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10.1136/emermed-2020-210528

http://scihub22266oqcxt.onion/10.1136/emermed-2020-210528
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33273040!7716294!33273040
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suck abstract from ncbi


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pmid33273040      Emerg+Med+J 2021 ; 38 (2): 88-93
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  • Post-exertion oxygen saturation as a prognostic factor for adverse outcome in patients attending the emergency department with suspected COVID-19: a substudy of the PRIEST observational cohort study #MMPMID33273040
  • Goodacre S; Thomas B; Lee E; Sutton L; Loban A; Waterhouse S; Simmonds R; Biggs K; Marincowitz C; Schutter J; Connelly S; Sheldon E; Hall J; Young E; Bentley A; Challen K; Fitzsimmons C; Harris T; Lecky F; Lee A; Maconochie I; Walter D
  • Emerg Med J 2021[Feb]; 38 (2): 88-93 PMID33273040show ga
  • BACKGROUND: Measurement of post-exertion oxygen saturation has been proposed to assess illness severity in suspected COVID-19 infection. We aimed to determine the accuracy of post-exertional oxygen saturation for predicting adverse outcome in suspected COVID-19. METHODS: We undertook a substudy of an observational cohort study across 70 emergency departments during the first wave of the COVID-19 pandemic in the UK. We collected data prospectively, using a standardised assessment form, and retrospectively, using hospital records, from patients with suspected COVID-19, and reviewed hospital records at 30 days for adverse outcome (death or receiving organ support). Patients with post-exertion oxygen saturation recorded were selected for this analysis. We constructed receiver-operating characteristic curves, calculated diagnostic parameters, and developed a multivariable model for predicting adverse outcome. RESULTS: We analysed data from 817 patients with post-exertion oxygen saturation recorded after excluding 54 in whom measurement appeared unfeasible. The c-statistic for post-exertion change in oxygen saturation was 0.589 (95% CI 0.465 to 0.713), and the positive and negative likelihood ratios of a 3% or more desaturation were, respectively, 1.78 (1.25 to 2.53) and 0.67 (0.46 to 0.98). Multivariable analysis showed that post-exertion oxygen saturation was not a significant predictor of adverse outcome when baseline clinical assessment was taken into account (p=0.368). Secondary analysis excluding patients in whom post-exertion measurement appeared inappropriate resulted in a c-statistic of 0.699 (0.581 to 0.817), likelihood ratios of 1.98 (1.26 to 3.10) and 0.61 (0.35 to 1.07), and some evidence of additional prognostic value on multivariable analysis (p=0.019). CONCLUSIONS: Post-exertion oxygen saturation provides modest prognostic information in the assessment of selected patients attending the emergency department with suspected COVID-19. TRIAL REGISTRATION NUMBER: ISRCTN Registry (ISRCTN56149622) http://www.isrctn.com/ISRCTN28342533.
  • |*Physical Exertion[MESH]
  • |Adult[MESH]
  • |Aged[MESH]
  • |COVID-19/*diagnosis[MESH]
  • |Emergency Service, Hospital[MESH]
  • |Female[MESH]
  • |Humans[MESH]
  • |Male[MESH]
  • |Middle Aged[MESH]
  • |Oxygen/*analysis[MESH]
  • |Prognosis[MESH]


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