measurement, 70.3% for blood culture, 68.4% for antibiotic administration, 80.3% for fluid resuscitation, 97.8% for vasopressor application, 68.0% for central venous pressure measurement, 22.0% for central venous oxygen saturation measurement, and 59.2% for repeated lactate measurement. Among patients who underwent interventions for source control (n=117, 25.1%), 43 (36.8%) received interventions within 12 hours of ED arrival. The in-hospital, 28-day, and 90-day mortality rates were 22.9%, 21.8%, and 27.1%, respectively. The median ED and hospital lengths of stay were 6.8 hours and 12 days, respectively. Conclusion This preliminary report revealed a mortality of over 20% in patients with septic shock, which suggests that there are areas for improvement in terms of the quality of initial resuscitation and outcomes of septic shock patients in the ED.

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    Arom Choi, Yoo Seok Park, Tae Gun Shin, Kap Su Han, Won Young Kim, Gu Hyun Kang, Kyuseok Kim, Sung-Hyuk Choi, Tae Ho Lim, Gil Joon Suh
    The American Journal of Emergency Medicine.2019; 37(6): 1054.     CrossRef
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    Journal of Clinical Medicine.2019; 8(1): 102.     CrossRef
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    Hongjung Kim, Sung Phil Chung, Sung-Hyuk Choi, Gu Hyun Kang, Tae Gun Shin, Kyuseok Kim, Yoo Seok Park, Kap Su Han, Han Sung Choi, Gil Joon Suh, Won Young Kim, Tae Ho Lim, Byuk Sung Ko
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    Hyeri Seok, Dae Won Park
    Journal of the Korean Medical Association.2019; 62(12): 638.     CrossRef
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    Byuk Sung Ko, Kyuseok Kim, Sung-Hyuk Choi, Gu Hyun Kang, Tae Gun Shin, You Hwan Jo, Seung Mok Ryoo, Jin Ho Beom, Woon Yong Kwon, Kap Su Han, Han Sung Choi, Sung Phil Chung, Gil Joon Suh, Tae Ho Lim, Won Young Kim
    Critical Care.2018;[Epub]     CrossRef
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    Jikyoung Shin, Sung Yeon Hwang, Ik Joon Jo, Won Young Kim, Seung Mok Ryoo, Gu Hyun Kang, Kyuseok Kim, You Hwan Jo, Sung Phil Chung, Young Seon Joo, Jin Ho Beom, Young Hoon Yoon, Kap Su Han, Tae Ho Lim, Han Sung Choi, Woon Yong Kwon, Gil Joon Suh, Sung-Hyu
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    Journal of Trauma and Injury.2018; 31(3): 166.     CrossRef
  • 13,081 View
  • 181 Download
  • 30 Web of Science
  • 33 Crossref

Resuscitation

Impact of early coronary angiography on the survival to discharge after out-of-hospital cardiac arrest
Jikyoung Shin, Eunsil Ko, Won Chul Cha, Tae Rim Lee, Hee Yoon, Sung Yeon Hwang, Tae Gun Shin, Min Seob Sim, Ik Joon Jo, Keun Jeong Song, Joong Eui Rhee, Yeon Kwon Jeong, Jin-Ho Choi
Clin Exp Emerg Med 2017;4(2):65-72.   Published online June 30, 2017
DOI: https://doi.org/10.15441/ceem.16.167

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Impact of early coronary angiography on the survival to discharge after out-of-hospital cardiac arrest
Clin Exp Emerg Med. 2017;4(2):65-72.   Published online June 30, 2017
DOI: https://doi.org/10.15441/ceem.16.167
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Impact of early coronary angiography on the survival to discharge after out-of-hospital cardiac arrest
Clin Exp Emerg Med. 2017;4(2):65-72.   Published online June 30, 2017
DOI: https://doi.org/10.15441/ceem.16.167
Close
Objective
Acute myocardial infarction is a major cause of out-of-hospital cardiac arrest (OHCA). Coronary angiography (CAG) enables diagnostic confirmation of coronary artery disease and subsequent revascularization, which might improve the prognosis of OHCA survivors. Non-randomized data has shown a favorable impact of CAG on prognosis for this population. However, the optimal timing of CAG has been debated.
Methods
The clinical outcomes of 607 OHCA patients registered in CAPTURES (Cardiac Arrest Pursuit Trial with Unique Registration and Epidemiologic Surveillance), a nationwide multicenter registry performed in 27 hospitals, were analyzed. Early CAG was defined as CAG performed within 24 hours of emergency department admission. The primary outcome was survival to discharge, with neurologically favorable status defined by cerebral performance category scores ≤2.
Results
Compared to patients without CAG (n=469), patients who underwent early CAG (n=138) were younger, more likely to be male, and more likely to have received bystander cardiopulmonary resuscitation, pre-hospital defibrillation, and revascularization (P<0.01 for all). Analysis of 115 propensity score-matched pairs showed that early CAG is associated with a 2.3-fold increase in survival to discharge with neurologically favorable status (P<0.001, all). Survival to discharge increased consistently according to the time interval between emergency department visit and CAG (P<0.05).
Conclusion
Early CAG of OHCA patients was associated with better survival and favorable neurologic outcomes at discharge. However, there was no clear time threshold for CAG that predicted survival to discharge.

