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"You Hwan Jo"

Original Article

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.
  • 3,213 View
  • 89 Download

Brief Research Report

Emergency Medical Services | Public Health & Policy

Emergency department utilization in elderly patients: a report from the National Emergency Department Information System (NEDIS) of Korea, 2018-2022
Sun Young Lim, You Hwan Jo, Seongjung Kim, Eunsil Ko, Young Sun Ro, Jungeon Kim, Sumin Baek
Clin Exp Emerg Med 2023;10(S):S26-S35.   Published online November 8, 2023
DOI: https://doi.org/10.15441/ceem.23.146

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Emergency department utilization in elderly patients: a report from the National Emergency Department Information System (NEDIS) of Korea, 2018-2022
Clin Exp Emerg Med. 2023;10(S):S26-S35.   Published online November 8, 2023
DOI: https://doi.org/10.15441/ceem.23.146
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Emergency department utilization in elderly patients: a report from the National Emergency Department Information System (NEDIS) of Korea, 2018-2022
Clin Exp Emerg Med. 2023;10(S):S26-S35.   Published online November 8, 2023
DOI: https://doi.org/10.15441/ceem.23.146
Close
Objective
With general aging of the population, emergency department (ED) utilization by elderly patients is increasing. In this study, we analyzed data on ED visits of patients aged 65 years and older in Korea.
Methods
The study is a retrospective analysis of National Emergency Department Information System (NEDIS) data from 2018–2022, focusing on patients aged 65 years and older who visited EDs across Korea. ED utilization data were analyzed using Korean Triage and Acuity Scale (KTAS) scores. The patients were divided into three age groups, and common chief complaints and diagnoses were identified. Age- and sex-standardized ED visits per 100,000 population and outcomes were also analyzed.
Results
During the study period, there was a total of 9,803,065 elderly patient ED visits. The mean patient age was 76.4±7.6 years, and 47.6% were men. The ED mortality rate and in-hospital mortality rate were 1.8% and 4.6%, respectively. The KTAS scores 1–2 group accounted for 11.0% of patients, KTAS score 3 group for 42.5%, KTAS scores 4–5 group for 37.2%, and KTAS score unknown group for 9.4%. When patients were categorized into three age groups, the oldest group exhibited the highest rates of KTAS score 1, severe illness diagnoses, and mortality. The most frequently reported chief complaint was abdominal pain, and the most common diagnosis was light headedness. When analyzing the data by year, the COVID-19 outbreak had a discernible impact on ED visits and clinical outcomes.
Conclusion
Over the past 5 years, ED visits for elderly patients have averaged 26,050 per 100,000 population per year, with a temporary decline during the COVID-19 pandemic and a subsequent upward trend.

