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Variable oxygen administration in surgical and medical wards evaluated by 30‐day mortality—An observational study
Author(s) -
Troensegaard Hannibal,
Petersen Cecilie,
Pedersen Niels E.,
Petersen Tonny S.,
Meyhoff Christian S.
Publication year - 2021
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/aas.13810
Subject(s) - medicine , exacerbation , copd , hyperoxia , oxygen therapy , myocardial infarction , observational study , logistic regression , emergency medicine , anesthesia , lung
Background Several studies in surgery and initial management of critical illness have indicated harmful effects of short‐term exposure to hyperoxia. Exposure to and consequences of excessive oxygen administration in hospital wards are sparsely investigated. The aim of this study was to investigate the association between excessive oxygen administration in patients admitted to surgical or medical wards and 30‐day mortality. Methods We included patients in the Capital Region of Denmark who were admitted to hospital in 2014 for either myocardial infarction, acute exacerbation of chronic obstructive pulmonary disease (COPD), hip fracture or open abdominal surgery. We defined groups of inadequate, adequate or excessive oxygen administration based on peripheral oxygen saturation and oxygen administration values in the first 48 hours after admission. The primary outcome was mortality within 30 days, and data were analysed with multivariable logistic regression for age, gender and comorbidities. Results We retrieved data from 11 196 patients, of which 81% had adequate, 18% had excessive and 1.8% inadequate oxygen administration. Mortality at 30 days was 4.2%, 7.6% and 27%, respectively, OR 1.46 (95%CI 1.16‐1.84), P = .001 for patients with excessive compared to adequate oxygen administration. The association was significant in subgroups of patients admitted for acute exacerbation of COPD (OR 1.67, 95%CI 1.19‐2.34) and myocardial infarction (OR 3.50, 95%CI 1.55‐7.89). Conclusion Patients who received excessive oxygen administration in surgical and medical wards during the first 48 hours of admission had a higher mortality risk within 30 days compared to patients with adequate oxygen administration. However, inadequate oxygen therapy still renders highest mortality and should be avoided.