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Original Articles
- CPR/Resuscitation
- Prognostic value of initial hemoglobin levels for neurological outcomes in patients with out-of-hospital cardiac arrest in South Korea
- Jihun Keum, Kyung Hun Yoo, Yongil Cho, Tae Ho Lim, Hyunggoo Kang, Jaehoon Oh, Byuk Sung Ko, Juncheol Lee
- Received October 21, 2025 Accepted March 2, 2026 Published online May 19, 2026
- DOI: https://doi.org/10.4266/acc.005075 [Epub ahead of print]
- 591 View
- 12 Download
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Abstract
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Supplementary Material - Background
Previous studies suggest that lower hemoglobin (Hb) levels are associated with adverse outcomes after out-of-hospital cardiac arrest (OHCA). However, most of these were limited by small sample sizes and single-center designs. We aimed to evaluate the association between initial Hb levels and clinical outcomes after OHCA using a large multicenter registry.
Methods
This retrospective observational study analyzed prospectively collected multicenter registry data. Hb levels measured at emergency department arrival were analyzed as continuous variables with restricted cubic spline (RCS) models, which flexibly characterize dose–response relationships with unfavorable neurological outcomes and in-hospital mortality. Generalized estimating equations with a logit link were used to account for within-hospital clustering and to adjust for clinically relevant covariates.
Results
Lower Hb levels were independently associated with higher adjusted odds of unfavorable neurological outcomes and in-hospital mortality. RCS analyses showed a statistically significant overall association between Hb levels and both outcomes after multivariable adjustment (overall P<0.001). The adjusted odds of adverse outcomes increased progressively with decreasing Hb levels. Cluster-adjusted analyses using generalized estimating equations yielded consistent results.
Conclusions
Initial Hb levels were independently associated with neurological outcomes and in-hospital mortality after OHCA. Modeling Hb as a continuous variable showed a graded association across the Hb spectrum. These findings highlight the prognostic relevance of baseline Hb levels.
- Epidemiology
- Long-term mortality of adult patients with carbon monoxide poisoning presenting to the emergency department in Korea: a population-based cohort study
- Sang Hwan Lee, Soo Rack Ryu, Kyung Hun Yoo, Juncheol Lee, Yongil Cho, Tae Ho Lim, Hyunggoo Kang, Jaehoon Oh, Byuk Sung Ko
- Acute Crit Care. 2024;39(4):526-534. Published online November 18, 2024
- DOI: https://doi.org/10.4266/acc.2024.00199
- 10,835 View
- 181 Download
- 1 Web of Science
- 2 Crossref
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Abstract
PDFSupplementary Material
- Background
Carbon monoxide (CO) poisoning can lead to significant morbidity and mortality. However, relatively few studies have investigated its long-term mortality impact. This nationwide population-based cohort study examined the association between CO poisoning and long-term mortality.
Methods
This retrospective study utilized data from the National Health Insurance Service database in South Korea. We compared the patients with CO poisoning to those without CO poisoning. Inverse probability treatment weights were applied to both groups to control for potential confounding factors. Subsequently, mortality was assessed using the incidence rate and Cox proportional hazard ratios.
Results
This study included 23,387 patients with CO poisoning and 359,851 without it. Over a median follow-up period of 7.6 years after CO poisoning diagnosis, the mortality risk was 2.6 times higher in patients with CO poisoning compared to that in the control group. In a long-term follow-up of patients surviving beyond 30 days, mortality remained 2.18 times higher. Additionally, a higher mortality risk was observed in the relatively younger age group (18–39 years) and the group with fewer underlying diseases, as indicated by a Charlson Comorbidity Index score of 0.
Conclusions
CO poisoning is associated with an elevated long-term mortality rate particularly in a relatively young and healthy population. -
Citations
Citations to this article as recorded by
- Optimizing hyperbaric oxygen initiation time in carbon monoxide poisoning: a 3-hour window enhances neurological recovery via lactate clearance
Dongjun Xu, Xiaoqin Xu, Hui Sun, Jun Xu, Danting Fei, Yaye Shen
Open Medicine.2026;[Epub] CrossRef - Fatal carbon monoxide poisoning in older adults: findings from a 15-year series of forensic autopsies in Turkey
Samet Kiyak, Yusuf Atan, Gökhan Taşkin, Ramazan Kiyak, Ahmet Sedat Dündar
Frontiers in Public Health.2026;[Epub] CrossRef
- Optimizing hyperbaric oxygen initiation time in carbon monoxide poisoning: a 3-hour window enhances neurological recovery via lactate clearance
Case Report
- Cardiology
- Recurrent Pulseless Ventricular Tachycardia Induced by Commotio Cordis Treated with Therapeutic Hypothermia
- Sanghyun Lee, Hyunggoo Kang, Taeho Lim, Jaehoon Oh, Chiwon Ahn, Juncheal Lee, Changsun Kim
- Korean J Crit Care Med. 2015;30(4):349-353. Published online November 30, 2015
- DOI: https://doi.org/10.4266/kjccm.2015.30.4.349
- 10,760 View
- 82 Download
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Abstract
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- The survival rate of commotio cordis is low, and there is often associated neurological disability if return of spontaneous circulation (ROSC) can be achieved. We report a case of commotio cordis treated with therapeutic hypothermia (TH) that demonstrated a favorable outcome. A 16-year-old female was transferred to our emergency department (ED) for collapse after being struck in the chest with a dodgeball. She has no history of heart problems. She was brought to our ED with pulseless ventricular tachycardia (VT), and ROSC was achieved with defibrillation. She was comatose at our ED and was treated with TH at a target temperature of 33°C for 24 hours. After transfer to the intensive care unit, pulseless VT occurred, and defibrillation was performed twice. She recovered to baseline neurologic status with the exception of some memory difficulties.
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