Impact of early hyperoxia on 28-day in-hospital mortality in patients with myocardial injury
Despite relevant evidence that supplemental oxygen therapy can be harmful to patients with myocardial injury, the association between hyperoxia and the clinical outcome of such patients has not been evaluated. We assessed whether early hyperoxia negatively affects outcomes in hospitalized patients w...
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| description | Despite relevant evidence that supplemental oxygen therapy can be harmful to patients with myocardial injury, the association between hyperoxia and the clinical outcome of such patients has not been evaluated. We assessed whether early hyperoxia negatively affects outcomes in hospitalized patients with myocardial injury.
This was a retrospective study conducted at a tertiary referral teaching hospital. Between January 2010 and December 2016, 2,376 consecutive emergency department patients with myocardial injury, defined as a peak troponin-I level ≥ 0.2 ng/mL, within the first 24 hours of presentation were included. The metrics used to define hyperoxia were the maximum average partial pressure of oxygen (PaO2MAX), average partial pressure of oxygen (PaO2AVG), and area under the curve during the first 24 hours (AUC24). The association between early hyperoxia within 24 hours after presentation and clinical outcomes was evaluated using multiple imputation and logistic regression analysis. The primary outcome was 28-day in-hospital mortality. The secondary outcomes were new-onset cardiovascular, coagulation, hepatic, renal, and respiratory dysfunctions (sequential organ failure sub-score ≥ 2).
Compared with normoxic patients, the adjusted odds ratios (ORs) for PaO2MAX, PaO2AVG, and AUC24 were 1.55 (95% confidence interval (CI) 1.05-2.27; p = 0.026), 2.13 (95% CI 1.45-3.12; p = 0.001), and 1.73 (95% CI 1.15-2.61; p = 0.008), respectively, in patients with mild hyperoxia and 6.01 (95% CI 3.98-9.07; p < 0.001), 8.92 (95% CI 3.33-23.88; p < 0.001), and 7.32 (95% CI 2.72-19.70; p = 0.001), respectively, in patients with severe hyperoxia. The incidence of coagulation and hepatic dysfunction (sequential organ failure sub-score ≥ 2) was significantly higher in the mild and severe hyperoxia group.
Hyperoxia during the first 24 hours of presentation is associated with an increased 28-day in-hospital mortality rate and risks of coagulation and hepatic dysfunction in patients with myocardial injury. |
| doi_str_mv | 10.1371/journal.pone.0201286 |
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This was a retrospective study conducted at a tertiary referral teaching hospital. Between January 2010 and December 2016, 2,376 consecutive emergency department patients with myocardial injury, defined as a peak troponin-I level ≥ 0.2 ng/mL, within the first 24 hours of presentation were included. The metrics used to define hyperoxia were the maximum average partial pressure of oxygen (PaO2MAX), average partial pressure of oxygen (PaO2AVG), and area under the curve during the first 24 hours (AUC24). The association between early hyperoxia within 24 hours after presentation and clinical outcomes was evaluated using multiple imputation and logistic regression analysis. The primary outcome was 28-day in-hospital mortality. The secondary outcomes were new-onset cardiovascular, coagulation, hepatic, renal, and respiratory dysfunctions (sequential organ failure sub-score ≥ 2).
Compared with normoxic patients, the adjusted odds ratios (ORs) for PaO2MAX, PaO2AVG, and AUC24 were 1.55 (95% confidence interval (CI) 1.05-2.27; p = 0.026), 2.13 (95% CI 1.45-3.12; p = 0.001), and 1.73 (95% CI 1.15-2.61; p = 0.008), respectively, in patients with mild hyperoxia and 6.01 (95% CI 3.98-9.07; p < 0.001), 8.92 (95% CI 3.33-23.88; p < 0.001), and 7.32 (95% CI 2.72-19.70; p = 0.001), respectively, in patients with severe hyperoxia. The incidence of coagulation and hepatic dysfunction (sequential organ failure sub-score ≥ 2) was significantly higher in the mild and severe hyperoxia group.