Citations

Citations to this article as recorded by  Crossref logo
  • The Prognostic Value of the Clinical Frailty Scale in Critically Ill Older Adult Patients in the Emergency Department
    Young Woo Um, You Hwan Jo, Jae Hyuk Lee, Inwon Park, Ji Eun Hwang, Seung Hyun Kang, Narae Kim
    The Journal of Emergency Medicine.2026; 80: 33.     CrossRef
  • Interventions according to patient severity in an emergency department based short stay unit: Nursing intervention classification and social network analysis
    Dain Lee, Soyoung Kim, Jaehoon Kim, Joohee Chung, Sunhee Yun, Yeonhee Lee, Il Hyun Lee, Hanjong Park
    International Emergency Nursing.2026; 84: 101730.     CrossRef
  • Emergency Nurses’ Experiences of Triaging Geriatric Trauma Patients: A Qualitative Study
    Yunli Yang, Yanan Liu, Yihua Ding, Yuxuan Qin, Wei Yu, Xiang Li, Huarong Wang, Yanhong Zhang, Shuyan Wang
    Journal of Emergency Nursing.2026;[Epub]     CrossRef
  • Determinants of Emergency Department Length of Stay and the Mediation Effect of Disposition Among Injury Patients in South Korea: A Nationwide Retrospective Study
    Min-Seok Choi, Su-il Kim, Yun-Deok Jang
    Healthcare.2026; 14(4): 469.     CrossRef
  • Comparison of prognosis in emergency department elderly septic shock patients with initial hypotension versus delayed hypotension
    Chaeeun Lee, Gil Joon Suh, Sung-Hyuk Choi, Sung Phil Chung, Won Young Kim, Tae Ho Lim, Sangchun Choi, Tae Gun Shin, Sangun Nah, Sangsoo Han
    European Journal of Emergency Medicine.2026;[Epub]     CrossRef
  • Association between emergency department crowding and mortality: a nationwide analysis stratified by emergency department levels: a retrospective cohort study
    Minha Kim, Jin-Hee Lee, Minyoung Choi, Doyeop Kim, Hanseok Chang, Sejin Heo, Seung Jin Maeng, Tae Gun Shin, Eunsil Ko, Hansol Chang
    BMC Emergency Medicine.2026;[Epub]     CrossRef
  • A team without a name: emergency medicine recognition and its impact on working conditions and well-being
    Megan Gates Kemnitz, Eugenia-Maria Lupan-Muresan, Francis Somville, Bruno Barcella, Noaa Shopen, María de los Angeles López Hernández, Eric P. Heymann
    Medizinische Klinik - Intensivmedizin und Notfallmedizin.2025; 120(6): 481.     CrossRef
  • ANALYSIS OF GERIATRIC POPULATION VISITING EMERGENCY DEPARTMENT: A PROSPECTIVE STUDY
    JAHNU BHOJ NAGAL, BHUVNESHWARI JAITAWAT, TEJPAL YADAV, KAVITA JAIN
    International Journal of Current Pharmaceutical Research.2025; : 129.     CrossRef
  • Occupational Toxic Effect Episodes in a University Hospital, 2021–2024: A Descriptive Analysis Within the Korean Occupational Disease Surveillance Center
    Yangwoo Kim, Ha-Eun Lee, Jei Kim, Tae-Won Jang
    Safety and Health at Work.2025; 16(4): 438.     CrossRef
  • Impact of direct prehospital transport on mortality in patients with severe trauma based on the injury severity score: a nationwide observational study in the Republic of Korea
    Sun Ju Kim, KeunKyun Kim, Oh Hyun Kim, Chan Yong Park
    Osong Public Health and Research Perspectives.2025; 16(4): 381.     CrossRef
  • Factors Influencing Hospitalization Among Older Adults in Tokyo's Emergency Medical Services: The Role of Cerebral Disease and Seasonal Variations
    Kohri Megumi, Ryotaro Suga, Kensuke Suzuki, Satoo Ogawa, Hiroyuki Yokota
    Geriatrics & Gerontology International.2025; 25(12): 1724.     CrossRef
  • Structured simulation-based education in emergency medicine residency programs: Pavia’s proposal for competence development and crisis management (Italy)
    Bruno Barcella, Marco Bonzano, Stefano Perlini, Francesco Salinaro, Emergency Medicine Simulation Group
    Emergency Care Journal.2025;[Epub]     CrossRef
  • The prevalence and factors of adverse health outcomes in Chinese older emergency patients: a cohort study
    Xinyu Ren, Manping Gu, Kebiao Zhang, Hong Li, Rui He
    BMC Geriatrics.2025;[Epub]     CrossRef
  • Emergency department crowding: a national data report
    Hansol Chang, Eunsil Ko, Jin-Hee Lee, Minha Kim, Taerim Kim, Tae Gun Shin, Seongjung Kim
    Clinical and Experimental Emergency Medicine.2024; 11(4): 331.     CrossRef
  • Factors that predict emergency department length of stay in analysis of national data
    Minha Kim, Sujeong Lee, Minyoung Choi, Doyeop Kim, Junsang Yoo, Tae Gun Shin, Jin-Hee Lee, Seongjung Kim, Hansol Chang, Eunsil Ko
    Clinical and Experimental Emergency Medicine.2024; 12(1): 35.     CrossRef
  • 7,956 View
  • 238 Download
  • 12 Web of Science
  • 15 Crossref

