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The predictive value of PaO2/FIO2 and additional parameters for in-hospital mortality in patients with acute pulmonary embolism: an 8-year prospective observational single-center cohort study
- Source :
- BMC Pulmonary Medicine, BMC Pulmonary Medicine, Vol 19, Iss 1, Pp 1-8 (2019)
- Publication Year :
- 2019
- Publisher :
- BioMed Central, 2019.
-
Abstract
- Background Rapid stratification and appropriate treatment on admission are critical to saving lives of patients with acute pulmonary embolism (PE). None of the clinical prediction tools perform well when applied to all patients with acute PE. It may be important to integrate respiratory features into the 2014 European Society of Cardiology model. First, we aimed to assess the relationship between the arterial partial pressure of oxygen/fraction of inspired oxygen (PaO2/FIO2) ratio and in-hospital mortality, determine the optimal cutoff value of PaO2/FIO2, and determine if this value, which is quick and easy to obtain on admission, is a predictor of in-hospital mortality in this population. Second, we aimed to evaluate the potential additional determinants including laboratory parameters that may affect the in-hospital mortality. We hypothesized that the PaO2/FiO2 ratio would be a clinical prediction tool for in-hospital mortality in patients with acute PE. Methods A prospective single-center observational cohort study was conducted in Beijing Hospital from January 2010 to November 2017. Arterial blood gas analysis data captured on admission, clinical characteristics, risk factors, laboratory data, imaging findings, and in-hospital mortality were compared between survivors and non-survivors. The area under the receiver operating characteristic curve (AUC) for in-hospital mortality based on the PaO2/FiO2 value was determined, and the association between the parameters and in-hospital mortality was analyzed by using logistic regression analysis. Results Body mass index, history of cancer, PaO2/FiO2 value, pulse rate, cardiac troponin I level, lactate dehydrogenase level, white blood cell count, D-dimer level, and risk stratification measurements differed between survivors and non-survivors. The optimal cutoff value of PaO2/FiO2 for predicting mortality was 265 (AUC = 0.765, P 2/FiO2 ratio P = 0.004), history of cancer (95% CI 1.161–15.927, P = 0.029), and risk stratification (95% CI 1.047–16.957, P = 0.043) continued to be associated with an increased risk of in-hospital mortality of acute PE. Conclusion A simple determination of the PaO2/FiO2 ratio at 2/FiO2 ratio
- Subjects :
- Male
030204 cardiovascular system & hematology
Logistic regression
PaO2/FiO2 ratio
0302 clinical medicine
Fraction of inspired oxygen
030212 general & internal medicine
Hospital Mortality
Prospective Studies
Aged, 80 and over
education.field_of_study
respiratory system
Middle Aged
Prognosis
Pulmonary embolism
In-hospital mortality
Beijing
Acute Disease
Female
Cohort study
circulatory and respiratory physiology
Research Article
Pulmonary and Respiratory Medicine
medicine.medical_specialty
Partial Pressure
Population
Predictive value
03 medical and health sciences
Predictive Value of Tests
Internal medicine
medicine
Humans
education
Aged
lcsh:RC705-779
Receiver operating characteristic
business.industry
lcsh:Diseases of the respiratory system
medicine.disease
Confidence interval
respiratory tract diseases
Oxygen
Logistic Models
ROC Curve
Parameters
Multivariate Analysis
Blood Gas Analysis
business
Pulmonary Embolism
Body mass index
Subjects
Details
- Language :
- English
- ISSN :
- 14712466
- Volume :
- 19
- Database :
- OpenAIRE
- Journal :
- BMC Pulmonary Medicine
- Accession number :
- edsair.doi.dedup.....8b58783fa137df4baf08bdd3207042ee