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    Sachin Kumar, Bahaa Abdelghaffar, Meghana Iyer, Ghaith Shamaileh, Raunak Nair, Weili Zheng, Beni Verma, Venu Menon, Samir R. Kapadia, Grant W. Reed
    Journal of the Society for Cardiovascular Angiography & Interventions.2023; 2(1): 100536.     CrossRef
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    Nuno Alves, Mauro Mota, Madalena Cunha, Joana Maria Ribeiro
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    Clinical and Experimental Emergency Medicine.2021; 8(S): S41.     CrossRef
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    N.V. Bragina, T.G. Markova, V.I. Gorbachev
    Anesteziologiya i reanimatologiya.2021; (4): 140.     CrossRef
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    Gun Tak Lee, Sung Yeon Hwang, Ik Joon Jo, Tae Rim Kim, Hee Yoon, Won Chul Cha, Min Seob Sim, Sang Do Shin, Tae Gun Shin, Jin-Ho Choi
    Medicine.2021; 100(48): e27855.     CrossRef
  • Coronary Angiography in Patients With Out-of-Hospital Cardiac Arrest Without ST-Segment Elevation
    Beni R. Verma, Vikram Sharma, Shashank Shekhar, Manpreet Kaur, Shameer Khubber, Agam Bansal, Jarmanjeet Singh, Keerat Rai Ahuja, Salik Nazir, Michael Chetrit, Venu Menon, Grant Reed, Samir Kapadia
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    Youngjoon Kang
    Acute and Critical Care.2019; 34(3): 173.     CrossRef
  • Selective Coronary Angiography Following Cardiac Arrest
    Jayasheel O. Eshcol, Adnan K. Chhatriwalla
    Cardiovascular Innovations and Applications.2019;[Epub]     CrossRef
  • Predictors of Obstructive Coronary Disease and Mortality in Adults Having Cardiac Arrest
    Jignesh K. Patel, Ganesh Thippeswamy, Abdo Kataya, Charles A. Loeb, Puja B. Parikh
    The American Journal of Cardiology.2018; 122(1): 12.     CrossRef
  • 14,788 View
  • 171 Download
  • 7 Web of Science
  • 10 Crossref

Emergency Medical Services | Critical Care

Emergency medical service personnel need to improve knowledge and attitude regarding prehospital sepsis care
Joongmin Park, Sung Yeon Hwang, Tae Gun Shin, Ik Joon Jo, Hee Yoon, Tae Rim Lee, Won Chul Cha, Min Seob Sim
Clin Exp Emerg Med 2017;4(1):48-55.   Published online March 30, 2017
DOI: https://doi.org/10.15441/ceem.16.159

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Emergency medical service personnel need to improve knowledge and attitude regarding prehospital sepsis care
Clin Exp Emerg Med. 2017;4(1):48-55.   Published online March 30, 2017
DOI: https://doi.org/10.15441/ceem.16.159
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Emergency medical service personnel need to improve knowledge and attitude regarding prehospital sepsis care
Clin Exp Emerg Med. 2017;4(1):48-55.   Published online March 30, 2017
DOI: https://doi.org/10.15441/ceem.16.159
Close
Objective
We aimed to evaluate the knowledge and attitudes of emergency medical service (EMS) personnel pertaining to sepsis. We also compared EMS personnel’s knowledge of sepsis and their intention to engage in prehospital sepsis management.
Methods
The survey was conducted during education conferences for EMS personnel in December 2013 and January 2015 in Seoul, Korea. The questionnaire composed of 10 questions relevant to sepsis, was distributed on-scene, and was retrieved by investigators after the conference. We classified subjects into active and passive groups based on intent to participate in prehospital sepsis care.
Results
A total of 271 questionnaires were distributed; 255 EMS personnel (94%) completed the survey, 126 (49%) of whom were first-degree emergency medical technicians (EMTs). Less than 75% of subjects provided clinically relevant responses to questions about the definitions of sepsis, tachycardia, tachypnea, hypotension, hypothermia, fluid resuscitation, and vasopressor. Only 15% of participants had suspected that a patient had sepsis, and 9% reported that they could identify patients with sepsis during transportation. Overall, first-degree EMTs showed higher levels of knowledge and a positive attitude to sepsis compared with non-first-degree EMTs. Sixty percent of the participants reported that they were actively involved in prehospital sepsis care. The active group showed significantly higher levels of knowledge and more positive responses to the clinical impact of prehospital sepsis care.
Conclusion
Our study showed that is a substantial portion of EMS personnel lacks appropriate level of knowledge on sepsis care. We also found that the intention to engage in sepsis management was associated with appropriate knowledge of sepsis.