Review Article

Critical Care

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, for the Korean Shock Society investigators
Clin Exp Emerg Med 2023;10(3):255-264.   Published online July 13, 2023
DOI: https://doi.org/10.15441/ceem.23.065

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Hemodynamic management of septic shock: beyond the Surviving Sepsis Campaign guidelines
Clin Exp Emerg Med. 2023;10(3):255-264.   Published online July 13, 2023
DOI: https://doi.org/10.15441/ceem.23.065
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Hemodynamic management of septic shock: beyond the Surviving Sepsis Campaign guidelines
Clin Exp Emerg Med. 2023;10(3):255-264.   Published online July 13, 2023
DOI: https://doi.org/10.15441/ceem.23.065
Close
Although the Surviving Sepsis Campaign guidelines provide standardized and generalized guidance, they are less individualized. This review focuses on recent updates in the hemodynamic management of septic shock. Monitoring and intervention for septic shock should be personalized according to the phase of shock. In the salvage phase, fluid resuscitation and vasopressors should be given to provide life-saving tissue perfusion. During the optimization phase, tissue perfusion should be optimized. In the stabilization and de-escalation phases, minimal fluid infusion and safe fluid removal should be performed, respectively, while preserving organ perfusion. There is controversy surrounding the use of restrictive versus liberal fluid strategies after initial resuscitation. Fluid administration after initial resuscitation should depend upon the patient’s fluid responsiveness and requires individualized management. A number of dynamic tests have been proposed to monitor fluid responsiveness, which can help clinicians decide whether to give fluid or not. The optimal timing for the initiation of vasopressor agents is unknown. Recent data suggest that early vasopressor initiation should be considered. Inotropes can be considered in patients with decreased cardiac contractility associated with impaired tissue perfusion despite adequate volume status and arterial blood pressure. Venoarterial extracorporeal membrane oxygenation should be considered for refractory septic shock with severe cardiac systolic dysfunction.

