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3 "Chang Hwan Sohn"
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Original Article
CPR/Resuscitation
APACHE II Score Immediately after Cardiac Arrest as a Predictor of Good Neurological Outcome in Out-of-Hospital Cardiac Arrest Patients Receiving Targeted Temperature Management
Sang-Il Kim, Youn-Jung Kim, You-Jin Lee, Seung Mok Ryoo, Chang Hwan Sohn, Dong Woo Seo, Yoon-Seon Lee, Jae Ho Lee, Kyoung Soo Lim, Won Young Kim
Acute Crit Care. 2018;33(2):83-88.   Published online May 31, 2018
DOI: https://doi.org/10.4266/acc.2017.00514
  • 6,492 View
  • 99 Download
  • 5 Web of Science
  • 4 Crossref
AbstractAbstract PDF
Background
This study assessed the association between the initial Acute Physiology and Chronic Health Evaluation (APACHE) II score and good neurological outcome in comatose survivors of out-of-hospital cardiac arrest who received targeted temperature management (TTM).
Methods
Data from survivors of cardiac arrest who received TTM between January 2011 and June 2016 were retrospectively analyzed. The initial APACHE II score was determined using the data immediately collected after return of spontaneous circulation rather than within 24 hours after being admitted to the intensive care unit. Good neurological outcome, defined as Cerebral Performance Category 1 or 2 on day 28, was the primary outcome of this study.
Results
Among 143 survivors of cardiac arrest who received TTM, 62 (43.4%) survived, and 34 (23.8%) exhibited good neurological outcome on day 28. The initial APACHE II score was significantly lower in the patients with good neurological outcome than in those with poor neurological outcome (23.71 ± 4.39 vs. 27.62 ± 6.16, P = 0.001). The predictive ability of the initial APACHE II score for good neurological outcome, assessed using the area under the receiver operating characteristic curve, was 0.697 (95% confidence interval [CI], 0.599 to 0.795; P = 0.001). The initial APACHE II score was associated with good neurological outcome after adjusting for confounders (odds ratio, 0.878; 95% CI, 0.792 to 0.974; P = 0.014).
Conclusions
In the present study, the APACHE II score calculated in the immediate post-cardiac arrest period was associated with good neurological outcome. The initial APACHE II score might be useful for early identification of good neurological outcome.

