IMPORTANCE OF COLD SWEAT FOR THE EARLY RECOGNITION OF SHOCK IN TRAUMA PATIENTS

DOI
  • YUMOTO Tetsuya
    Advanced Emergency and Critical Care Medical Center, Okayama University Hospital
  • TSUKAHARA Kohei
    Advanced Emergency and Critical Care Medical Center, Okayama University Hospital
  • IIDA Atsuyoshi
    Advanced Emergency and Critical Care Medical Center, Okayama University Hospital
  • TERADO Michihisa
    Advanced Emergency and Critical Care Medical Center, Okayama University Hospital
  • SATO Keiji
    Advanced Emergency and Critical Care Medical Center, Okayama University Hospital
  • UGAWA Toyomu
    Advanced Emergency and Critical Care Medical Center, Okayama University Hospital
  • UJIKE Yoshihito
    Department of Acute Care and Primary Care Medicine, Kawasaki Medical School Hospital
  • NISHIMURA Tetsuro
    Traumatology and Critical Care Medical Center, National Hospital Organization Osaka National Hospital
  • SADAMITSU Daikai
    Traumatology and Critical Care Medical Center, National Hospital Organization Osaka National Hospital
  • TSUCHIYA Asuka
    Department of Emergency Medicine, National Hospital Organization Mito Medical Center
  • UEKI Hamaichi
    Department of Surgery, National Hospital Organization Mito Medical Center
  • TAKAMA Tatsuo
    Department of Emergency Medicine, School of Medicine, University of Occupational and Environmental Health
  • MAYUMI Toshihiko
    Department of Emergency Medicine, School of Medicine, University of Occupational and Environmental Health

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Other Title
  • 外傷患者における冷汗の意義
  • －多施設共同前向き観察研究より－
  • -MULTICENTER PROSPECT IV E OBSERVATIONAL STUDY-

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We performed a multicenter prospective observational study on the importance of cold sweat as a skin-related finding for the early recognition of shock in trauma patients. Patients with shock were defined as those who required interventions to resolve hemorrhagic or obstructive shock. Cold sweat was evaluated at 4 sites on both the left and right sides by 2 physicians. Cold sweat was defined present when observed at a minimum of １ site by both physicians. Shock was present in 54 (13%) and cold sweat in 36 (9%) of 411 trauma patients. The sensitivity, specificity, and positive and negative predictive values of cold sweat for shock were 35, 95, 53, and 91%, respectively. Patients with cold sweat in shock showed a significantly higher incidence of tachycardia, lower base excess, and higher lactic acid level compared with patients without cold sweat. The sensitivity of cold sweat for shock was not high, but its specificity was high. Therefore, for the early recognition of shock, it is important to actively determine the presence or absence of cold sweat, and combine this with other findings.

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