Effect of early hyperoxemia on the outcome in servere blunt chest trauma: A propensity score-based analysis of a single-center retrospective cohort

Abstract

Purpose: Our study aimed to explore the association between early hyperoxemia of the first 24 h on outcomes in patients with severe blunt chest trauma.

Materials and methods: In a level I trauma center, we conducted a retrospective study of 426 consecutive patients. Hyperoxemic groups were classified in severe (average PaO₂ ≥ 200 mmHg), moderate (≥150 and < 200 mmHg) or mild (≥ 100 and < 200 mmHg) and compared to control group (≥60 and < 100 mmHg) using a propensity score based analysis. The first endpoint was the incidence of a composite outcome including death and hospital-acquired pneumonia occurring from admission to day 28. The secondary endpoints were the incidence of death, the number of hospital-acquired pneumonia, mechanical ventilation-free days and intensive care unit-free day at day 28.

Results: The incidence of the composite endpoint was lower in the severe hyperoxemia group(OR, 0.25; 95%CI, 0.09-0.73; P < 0.001) compared with control. The 28-day mortality incidence was lower in severe (OR, 0.23; 95%CI, 0.08-0.68; P < 0.001) hyperoxemia group (OR, 0.41; 95%CI, 0.17-0.97; P = 0.04). Significant association was found between hyperoxemia and secondary outcomes.

Conclusion: In our cohort early hyperoxemia during the first 24 h of admission after severe blunt chest trauma was not associated with worse outcome.

Keywords: ARDS; Blunt chest trauma; Critical care; Hyperoxia; Mechanical ventilation; Pneumonia.