Dataset Information

Harmful effects of early hyperoxaemia in patients admitted to general wards: an observational cohort study in South Korea.

ABSTRACT:

Objectives

We evaluated the association between hyperoxaemia induced by a non-invasive oxygen supply for 3 days after emergency department (ED) arrival and the clinical outcomes at day 5 after ED arrival.

Design

Observational cohort study.

Setting and patients

Consecutive ED patients ?16 years of age with available arterial blood gas analysis results who were admitted to our hospital were enrolled from January 2010 to December 2016.

Interventions

The highest (PaO_2MAX), average (PaO_2AVG) and median (PaO_2MED) PaO₂ (arterial oxygen pressure) values within 72?hours and the area under the curve divided by the time elapsed between ED admittance and the last PaO₂ result (AUC₇₂) were used to assess hyperoxaemia. The AUC₇₂ values were calculated using the trapezoid rule.

Outcomes

The primary outcome was the 90-day in-hospital mortality rate. The secondary outcomes were intensive care unit (ICU) transfer and respiratory failure at day 5 after ED arrival, as well as new-onset cardiovascular, coagulation, hepatic and renal dysfunction at day 5 after ED arrival.

Results

Among the 10?141 patients, the mortality rate was 5.8%. The adjusted ORs of in-hospital mortality for PaO_2MAX, PaO_2AVG, PaO_2MED and AUC₇₂ were 0.79 (95% CI 0.61 to 1.02; p=0.0715), 0.92 (95% CI 0.69 to 1.24; p=0.5863), 0.82 (95% CI 0.61 to 1.11; p=0.2005) and 1.53 (95% CI 1.25 to 1.88; p<0.0001). All of the hyperoxaemia variables showed significant positive correlations with ICU transfer at day 5 after ED arrival (p<0.05). AUC₇₂ was positively correlated with respiratory failure, as well as cardiovascular, hepatic and renal dysfunction (p<0.05). PaO_2MAX was positively correlated with cardiovascular dysfunction. PaO_2MAX and AUC₇₂ were negatively correlated with coagulation dysfunction (p<0.05).

Conclusions

Hyperoxaemia during the first 3 days in patients outside the ICU is associated with in-hospital mortality and ICU transfer at day 5 after arrival at the ED.

SUBMITTER: Jeong JH

PROVIDER: S-EPMC6224716 | biostudies-literature | 2018 Oct

REPOSITORIES: biostudies-literature

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Publications

Harmful effects of early hyperoxaemia in patients admitted to general wards: an observational cohort study in South Korea.

Jeong Jin Hee JH Kim Dong Hoon DH Kim Tae Yun TY Kang Changwoo C Lee Soo Hoon SH Lee Sang Bong SB Kim Seong Chun SC Park Yong Joo YJ

BMJ open 20181025 10

<h4>Objectives</h4>We evaluated the association between hyperoxaemia induced by a non-invasive oxygen supply for 3 days after emergency department (ED) arrival and the clinical outcomes at day 5 after ED arrival.<h4>Design</h4>Observational cohort study.<h4>Setting and patients</h4>Consecutive ED patients ≥16 years of age with available arterial blood gas analysis results who were admitted to our hospital were enrolled from January 2010 to December 2016.<h4>Interventions</h4>The highest (PaO<sub ...[more]

PMID: 30366913

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Project description:BACKGROUND:Disability, which is considered a health-related condition, increases care demands and socioeconomic burdens for both families and communities. To confirm the trend of dynamic longitudinal changes in disability, this study aims to explore how disability is divided by the trajectory method, which deals with time-sequenced data. Additionally, this study examines the differences in demographics, geriatric conditions, and time spent at home among the trajectory groups in community-dwelling older adults. Home time is defined as the period during which the patient was not in a hospital or health care facility during their lifetime. METHODS:Records of 786 community-dwelling older participants were analyzed from the Aging Study of PyeongChang Rural Area, a population-based cohort study that took place over three years. Using 7 domains of activities of daily living and 10 domains of instrumental activities of daily living, participants were grouped into no dependency (0 disabled domain), mild (1 disabled domain), and severe (2 or more disabled domains) disability groups. The longitudinal trajectory group of disability was calculated as a trajectory method. Three distinct trajectory groups were calculated over time: a relatively-stable group (78.5%; n?=?617), a gradually-aggravated group (16.0%; n?=?126), and a rapidly-deteriorated group (5.5%; n?=?43). RESULTS:The average age of 786 participants was 73.3?years (SD: 5.8), and the percentage of female was 52.7%. It was found that 78.5% of patients showed relatively no dependence and 5.5% of older adults in a rural area showed severe dependence. Through applying the trajectory method, it was shown that the Short Physical Performance Battery (SPPB) score was 10.2 points in the relatively-stable group and 3.1 points in the rapidly-deteriorating group by the 3rd year. Additionally, by the trajectory method, the rate of decrease in home time was 3.33% in the rapidly-deteriorated group compared to the relatively-stable group. CONCLUSIONS:This study shows the difference in demographics and geriatric conditions (such as SPPB) through the examination of longitudinal trajectory groups of disability in community-dwelling older adults. Significant differences were also found in the amount of home time among the trajectory groups.

Dataset Information

Harmful effects of early hyperoxaemia in patients admitted to general wards: an observational cohort study in South Korea.

Objectives

Design

Setting and patients

Interventions

Outcomes

Results

Conclusions

Publications

Harmful effects of early hyperoxaemia in patients admitted to general wards: an observational cohort study in South Korea.

Similar Datasets

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