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

-MULTICENTER PROSPECT IV E OBSERVATIONAL STUDY-

Abstract

　　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.