Early Predictors of Critical Cases for the Patients Who Visited Emergency Department due to Gas Inhalation: Early Predictors of Severity in Gas Inhalation.
- Author:
Jung Sung HWANG
1
;
Wook Jin CHOI
;
Sun Hyu KIM
;
Byung Ho CHOI
;
Hye Ji LEE
;
Ryeok AHN
;
Eun Seog HONG
Author Information
1. Department of Emergency Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea. uuh0729166@hanmail.net
- Publication Type:Original Article
- Keywords:
Predictive value of tests;
Smoke inhalation injury;
Triage;
Blood gas analysis;
Emergency medicine
- MeSH:
Blood Gas Analysis;
Demography;
Emergencies*;
Emergency Medical Services;
Emergency Medicine;
Emergency Service, Hospital*;
Heart Arrest;
Humans;
Hydrogen-Ion Concentration;
Inhalation*;
Lactic Acid;
Predictive Value of Tests;
Retrospective Studies;
Smoke Inhalation Injury;
Triage;
Ulsan;
Vital Signs
- From:Journal of the Korean Society of Emergency Medicine
2017;28(5):475-483
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: To define early predictors of critical cases involving patients who visited the emergency department (ED) due to gas inhalation, with the goal of identifying patients who require intensive monitoring and treatment. METHODS: The retrospective study was carried out for patients who visited the ED at Ulsan University Hospital due to gas inhalation from March 2014 to February 2016. General demographics, mechanism of accident, critical symptoms, vital signs, blood lab test results, severity, and clinical manifestation were investigated. Patients were divided into a critical group and non-critical group, and predictors of critical cases were investigated by comparing both groups. RESULTS: Of the 180 patients, 26 patients were in the critical group. In this group, more patients displayed altered mentality and cardiac arrest (both p<0.001). The critical group also showed significantly higher fractions for low-blood pressure (systolic blood pressure<90 mmHg; p<0.001), number of critical symptoms (p<0.001), transport by emergency medical services (p=0.003), and consultation involving other departments (p<0.001). Patients in the critical group showed higher Korean Triage and Acuity Scale (KTAS) level (p<0.001), lactate value (p=0.001), and carboxy-hemoglobin value (p=0.017) as well as older age (p=0.001), lower pH (p=0.001), and HCO₃⁻ value (p<0.001). Multiple regression analysis revealed that predictors of critical cases were older age and higher KTAS level (both p<0.001). CONCLUSION: Patients admitted to the ED for treatment of gas inhalation, who were older and had a higher KTAS level, require intensive monitoring and treatment.
