Variable oxygen administration in surgical and medical wards evaluated by 30-day mortality—An observational study

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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.

Original languageEnglish
JournalActa Anaesthesiologica Scandinavica
Volume65
Issue number7
Pages (from-to)952-958
Number of pages7
ISSN0001-5172
DOIs
Publication statusPublished - 2021

Bibliographical note

Funding Information:
This project was funded by the internal research grant at Bispebjerg and Frederiksberg Hospital.

Funding Information:
Christian S. Meyhoff: Direct and indirect departmental funding from Ferring Pharmaceuticals, Merck, Sharp & Dohme, Radiometer, and Boehringer Ingelheim as well as lecture fees from Radiometer outside submitted work. Co‐founder of a start‐up company, WARD247 ApS, with the aim of pursuing the regulatory and commercial activities of the WARD‐project, a Danish Innovation Fund Denmark supported project of wireless monitoring of vital signs. WARD247 ApS has finalized terms for license agreement for any WARD‐project software and patents. There are currently no patents pending or filed. as well as Lecture fees from Radiometer. All mentioned entities outside submitted work.

Publisher Copyright:
© 2021 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd

    Research areas

  • mortality, observational, oxygen, supplemental oxygen

ID: 280674014