{"title":"在医院病房治疗的潜在危重病人高氧血症的发生率和危险因素：一项回顾性研究","authors":"Mehmet Nuri Yakar, Doğukan Şenberber, Ozan Balkabak, Nurgazy Shermatov, Kaan Köşker, Selin Elden, Emel Ibişoğlu, Begüm Ergan, Volkan Hanci, Necati Gökmen","doi":"10.55730/1300-0144.6048","DOIUrl":null,"url":null,"abstract":"<p><strong>Background/aim: </strong>The literature shows a link between hyperoxemia and poor outcomes, whereas this association remains unclear in hospital wards. This study aims to determine the incidence of hyperoxemia in hospital wards and its risk factors.</p><p><strong>Materials and methods: </strong>Patients aged ≥ 18 years who underwent an evaluation by an intensivist between 1 January 2020 and 31 December 2020, while receiving treatment in hospital wards, were included in the study following ethics committee approval. Patients with hypoxemia (partial pressure of oxygen [PaO<sub>2</sub>] < 60 mmHg), a condition related to Coronavirus disease 2019, a hospital stay < 1 day, or missing data were excluded. Patients were divided into two groups: normoxemia (60 mmHg ≤ PaO<sub>2</sub> < 120 mmHg) and hyperoxemia.</p><p><strong>Results: </strong>The incidence of hyperoxemia was 42.2%. Patients with hyperoxemia had longer hospital stays and higher intensive care unit admission rates than those with normoxemia. Partial pressure of carbon dioxide < 30 mmHg (OR, 1.61; 95% CI, 1.16-2.25; p = 0.005), hemoglobin ≤ 10.3 g/dL (OR, 1.33; 95% CI, 1.01-1.75; p = 0.044), positive pressure ventilation (OR, 1.73; 95% CI, 1.09-2.74; p = 0.021), fraction of inspired oxygen ≥ 50% (OR, 1.71; 95% CI, 1.10-2.65; p = 0.018), type IV respiratory failure (OR, 1.62; 95% CI, 1.05-2.51; p = 0.030), and receiving treatment on surgical units (OR, 1.47; 95% CI, 1.02-2.12; p = 0.038) were independently associated with hyperoxemia. Charlson comorbidity index > 6 (OR, 0.64; 95% CI, 0.49-0.85; p = 0.002), and chronic obstructive pulmonary disease exacerbation (OR, 0.51; 95% CI, 0.29-0.89; p = 0.017) were independently associated with normoxemia.</p><p><strong>Conclusion: </strong>Monitoring potentially critically ill patients receiving oxygen therapy in wards is essential to mitigate hyperoxemia and optimize the use of healthcare resources. Further research could focus on developing strategies to accomplish this objective.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"55 4","pages":"949-960"},"PeriodicalIF":1.0000,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12419062/pdf/","citationCount":"0","resultStr":"{\"title\":\"Incidence and risk factors of hyperoxemia among potentially critically ill patients treated in hospital wards: a retrospective study.\",\"authors\":\"Mehmet Nuri Yakar, Doğukan Şenberber, Ozan Balkabak, Nurgazy Shermatov, Kaan Köşker, Selin Elden, Emel Ibişoğlu, Begüm Ergan, Volkan Hanci, Necati Gökmen\",\"doi\":\"10.55730/1300-0144.6048\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background/aim: </strong>The literature shows a link between hyperoxemia and poor outcomes, whereas this association remains unclear in hospital wards. This study aims to determine the incidence of hyperoxemia in hospital wards and its risk factors.</p><p><strong>Materials and methods: </strong>Patients aged ≥ 18 years who underwent an evaluation by an intensivist between 1 January 2020 and 31 December 2020, while receiving treatment in hospital wards, were included in the study following ethics committee approval. Patients with hypoxemia (partial pressure of oxygen [PaO<sub>2</sub>] < 60 mmHg), a condition related to Coronavirus disease 2019, a hospital stay < 1 day, or missing data were excluded. Patients were divided into two groups: normoxemia (60 mmHg ≤ PaO<sub>2</sub> < 120 mmHg) and hyperoxemia.</p><p><strong>Results: </strong>The incidence of hyperoxemia was 42.2%. Patients with hyperoxemia had longer hospital stays and higher intensive care unit admission rates than those with normoxemia. Partial pressure of carbon dioxide < 30 mmHg (OR, 1.61; 95% CI, 1.16-2.25; p = 0.005), hemoglobin ≤ 10.3 g/dL (OR, 1.33; 95% CI, 1.01-1.75; p = 0.044), positive pressure ventilation (OR, 1.73; 95% CI, 1.09-2.74; p = 0.021), fraction of inspired oxygen ≥ 50% (OR, 1.71; 95% CI, 1.10-2.65; p = 0.018), type IV respiratory failure (OR, 1.62; 95% CI, 1.05-2.51; p = 0.030), and receiving treatment on surgical units (OR, 1.47; 95% CI, 1.02-2.12; p = 0.038) were independently associated with hyperoxemia. Charlson comorbidity index > 6 (OR, 0.64; 95% CI, 0.49-0.85; p = 0.002), and chronic obstructive pulmonary disease exacerbation (OR, 0.51; 95% CI, 0.29-0.89; p = 0.017) were independently associated with normoxemia.