Citations

Citations to this article as recorded by  Crossref logo
  • Red Blood Cell Transfusion Beyond Restrictive Thresholds in Patients With Septic Shock and an Elevated Lactate Level: A Multicenter Observational Study
    Kyung Hun Yoo, Gil Joon Suh, Woon Yong Kwon, Sung-Hyuk Choi, Sung Phil Chung, Won Young Kim, Kyuseok Kim, Yoo Seok Park, Tae Gun Shin, Byuk Sung Ko, Tae Ho Lim, Yongil Cho
    Journal of Korean Medical Science.2026;[Epub]     CrossRef
  • The impact of ketamine on ICU mortality in patients with sepsis: A retrospective cohort study
    Yifei Liu, Jie Yue, Guangdong Wang, Yuxia Jiang, Aihua Shu
    Journal of Critical Care.2026; 92: 155422.     CrossRef
  • Comparison of prognosis in emergency department elderly septic shock patients with initial hypotension versus delayed hypotension
    Chaeeun Lee, Gil Joon Suh, Sung-Hyuk Choi, Sung Phil Chung, Won Young Kim, Tae Ho Lim, Sangchun Choi, Tae Gun Shin, Sangun Nah, Sangsoo Han
    European Journal of Emergency 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
  • Comparison between norepinephrine plus epinephrine and norepinephrine plus vasopressin after return of spontaneous circulation in patients with out-of-hospital cardiac arrest
    Sejoong Ahn, Bo-Yeong Jin, Sukyo Lee, Jong-Hak Park, Hanjin Cho, Sungwoo Moon, Sang Kuk Han, Phil Cho Choi, Young Hwan Lee, Sang O. Park, Jong Seok Lee, Ki Young Jeong, Sung Hyuk Choi, Young Hoon Yoon, Su Jin Kim, Kap Su Han, Min Seob Sim, Gun Tak Lee, Yo
    Scientific Reports.2025;[Epub]     CrossRef
  • Using machine learning techniques for early prediction of tracheal intubation in patients with septic shock: a multi-center study in South Korea
    Ji Han Heo, Taegyun Kim, Tae Gun Shin, Gil Joon Suh, Woon Yong Kwon, Hayoung Kim, Heesu Park, Heejun Kim, Sol Han
    Acute and Critical Care.2025; 40(2): 221.     CrossRef
  • Sepsis Heterogeneity and Precision Medicine: Typing Challenges from Clinical Syndromes to Molecular Mechanisms
    硕 盛
    Journal of Clinical Personalized Medicine.2025; 04(03): 259.     CrossRef
  • The evolving landscape of emergency care
    Lewis J. Kaplan
    Current Opinion in Critical Care.2025; 31(3): 235.     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
  • From Fluid Responsiveness to Prognosis: The Emerging Role of Point-of-Care Echocardiography in Sepsis
    Andrea Piccioni, Gloria Rozzi, Giacomo Spaziani, Michela Novelli, Mariella Fuorlo, Marcello Candelli, Giulia Pignataro, Luca Santarelli, Marcello Covino, Antonio Gasbarrini, Francesco Franceschi
    Diagnostics.2025; 15(20): 2612.     CrossRef
  • Impact of diastolic blood pressure time under range on mortality and acute kidney injury in septic patients: a retrospective cohort study
    Jian Zhao, Si Tong Lin, Ai Hua Qin, Cheng Rui Zhou, Xiang Dong Huang, Hua Guo Chen, Shu Qin Zhou, Hu Peng, Yuan Zhuo Chen
    BMC Anesthesiology.2025;[Epub]     CrossRef
  • Comparison of non-invasive strategies to drive fluid resuscitation in sepsis or septic shock: a meta-analysis of RCTs
    Mara Graziani, Laura Gasperini, Claudia Gasperini, Giorgio Maraziti, Gennaro De Pascale, Cecilia Becattini
    Internal and Emergency Medicine.2025;[Epub]     CrossRef
  • Effect of Intravenous Push and Piggyback Administration of Ceftriaxone on Mortality in Sepsis
    Sun Young Lim, Sumin Baek, You Hwan Jo, Jae Hyuk Lee, Young Woo Um, Hee Eun Kim, Dongkwan Han
    The Journal of Emergency Medicine.2024; 66(5): e632.     CrossRef
  • Temperature trajectories and mortality in hypothermic sepsis patients
    Dongkwan Han, Seung Hyun Kang, Young Woo Um, Hee Eun Kim, Ji Eun Hwang, Jae Hyuk Lee, You Hwan Jo, Yoon Sun Jung, Hui Jai Lee
    The American Journal of Emergency Medicine.2024; 84: 18.     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
  • Removal of circulating mitochondrial N-formyl peptides via immobilized antibody therapy restores sepsis-induced neutrophil dysfunction
    Woon Yong Kwon, Yoon Sun Jung, Gil Joon Suh, Sung Hee Kim, Areum Lee, Jeong Yeon Kim, Hayoung Kim, Heesu Park, Jieun Shin, Taegyun Kim, Kyung Su Kim, Kiyoshi Itagaki, Carl J Hauser
    Journal of Leukocyte Biology.2024; 116(5): 1169.     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
  • 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
  • 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
  • External validation of a modified cardiovascular sequential organ failure assessment score in patients with suspected infection using the MIMIC-IV database
    Sung Yeon Hwang, Inkyu Kim, Byuk Sung Ko, Seung Mok Ryoo, Eunah Han, Hui Jai Lee, Daun Jeong, Tae Gun Shin, Kyuseok Kim, Vipa Thanachartwet
    PLOS ONE.2024; 19(11): e0312185.     CrossRef
  • PiCCO or Cardiac Ultrasound? Which Is Better for Hemodynamic Monitoring in ICU?
    Maria Andrei, Nicoleta Alice Dragoescu, Andreea Stanculescu, Luminita Chiutu, Octavian Dragoescu, Octavian Istratoaie
    Medicina.2024; 60(11): 1884.     CrossRef
  • Assessment of organ failure in sepsis patients in the emergency department: clinical evaluation, Sequential Organ Failure Assessment (SOFA) score, and future perspectives
    Tae Gun Shin
    Clinical and Experimental Emergency Medicine.2024; 11(4): 327.     CrossRef
  • Hemşirelerin Sepsis Farkındalığı ve Sepsis Tanılı Hastalarda Hemşirelik Yönetimi
    Pınar Erman, Güler Balcı Alparslan
    Yoğun Bakım Hemşireliği Dergisi.2024; 28(3): 213.     CrossRef
  • 37,902 View
  • 7,241 Download
  • 20 Web of Science
  • 23 Crossref

