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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 (PaO2MAX), average (PaO2AVG) and median (PaO2MED) 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 PaO2MAX, PaO2AVG, PaO2MED 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). PaO2MAX was positively correlated with cardiovascular dysfunction. PaO2MAX 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
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]