Hyperoxia during the first 24 hours of presentation is associated with an increased 28-day in-hospital mortality rate and risks of coagulation and hepatic dysfunction in patients with myocardial injury.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0201286</identifier><identifier>PMID: 30086143</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Acute coronary syndromes ; Angina pectoris ; Biology and Life Sciences ; Calcium-binding protein ; Cardiology ; Care and treatment ; Clinical trials ; Coagulation ; Confidence intervals ; Critical care ; Diagnosis ; Emergency medical care ; Emergency medical services ; Health aspects ; Health sciences ; Heart attack ; Heart attacks ; Hospitals ; Hyperoxia ; Injuries ; Intensive care ; Medicine ; Medicine and Health Sciences ; Mortality ; Oxygen ; Oxygen therapy ; Partial pressure ; Patient outcomes ; Patients ; Pediatrics ; Physical Sciences ; Pressure ; Regression analysis ; Singers ; Statistical analysis ; Studies ; Systematic review ; Task forces ; Teaching methods ; Troponin</subject><ispartof>PloS one, 2018-08, Vol.13 (8), p.e0201286-e0201286</ispartof><rights>COPYRIGHT 2018 Public Library of Science</rights><rights>2018 Kim et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2018 Kim et al 2018 Kim et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-9925fa6464d8d1bd8776f9efcda1f3f80088a4813d1cdefa773f637ca27cfdeb3</citedby><cites>FETCH-LOGICAL-c692t-9925fa6464d8d1bd8776f9efcda1f3f80088a4813d1cdefa773f637ca27cfdeb3</cites><orcidid>0000-0002-2045-3213 ; 0000-0002-2512-5905 ; 0000-0001-6040-7206</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6080775/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6080775/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30086143$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Lopez-Delgado, Juan Carlos</contributor><creatorcontrib>Kim, Tae Yun</creatorcontrib><creatorcontrib>Kim, Dong Hoon</creatorcontrib><creatorcontrib>Kim, Seong Chun</creatorcontrib><creatorcontrib>Kang, Changwoo</creatorcontrib><creatorcontrib>Lee, Soo Hoon</creatorcontrib><creatorcontrib>Jeong, Jin Hee</creatorcontrib><creatorcontrib>Lee, Sang Bong</creatorcontrib><creatorcontrib>Park, Yong Joo</creatorcontrib><creatorcontrib>Lim, Daesung</creatorcontrib><title>Impact of early hyperoxia on 28-day in-hospital mortality in patients with myocardial injury</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Despite relevant evidence that supplemental oxygen therapy can be harmful to patients with myocardial injury, the association between hyperoxia and the clinical outcome of such patients has not been evaluated. We assessed whether early hyperoxia negatively affects outcomes in hospitalized patients with myocardial injury.
This was a retrospective study conducted at a tertiary referral teaching hospital. Between January 2010 and December 2016, 2,376 consecutive emergency department patients with myocardial injury, defined as a peak troponin-I level ≥ 0.2 ng/mL, within the first 24 hours of presentation were included. The metrics used to define hyperoxia were the maximum average partial pressure of oxygen (PaO2MAX), average partial pressure of oxygen (PaO2AVG), and area under the curve during the first 24 hours (AUC24). The association between early hyperoxia within 24 hours after presentation and clinical outcomes was evaluated using multiple imputation and logistic regression analysis. The primary outcome was 28-day in-hospital mortality. The secondary outcomes were new-onset cardiovascular, coagulation, hepatic, renal, and respiratory dysfunctions (sequential organ failure sub-score ≥ 2).
Compared with normoxic patients, the adjusted odds ratios (ORs) for PaO2MAX, PaO2AVG, and AUC24 were 1.55 (95% confidence interval (CI) 1.05-2.27; p = 0.026), 2.13 (95% CI 1.45-3.12; p = 0.001), and 1.73 (95% CI 1.15-2.61; p = 0.008), respectively, in patients with mild hyperoxia and 6.01 (95% CI 3.98-9.07; p < 0.001), 8.92 (95% CI 3.33-23.88; p < 0.001), and 7.32 (95% CI 2.72-19.70; p = 0.001), respectively, in patients with severe hyperoxia. The incidence of coagulation and hepatic dysfunction (sequential organ failure sub-score ≥ 2) was significantly higher in the mild and severe hyperoxia group.
