Emergency Medicine Department, University Hospital of Bordeaux, 1 place Amélie Raba Léon, Bordeaux 33000, France.
Emergency Medicine Department, University Hospital of Bordeaux, 1 place Amélie Raba Léon, Bordeaux 33000, France; INSERM, ISPED, Bordeaux Population Health research center INSERM U1219-"Injury Epidemiology Transport Occupation" team, Université de Bordeaux, 146 Rue Léo Saignat, Bordeaux 33000, France.
Am J Emerg Med. 2021 Jun;44:116-120. doi: 10.1016/j.ajem.2021.01.092. Epub 2021 Feb 6.
We assessed the performance of the ratio of peripheral arterial oxygen saturation to the inspired fraction of oxygen (SpO/FiO) to predict the ratio of partial pressure arterial oxygen to the fraction of inspired oxygen (PaO/FiO) among patients admitted to our emergency department (ED) during the SARS-CoV-2 outbreak.
We retrospectively studied patients admitted to an academic-level ED in France who were undergoing a joint measurement of SpO and arterial blood gas. We compared SpO with SaO and evaluated performance of the SpO/FiO ratio for the prediction of 300 and 400 mmHg PaO/FiO cut-off values in COVID-19 positive and negative subgroups using receiver-operating characteristic (ROC) curves.
During the study period from February to April 2020, a total of 430 arterial samples were analyzed and collected from 395 patients. The area under the ROC curves of the SpO/FiO ratio was 0.918 (CI 95% 0.885-0.950) and 0.901 (CI 95% 0.872-0.930) for PaO/FiO thresholds of 300 and 400 mmHg, respectively. The positive predictive value (PPV) of an SpO/FiO threshold of 350 for PaO/FiO inferior to 300 mmHg was 0.88 (CI95% 0.84-0.91), whereas the negative predictive value (NPV) of the SpO/FiO threshold of 470 for PaO/FiO inferior to 400 mmHg was 0.89 (CI95% 0.75-0.96). No significant differences were found between the subgroups.
The SpO/FiO ratio may be a reliable tool for hypoxemia screening among patients admitted to the ED, particularly during the SARS-CoV-2 outbreak.
我们评估了外周动脉血氧饱和度与吸入氧分数的比值（SpO/FiO）预测 SARS-CoV-2 爆发期间我院急诊科（ED）收治患者动脉血氧分压与吸入氧分数比值（PaO/FiO）的性能。
我们回顾性研究了在法国一所学术水平的 ED 接受 SpO 和动脉血气联合测量的患者。我们将 SpO 与 SaO 进行比较，并使用接受者操作特征（ROC）曲线评估 SpO/FiO 比值在 COVID-19 阳性和阴性亚组中预测 300 和 400mmHg PaO/FiO 截止值的性能。
在 2020 年 2 月至 4 月的研究期间，共分析了来自 395 名患者的 430 个动脉样本。SpO/FiO 比值的 ROC 曲线下面积分别为 0.918（95%CI 0.885-0.950）和 0.901（95%CI 0.872-0.930），用于 PaO/FiO 阈值分别为 300 和 400mmHg。SpO/FiO 阈值为 350 时，PaO/FiO 低于 300mmHg 的阳性预测值（PPV）为 0.88（95%CI95% 0.84-0.91），而 SpO/FiO 阈值为 470 时，PaO/FiO 低于 400mmHg 的阴性预测值（NPV）为 0.89（95%CI 0.75-0.96）。亚组之间无显著差异。
SpO/FiO 比值可能是 ED 收治患者低氧血症筛查的可靠工具，特别是在 SARS-CoV-2 爆发期间。
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