Citations

Citations to this article as recorded by  
  • Prediction performance of scoring systems after out-of-hospital cardiac arrest: A systematic review and meta-analysis
    Boldizsár Kiss, Rita Nagy, Tamás Kói, Andrea Harnos, István Ferenc Édes, Pál Ábrahám, Henriette Mészáros, Péter Hegyi, Endre Zima, Jignesh K. Patel
    PLOS ONE.2024; 19(2): e0293704.     CrossRef
  • Predicting the survivals and favorable neurologic outcomes after targeted temperature management by artificial neural networks
    Wei-Ting Chiu, Chen-Chih Chung, Chien-Hua Huang, Yu-san Chien, Chih-Hsin Hsu, Cheng-Hsueh Wu, Chen-Hsu Wang, Hung-Wen Chiu, Lung Chan
    Journal of the Formosan Medical Association.2022; 121(2): 490.     CrossRef
  • Artificial neural network-boosted Cardiac Arrest Survival Post-Resuscitation In-hospital (CASPRI) score accurately predicts outcome in cardiac arrest patients treated with targeted temperature management
    Szu-Yi Chou, Oluwaseun Adebayo Bamodu, Wei-Ting Chiu, Chien-Tai Hong, Lung Chan, Chen-Chih Chung
    Scientific Reports.2022;[Epub]     CrossRef
  • Novel Approaches to Risk Stratification of In-Hospital Cardiac Arrest
    Jason J. Yang, Xiao Hu, Noel G. Boyle, Duc H. Do
    Current Cardiovascular Risk Reports.2021;[Epub]     CrossRef
Case Report
Toxicology
Methemoglobinemia Caused by an Inert Ingredient after Intentional Ingestion of Pesticide
Ru Bi Jeong, Chang Hwan Sohn, Dong Woo Seo, Won Young Kim, Seung Mok Ryoo, Bum Jin Oh, Kyoung Soo Lim
Korean J Crit Care Med. 2014;29(4):341-343.   Published online November 30, 2014
DOI: https://doi.org/10.4266/kjccm.2014.29.4.341
  • 5,198 View
  • 72 Download
AbstractAbstract PDF
We report two cases of toxic methemoglobinemia caused by an inert ingredient in pesticide product after intentional ingestion of pesticide. First, 51-year-old male visited to the emergency department (ED) after the ingestion of pesticide in a suicide attempt. Initial methemoglobin (MetHb) level was 25.6%. We did not know the cause of methemoglobinemia at that time. Second, 56-year-old female visited to the ED after the ingestion of the same pesticide in a suicide attempt. MetHb level after 30 minutes was 16.1%. The patients were treated with methylene blue. We contacted to the Korean Rural Development Administration and estimated that magnesium nitrate was more likely to cause methemoglobinemia. This report highlights the importance of considering the possibility of methemoglobinemia caused by inert ingredient in pesticide and early antidotal therapy.
Original Article
Clinical Feature and Prognostic Factors of Emphysematous Pyelonephritis
Won Soek Yang, Won Young Kim, Chang Hwan Sohn, Dong Woo Seo, Jae Ho Lee, Won Kim, Kyoung Soo Lim
Korean J Crit Care Med. 2012;27(2):89-93.
DOI: https://doi.org/10.4266/kjccm.2012.27.2.89
  • 2,585 View
  • 36 Download
  • 1 Crossref
AbstractAbstract PDF
BACKGROUND
Emphysematous pyelonephritis (EPN) is a rare and potentially life-threatening condition that requires prompt evaluation and management. However, its clinical presentation and outcomes vary widely. This study was conducted to ascertain the clinical features and prognostic factors regarding EPN.
METHODS
All patients diagnosed with EPN radiologically and treated at the emergency department in the university-affiliated, tertiary-referral center, from January 1999 to December 2009 were evaluated. The patients' demographic and clinical characteristics, computed tomographic findings, treatment, and outcomes were analyzed retrospectively.
RESULTS
Overall 14 patients diagnosed with EPN were admitted. There were 12 females and 2 males. A history of diabetes was found in 12 (85.7%) patients and was the most common comorbidity. The chief complaint among patients was flank pain (42.9%). Severe sepsis or septic shock was noted in 10 (71.4%) patients. Thirteen cases had unilateral involvement and one case had bilateral involvement. More than half of patients had Escherichia.coli in culture. Mean serum levels of HbA1c, creatinine, C-reactive protein (CRP) were 9.4 +/- 2.7, 2.4 +/- 1.4 mg/dl, and 22.4 +/- 13.1 mg/dl. Eight (57.1%) patients received antibiotic treatment alone and four (28.6%) patients received the concurrent percutaneous drainage as well as antibiotics. Hospital mortality was 7.1%. A higher initial serum CRP level (20.3 vs. 49.8 mg/dl, p = 0.02) and HbA1c level (8.7 vs. 16.4, p = 0.01) was associated with hospital mortality.
CONCLUSIONS
Antibiotics alone provide a high success rate for the treatment of EPN. Higher serum CRP and HbA1c level was associated with a higher mortality rate in patients with EPN.

Citations

Citations to this article as recorded by  
  • Analysis of Kidney Computed Tomographic Findings in Patients with Acute Pyelonephritis and Septic Shock
    Soonseong Kwon, Sangchan Jin, Wooik Choi, Sungjin Kim
    Korean Journal of Critical Care Medicine.2013; 28(4): 272.     CrossRef

ACC : Acute and Critical Care