Bowton D L, Scuderi P E, Haponik E F
Department of Medicine, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, North Carolina 27157.
Am J Med. 1994 Jul;97(1):38-46. doi: 10.1016/0002-9343(94)90046-9.
The effect on survival of episodic hypoxemia was prospectively studied in 100 patients hospitalized on general medicine services of a large, tertiary care, university hospital. Pulse oximetry monitoring (POM) was initiated within 24 hours of admission and was maintained for approximately 24 hours independent of patient management. Hypoxemia lasting for at least 5 consecutive minutes and resulting in an arterial oxygen saturation of less than 90% occurred in 26 of the 100 patients. No clinical characteristics were found that could reliably distinguish those patients who did develop hypoxemia from those who did not, though the small number of patients in many categories precludes drawing firm conclusions. However, severe desaturation was unlikely to occur in patients with normal chest roentgenograms. During the following 4 to 7 months, 8 patients (32%) suffering episodic hypoxemia died, while only 7 individuals (10%) without hypoxemia died, an increase in mortality that remained significant after adjustment for severity of illness. The relative risk of death associated with desaturation was 3.3 (95% CI 1.41 to 8.2). The severity of hemoglobin oxygen desaturation, expressed as the saturation-time index, correlated inversely with survival time.
在一家大型三级护理大学医院的普通内科病房住院的100例患者中，对间歇性低氧血症对生存的影响进行了前瞻性研究。入院后24小时内开始进行脉搏血氧饱和度监测（POM），并持续约24小时，与患者管理无关。100例患者中有26例出现持续至少5分钟且导致动脉血氧饱和度低于90%的低氧血症。虽然许多类别中的患者数量较少，无法得出确凿结论，但未发现能可靠区分发生低氧血症的患者与未发生低氧血症患者的临床特征。然而，胸部X线片正常的患者不太可能发生严重的血氧饱和度降低。在接下来的4至7个月中，8例（32%）患有间歇性低氧血症的患者死亡，而无低氧血症的患者仅有7例（10%）死亡，在对疾病严重程度进行调整后，死亡率的增加仍然显著。与血氧饱和度降低相关的死亡相对风险为3.3（95%可信区间1.41至8.2）。以饱和时间指数表示的血红蛋白氧饱和度降低的严重程度与生存时间呈负相关。
