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The Association between Arterial Oxygen Tension, Hemoglobin Concentration, and Mortality in Mechanically Ventilated Critically Ill Patients
BACKGROUND: Hypoxemia and anemia are common findings in critically ill patients admitted to Intensive Care Units. Both are independently associated with significant morbidity and mortality. However, the interaction between oxygenation and anemia and their impact on mortality in critically ill patien...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Medknow Publications & Media Pvt Ltd
2018
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6069304/ https://www.ncbi.nlm.nih.gov/pubmed/30111921 http://dx.doi.org/10.4103/ijccm.IJCCM_66_18 |
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author | Ramanan, Mahesh Fisher, Nick |
author_facet | Ramanan, Mahesh Fisher, Nick |
author_sort | Ramanan, Mahesh |
collection | PubMed |
description | BACKGROUND: Hypoxemia and anemia are common findings in critically ill patients admitted to Intensive Care Units. Both are independently associated with significant morbidity and mortality. However, the interaction between oxygenation and anemia and their impact on mortality in critically ill patients has not been clearly defined. We undertook this study to determine whether hemoglobin (Hb) level would modify the association between hypoxemia and mortality in mechanically ventilated critically ill patients. METHODS: We performed a retrospective cohort study of all mechanically ventilated adult patients (aged >16 years) in the Australian and New Zealand Intensive Care Society Adult Patient Database (APD) admitted over a 10-year period. Multivariate hierarchical logistic regression was used to assess the relationship between hypoxemia and hospital mortality stratified by Hb. RESULTS: Of 1,196,089 patients in the APD, 219,723 satisfied our inclusion and exclusion criteria. There was a linear negative relationship between hypoxemia and hospital mortality which was significantly modified when stratified by Hb. Hb independently increased the risk of mortality in patients with arterial oxygen tension <102. CONCLUSIONS: Hb is an effect modifier on the association between oxygenation and mortality. |
format | Online Article Text |
id | pubmed-6069304 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-60693042018-08-15 The Association between Arterial Oxygen Tension, Hemoglobin Concentration, and Mortality in Mechanically Ventilated Critically Ill Patients Ramanan, Mahesh Fisher, Nick Indian J Crit Care Med Research Article BACKGROUND: Hypoxemia and anemia are common findings in critically ill patients admitted to Intensive Care Units. Both are independently associated with significant morbidity and mortality. However, the interaction between oxygenation and anemia and their impact on mortality in critically ill patients has not been clearly defined. We undertook this study to determine whether hemoglobin (Hb) level would modify the association between hypoxemia and mortality in mechanically ventilated critically ill patients. METHODS: We performed a retrospective cohort study of all mechanically ventilated adult patients (aged >16 years) in the Australian and New Zealand Intensive Care Society Adult Patient Database (APD) admitted over a 10-year period. Multivariate hierarchical logistic regression was used to assess the relationship between hypoxemia and hospital mortality stratified by Hb. RESULTS: Of 1,196,089 patients in the APD, 219,723 satisfied our inclusion and exclusion criteria. There was a linear negative relationship between hypoxemia and hospital mortality which was significantly modified when stratified by Hb. Hb independently increased the risk of mortality in patients with arterial oxygen tension <102. CONCLUSIONS: Hb is an effect modifier on the association between oxygenation and mortality. Medknow Publications & Media Pvt Ltd 2018-07 /pmc/articles/PMC6069304/ /pubmed/30111921 http://dx.doi.org/10.4103/ijccm.IJCCM_66_18 Text en Copyright: © 2018 Indian Journal of Critical Care Medicine http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. |
spellingShingle | Research Article Ramanan, Mahesh Fisher, Nick The Association between Arterial Oxygen Tension, Hemoglobin Concentration, and Mortality in Mechanically Ventilated Critically Ill Patients |
title | The Association between Arterial Oxygen Tension, Hemoglobin Concentration, and Mortality in Mechanically Ventilated Critically Ill Patients |
title_full | The Association between Arterial Oxygen Tension, Hemoglobin Concentration, and Mortality in Mechanically Ventilated Critically Ill Patients |
title_fullStr | The Association between Arterial Oxygen Tension, Hemoglobin Concentration, and Mortality in Mechanically Ventilated Critically Ill Patients |
title_full_unstemmed | The Association between Arterial Oxygen Tension, Hemoglobin Concentration, and Mortality in Mechanically Ventilated Critically Ill Patients |
title_short | The Association between Arterial Oxygen Tension, Hemoglobin Concentration, and Mortality in Mechanically Ventilated Critically Ill Patients |
title_sort | association between arterial oxygen tension, hemoglobin concentration, and mortality in mechanically ventilated critically ill patients |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6069304/ https://www.ncbi.nlm.nih.gov/pubmed/30111921 http://dx.doi.org/10.4103/ijccm.IJCCM_66_18 |
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