Predictive accuracy of biomarkers for survival among cardiac arrest patients with hypothermia: A prospective observational cohort study in Japan

Okada, Yohei; Kiguchi, Takeyuki; Irisawa, Taro; Yoshiya, Kazuhisa; Yamada, Tomoki; Hayakawa, Koichi; Noguchi, Kazuo; Nishimura, Tetsuro; Ishibe, Takuya; Yagi, Yoshiki; Kishimoto, Masafumi; Shintani, Hiroshi; Hayashi, Yasuyuki; Sogabe, Taku; Morooka, Takaya; Sakamoto, Haruko; Suzuki, Keitaro; Nakamura, Fumiko; Nishioka, Norihiro; Matsuyama, Tasuku; Matsui, Satoshi; Shimazu, Takeshi; Koike, Kaoru; Kawamura, Takashi; Kitamura, Tetsuhisa; Iwami, Taku

doi:https://doi.org/10.1186/s13049-020-00765-2

Predictive accuracy of biomarkers for survival among cardiac arrest patients with hypothermia: A prospective observational cohort study in Japan

Okada, Yohei; Kiguchi, Takeyuki; Irisawa, Taro et al.

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 2020, 28, 75

Number of Access:3,188（2025-10-21 12:16 Counts）

Identifier to cite or link to this item: https://hdl.handle.net/11094/78369

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Title	Predictive accuracy of biomarkers for survival among cardiac arrest patients with hypothermia: A prospective observational cohort study in Japan
Creator	CreatorName Okada, Yohei
	NRID 1000030724380 1000030724380 CreatorName Kiguchi, Takeyuki
	NRID 1000050379202 1000050379202 researchmap permalink taroiri taroiri Scopus Author ID 7006596493 7006596493 CreatorName Irisawa, Taro
	NRID 1000040379201 1000040379201 CreatorName Yoshiya, Kazuhisa
	NRID 1000040623434 1000040623434 CreatorName Yamada, Tomoki
	NRID 1000060403086 1000060403086 CreatorName Hayakawa, Koichi
	CreatorName Noguchi, Kazuo
	CreatorName Nishimura, Tetsuro
	CreatorName Ishibe, Takuya
	CreatorName Yagi, Yoshiki
	CreatorName Kishimoto, Masafumi
	CreatorName Shintani, Hiroshi
	CreatorName Hayashi, Yasuyuki
	CreatorName Sogabe, Taku
	CreatorName Morooka, Takaya
	CreatorName Sakamoto, Haruko
	CreatorName Suzuki, Keitaro
	CreatorName Nakamura, Fumiko
	CreatorName Nishioka, Norihiro
	NRID 1000050829025 1000050829025 CreatorName Matsuyama, Tasuku
	CreatorName Matsui, Satoshi
	NRID 1000050196474 1000050196474 CreatorName Shimazu, Takeshi
	NRID 1000010267164 1000010267164 CreatorName Koike, Kaoru
	NRID 1000010252230 1000010252230 CreatorName Kawamura, Takashi
	NRID 1000030639810 1000030639810 ORCID 0000-0003-0107-0580 0000-0003-0107-0580 researchmap permalink Kitamura_T Kitamura_T Scopus Author ID 22234282700 22234282700 CreatorName Kitamura, Tetsuhisa
	NRID 1000060437291 1000060437291 CreatorName Iwami, Taku
Subject	Diagnosis
	Hypothermia
	Out-of-hospital cardiac arrest
	Prediction
	Prognosis
Description	Okada, Y., Kiguchi, T., Irisawa, T. et al. Predictive accuracy of biomarkers for survival among cardiac arrest patients with hypothermia: a prospective observational cohort study in Japan. Scand J Trauma Resusc Emerg Med 28, 75 (2020). https://doi.org/10.1186/s13049-020-00765-2
Abstract	Background: There is limited information on the predictive accuracy of commonly used predictors, such as lactate, pH or serum potassium for the survival among out-of-hospital cardiac arrest (OHCA) patients with hypothermia. This study aimed to identify the predictive accuracy of these biomarkers for survival among OHCA patients with hypothermia. Methods: In this retrospective analysis, we analyzed the data from a multicenter, prospective nationwide registry among OHCA patients transported to emergency departments in Japan (the JAAM-OHCA Registry). We included all adult (≥18 years) OHCA patients with hypothermia (≤32.0 °C) who were registered from June 2014 to December 2017 and whose blood test results on hospital arrival were recorded. We calculated the predictive accuracy of pH, lactate, and potassium for 1-month survival. Results: Of the 34,754 patients in the JAAM-OHCA database, we included 754 patients from 66 hospitals. The 1-month survival was 5.8% (44/754). The areas under the curve of the predictors and 95% confidence interval were as follows: pH 0.829 [0.767-0.877] and lactate 0.843 [0.793-0.882]. On setting the cutoff points of 6.9 in pH and 120 mg/dL (13.3 mmol/L) in lactate, the predictors had a high sensitivity (lactate: 0.91; pH 0.91) and a low negative likelihood ratio (lactate: 0.14; pH 0.13), which are suitable to exclude survival to 1 month. Furthermore, in additional analysis that included only the patients with potassium values available, a cutoff point of 7.0 (mmol/L) for serum potassium had high sensitivity (0.96) and a low negative likelihood ratio (0.09). Conclusion: This study indicated the predictive accuracy of serum lactate, pH, and potassium for 1-month survival among adult OHCA patients with hypothermia. These biomarkers may help define a more appropriate resuscitation strategy.
Publisher	BioMed Central
Source Title	Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Volume (Issue)	28
Page	75
Date of Issued	2020-08-05
Language	English
Handle URL	https://hdl.handle.net/11094/78369
eISSN	17577241
Relation.isIdenticalTo	DOI (Publisher Version) https://doi.org/10.1186/s13049-020-00765-2
Relation.isIdenticalTo	PMID 32758271
Access Rights	open access
CopyRight	© 2020 The Author(s). This article is licensed under a Creative Commons Attribution 4.0 International License.
oaire:version	Version of Record
Category	学術雑誌論文 Journal Article

