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Volume 13 Issue 1
Jan.  2022
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WANG Yang, CHEN Hao. The Search for Optimal Pulse Oxygen Saturation Targets in Pulmonary Embolism Patients[J]. Medical Journal of Peking Union Medical College Hospital, 2022, 13(1): 89-95. DOI: 10.12290/xhyxzz.2021-0212
Citation: WANG Yang, CHEN Hao. The Search for Optimal Pulse Oxygen Saturation Targets in Pulmonary Embolism Patients[J]. Medical Journal of Peking Union Medical College Hospital, 2022, 13(1): 89-95. DOI: 10.12290/xhyxzz.2021-0212
shu

The Search for Optimal Pulse Oxygen Saturation Targets in Pulmonary Embolism Patients

  • 1.

    Pulmonary and Critical Care Medicine, First People's Hospital of Chongqing Liangjiang New Area, Chongqing 401121, China

  • 2.

    Pulmonary and Critical Care Medicine, Dianjiang People's Hospital, Chongqing 408300, China

Funds: 

Medical Scientific Research Project of Chongqing Health Commission 2022WSJK051

More Information
  • Corresponding author:

    CHEN Hao, E-mail: 1041863309@qq.com

  • Received Date: February 20, 2021
  • Accepted Date: May 19, 2021
  • Available Online: January 27, 2022
  • Issue Publish Date: January 29, 2022
    Graphical Abstract
    • Abstract
  •   Objective  To determine the association between pulse oximetry-derived oxygen saturation(SpO2) and all-cause in-hospital mortality of patients with pulmonary embolism during oxygen therapy.
      Methods  Clinical data of the patients with pulmonary embolism as the primary diagnosis in different American medical institutions from the eICU database during 2014 to 2015 were retrieved. Generalized additive model (GAM) was constructed and the graph was drawn to analyze the association between median SpO2 and all-cause in-hospital mortality. The lowest and smooth area of the curve was the optimal SpO2 range. Moreover, the mult- ivariate Cox regression model was applied to verify the association between SpO2 level during oxygen therapy and all-cause in-hospital mortality of patients with pulmonary embolism.
      Results  A total of 422 patients with pulmonary embolism that met the inclusion and exclusion criteria were enrolled. The median score of SpO2 was 97%(95%, 98%) during oxygen therapy.A total of 336 (79.6%) patients were discharged from the hospital and 86 (20.4%) patients died. The GAM indicated a U-shaped relationship between the median score of SpO2 and all-cause in-hospital mortality in patients with pulmonary embolism. In addition, the lowest mortality was observed when the SpO2 range was 96%-98%. Multivariable Cox regression analysis confirmed that the SpO2 level was independently associated with decreased mortality. Taking patients with median SpO2 rang of 96% to 98% as controls, the risk of all-cause in-hospital mortality was increased by 129.8% in patients with median SpO2 < 96% (HR=2.298, 95% CI: 1.268-4.163, P=0.006) and 77.3% in patients with median SpO2 > 98% (HR=1.773, 95% CI: 1.068-2.942, P=0.027).
      Conclusions  The relationship between SpO2 levels and all-cause in-hospital mortality followed a U-shaped curve in patients with pulmonary embolism. The risk of all-cause in-hospital mortality was lowest when SpO2 was between 96% to 98% during oxygen therapy, which may be the target range of oxygenation.
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    • References (33)
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