{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T22:45:39Z","timestamp":1792449939359,"version":"4.5.0"},"reference-count":34,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2023,3,20]],"date-time":"2023-03-20T00:00:00Z","timestamp":1679270400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100002736","name":"Covidien","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002736","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>This study assessed the ability of end\u2010tidal carbon dioxide (ETCO<jats:sub>2<\/jats:sub>) in predicting in\u2010hospital mortality and intensive care unit (ICU) admission compared to standard vital signs at ED triage as well as comparing to measures of metabolic acidosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This prospective study enrolled adult patients presenting to the ED of a tertiary care Level\u2009I trauma center over 30\u2009months. Patients had standard vital signs measured along with exhaled ETCO<jats:sub>2<\/jats:sub> at triage. Outcome measures included in\u2010hospital mortality; ICU admission; and correlations with lactate, sodium bicarbonate (HCO<jats:sub>3<\/jats:sub>), and anion gap.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 1136 patients enrolled and 1091 patients with outcome data available. There were 26 (2.4%) patients who did not survive to hospital discharge. Mean ETCO<jats:sub>2<\/jats:sub> levels were 34 (33\u201334) in survivors and 22 (18\u201326) nonsurvivors (<jats:italic>p<\/jats:italic>\u00a0&lt;\u20090.001). The area under the curve (AUC) for predicting in\u2010hospital mortality for ETCO<jats:sub>2<\/jats:sub> was 0.82 (0.72\u20130.91). In comparison the AUC for temperature was 0.55 (0.42\u20130.68), respiratory rate (RR) 0.59 (0.46\u20130.73), systolic blood pressure (SBP) 0.77 (0.67\u20130.86), diastolic blood pressure (DBP) 0.70 (0.59\u20130.81), heart rate (HR) 0.76 (0.66\u20130.85), and oxygen saturation (SpO<jats:sub>2<\/jats:sub>) 0.53 (0.40\u20130.67). There were 64 (6%) patients admitted to the ICU, and the ETCO<jats:sub>2<\/jats:sub> AUC for predicting ICU admission was 0.75 (0.67\u20130.80). In comparison the AUC for temperature was 0.51, RR 0.56, SBP 0.64, DBP 0.63, HR 0.66, and SpO<jats:sub>2<\/jats:sub> 0.53. Correlations between expired ETCO<jats:sub>2<\/jats:sub> and serum lactate, anion gap, and HCO<jats:sub>3<\/jats:sub> were rho\u00a0=\u00a0\u22120.25 (<jats:italic>p<\/jats:italic>\u00a0&lt;\u20090.001), rho\u00a0=\u00a0\u22120.20 (<jats:italic>p<\/jats:italic>\u00a0&lt;\u20090.001), and rho\u00a0=\u00a00.330 (<jats:italic>p<\/jats:italic>\u00a0&lt;\u20090.001), respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>ETCO<jats:sub>2<\/jats:sub> was a better predictor of in\u2010hospital mortality and ICU admission than the standard vital signs at ED triage. ETCO<jats:sub>2<\/jats:sub> correlated significantly with measures of metabolic acidosis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acem.14703","type":"journal-article","created":{"date-parts":[[2023,2,21]],"date-time":"2023-02-21T17:57:26Z","timestamp":1677002246000},"page":"832-841","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["End\u2010tidal carbon dioxide measured at emergency department triage outperforms standard triage vital signs in predicting in\u2010hospital mortality and intensive care unit admission"],"prefix":"10.1111","volume":"30","author":[{"given":"Jay G.","family":"Ladde","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine Orlando Regional Medical Center  Orlando Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stacie","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Orlando Regional Medical Center 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