Citations

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    Lea Draeger, Carolin Fleischmann-Struzek, Sabine Gehrke-Beck, Christoph Heintze, Daniel O. Thomas-Rueddel, Konrad Schmidt
    BMC Health Services Research.2025;[Epub]     CrossRef
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    Marie Egebjerg Jensen, Arne Sylvester Jensen, Carsten Meilandt, Kristian Winther Jørgensen, Ulla Væggemose, Allan Bach, Hans Kirkegaard, Marie Kristine Jessen
    Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine.2022;[Epub]     CrossRef
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    Martin Holmbom, Maria Andersson, Sören Berg, Dan Eklund, Pernilla Sobczynski, Daniel Wilhelms, Anna Moberg, Mats Fredrikson, Åse Östholm Balkhed, Håkan Hanberger
    BMJ Open.2021; 11(11): e052582.     CrossRef
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    Stefani Stefani, Yanny Trisyani, Anita Setyawati
    Open Access Macedonian Journal of Medical Sciences.2021; 9(T6): 116.     CrossRef
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    BassamHassan Basaffar, NasserSafar Aloitibi, RashedMohammad Alzahrani, OmarOsama Felimban, KhalidSafir Algethami, AbdullahHamdan Alshehri
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  • 156 Download
  • 7 Web of Science
  • 7 Crossref

Case Report

Toxicology

Upper airway obstruction resulting from acute mucosal injury induced by direct ingestion of sodium picosulfate/magnesium citrate powder
Gyeong Bo Kim, Sung Yeon Hwang, Tae Gun Shin, Tae Rim Lee, Won Chul Cha, Min Seob Sim, Ik Joon Jo, Keun Jeong Song, Joong Eui Rhee, Yeon Kwon Jeong
Clin Exp Emerg Med 2016;3(2):109-111.   Published online June 30, 2016
DOI: https://doi.org/10.15441/ceem.15.023

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Upper airway obstruction resulting from acute mucosal injury induced by direct ingestion of sodium picosulfate/magnesium citrate powder
Clin Exp Emerg Med. 2016;3(2):109-111.   Published online June 30, 2016
DOI: https://doi.org/10.15441/ceem.15.023
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Upper airway obstruction resulting from acute mucosal injury induced by direct ingestion of sodium picosulfate/magnesium citrate powder
Clin Exp Emerg Med. 2016;3(2):109-111.   Published online June 30, 2016
DOI: https://doi.org/10.15441/ceem.15.023
Close
A 59-year-old man presented to the emergency department with a chief complaint of sore throat after swallowing sodium picosulfate/magnesium citrate powder for bowel preparation, without first dissolving it in water. The initial evaluation showed significant mucosal injury involving the oral cavity, pharynx, and epiglottis. Endotracheal intubation was performed for airway protection in the emergency department, because the mucosal swelling resulted in upper airway compromise. After conservative treatment in the intensive care unit, he underwent tracheostomy because stenosis of the supraglottic and subglottic areas was not relieved. The tracheostomy tube was successfully removed after confirming recovery, and he was discharged 3 weeks after admission.

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  • Esophageal Stricture Caused by the Ingestion of Undissolved Picosulfate Powder
    Daehyun Kim, Byungha Cho, Jong Wook Choi, Ki Bae Kim, Seon Mee Park
    Clinical Endoscopy.2021; 54(1): 122.     CrossRef
  • 15,551 View
  • 106 Download
  • 1 Web of Science
  • 1 Crossref
Original Articles

Resuscitation | Education & Simulation

Factors affecting the accuracy of chest compression depth estimation
Jung Hee Kang, Won Chul Cha, Minjung Kathy Chae, Hang A Park, Sung Yeon Hwang, Sang Chan Jin, Tae Rim Lee, Tae Gun Shin, Min Seob Sim, Ik Joon Jo, Keun Jeong Song, Joong Eui Rhee, Yeon Kwon Jeong
Clin Exp Emerg Med 2014;1(2):101-108.   Published online December 31, 2014
DOI: https://doi.org/10.15441/ceem.14.006