Original Articles

Airway

Usability testing of a blind intubation device for intubation novices: a randomized crossover simulation study
Dae Kon Kim, Yu Jin Kim, Joo Jeong, Yoon Ha Joo, You Hwan Jo, Seung Min Park
Clin Exp Emerg Med 2023;10(2):181-190.   Published online February 14, 2023
DOI: https://doi.org/10.15441/ceem.22.370

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Usability testing of a blind intubation device for intubation novices: a randomized crossover simulation study
Clin Exp Emerg Med. 2023;10(2):181-190.   Published online February 14, 2023
DOI: https://doi.org/10.15441/ceem.22.370
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Usability testing of a blind intubation device for intubation novices: a randomized crossover simulation study
Clin Exp Emerg Med. 2023;10(2):181-190.   Published online February 14, 2023
DOI: https://doi.org/10.15441/ceem.22.370
Close
Objective
A new blind intubation device (BID) has been developed for endotracheal intubation. This study aimed to test the usability of the BID in comparison to direct laryngoscopy (DL) and video laryngoscopy (VL) with inexperienced healthcare providers for endotracheal intubation.
Methods
This was a randomized crossover simulation study. Participants who had conducted fewer than five live intubation sessions were included in the study. The manikin simulation was conducted using a Laerdal trainer airway manikin. Participants performed intubation using all three devices, DL, VL, and BID. The primary outcome was intubation success rate in the first pass the secondary outcome was intubation time to first ventilation, and the tertiary outcome was dental injury.
Results
A total of 45 healthcare workers who were novices in intubation participated in this study, including 13 physicians (interns), 14 emergency medical technicians, and 18 nurses. The intubation success rates in the first pass with BID, DL, and VL were 93.3%, 91.1%, and 97.8%, respectively (P=0.53). The intubation times to first ventilation with BID, DL, and VL were 13.15±6.16, 19.07±7.71, and 17.31±6.57 seconds, respectively (P<0.01). The proportions of dental injuries associated with BID, DL, and VL were 0% for physicians; 28.6%, 14.3%, and 0%, respectively for emergency medical technicians; and 27.8%, 11.1%, and 16.7%, respectively for nurses.
Conclusion
We performed a pilot study to test the usability of the new BID. There was no significant difference in intubation success rate in the first pass among BID, DL, and VL. The intubation time to first ventilation was shorter with the BID compared to DL and VL.
  • 6,240 View
  • 158 Download
  • 1 Web of Science

