Ruma Thakuria, Emmanuel Easterson Ernest, Apala Roy Chowdhury, Neha Pangasa, Choro Athiphro Kayina, Sulagna Bhattacharjee, Puneet Khanna, Dalim K Baidya, Banupriya Ravichandrane, Souvik Maitra
{"title":"预测急诊手术患者术后结果的氧合指数和氧饱和度指数：一项前瞻性队列研究","authors":"Ruma Thakuria, Emmanuel Easterson Ernest, Apala Roy Chowdhury, Neha Pangasa, Choro Athiphro Kayina, Sulagna Bhattacharjee, Puneet Khanna, Dalim K Baidya, Banupriya Ravichandrane, Souvik Maitra","doi":"10.5005/jp-journals-10071-24749","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The OI was originally evaluated as a prognostic tool for acute hypoxemic respiratory failure in children and was an independent predictor for mortality in adult patients with acute respiratory distress syndrome (ARDS).</p><p><strong>Methods: </strong>Oxygenation index and OSI of 201 adult patients undergoing emergency surgery were evaluated at different time points. The primary objective of this study was to find the correlation between OI and OSI. The secondary objectives were to find the prognostic utility of OI and OSI for postoperative mechanical ventilation and mortality.</p><p><strong>Results: </strong>Significant statistical correlation was found between OI and OSI both at the beginning (<i>r</i> <sup>2</sup> = 0.61; <i>p</i> < 0.001) and immediately after surgery (<i>r</i> <sup>2</sup> = 0.47; <i>p</i> < 0.001). Oxygen saturation index at the beginning [area under the receiver operating characteristics curve (AUROC) (95% CI) 0.76 (0.62-0.89); best cutoff 3.9, sensitivity 64% and specificity 45%] and immediately after surgery [AUROC (95% CI) 0.82 (0.72-0.92); best cutoff 3.57, sensitivity 79%, and specificity 62%] were reasonable predictors of the requirement of invasive ventilatory support. Exploratory analysis reported that older age (<i>p</i> = 0.02), higher total leukocyte count (<i>p</i> = 0.002), higher arterial lactate (<i>p</i> = 0.02), and higher driving pressure (<i>p</i> < 0.001) were independently associated with hospital mortality.</p><p><strong>Conclusion: </strong>In adult patients undergoing emergency laparotomy under general anesthesia, OI and OSI were found to be correlated. Both metrics demonstrated reasonable accuracy in predicting the need for invasive ventilatory support beyond 24 hours and hospital mortality.</p><p><strong>How to cite this article: </strong>Thakuria R, Ernest EE, Chowdhury AR, Pangasa N, Kayina CA, Bhattacharjee S, <i>et al</i>. Oxygenation Index and Oxygen Saturation Index for Predicting Postoperative Outcome in Patients Undergoing Emergency Surgery: A Prospective Cohort Study. Indian J Crit Care Med 2024;28(7):645-649.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":null,"pages":null},"PeriodicalIF":1.5000,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11234125/pdf/","citationCount":"0","resultStr":"{\"title\":\"Oxygenation Index and Oxygen Saturation Index for Predicting Postoperative Outcome in Patients Undergoing Emergency Surgery: A Prospective Cohort Study.\",\"authors\":\"Ruma Thakuria, Emmanuel Easterson Ernest, Apala Roy Chowdhury, Neha Pangasa, Choro Athiphro Kayina, Sulagna Bhattacharjee, Puneet Khanna, Dalim K Baidya, Banupriya Ravichandrane, Souvik Maitra\",\"doi\":\"10.5005/jp-journals-10071-24749\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The OI was originally evaluated as a prognostic tool for acute hypoxemic respiratory failure in children and was an independent predictor for mortality in adult patients with acute respiratory distress syndrome (ARDS).</p><p><strong>Methods: </strong>Oxygenation index and OSI of 201 adult patients undergoing emergency surgery were evaluated at different time points. The primary objective of this study was to find the correlation between OI and OSI. The secondary objectives were to find the prognostic utility of OI and OSI for postoperative mechanical ventilation and mortality.</p><p><strong>Results: </strong>Significant statistical correlation was found between OI and OSI both at the beginning (<i>r</i> <sup>2</sup> = 0.61; <i>p</i> < 0.001) and immediately after surgery (<i>r</i> <sup>2</sup> = 0.47; <i>p</i> < 0.001). Oxygen saturation index at the beginning [area under the receiver operating characteristics curve (AUROC) (95% CI) 0.76 (0.62-0.89); best cutoff 3.9, sensitivity 64% and specificity 45%] and immediately after surgery [AUROC (95% CI) 0.82 (0.72-0.92); best cutoff 3.57, sensitivity 79%, and specificity 62%] were reasonable predictors of the requirement of invasive ventilatory support. Exploratory analysis reported that older age (<i>p</i> = 0.02), higher total leukocyte count (<i>p</i> = 0.002), higher arterial lactate (<i>p</i> = 0.02), and higher driving pressure (<i>p</i> < 0.001) were independently associated with hospital mortality.