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Factors affecting the accuracy of chest compression depth estimation
Clin Exp Emerg Med. 2014;1(2):101-108.   Published online December 31, 2014
DOI: https://doi.org/10.15441/ceem.14.006
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Factors affecting the accuracy of chest compression depth estimation
Clin Exp Emerg Med. 2014;1(2):101-108.   Published online December 31, 2014
DOI: https://doi.org/10.15441/ceem.14.006
Close
Objective
We aimed to estimate the accuracy of visual estimation of chest compression depth and identify potential factors affecting accuracy.
Methods
This simulation study used a basic life support mannequin, the Ambu man. We recorded chest compression with 7 different depths from 1 to 7 cm. Each video clip was recorded for a cycle of compression. Three different viewpoints were used to record the video. After filming, 25 clips were randomly selected. Health care providers in an emergency department were asked to estimate the depth of compressions while watching the selected video clips. Examiner determinants such as experience and cardiopulmonary resuscitation training and environment determinants such as the location of the camera (examiner) were collected and analyzed. An estimated depth was considered correct if it was consistent with the one recorded. A multivariate analysis predicting the accuracy of compression depth estimation was performed.
Results
Overall, 103 subjects were enrolled in the study; 42 (40.8%) were physicians, 56 (54.4%) nurses, and 5 (4.8%) emergency medical technicians. The mean accuracy was 0.89 (standard deviation, 0.76). Among examiner determinants, only subjects’ occupation and clinical experience showed significant association with outcome (P=0.03 and P=0.08, respectively). All environmental determinants showed significant association with the outcome (all P<0.001). Multivariate analysis showed that accuracy rate was significantly associated with occupation, camera position, and compression depth.
Conclusions
The accuracy rate of chest compression depth estimation was 0.89 and was significantly related with examiner’s occupation, camera view position, and compression depth.
  • 12,797 View
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Critical Care

Impact of timely antibiotic administration on outcomes in patients with severe sepsis and septic shock in the emergency department
Young Min Joo, Minjung Kathy Chae, Sung Yeon Hwang, Sang-Chan Jin, Tae Rim Lee, Won Chul Cha, Ik Joon Jo, Min Seob Sim, Keun Jeong Song, Yeon Kwon Jeong, Tae Gun Shin
Clin Exp Emerg Med 2014;1(1):35-40.   Published online September 30, 2014
DOI: https://doi.org/10.15441/ceem.14.012

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Impact of timely antibiotic administration on outcomes in patients with severe sepsis and septic shock in the emergency department
Clin Exp Emerg Med. 2014;1(1):35-40.   Published online September 30, 2014
DOI: https://doi.org/10.15441/ceem.14.012
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Impact of timely antibiotic administration on outcomes in patients with severe sepsis and septic shock in the emergency department
Clin Exp Emerg Med. 2014;1(1):35-40.   Published online September 30, 2014
DOI: https://doi.org/10.15441/ceem.14.012
Close
Objective

We aimed to investigate the effect of timely antibiotic administration on outcomes in patients with severe sepsis and septic shock.

 Methods

We analyzed data from a sepsis registry that included adult patients who initially presented to the emergency department (ED) and met criteria for severe sepsis or septic shock. Timely antibiotic use was defined as administration of a broad-spectrum antibiotic within three hours from the time of ED arrival. Multivariable logistic and linear regression analyses were performed to assess associations between timely administration of antibiotics and outcomes, including hospital mortality, 48-hour change in Sequential Organ Failure Assessment (SOFA) score (delta SOFA), and hospital length of stay (LOS).

 Results

A total of 591 patients were included in the study. In-hospital mortality was 16.9% for patients receiving timely antibiotics (n=377) and 22.9% for patients receiving delayed antibiotics (n=214; P=0.04). The adjusted odds ratio for in-hospital survival was 0.54 (95% confidence interval [CI], 0.34 to 0.87; P=0.01) in patients who received timely antibiotics. Timely antibiotic administration was also significantly associated with higher delta SOFA (2 vs. 1) and shorter hospital LOS among survivors (11 days vs. 15 days). Multivariable linear regression analyses showed that timely antibiotic administration was significantly associated with increased delta SOFA and decreased hospital LOS.

 Conclusion

Antibiotic administration within three hours from the time of ED arrival was significantly associated with improved outcomes, including in-hospital survival, reversal of organ failure, and shorter hospital LOS, in patients with severe sepsis and septic shock.

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  • The Impact of Timing of Antibiotics on Outcomes in Severe Sepsis and Septic Shock
    Sarah A. Sterling, W. Ryan Miller, Jason Pryor, Michael A. Puskarich, Alan E. Jones
    Critical Care Medicine.2015; 43(9): 1907.     CrossRef
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CEEM : Clinical and Experimental Emergency Medicine