Critical Care

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

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

Citations

Citations to this article as recorded by  Crossref logo
  • Red Blood Cell Transfusion Beyond Restrictive Thresholds in Patients With Septic Shock and an Elevated Lactate Level: A Multicenter Observational Study
    Kyung Hun Yoo, Gil Joon Suh, Woon Yong Kwon, Sung-Hyuk Choi, Sung Phil Chung, Won Young Kim, Kyuseok Kim, Yoo Seok Park, Tae Gun Shin, Byuk Sung Ko, Tae Ho Lim, Yongil Cho
    Journal of Korean Medical Science.2026;[Epub]     CrossRef
  • Clinical Risk Models in Emphysematous Pyelonephritis: Toward a Unified Prognostic Approach
    Erkan Arslan
    Ibnosina Journal of Medicine and Biomedical Sciences.2026; 18(01): 006.     CrossRef
  • 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
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    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
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    Sukyo Lee, Juhyun Song, Sungwoo Lee, Su Jin Kim, Kap Su Han, Sijin Lee
    Journal of Clinical Medicine.2024; 13(18): 5389.     CrossRef
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    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
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Comparison of body water status and its distribution in patients with non-septic infection, patients with sepsis, and healthy controls
Jieun Shin, Inwon Park, Jae Hyuk Lee, Jong Soo Han, Byunghyun Kim, Dong-Hyun Jang, Sang-Min Lee, Che Uk Lee, You Hwan Jo
Clin Exp Emerg Med 2021;8(3):173-181.   Published online September 30, 2021
DOI: https://doi.org/10.15441/ceem.20.094

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Comparison of body water status and its distribution in patients with non-septic infection, patients with sepsis, and healthy controls
Clin Exp Emerg Med. 2021;8(3):173-181.   Published online September 30, 2021
DOI: https://doi.org/10.15441/ceem.20.094
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Comparison of body water status and its distribution in patients with non-septic infection, patients with sepsis, and healthy controls
Clin Exp Emerg Med. 2021;8(3):173-181.   Published online September 30, 2021
DOI: https://doi.org/10.15441/ceem.20.094
Close
Objective
Although fluid resuscitation is the cornerstone of treatment for sepsis, the role of body water status in sepsis is poorly understood. This study aimed to understand how body water and its distribution are modified in patients with sepsis and those with non-septic infection compared to healthy individuals.
Methods
Two groups of adults presumed to have non-septic infection (n=87) and sepsis (n=54) were enrolled in this prospective study in a single emergency department, and they were compared to sex-, age-, and height-matched (1:3 ratio) healthy controls (n=11,190) from retrospective data in a health promotion center. Total body water (TBW), intracellular water (ICW), and extracellular water (ECW), determined using direct segmental multi-frequent bioelectrical impedance analysis (InBody S10) were expressed as indices for normalization by body weight (BW). The ratio of ECW to TBW (ECW/TBW) was evaluated to determine body water distribution.
Results
TBW/BW, ICW/BW, and ECW/BW were significantly higher in the non-septic infection group than in the healthy group (P<0.001), but ECW/TBW was not significantly different (P=0.690). There were no differences in TBW/BW and ICW/BW between the sepsis and healthy groups (P=0.083 and P=0.963). However, ECW/BW and ECW/TBW were significantly higher in the sepsis group than in the healthy group (P<0.001).
Conclusion
Compared to the healthy group, the ratio of body water to BW was significantly increased in the non-septic infection group, while ECW/BW and ECW/TBW were significantly increased in the sepsis group. These indices could be utilized as diagnostic variables of body water deficit in septic patients.

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    Mohammad Mir, Jiawen Chen, Aneri Patel, Meghan R. Pinezich, Maria R. Hudock, Alexander Yoon, Mohamed Diane, John O'Neill, Matthew Bacchetta, Gordana Vunjak-Novakovic, Jinho Kim
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  • 144 Download
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Quick Sepsis-related Organ Failure Assessment score is not sensitive enough to predict 28-day mortality in emergency department patients with sepsis: a retrospective review
Kyung Su Kim, Gil Joon Suh, Kyuseok Kim, Woon Yong Kwon, Jonghwan Shin, You Hwan Jo, Jae Hyuk Lee, Huijai Lee
Clin Exp Emerg Med 2019;6(1):77-83.   Published online March 28, 2019
DOI: https://doi.org/10.15441/ceem.17.294

