Prehospital hypoxemia, measured by pulse oximetry, predicts hospital outcomes during the New York City COVID-19 pandemic.
Prehospital hypoxemia, measured by pulse oximetry, predicts hospital outcomes during the New York City COVID-19 pandemic.
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DOI：
10.1002/emp2.12407
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发表时间：
2021-04
影响因子：
2.3
通讯作者：
Prezant DJ
中科院分区：
文献类型：
--
作者：
Lancet EA;Gonzalez D;Alexandrou NA;Zabar B;Lai PH;Hall CB;Braun J;Zeig-Owens R;Isaacs D;Ben-Eli D;Reisman N;Kaufman B;Asaeda G;Weiden MD;Nolan A;Teo H;Wei E;Natsui S;Philippou C;Prezant DJ
确定在控制竞争性死亡风险后，由纽约市（NYC）9 - 1 - 1急救医疗服务（EMS）测量的血氧饱和度（院外SpO 2）是否是2019冠状病毒病（COVID-19）住院死亡率和住院时间的独立预测因子。如果是这样，院外SpO 2可能对初始分诊有用。一项基于人群的纵向研究，研究对象为2020年3月5日至4月30日（纽约市COVID-19高峰期）通过EMS运送到急诊科（艾德）的成年患者。入选要求在呼吸室内空气时进行EMS院前SpO 2测量，运送至急诊科，并进行严重急性呼吸综合征冠状病毒2型（SARS-CoV-2）逆转录聚合酶链反应试验阳性。多变量logistic回归模型将死亡率作为院前SpO 2的函数，控制协变量（年龄、性别、人种/种族和合并症）。还进行了竞争风险模型，以估计院外SpO 2对存活出院累积发生率的绝对风险。在1673例患者中，在控制了竞争性死亡风险后，院外SpO 2和年龄是院内死亡率和住院时间的独立预测因素。在≥66岁的患者中，院外SpO 2>90%的死亡概率为26%，院外SpO 2 ≤ 90%的死亡概率为54%。在<66岁的患者中，院外SpO 2>90%的死亡概率为11.5%，而院外SpO 2 ≤ 90%的死亡概率为31%。无论年龄如何，院外SpO 2水平≤90%与存活出院的可能性降低50%以上相关。院外SpO 2和年龄预测的住院死亡率和住院时间：院外SpO 2 ≤90%强烈支持立即入院的分诊决定。对于院外SpO 2> 90%的患者，入院的决定取决于多种因素，包括年龄、资源可用性（门诊患者vs住院患者）以及新治疗的潜在影响。
To 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. A 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. In 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. Out‐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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影响因子：
3.7
作者：
Bjarnason A;Thorleifsdottir G;Löve A;Gudnason JF;Asgeirsson H;Hallgrimsson KL;Kristjansdottir BS;Haraldsson G;Baldursson O;Kristinsson KG;Gottfredsson M
通讯作者：
Gottfredsson M
DOI：
10.1111/jth.14849
发表时间：
2020-07
期刊：
Journal of thrombosis and haemostasis : JTH
影响因子：
--
作者：
通讯作者：
--
影响因子：
5.7
作者：
Lipnick, Michael S.;Feiner, John R.;Bickler, Philip E.
通讯作者：
Bickler, Philip E.
影响因子：
105.7
作者：
Petrilli, Christopher M.;Jones, Simon A.;Horwitz, Leora I.
通讯作者：
Horwitz, Leora I.
影响因子：
8.9
作者：
Xie, Jiang;Covassin, Naima;Somers, Virend K.
通讯作者：
Somers, Virend K.