Analysis of Discrepancies Between Pulse Oximetry and Arterial Oxygen Saturation Measurements by Race and Ethnicity and Association With Organ Dysfunction and Mortality

作者：An-Kwok Ian Wong, Marie‐Laure Charpignon, Han Kim, Christopher S. Josef, Anne de Hond, Jhalique Jane R. Fojas, Azade Tabaie, Xiaoli Liu, Eduardo Mireles‐Cabodevila, Leandro Carvalho, Rishikesan Kamaleswaran, Rajapaksha W. M. A. Madushani, Lasith Adhikari, Andre L. Holder, Ewout Willem Steyerberg, Timothy G. Buchman, Mary E. Lough, Leo Anthony Celi · 发表于：JAMA Network Open · 年份：2021 · DOI：10.1001/jamanetworkopen.2021.31674 · 被引用次数：271 · 研究领域：Non-Invasive Vital Sign Monitoring、Sepsis Diagnosis and Treatment、Optical Imaging and Spectroscopy Techniques

Importance: Discrepancies in oxygen saturation measured by pulse oximetry (Spo2), when compared with arterial oxygen saturation (Sao2) measured by arterial blood gas (ABG), may differentially affect patients according to race and ethnicity. However, the association of these disparities with health outcomes is unknown. Objective: To examine racial and ethnic discrepancies between Sao2 and Spo2 measures and their associations with clinical outcomes. Design, Setting, and Participants: This multicenter, retrospective, cross-sectional study included 3 publicly available electronic health record (EHR) databases (ie, the Electronic Intensive Care Unit-Clinical Research Database and Medical Information Mart for Intensive Care III and IV) as well as Emory Healthcare (2014-2021) and Grady Memorial (2014-2020) databases, spanning 215 hospitals and 382 ICUs. From 141 600 hospital encounters with recorded ABG measurements, 87 971 participants with first ABG measurements and an Spo2 of at least 88% within 5 minutes before the ABG test were included. Exposures: Patients with hidden hypoxemia (ie, Spo2 ≥88% but Sao2 <88%). Main Outcomes and Measures: Outcomes, stratified by race and ethnicity, were Sao2 for each Spo2, hidden hypoxemia prevalence, initial demographic characteristics (age, sex), clinical outcomes (in-hospital mortality, length of stay), organ dysfunction by scores (Sequential Organ Failure Assessment [SOFA]), and laboratory values (lactate and creatinine levels) before and 24...