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

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    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
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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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    Heekyung Lee, Sung-Hyuk Choi, Kyuseok Kim, Tae Gun Shin, Yoo Seok Park, Seung Mok Ryoo, Gil Joon Suh, Woon Yong Kwon, Tae Ho Lim, Donghee Son, Won Young Kim, Byuk Sung Ko
    Journal of Critical Care.2021; 66: 154.     CrossRef
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    Jong Eun Park, Tae Gun Shin, Ik Joon Jo, Kyeongman Jeon, Gee Young Suh, Minsu Park, Hojeong Won, Chi Ryang Chung, Sung Yeon Hwang
    Journal of Clinical Medicine.2020; 9(1): 193.     CrossRef
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    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
  • Normothermia in Patients With Sepsis Who Present to Emergency Departments Is Associated With Low Compliance With Sepsis Bundles and Increased In-Hospital Mortality Rate*
    Sunghoon Park, Kyeongman Jeon, Dong Kyu Oh, Eun Young Choi, Gil Myeong Seong, Jeongwon Heo, Youjin Chang, Won Gun Kwack, Byung Ju Kang, Won-Il Choi, Kyung Chan Kim, So Young Park, Yoon Mi Shin, Heung Bum Lee, So Hee Park, Seok Chan Kim, Sang Hyun Kwak, Ja
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    Youn-Jung Kim, Jihoon Kang, Min-Ju Kim, Seung Mok Ryoo, Gu Hyun Kang, Tae Gun Shin, Yoo Seok Park, Sung-Hyuk Choi, Woon Yong Kwon, Sung Phil Chung, Won Young Kim
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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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    Tae Gun Shin, Youn-Jung Kim, Seung Mok Ryoo, Sung Yeon Hwang, Ik Joon Jo, Sung Phil Chung, Sung-Hyuk Choi, Gil Joon Suh, Won Young Kim
    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
    Journal of Critical Care.2019; 53: 176.     CrossRef
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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
  • Prognostic Value of The Lactate/Albumin Ratio for Predicting 28-Day Mortality in Critically ILL Sepsis Patients
    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
    Shock.2018; 50(5): 545.     CrossRef
  • Significance of Biomarkers as a Predictive Factor for Post-Traumatic Sepsis
    Kyung-Wuk Lee, Sung-Hyuk Choi, Young-Hoon Yoon, Jung-Youn Kim, Young-Duck Cho, Han-Jin Cho, Sung-Jun Park
    Journal of Trauma and Injury.2018; 31(3): 166.     CrossRef
  • 13,081 View
  • 181 Download
  • 30 Web of Science
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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.

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    Wenbin Nan, Siqi Li, Jinfa Wan, Zhenyu Peng
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    Egyptian Pediatric Association Gazette.2024;[Epub]     CrossRef
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    Na Li, Wenli Chu
    BMC Pulmonary Medicine.2023;[Epub]     CrossRef
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    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
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    瑞 杨
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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
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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
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    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
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    Mandana Pouladzadeh, Mehdi Safdarian, Parastoo Moradi Choghakabodi, Fatemeh Amini, Alireza Sokooti
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    Human Vaccines & Immunotherapeutics.2021; 17(12): 5460.     CrossRef
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    Cristina Represas, Maribel Botana, Alberto Fernández-Villar
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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
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    Julia Johanna Grannemann, Achim Röper, Sebastian Rehberg, Gerrit Jansen
    Der Anaesthesist.2021; 70(10): 866.     CrossRef
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    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
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    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
  • 12,572 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
  • 10,554 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.

Citations

Citations to this article as recorded by  Crossref logo
  • Rediscovery of acute lung injury in cardiac arrest: Breathing fresh air into a neglected component of the post-cardiac arrest syndrome
    Willard W. Sharp, Lin Piao
    Resuscitation.2025; 207: 110495.     CrossRef
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    Ingo Voigt, Marco Mighali, Heinrich Wieneke, Oliver Bruder
    Internal and Emergency Medicine.2024; 19(2): 501.     CrossRef
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    N. D.B. Ehelepola, R. M.D.C. Ranathunga, A. B. Abeysundara, H. M.R.P. Jayawardana, P. S.K. Nanayakkara
    BMC Anesthesiology.2024;[Epub]     CrossRef
  • Lung parenchymal and pleural findings on computed tomography after out-of-hospital cardiac arrest
    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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    Shock.2018; 50(6): 706.     CrossRef
  • Sodium bicarbonate administration during ongoing resuscitation is associated with increased return of spontaneous circulation
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    The American Journal of Emergency Medicine.2015; 33(11): 1659.     CrossRef
  • 16,935 View
  • 137 Download
  • 20 Web of Science
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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
Close
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
  • 12,697 View
  • 79 Download
  • 1 Crossref

