Admission SpO2 and ROX index predict outcome in patients with COVID-19
| Autor: | Amr Hussein, Ahmed Hasanin, Akram El Adawy, Ahmed Lotfy, Islam El-Hefnawy, Ashraf Rady, Ahmed Mukhtar, Mohamed Hassan, Hanan Mostafa |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male Respiratory rate Critical Care medicine.medical_treatment Peripheral oxygen saturation Article ROX index Respiratory Rate Predictive Value of Tests Oxygen therapy Mechanical ventilatory support Medicine Humans Oxygen saturation (medicine) Aged Retrospective Studies Mechanical ventilation Noninvasive Ventilation Receiver operating characteristic business.industry Diagnostic Tests Routine SARS-CoV-2 Oxygen Inhalation Therapy COVID-19 Retrospective cohort study General Medicine Middle Aged Respiration Artificial Confidence interval Hospitalization Treatment Outcome Oxygen Saturation Anesthesia Emergency Medicine Room air distribution Female Blood Gas Analysis business |
| Zdroj: | The American Journal of Emergency Medicine |
| ISSN: | 1532-8171 0735-6757 |
| Popis: | BACKGROUND: This study aimed to evaluate the accuracy of pulse oximetry-derived oxygen saturation (SpO2) on room air, determined at hospital admission, as a predictor for the need for mechanical ventilatory support in patients with Coronavirus Disease-2019 (COVID-19). METHODS: In this retrospective observational study, demographic and clinical details of the patients were obtained during ICU admission. SpO2 and respiratory rate (RR) on room air were determined within the first 6 h of hospital admission. As all measurements were obtained on room air, we calculated the simplified respiratory rateoxygenation (ROX) index by dividing the SpO2 by the RR. Based on the use of any assistance of mechanical ventilator (invasive or noninvasive), patients were divided into mechanical ventilation (MV) group and oxygen therapy group. The accuracy of the SpO2, CT score, and ROX index to predict the need to MV were determined using the Area under receiver operating curve (AUC). RESULTS: We included 72 critically ill patients who tested COVID-19-positive. SpO2 on the room air could predict any MV requirement (AUC [95% confidence interval]: 0.9 [0.8-0.96], sensitivity: 70%, specificity 100%, cut-off value ≤78%, P < 0.001). Within the MV group, the use of noninvasive ventilation (NIV) was successful in 37 (74%) patients, whereas 13 patients (26%) required endotracheal intubation. The cut-off ROX value for predicting early NIV failure was ≤1.4, with a sensitivity of 85%, a specificity of 86%, and an AUC of 0.86 (95% confidence interval of 0.73-0.94, P < 0.0001). CONCLUSIONS: A baseline SpO2 ≤78% is an excellent predictor of MV requirement with a positive predictive value of 100%. Moreover, the ROX index measured within the first 6 h of hospital admission is a good indicator of early NIV failure. |
| Databáze: | OpenAIRE |
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