Work

Association of oxygen saturation and mortality in patients with acute respiratory failure

Year: 2024

Type: article

Abstract: BACKGROUND: The variability and disparities in the recommended targets across different international guidelines suggest the optimal oxygen saturation (SpO2) target for acute respiratory failure (ARF) patients be further explored. OBJECTIVES: To explore the association between SpO2 and in-hospital mortality of ARF patients, as well as to determine the optimum SpO2 for ARF patients. MATERIAL AND METHODS: In this cohort study, 3,225 ARF patients were included at the end of the follow-up; among them, and 1,249 patients survived and 1,976 died. The restricted cubic spline (RCS) was drawn to show the nonlinear association between the median SpO2 and the risk of in-hospital mortality of ARF patients and to identify the optimal range of SpO2. Cox regression was applied to identify the association between the median SpO2 and the risk of in-hospital mortality in ARF patients. Kaplan-Meier curves were plotted to identify the in-hospital mortality of ARF patients. RESULTS: The in-hospital mortality rate was 61.2% in all ARF patients at the end of the follow-up. The median SpO2 was associated with decreased risk of in-hospital mortality of ARF patients after adjusting for confounders (hazard ratio (HR) = 0.95, 95% confidence interval (95% CI): 0.93-0.97). The median SpO2 was non-linearly correlated with the in-hospital mortality of ARF patients. The overall survival (OS) was higher in the 96-98% group. A median SpO2 ≤ 96% was associated with an increased risk of in-hospital mortality in ARF patients accompanied by malignant cancer (HR = 1.55, 95% CI: 1.24-1.94), renal failure (HR = 1.45, 95% CI: 1.24-1.70), chronic obstructive pulmonary disease (COPD; HR = 1.70, 95% CI: 1.27-2.28) and atrial fibrillation (AF; HR = 1.25, 95% CI: 1.02-1.53). The median SpO2 > 98% was associated with an elevated risk of in-hospital mortality in ARF patients accompanied by AF (HR = 1.22, 95% CI: 1.04-1.44). CONCLUSIONS: The median SpO2 was linked to a decreased risk of in-hospital mortality in ARF patients.

Source: Advances in Clinical and Experimental Medicine

DOI: 10.17219/acem/189879

Authors: Li Ai, Ran Li, Xixian Teng, Jing Li, Bing Hai

Institutions: Kunming Medical University, Second Affiliated Hospital of Kunming Medical College

Language: English

Topic: Respiratory Support and Mechanisms

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $754