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Supplemental oxygen therapy in trauma patients: an exploratory registry-based study

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@article{bfc1f837e59d453a8b4e763c375eed90,
title = "Supplemental oxygen therapy in trauma patients: an exploratory registry-based study",
abstract = "BACKGROUND: Supplemental oxygen (SO) is one of the most commonly administered drugs in trauma patients and is recommended by guidelines. However, evidence supporting uniform administration is sparse, and excess oxygen use has been shown to be harmful in other patient populations. We hypothesized that SO may be harmful in patients with oxygen saturation>97%.METHODS: Patients with available information on SO-therapy in the American Trauma Quality Improvement Program 2017 database were included. Patients were categorized into three groups according to Emergency Department (ED) oxygen saturation: 1) Saturation<94%; 2) Saturation 94-97%; 3) Saturation 98-100%. Primary outcome was in-hospital mortality with comparisons made between patients who received SO or not. Secondary outcome was acute respiratory distress syndrome (ARDS). Patients were compared after propensity score matching.RESULTS: Overall, 864,340 patients were identified. Mean age was 47.4 ± 24.4 years and median injury severity score was 9. SO was associated with an increased risk of in-hospital mortality: (all patients: adjusted odds ratio (aOR) with 95% confidence interval (CI) 3.07 [2.92-3.22], ED saturation <94%: 2.63 [2.38-2.91], ED saturation 94%-97%: 2.71 [2.47-2.97], ED saturation >97%: 3.38 [3.16-3.61]. Same pattern was seen for in-hospital ARDS: (aOR 1.79, 95% CI [1.59-2.02], ED saturation <94%: aOR 1.75, 95% CI 1.37-2.24, ED saturation 94%-97%: aOR 1.81, 95% CI 1.43-2.29, ED saturation >97%: aOR 2.31, 95% CI 1.92-2.79).CONCLUSION: Based on propensity matched, registry data for trauma patients, the administration of SO was associated with a higher incidence of in-hospital mortality and ARDS. The highest risk was found in patients with an ED saturation >97%.",
keywords = "ARDS, mortality, oxygen therapy, trauma",
author = "Christensen, {Mathias A} and Jacob Steinmetz and George Velmahos and Rasmussen, {Lars S}",
note = "{\textcopyright} 2021 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.",
year = "2021",
month = aug,
doi = "10.1111/aas.13829",
language = "English",
volume = "65",
pages = "967--978",
journal = "Acta Anaesthesiologica Scandinavica",
issn = "0001-5172",
publisher = "Wiley-Blackwell Munksgaard",
number = "7",

}

RIS

TY - JOUR

T1 - Supplemental oxygen therapy in trauma patients

T2 - an exploratory registry-based study

AU - Christensen, Mathias A

AU - Steinmetz, Jacob

AU - Velmahos, George

AU - Rasmussen, Lars S

N1 - © 2021 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

PY - 2021/8

Y1 - 2021/8

N2 - BACKGROUND: Supplemental oxygen (SO) is one of the most commonly administered drugs in trauma patients and is recommended by guidelines. However, evidence supporting uniform administration is sparse, and excess oxygen use has been shown to be harmful in other patient populations. We hypothesized that SO may be harmful in patients with oxygen saturation>97%.METHODS: Patients with available information on SO-therapy in the American Trauma Quality Improvement Program 2017 database were included. Patients were categorized into three groups according to Emergency Department (ED) oxygen saturation: 1) Saturation<94%; 2) Saturation 94-97%; 3) Saturation 98-100%. Primary outcome was in-hospital mortality with comparisons made between patients who received SO or not. Secondary outcome was acute respiratory distress syndrome (ARDS). Patients were compared after propensity score matching.RESULTS: Overall, 864,340 patients were identified. Mean age was 47.4 ± 24.4 years and median injury severity score was 9. SO was associated with an increased risk of in-hospital mortality: (all patients: adjusted odds ratio (aOR) with 95% confidence interval (CI) 3.07 [2.92-3.22], ED saturation <94%: 2.63 [2.38-2.91], ED saturation 94%-97%: 2.71 [2.47-2.97], ED saturation >97%: 3.38 [3.16-3.61]. Same pattern was seen for in-hospital ARDS: (aOR 1.79, 95% CI [1.59-2.02], ED saturation <94%: aOR 1.75, 95% CI 1.37-2.24, ED saturation 94%-97%: aOR 1.81, 95% CI 1.43-2.29, ED saturation >97%: aOR 2.31, 95% CI 1.92-2.79).CONCLUSION: Based on propensity matched, registry data for trauma patients, the administration of SO was associated with a higher incidence of in-hospital mortality and ARDS. The highest risk was found in patients with an ED saturation >97%.

AB - BACKGROUND: Supplemental oxygen (SO) is one of the most commonly administered drugs in trauma patients and is recommended by guidelines. However, evidence supporting uniform administration is sparse, and excess oxygen use has been shown to be harmful in other patient populations. We hypothesized that SO may be harmful in patients with oxygen saturation>97%.METHODS: Patients with available information on SO-therapy in the American Trauma Quality Improvement Program 2017 database were included. Patients were categorized into three groups according to Emergency Department (ED) oxygen saturation: 1) Saturation<94%; 2) Saturation 94-97%; 3) Saturation 98-100%. Primary outcome was in-hospital mortality with comparisons made between patients who received SO or not. Secondary outcome was acute respiratory distress syndrome (ARDS). Patients were compared after propensity score matching.RESULTS: Overall, 864,340 patients were identified. Mean age was 47.4 ± 24.4 years and median injury severity score was 9. SO was associated with an increased risk of in-hospital mortality: (all patients: adjusted odds ratio (aOR) with 95% confidence interval (CI) 3.07 [2.92-3.22], ED saturation <94%: 2.63 [2.38-2.91], ED saturation 94%-97%: 2.71 [2.47-2.97], ED saturation >97%: 3.38 [3.16-3.61]. Same pattern was seen for in-hospital ARDS: (aOR 1.79, 95% CI [1.59-2.02], ED saturation <94%: aOR 1.75, 95% CI 1.37-2.24, ED saturation 94%-97%: aOR 1.81, 95% CI 1.43-2.29, ED saturation >97%: aOR 2.31, 95% CI 1.92-2.79).CONCLUSION: Based on propensity matched, registry data for trauma patients, the administration of SO was associated with a higher incidence of in-hospital mortality and ARDS. The highest risk was found in patients with an ED saturation >97%.

KW - ARDS

KW - mortality

KW - oxygen therapy

KW - trauma

UR - http://www.scopus.com/inward/record.url?scp=85104762162&partnerID=8YFLogxK

U2 - 10.1111/aas.13829

DO - 10.1111/aas.13829

M3 - Journal article

C2 - 33840093

VL - 65

SP - 967

EP - 978

JO - Acta Anaesthesiologica Scandinavica

JF - Acta Anaesthesiologica Scandinavica

SN - 0001-5172

IS - 7

ER -

ID: 64826622