</p><p><strong>Conclusion: </strong>In adult patients undergoing emergency laparotomy under general anesthesia, OI and OSI were found to be correlated. Both metrics demonstrated reasonable accuracy in predicting the need for invasive ventilatory support beyond 24 hours and hospital mortality.</p><p><strong>How to cite this article: </strong>Thakuria R, Ernest EE, Chowdhury AR, Pangasa N, Kayina CA, Bhattacharjee S, <i>et al</i>. Oxygenation Index and Oxygen Saturation Index for Predicting Postoperative Outcome in Patients Undergoing Emergency Surgery: A Prospective Cohort Study. Indian J Crit Care Med 2024;28(7):645-649.</p>\",\"PeriodicalId\":47664,\"journal\":{\"name\":\"Indian Journal of Critical Care Medicine\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2024-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11234125/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Indian Journal of Critical Care Medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.5005/jp-journals-10071-24749\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CRITICAL CARE MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Indian Journal of Critical Care Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5005/jp-journals-10071-24749","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}
引用次数: 0
摘要
背景：氧合指数最初被评估为儿童急性缺氧性呼吸衰竭的预后工具，并且是急性呼吸窘迫综合征（ARDS）成人患者死亡率的独立预测指标：方法： 在不同时间点评估了 201 名接受急诊手术的成人患者的氧合指数和 OSI。本研究的首要目标是找出氧合指数和 OSI 之间的相关性。次要目标是找出 OI 和 OSI 对术后机械通气和死亡率的预后作用：结果：OI 和 OSI 在术后初期（r 2 = 0.61；p < 0.001）和术后即刻（r 2 = 0.47；p < 0.001）均存在显著的统计学相关性。开始时的氧饱和度指数[接收者操作特征曲线下面积（AUROC）（95% CI）为 0.76 (0.62-0.89)；最佳临界值为 3.9，灵敏度为 64%，特异度为 45%]和手术后立即的氧饱和度指数[接收者操作特征曲线下面积（AUROC）（95% CI）为 0.82 (0.72-0.92)；最佳临界值为 3.57，灵敏度为 79%，特异度为 62%]是有创通气支持需求的合理预测指标。探索性分析表明，年龄较大（p = 0.02）、白细胞总数较高（p = 0.002）、动脉乳酸较高（p = 0.02）和驱动压力较高（p < 0.001）与住院死亡率独立相关：结论：在全身麻醉下接受急诊开腹手术的成人患者中，OI 和 OSI 具有相关性。这两项指标在预测24小时后有创呼吸支持需求和住院死亡率方面都表现出了合理的准确性：Thakuria R、Ernest EE、Chowdhury AR、Pangasa N、Kayina CA、Bhattacharjee S 等：《预测急诊手术患者术后结果的氧合指数和氧饱和度指数》：一项前瞻性队列研究。Indian J Crit Care Med 2024;28(7):645-649.
Oxygenation Index and Oxygen Saturation Index for Predicting Postoperative Outcome in Patients Undergoing Emergency Surgery: A Prospective Cohort Study.
Background: The OI was originally evaluated as a prognostic tool for acute hypoxemic respiratory failure in children and was an independent predictor for mortality in adult patients with acute respiratory distress syndrome (ARDS).
Methods: Oxygenation index and OSI of 201 adult patients undergoing emergency surgery were evaluated at different time points. The primary objective of this study was to find the correlation between OI and OSI. The secondary objectives were to find the prognostic utility of OI and OSI for postoperative mechanical ventilation and mortality.
Results: Significant statistical correlation was found between OI and OSI both at the beginning (r2 = 0.61; p < 0.001) and immediately after surgery (r2 = 0.47; p < 0.001). Oxygen saturation index at the beginning [area under the receiver operating characteristics curve (AUROC) (95% CI) 0.76 (0.62-0.89); best cutoff 3.9, sensitivity 64% and specificity 45%] and immediately after surgery [AUROC (95% CI) 0.82 (0.72-0.92); best cutoff 3.57, sensitivity 79%, and specificity 62%] were reasonable predictors of the requirement of invasive ventilatory support. Exploratory analysis reported that older age (p = 0.02), higher total leukocyte count (p = 0.002), higher arterial lactate (p = 0.02), and higher driving pressure (p < 0.001) were independently associated with hospital mortality.
Conclusion: In adult patients undergoing emergency laparotomy under general anesthesia, OI and OSI were found to be correlated. Both metrics demonstrated reasonable accuracy in predicting the need for invasive ventilatory support beyond 24 hours and hospital mortality.
How to cite this article: Thakuria R, Ernest EE, Chowdhury AR, Pangasa N, Kayina CA, Bhattacharjee S, et al. Oxygenation Index and Oxygen Saturation Index for Predicting Postoperative Outcome in Patients Undergoing Emergency Surgery: A Prospective Cohort Study. Indian J Crit Care Med 2024;28(7):645-649.
期刊介绍：
Indian Journal of Critical Care Medicine (ISSN 0972-5229) is specialty periodical published under the auspices of Indian Society of Critical Care Medicine. Journal encourages research, education and dissemination of knowledge in the fields of critical and emergency medicine.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
