Kirikkale University Faculty of Medicine, Department of Emergency Medicine, Kirikkale, Turkey.
Kirikkale University Faculty of Medicine, Department of Orthopedics and Traumatology, Kirikkale, Turkey.
Am J Emerg Med. 2019 Jun;37(6):1065-1068. doi: 10.1016/j.ajem.2018.08.049. Epub 2018 Aug 19.
BACKGROUND & AIM: The aim of this study was to compare hypothermia patients with and without an Osborn wave (OW) in terms of physical examination findings, laboratory results, and clinical survival.
The study was carried out retrospectively on hypothermic patients. The hypothermic patients were divided into two groups. Group 1 comprised patients with OW on electrocardiogram (ECG), and Group 2 comprised patients without OW on ECG. The Mann-Whitney U test was used to compare the two groups, and the relationships between the variables and the presence of OW and mortality were analyzed with ANOVA. A value of p < 0.05 was considered statistically significant.
OW was detected on ECG of 41.9% of the patients (Group 1). The mean body temperature was 30.8 ± 4.1 °C in Group 1 and 33.3 ± 1.6 °C in Group 2 (p = 0.106). The mean creatinine level was 1.01 ± 0.6 mg/dl in Group 1 and 0.73 ± 0.5 mg/dl in Group 2 (p = 0.046). The mean bicarbonate level was 15.9 ± 3.8 mmol/l in Group 1 and 18.6 ± 3.5 mmol/l in Group 2 (p = 0.038). A relationship was determined between the presence of OW and pH, bicarbonate, and creatinine levels (p = 0.026; 0.013; 0.042, respectively). The mortality rate was 69.2% in Group 1 and 77.8% in Group 2 (p = 0.689).
Although there is a relationship between the decrease in bicarbonate levels, changes in kidney functions that cause acidosis, and the presence of OW, it has no effect on mortality. The presence of OW in hypothermic patients is insufficient to make a decision regarding mortality.
本研究旨在比较出现与不出现 Osborn 波（OW）的低体温患者在体格检查结果、实验室结果和临床存活率方面的差异。
本研究对低体温患者进行回顾性研究。将低体温患者分为两组。第 1 组为心电图（ECG）出现 OW 的患者，第 2 组为 ECG 无 OW 的患者。采用 Mann-Whitney U 检验比较两组，采用方差分析（ANOVA）分析变量与 OW 及死亡率之间的关系。p 值<0.05 被认为具有统计学意义。
在 41.9%的患者（第 1 组）的 ECG 上检测到 OW。第 1 组的平均体温为 30.8±4.1°C，第 2 组为 33.3±1.6°C（p=0.106）。第 1 组的平均肌酐水平为 1.01±0.6mg/dl，第 2 组为 0.73±0.5mg/dl（p=0.046）。第 1 组的平均碳酸氢盐水平为 15.9±3.8mmol/L，第 2 组为 18.6±3.5mmol/L（p=0.038）。OW 的存在与 pH 值、碳酸氢盐和肌酐水平之间存在相关性（p=0.026；0.013；0.042）。第 1 组的死亡率为 69.2%，第 2 组为 77.8%（p=0.689）。
尽管低体温患者出现 OW 与碳酸氢盐水平降低、导致酸中毒的肾功能变化之间存在相关性，但这与死亡率无关。OW 在低体温患者中的出现不足以决定死亡率。