Hyperoxia during the first 24 hours of presentation is associated with an increased 28-day in-hospital mortality rate and risks of coagulation and hepatic dysfunction in patients with myocardial injury.</description><subject>Acute coronary syndromes</subject><subject>Angina pectoris</subject><subject>Biology and Life Sciences</subject><subject>Calcium-binding protein</subject><subject>Cardiology</subject><subject>Care and treatment</subject><subject>Clinical trials</subject><subject>Coagulation</subject><subject>Confidence intervals</subject><subject>Critical care</subject><subject>Diagnosis</subject><subject>Emergency medical care</subject><subject>Emergency medical services</subject><subject>Health aspects</subject><subject>Health sciences</subject><subject>Heart attack</subject><subject>Heart attacks</subject><subject>Hospitals</subject><subject>Hyperoxia</subject><subject>Injuries</subject><subject>Intensive care</subject><subject>Medicine</subject><subject>Medicine and Health Sciences</subject><subject>Mortality</subject><subject>Oxygen</subject><subject>Oxygen therapy</subject><subject>Partial pressure</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>Physical Sciences</subject><subject>Pressure</subject><subject>Regression analysis</subject><subject>Singers</subject><subject>Statistical analysis</subject><subject>Studies</subject><subject>Systematic review</subject><subject>Task forces</subject><subject>Teaching methods</subject><subject>Troponin</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNk1uL1DAUx4so7rr6DUQLguhDx1zaJH0RlsXLwMKCtychZHKZZmibmqS6_fZmdrrLVPZB8nDCye_8c3JyTpY9h2AFMYXvdm70vWhXg-v1CiAAESMPslNYY1QQBPDDo_1J9iSEHQAVZoQ8zk4wAIzAEp9mP9fdIGTMncm18O2UN9Ogvbu2Ind9jlihxJTbvmhcGGwUbd45n4yNe28-iGh1H0P-x8Ym7yYnhVc2UbbfjX56mj0yog362WzPsu8fP3y7-FxcXn1aX5xfFpLUKBZ1jSojSElKxRTcKEYpMbU2UglosGEpWSZKBrGCUmkjKMWGYCoFotIovcFn2cuD7tC6wOfCBI4AK2sIAaaJWB8I5cSOD952wk_cCctvHM5vufDRylZzVdcYYAQNqmDJKiXKDcVM14zKKmWw13o_3zZuOq1kKoAX7UJ0edLbhm_db04AA5RWSeDNLODdr1GHyDsbpG5b0Ws33uRdkaoktEzoq3_Q-183U1uRHmB749K9ci_Kz6uyRgkEOFGre6i0lO6sTF1kbPIvAt4uAhIT9XXcijEEvv765f_Zqx9L9vUR22jRxia4dozW9WEJlgdQeheC1-auyBDw_RDcVoPvh4DPQ5DCXhx_0F3QbdfjvxKjAcM</recordid><startdate>20180807</startdate><enddate>20180807</enddate><creator>Kim, 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of early hyperoxia on 28-day in-hospital mortality in patients with myocardial injury</title><author>Kim, Tae Yun ; Kim, Dong Hoon ; Kim, Seong Chun ; Kang, Changwoo ; Lee, Soo Hoon ; Jeong, Jin Hee ; Lee, Sang Bong ; Park, Yong Joo ; Lim, Daesung</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-9925fa6464d8d1bd8776f9efcda1f3f80088a4813d1cdefa773f637ca27cfdeb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Acute coronary syndromes</topic><topic>Angina pectoris</topic><topic>Biology and Life Sciences</topic><topic>Calcium-binding protein</topic><topic>Cardiology</topic><topic>Care and treatment</topic><topic>Clinical trials</topic><topic>Coagulation</topic><topic>Confidence intervals</topic><topic>Critical care</topic><topic>Diagnosis</topic><topic>Emergency medical care</topic><topic>Emergency medical services</topic><topic>Health aspects</topic><topic>Health 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Carlos</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of early hyperoxia on 28-day in-hospital mortality in patients with myocardial injury</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2018-08-07</date><risdate>2018</risdate><volume>13</volume><issue>8</issue><spage>e0201286</spage><epage>e0201286</epage><pages>e0201286-e0201286</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Despite relevant evidence that supplemental oxygen therapy can be harmful to patients with myocardial injury, the association between hyperoxia and the clinical outcome of such patients has not been evaluated. We assessed whether early hyperoxia negatively affects outcomes in hospitalized patients with myocardial injury.
