Association between Prehospital Hypoxemia and Admission to Intensive Care Unit during the COVID-19 Pandemic: A Retrospective Cohort Study
<i>Background and Objectives</i>: 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. <i>Mate...
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MDPI AG
2021-12-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/57/12/1362 |
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| author | Rémy Midez Christophe A. Fehlmann Christophe Marti Robert Larribau Frédéric Rouyer Filippo Boroli Laurent Suppan Birgit Andrea Gartner |
| author_facet | Rémy Midez Christophe A. Fehlmann Christophe Marti Robert Larribau Frédéric Rouyer Filippo Boroli Laurent Suppan Birgit Andrea Gartner |
| author_sort | Rémy Midez |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: 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. <i>Materials and Methods</i>: 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. <i>Results</i>: 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). <i>Conclusions</i>: 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. |
| first_indexed | 2024-03-10T03:36:17Z |
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| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-10T03:36:17Z |
| publishDate | 2021-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-823a8376b4ab4676a28e8a3166ea55db2023-11-23T09:28:57ZengMDPI AGMedicina1010-660X1648-91442021-12-015712136210.3390/medicina57121362Association between Prehospital Hypoxemia and Admission to Intensive Care Unit during the COVID-19 Pandemic: A Retrospective Cohort StudyRémy Midez0Christophe A. Fehlmann1Christophe Marti2Robert Larribau3Frédéric Rouyer4Filippo Boroli5Laurent Suppan6Birgit Andrea Gartner7Division of Anesthesiology, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, 1205 Geneva, SwitzerlandDivision of Emergency Medicine, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, 1205 Geneva, SwitzerlandDivision of Internal Medicine, Department of Medicine, University of Geneva Hospitals and Faculty of Medicine, 1205 Geneva, SwitzerlandDivision of Emergency Medicine, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, 1205 Geneva, SwitzerlandDivision of Emergency Medicine, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, 1205 Geneva, SwitzerlandDivision of Intensive Care Medicine, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, 1205 Geneva, SwitzerlandDivision of Emergency Medicine, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, 1205 Geneva, SwitzerlandDivision of Emergency Medicine, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, 1205 Geneva, Switzerland<i>Background and Objectives</i>: 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. <i>Materials and Methods</i>: 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. <i>Results</i>: 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). <i>Conclusions</i>: 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.https://www.mdpi.com/1648-9144/57/12/1362emergency medical servicesprehospitalCOVID-19emergency departmentintensive care unitacute respiratory distress syndrome |
| spellingShingle | Rémy Midez Christophe A. Fehlmann Christophe Marti Robert Larribau Frédéric Rouyer Filippo Boroli Laurent Suppan Birgit Andrea Gartner Association between Prehospital Hypoxemia and Admission to Intensive Care Unit during the COVID-19 Pandemic: A Retrospective Cohort Study Medicina emergency medical services prehospital COVID-19 emergency department intensive care unit acute respiratory distress syndrome |
| title | Association between Prehospital Hypoxemia and Admission to Intensive Care Unit during the COVID-19 Pandemic: A Retrospective Cohort Study |
| title_full | Association between Prehospital Hypoxemia and Admission to Intensive Care Unit during the COVID-19 Pandemic: A Retrospective Cohort Study |
| title_fullStr | Association between Prehospital Hypoxemia and Admission to Intensive Care Unit during the COVID-19 Pandemic: A Retrospective Cohort Study |
| title_full_unstemmed | Association between Prehospital Hypoxemia and Admission to Intensive Care Unit during the COVID-19 Pandemic: A Retrospective Cohort Study |
| title_short | Association between Prehospital Hypoxemia and Admission to Intensive Care Unit during the COVID-19 Pandemic: A Retrospective Cohort Study |
| title_sort | association between prehospital hypoxemia and admission to intensive care unit during the covid 19 pandemic a retrospective cohort study |
| topic | emergency medical services prehospital COVID-19 emergency department intensive care unit acute respiratory distress syndrome |
| url | https://www.mdpi.com/1648-9144/57/12/1362 |
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