Resource Type	journal article
Local Type	Journal Article
DCMI Type	Text
DCTERMS.bibliographicCitation	Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. 2020, 28, p. 75
DC.title	Predictive accuracy of biomarkers for survival among cardiac arrest patients with hypothermia: A prospective observational cohort study in Japan
DC.creator	Okada, Yohei
	Kiguchi, Takeyuki
	Irisawa, Taro
	Yoshiya, Kazuhisa
	Yamada, Tomoki
	Hayakawa, Koichi
	Noguchi, Kazuo
	Nishimura, Tetsuro
	Ishibe, Takuya
	Yagi, Yoshiki
	Kishimoto, Masafumi
	Shintani, Hiroshi
	Hayashi, Yasuyuki
	Sogabe, Taku
	Morooka, Takaya
	Sakamoto, Haruko
	Suzuki, Keitaro
	Nakamura, Fumiko
	Nishioka, Norihiro
	Matsuyama, Tasuku
	Matsui, Satoshi
	Shimazu, Takeshi
	Koike, Kaoru
	Kawamura, Takashi
	Kitamura, Tetsuhisa
	Iwami, Taku
DC.publisher	BioMed Central
DC.language' scheme='DCTERMS.RFC1766	English
DC.type' scheme='DCTERMS.DCMIType	Text
DCTERMS.issued' scheme='DCTERMS.W3CDTF	2020-08-05
DC.identifier	https://doi.org/10.1186/s13049-020-00765-2
DC.subject	Diagnosis
	Hypothermia
	Out-of-hospital cardiac arrest
	Prediction
	Prognosis
DC.description	Okada, Y., Kiguchi, T., Irisawa, T. et al. Predictive accuracy of biomarkers for survival among cardiac arrest patients with hypothermia: a prospective observational cohort study in Japan. Scand J Trauma Resusc Emerg Med 28, 75 (2020). https://doi.org/10.1186/s13049-020-00765-2
DCTERMS.abstract	Background: There is limited information on the predictive accuracy of commonly used predictors, such as lactate, pH or serum potassium for the survival among out-of-hospital cardiac arrest (OHCA) patients with hypothermia. This study aimed to identify the predictive accuracy of these biomarkers for survival among OHCA patients with hypothermia. Methods: In this retrospective analysis, we analyzed the data from a multicenter, prospective nationwide registry among OHCA patients transported to emergency departments in Japan (the JAAM-OHCA Registry). We included all adult (≥18 years) OHCA patients with hypothermia (≤32.0 °C) who were registered from June 2014 to December 2017 and whose blood test results on hospital arrival were recorded. We calculated the predictive accuracy of pH, lactate, and potassium for 1-month survival. Results: Of the 34,754 patients in the JAAM-OHCA database, we included 754 patients from 66 hospitals. The 1-month survival was 5.8% (44/754). The areas under the curve of the predictors and 95% confidence interval were as follows: pH 0.829 [0.767-0.877] and lactate 0.843 [0.793-0.882]. On setting the cutoff points of 6.9 in pH and 120 mg/dL (13.3 mmol/L) in lactate, the predictors had a high sensitivity (lactate: 0.91; pH 0.91) and a low negative likelihood ratio (lactate: 0.14; pH 0.13), which are suitable to exclude survival to 1 month. Furthermore, in additional analysis that included only the patients with potassium values available, a cutoff point of 7.0 (mmol/L) for serum potassium had high sensitivity (0.96) and a low negative likelihood ratio (0.09). Conclusion: This study indicated the predictive accuracy of serum lactate, pH, and potassium for 1-month survival among adult OHCA patients with hypothermia. These biomarkers may help define a more appropriate resuscitation strategy.
DC.rights	© 2020 The Author(s). This article is licensed under a Creative Commons Attribution 4.0 International License.
DC.format	78369
citation_title	Predictive accuracy of biomarkers for survival among cardiac arrest patients with hypothermia: A prospective observational cohort study in Japan
citation_author	Okada, Yohei
	Kiguchi, Takeyuki
	Irisawa, Taro
	Yoshiya, Kazuhisa
	Yamada, Tomoki
	Hayakawa, Koichi
	Noguchi, Kazuo
	Nishimura, Tetsuro
	Ishibe, Takuya
	Yagi, Yoshiki
	Kishimoto, Masafumi
	Shintani, Hiroshi
	Hayashi, Yasuyuki
	Sogabe, Taku
	Morooka, Takaya
	Sakamoto, Haruko
	Suzuki, Keitaro
	Nakamura, Fumiko
	Nishioka, Norihiro
	Matsuyama, Tasuku
	Matsui, Satoshi
	Shimazu, Takeshi
	Koike, Kaoru
	Kawamura, Takashi
	Kitamura, Tetsuhisa
	Iwami, Taku
citation_publisher	BioMed Central
citation_language	English
citation_date	2020-08-05
citation_journal_title	Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
citation_volume	28
citation_firstpage	75
citation_doi	https://doi.org/10.1186/s13049-020-00765-2
citation_pmid	32758271
citation_public_url	https://hdl.handle.net/11094/78369

Predictive accuracy of biomarkers for survival among cardiac arrest patients with hypothermia: A prospective observational cohort study in Japan

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