This was a retrospective study conducted at a tertiary referral teaching hospital. Between January 2010 and December 2016, 2,376 consecutive emergency department patients with myocardial injury, defined as a peak troponin-I level ≥ 0.2 ng/mL, within the first 24 hours of presentation were included. The metrics used to define hyperoxia were the maximum average partial pressure of oxygen (PaO2MAX), average partial pressure of oxygen (PaO2AVG), and area under the curve during the first 24 hours (AUC24). The association between early hyperoxia within 24 hours after presentation and clinical outcomes was evaluated using multiple imputation and logistic regression analysis. The primary outcome was 28-day in-hospital mortality. The secondary outcomes were new-onset cardiovascular, coagulation, hepatic, renal, and respiratory dysfunctions (sequential organ failure sub-score ≥ 2).
Compared with normoxic patients, the adjusted odds ratios (ORs) for PaO2MAX, PaO2AVG, and AUC24 were 1.55 (95% confidence interval (CI) 1.05-2.27; p = 0.026), 2.13 (95% CI 1.45-3.12; p = 0.001), and 1.73 (95% CI 1.15-2.61; p = 0.008), respectively, in patients with mild hyperoxia and 6.01 (95% CI 3.98-9.07; p < 0.001), 8.92 (95% CI 3.33-23.88; p < 0.001), and 7.32 (95% CI 2.72-19.70; p = 0.001), respectively, in patients with severe hyperoxia. The incidence of coagulation and hepatic dysfunction (sequential organ failure sub-score ≥ 2) was significantly higher in the mild and severe hyperoxia group.
Hyperoxia during the first 24 hours of presentation is associated with an increased 28-day in-hospital mortality rate and risks of coagulation and hepatic dysfunction in patients with myocardial injury.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>30086143</pmid><doi>10.1371/journal.pone.0201286</doi><tpages>e0201286</tpages><orcidid>https://orcid.org/0000-0002-2045-3213</orcidid><orcidid>https://orcid.org/0000-0002-2512-5905</orcidid><orcidid>https://orcid.org/0000-0001-6040-7206</orcidid><oa>free_for_read</oa></addata></record> |
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| recordid | cdi_plos_journals_2084911037 |
| source | DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Public Library of Science (PLoS) Journals Open Access; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Acute coronary syndromes Angina pectoris Biology and Life Sciences Calcium-binding protein Cardiology Care and treatment Clinical trials Coagulation Confidence intervals Critical care Diagnosis Emergency medical care Emergency medical services Health aspects Health sciences Heart attack Heart attacks Hospitals Hyperoxia Injuries Intensive care Medicine Medicine and Health Sciences Mortality Oxygen Oxygen therapy Partial pressure Patient outcomes Patients Pediatrics Physical Sciences Pressure Regression analysis Singers Statistical analysis Studies Systematic review Task forces Teaching methods Troponin |
| title | Impact of early hyperoxia on 28-day in-hospital mortality in patients with myocardial injury |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-23T13%3A33%3A53IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Impact%20of%20early%20hyperoxia%20on%2028-day%20in-hospital%20mortality%20in%20patients%20with%20myocardial%20injury&rft.jtitle=PloS%20one&rft.au=Kim,%20Tae%20Yun&rft.date=2018-08-07&rft.volume=13&rft.issue=8&rft.spage=e0201286&rft.epage=e0201286&rft.pages=e0201286-e0201286&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0201286&rft_dat=%3Cgale_plos_%3EA549284903%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2084911037&rft_id=info:pmid/30086143&rft_galeid=A549284903&rft_doaj_id=oai_doaj_org_article_d9930321f251485da4b738e987c53d17&rfr_iscdi=true |