Observational studyBlood advances2025
Triaging acute chest syndrome clinical decision-making using bedside SaO2/FiO2 ratio.
Observational study in Blood advances, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Mortality Associated with Intensive Care Unit Admission and Mechanical Ventilation in Adults with Acute Chest Syndrome: A Systematic Review.Medicina (Kaunas, Lithuania) · 2026Pooled it
- Beyond the trial data: why conservative oxygenation targets require nuanced implementation in pediatric critical care.Translational pediatrics · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
abstractAcute chest syndrome (ACS) severity is inconsistently defined, and its clinical course is difficult to predict. This retrospective observational study evaluated the utility of the ratio of pulse oximetry oxygen saturation (SaO2) to the fraction of inspired oxygen (SaO2/FiO2) in adult patients with ACS and its association with the clinical outcome of intensive care unit (ICU) transfer. Across all ACS hospitalizations at a tertiary medical center from 2017 to 2021, we characterized the SaO2/FiO2 ratio at 3 time points: emergency department (ED) presentation, ACS diagnosis, and antibiotic initiation. Of the 227 hospitalizations identified, 54% were female, the mean age was 29 years, 70% had hemoglobin SS, and 9% had obesity. Although ICU transfer was not strongly associated with the SaO2/FiO2 ratio at ED presentation (area under the curve [AUC], 0.59), it was strongly associated with the ratio at ACS diagnosis (AUC, 0.73) and antibiotic initiation (AUC, 0.74). Given the highest sensitivity at ACS diagnosis, a diagnostic SaO2/FiO2 cutoff of 310 was proposed for triaging likely ICU transfer (sensitivity, 63%; specificity, 82%; adjusted odds ratio, 8.94; 95% confidence interval [CI], 2.12-37.6; adjusted hazard ratio, 4.86; 95% CI, 1.91-12.4), with models adjusted for obesity, lung disease, and blood counts. This cutoff corresponds to an SaO2 acquired from pulse oximeter saturation <90% on 2 L/min nasal cannula support. We propose using the SaO2/FiO2 ratio cutoff of 310 prospectively as a simple bedside triage tool for adult patients with sickle cell disease hospitalized with ACS to be transferred to a higher level of care.
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