</p><p><strong>Conclusion: </strong>Monitoring potentially critically ill patients receiving oxygen therapy in wards is essential to mitigate hyperoxemia and optimize the use of healthcare resources. 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引用次数: 0
摘要
背景/目的：文献显示高氧血症与不良预后之间存在联系，然而在医院病房中这种关联尚不清楚。本研究旨在了解医院病房高氧血症的发生率及其危险因素。材料和方法：年龄≥18岁的患者，在2020年1月1日至2020年12月31日期间接受重症监护医师评估，同时在医院病房接受治疗，经伦理委员会批准纳入研究。排除低氧血症（氧分压[PaO2] < 60 mmHg）、与2019冠状病毒病相关、住院时间< 1天或缺少数据的患者。患者分为正常氧血症（60mmhg≤PaO2 < 120mmhg）和高氧血症两组。结果：高氧血症发生率为42.2%。与正常氧血症患者相比，高氧血症患者住院时间更长，重症监护病房住院率更高。二氧化碳分压< 30 mmHg (OR, 1.61, 95% CI, 1.16-2.25, p = 0.005)，血红蛋白≤10.3 g/dL (OR, 1.33, 95% CI, 1.01-1.75, p = 0.044)，正压通气（OR, 1.73, 95% CI, 1.09-2.74, p = 0.021），吸氧分数≥50% (OR, 1.71, 95% CI, 1.10-2.65, p = 0.018)， IV型呼吸衰竭（OR, 1.62, 95% CI, 1.05-2.51, p = 0.030），在外科单位接受治疗(OR, 1.47, 95% CI, 1.02-2.12；P = 0.038)与高氧血症独立相关。Charlson合并症指数bbb6 （OR, 0.64; 95% CI, 0.49-0.85; p = 0.002）和慢性阻塞性肺疾病加重（OR, 0.51; 95% CI, 0.29-0.89; p = 0.017）与常氧血症独立相关。结论：监护病房内接受氧疗的危重患者对缓解高氧血症和优化医疗资源利用至关重要。进一步的研究可以集中于制定实现这一目标的战略。
Incidence and risk factors of hyperoxemia among potentially critically ill patients treated in hospital wards: a retrospective study.
Background/aim: The literature shows a link between hyperoxemia and poor outcomes, whereas this association remains unclear in hospital wards. This study aims to determine the incidence of hyperoxemia in hospital wards and its risk factors.
Materials and methods: Patients aged ≥ 18 years who underwent an evaluation by an intensivist between 1 January 2020 and 31 December 2020, while receiving treatment in hospital wards, were included in the study following ethics committee approval. Patients with hypoxemia (partial pressure of oxygen [PaO2] < 60 mmHg), a condition related to Coronavirus disease 2019, a hospital stay < 1 day, or missing data were excluded. Patients were divided into two groups: normoxemia (60 mmHg ≤ PaO2 < 120 mmHg) and hyperoxemia.
Results: The incidence of hyperoxemia was 42.2%. Patients with hyperoxemia had longer hospital stays and higher intensive care unit admission rates than those with normoxemia. Partial pressure of carbon dioxide < 30 mmHg (OR, 1.61; 95% CI, 1.16-2.25; p = 0.005), hemoglobin ≤ 10.3 g/dL (OR, 1.33; 95% CI, 1.01-1.75; p = 0.044), positive pressure ventilation (OR, 1.73; 95% CI, 1.09-2.74; p = 0.021), fraction of inspired oxygen ≥ 50% (OR, 1.71; 95% CI, 1.10-2.65; p = 0.018), type IV respiratory failure (OR, 1.62; 95% CI, 1.05-2.51; p = 0.030), and receiving treatment on surgical units (OR, 1.47; 95% CI, 1.02-2.12; p = 0.038) were independently associated with hyperoxemia. Charlson comorbidity index > 6 (OR, 0.64; 95% CI, 0.49-0.85; p = 0.002), and chronic obstructive pulmonary disease exacerbation (OR, 0.51; 95% CI, 0.29-0.89; p = 0.017) were independently associated with normoxemia.
Conclusion: Monitoring potentially critically ill patients receiving oxygen therapy in wards is essential to mitigate hyperoxemia and optimize the use of healthcare resources. Further research could focus on developing strategies to accomplish this objective.
期刊介绍：
Turkish Journal of Medical sciences is a peer-reviewed comprehensive resource that provides critical up-to-date information on the broad spectrum of general medical sciences. The Journal intended to publish original medical scientific papers regarding the priority based on the prominence, significance, and timeliness of the findings. However since the audience of the Journal is not limited to any subspeciality in a wide variety of medical disciplines, the papers focusing on the technical details of a given medical subspeciality may not be evaluated for publication.
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