ArticleJournal of the American College of Emergency Physicians open2021
Prehospital hypoxemia, measured by pulse oximetry, predicts hospital outcomes during the New York City COVID-19 pandemic.
Article in Journal of the American College of Emergency Physicians open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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The trial behind it
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Process Improvement Approaches for Increasing the Response of Emergency Departments against the COVID-19 Pandemic: A Systematic Review.International journal of environmental research and public health · 2021Pooled it
- Pulse oximetry in pediatric care: Balancing advantages and limitations.World journal of clinical pediatrics · 2024Article
- Assistance time and peripheral oxygen saturation in prehospital emergency data as predictors of COVID19 hospital outcomes.Scientific reports · 2024Article
- Joint modeling of longitudinal and competing risks for assessing blood oxygen saturation and its association with survival outcomes in COVID-19 patients.Journal of education and health promotion · 2024Article
- A review of the effect of skin pigmentation on pulse oximeter accuracy.Physiological measurement · 2023Review
- Factors which impact the length of hospitalisation and death rate of COVID-19 patients based on initial triage using capillary blood gas tests: a single centre study.Scientific reports · 2022Article
- A Machine Learning Model for Predicting Hospitalization in Patients with Respiratory Symptoms during the COVID-19 Pandemic.Journal of clinical medicine · 2022Article
- Prognostic accuracy of triage tools for adults with suspected COVID-19 in a prehospital setting: an observational cohort study.Emergency medicine journal : EMJ · 2022Observational
- Article
- Emergency Medical Services Prehospital Response to the COVID-19 Pandemic in the US: A Brief Literature Review.Open access emergency medicine : OAEM · 2022Review
- Article
- Association between Prehospital Hypoxemia and Admission to Intensive Care Unit during the COVID-19 Pandemic: A Retrospective Cohort Study.Medicina (Kaunas, Lithuania) · 2021Article
- Admission SpOThe American journal of emergency medicine · 2021Observational
- Prehospital hypoxemia, measured by pulse oximetry, predicts hospital outcomes during the New York City COVID-19 pandemic.Journal of the American College of Emergency Physicians open · 2021Article
Corrections and comments
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Authors and funding
20 authors.
Funding
Abstract
objectiveTo determine if oxygen saturation (out-of-hospital SpO2), measured by New York City (NYC) 9-1-1 Emergency Medical Services (EMS), was an independent predictor of coronavirus disease 2019 (COVID-19) in-hospital mortality and length of stay, after controlling for the competing risk of death. If so, out-of-hospital SpO2 could be useful for initial triage.
methodsA population-based longitudinal study of adult patients transported by EMS to emergency departments (ED) between March 5 and April 30, 2020 (the NYC COVID-19 peak period). Inclusion required EMS prehospital SpO2 measurement while breathing room air, transport to emergency department, and a positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcription polymerase chain reaction test. Multivariable logistic regression modeled mortality as a function of prehospital SpO2, controlling for covariates (age, sex, race/ethnicity, and comorbidities). A competing risk model also was performed to estimate the absolute risks of out-of-hospital SpO2 on the cumulative incidence of being discharged from the hospital alive.
resultsIn 1673 patients, out-of-hospital SpO2 and age were independent predictors of in-hospital mortality and length of stay, after controlling for the competing risk of death. Among patients ≥66 years old, the probability of death was 26% with an out-of-hospital SpO2 >90% versus 54% with an out-of-hospital SpO2 ≤90%. Among patients <66 years old, the probability of death was 11.5% with an out-of-hospital SpO2 >90% versus 31% with an out-of-hospital SpO2 ≤ 90%. An out-of-hospital SpO2 level ≤90% was associated with over 50% decreased likelihood of being discharged alive, regardless of age.
conclusionsOut-of-hospital SpO2 and age predicted in-hospital mortality and length of stay: An out-of-hospital SpO2 ≤90% strongly supports a triage decision for immediate hospital admission. For out-of-hospital SpO2 >90%, the decision to admit depends on multiple factors, including age, resource availability (outpatient vs inpatient), and the potential impact of new treatments.
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Registered trials
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