Experimental study | Critical Care

Rapid rewarming after therapeutic hypothermia worsens outcome in sepsis
You Hwan Jo, Kyuseok Kim, Jae Hyuk Lee, Kwang Pil Rim, In Soo Cho
Clin Exp Emerg Med 2014;1(2):120-125.   Published online December 31, 2014
DOI: https://doi.org/10.15441/ceem.14.015

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Rapid rewarming after therapeutic hypothermia worsens outcome in sepsis
Clin Exp Emerg Med. 2014;1(2):120-125.   Published online December 31, 2014
DOI: https://doi.org/10.15441/ceem.14.015
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Rapid rewarming after therapeutic hypothermia worsens outcome in sepsis
Clin Exp Emerg Med. 2014;1(2):120-125.   Published online December 31, 2014
DOI: https://doi.org/10.15441/ceem.14.015
Close
Objective
This study was performed to investigate the effect of the rewarming rate on survival and acute lung injury in sepsis.
Methods
Male Sprague-Dawley rats underwent cecal ligation and incision. After 1 hour of sepsis induction, normothermia (37°C±0.5°C, NT group) or hypothermia (32°C±0.5°C) was induced. Hypothermia was maintained for 4 hours and rats were divided into two groups according to the rewarming rate: RW1 group, 1 hour of rewarming; and RW2 group, 2 hours of rewarming. In the survival study, rats were observed for 12 hours after sepsis induction (n=6 per group). In the second experiment, rats were sacrificed 7 hours after sepsis induction, and lung tissues and plasma were harvested (n=10 per group).
Results
In the survival study, the RW2 group survived longer than the RW1 group (P<0.05), but the RW1 and NT groups showed no significant difference in survival duration (P>0.05). The histological lung injury score and malondialdehyde concentrations in the lung tissues were significantly higher in the RW1 group than in the RW2 group (P<0.05). Plasma interleukin (IL)-6 concentration and the ratio of IL-6 to IL-10 were higher in the RW1 group than in the RW2 group (P<0.05).
Conclusion
Rapid rewarming after therapeutic hypothermia results in a shorter survival period and acute lung injury in sepsis, which could be associated with the inflammatory responses.

Citations

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  • Combination Therapy of Niacin and Apocynin Attenuates Lung Injury During Sepsis in Rats
    Heesu Park, Yoon Sun Jung, Gil Joon Suh, Woon Yong Kwon, Kyung Su Kim, Taegyun Kim, Hayoung Kim, Jieun Shin
    Journal of Surgical Research.2023; 285: 51.     CrossRef
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    M Martony, JA Hernandez, M de Wit, J St Leger, C Erlacher-Reid, J Vandenberg, NI Stacy
    Diseases of Aquatic Organisms.2019; 132(2): 85.     CrossRef
  • Is Therapeutic Hypothermia for Acute Respiratory Distress Syndrome the Future?
    Adam J. Hayek, Heath D. White, Shekhar Ghamande, Christopher Spradley, Alejandro C. Arroliga
    Journal of Intensive Care Medicine.2017; 32(7): 460.     CrossRef
  • 14,655 View
  • 119 Download
  • 5 Web of Science
  • 3 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
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    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
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    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
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    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
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    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
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    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
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    Lisa Mellhammar, Bertil Christensson, Adam Linder
    Open Forum Infectious Diseases.2015;[Epub]     CrossRef
  • 16,797 View
  • 166 Download
  • 14 Web of Science
  • 14 Crossref
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CEEM : Clinical and Experimental Emergency Medicine