Effect of hypoxia on mortality and disability in traumatic brain injury according to shock status

A cross-sectional analysis

Dong Eun Seo, Sang Do Shin, Kyoung Jun Song, Young Sun Ro, Ki Jeong Hong, Jeong Ho Park

Research output: Contribution to journalArticleResearchpeer-review

1 Citation (Scopus)

Abstract

Objectives: This study aimed to test the association between hypoxia level and outcomes according to shock status in traumatic brain injury (TBI) patients. Methods: Adult TBI patients transported by emergency medical services in 10 provinces were enrolled. Hypoxia was a main exposure; three groups by oxygen saturation (SaO2, non-hypoxia (≥94%), mild hypoxia (90 ≤ SaO2 < 94%)), and severe hypoxia (<90%). Shock status (<systolic blood pressure 90 mmHg) was an interactive exposure. The outcomes were hospital mortality and worsened disability (a 2-point increase of Glasgow Outcome Scale). Multivariable logistic regression was used to calculate the adjusted odds (AORs) with 95% Confidence intervals (CIs). Results: Of the 6125 patients, the mortality/disability rates were 49.4%/69.0% in severe hypoxia, 30.7%/46.9% in mild hypoxia, and 18.5%/27.5% in normoxia (p < 0.0001). Mortality/disability rates were 47.1%/57.1% in shock status and 20.5%/31.4% in non-shock status (p < 0.0001). AORs (95% CIs) for worsened disability/mortality compared with normoxia (reference) were 3.23 (2.47–4.21)/2.24 (1.70–2.96) in patients with severe hypoxia and 2.11 (1.63–2.74)/1.84 (1.39–2.45) in those with mild hypoxia. AORs (95% CIs) for worsened disability/mortality was 1.58 (1.20–2.09)/1.33 (1.01–1.76) by severe hypoxia than normoxia in patient with only non-shock status in the interaction analysis. Conclusions: There was a trend toward worsened outcomes with mild and severe hypoxia in patient with and without shock, however, the only met statistical significance for patients with both severe hypoxia and non-shock status.

Original languageEnglish
Pages (from-to)1709-1715
Number of pages7
JournalAmerican Journal of Emergency Medicine
Volume37
Issue number9
DOIs
StatePublished - 1 Sep 2019

Fingerprint

Shock
Cross-Sectional Studies
Mortality
Confidence Intervals
Traumatic Brain Injury
Hypoxia
Blood Pressure
Glasgow Outcome Scale
Emergency Medical Services
Hospital Mortality
Logistic Models
Oxygen

Keywords

  • Disability
  • Hypoxia
  • Shock
  • Survival
  • Traumatic brain injury

Cite this

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Effect of hypoxia on mortality and disability in traumatic brain injury according to shock status : A cross-sectional analysis. / Seo, Dong Eun; Shin, Sang Do; Song, Kyoung Jun; Ro, Young Sun; Hong, Ki Jeong; Park, Jeong Ho.

In: American Journal of Emergency Medicine, Vol. 37, No. 9, 01.09.2019, p. 1709-1715.

Research output: Contribution to journalArticleResearchpeer-review

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