tetano
Editor, Senior Moderator
Medicina (Kaunas)
. 2021 Dec 14;57(12):1362.
doi: 10.3390/medicina57121362.
Association between Prehospital Hypoxemia and Admission to Intensive Care Unit during the COVID-19 Pandemic: A Retrospective Cohort Study
Rémy Midez[SUP] 1 [/SUP], Christophe A Fehlmann[SUP] 2 [/SUP], Christophe Marti[SUP] 3 [/SUP], Robert Larribau[SUP] 2 [/SUP], Frédéric Rouyer[SUP] 2 [/SUP], Filippo Boroli[SUP] 4 [/SUP], Laurent Suppan[SUP] 2 [/SUP], Birgit Andrea Gartner[SUP] 2 [/SUP]
Affiliations
Abstract
Background and Objectives: The aim of this study was to assess the association between prehospital peripheral oxygen saturation (SpO[SUB]2[/SUB]) and intensive care unit (ICU) admission in confirmed or suspected coronavirus disease 19 (COVID-19) patients. Materials and Methods: We carried out a retrospective cohort study on patients requiring prehospital intervention between 11 March 2020 and 4 May 2020. All adult patients in whom a diagnosis of COVID-19 pneumonia was suspected by the prehospital physician were included. Patients who presented a prehospital confounding respiratory diagnosis and those who were not eligible for ICU admission were excluded. The main exposure was "Low SpO[SUB]2[/SUB]" defined as a value < 90%. The primary outcome was 48-h ICU admission. Secondary outcomes were 48-h mortality and 30-day mortality. We analyzed the association between low SpO[SUB]2[/SUB] and ICU admission or mortality with univariable and multivariable regression models. Results: A total of 145 patients were included. A total of 41 (28.3%) patients had a low prehospital SpO[SUB]2[/SUB] and 21 (14.5%) patients were admitted to the ICU during the first 48 h. Low SpO[SUB]2[/SUB] was associated with an increase in ICU admission (OR = 3.4, 95% CI = 1.2-10.0), which remained significant after adjusting for sex and age (aOR = 5.2, 95% CI = 1.8-15.4). Mortality was higher in low SpO[SUB]2[/SUB] patients at 48 h (OR = 7.1 95% CI 1.3-38.3) and at 30 days (OR = 3.9, 95% CI 1.4-10.7). Conclusions: In our physician-staffed prehospital system, first low prehospital SpO[SUB]2[/SUB] values were associated with a higher risk of ICU admission during the COVID-19 pandemic.
Keywords: COVID-19; acute respiratory distress syndrome; emergency department; emergency medical services; hypoxemia; intensive care unit; orientation; peripheral oxygen saturation; prehospital; triage.
. 2021 Dec 14;57(12):1362.
doi: 10.3390/medicina57121362.
Association between Prehospital Hypoxemia and Admission to Intensive Care Unit during the COVID-19 Pandemic: A Retrospective Cohort Study
Rémy Midez[SUP] 1 [/SUP], Christophe A Fehlmann[SUP] 2 [/SUP], Christophe Marti[SUP] 3 [/SUP], Robert Larribau[SUP] 2 [/SUP], Frédéric Rouyer[SUP] 2 [/SUP], Filippo Boroli[SUP] 4 [/SUP], Laurent Suppan[SUP] 2 [/SUP], Birgit Andrea Gartner[SUP] 2 [/SUP]
Affiliations
- PMID: 34946307
- DOI: 10.3390/medicina57121362
Abstract
Background and Objectives: The aim of this study was to assess the association between prehospital peripheral oxygen saturation (SpO[SUB]2[/SUB]) and intensive care unit (ICU) admission in confirmed or suspected coronavirus disease 19 (COVID-19) patients. Materials and Methods: We carried out a retrospective cohort study on patients requiring prehospital intervention between 11 March 2020 and 4 May 2020. All adult patients in whom a diagnosis of COVID-19 pneumonia was suspected by the prehospital physician were included. Patients who presented a prehospital confounding respiratory diagnosis and those who were not eligible for ICU admission were excluded. The main exposure was "Low SpO[SUB]2[/SUB]" defined as a value < 90%. The primary outcome was 48-h ICU admission. Secondary outcomes were 48-h mortality and 30-day mortality. We analyzed the association between low SpO[SUB]2[/SUB] and ICU admission or mortality with univariable and multivariable regression models. Results: A total of 145 patients were included. A total of 41 (28.3%) patients had a low prehospital SpO[SUB]2[/SUB] and 21 (14.5%) patients were admitted to the ICU during the first 48 h. Low SpO[SUB]2[/SUB] was associated with an increase in ICU admission (OR = 3.4, 95% CI = 1.2-10.0), which remained significant after adjusting for sex and age (aOR = 5.2, 95% CI = 1.8-15.4). Mortality was higher in low SpO[SUB]2[/SUB] patients at 48 h (OR = 7.1 95% CI 1.3-38.3) and at 30 days (OR = 3.9, 95% CI 1.4-10.7). Conclusions: In our physician-staffed prehospital system, first low prehospital SpO[SUB]2[/SUB] values were associated with a higher risk of ICU admission during the COVID-19 pandemic.
Keywords: COVID-19; acute respiratory distress syndrome; emergency department; emergency medical services; hypoxemia; intensive care unit; orientation; peripheral oxygen saturation; prehospital; triage.