title: Pulse oximetry in the diagnosis of acute heart failure.
abstract: OBJECTIVE
  Oxygen saturation by pulse oximetry is commonly used for monitoring critical patients, but its utility as a diagnostic marker of acute heart failure has not been assessed. This study analyzed the diagnostic role of oxygen saturation by pulse oximetry in a series of patients with acute myocardial infarction.
  
  
  METHODS
  In a prospective observational cohort study of 220 consecutive patients with acute myocardial infarction, data collection included baseline oxygen saturation by pulse oximetry (without oxygen), physiologic measurements, Killip class and data from portable chest radiography, recorded at the same hour on each of the first three days after admission. Patients were followed up for one year.
  
  
  RESULTS
  There were 612 assessments. Baseline oxygen saturation by pulse oximetry decreased progressively in relation to the presence and the severity of acute heart failure assessed by Killip classes 1 to 3 (mean: 95, 92 and 85, respectively; P<.001) or by Radiology Score 0 to 4 (95, 94, 92, 89 and 83, respectively; P<.001), with a correlation coefficient of 0.66 and 0.63, respectively. Receiver operating characteristic curves disclosed the cut-off of oxygen saturation by pulse oximetry<93 to have the greatest area, with a sensitivity of 65%, specificity 90%, and overall test accuracy 83%. Patients grouped according to lowest oxygen saturation by pulse oximetry showed significantly different rates of one-year mortality or rehospitalization for heart failure.
  
  
  CONCLUSIONS
  Baseline oxygen saturation by pulse oximetry is useful in establishing the diagnosis and severity of heart failure in acute settings such as myocardial infarction and may have prognostic implications.The diagnosis may be suspected when baseline oxygen saturation by pulse oximetry is <93. Full English text available from:www.revespcardiol.org.
authors: Unidad de Cuidados Intensivos, Hospital Sant Joan Despí Moisès Broggi, Consorci Sanitari Integral, Universidad de Barcelona, Sant Joan Despí, Barcelona, España. jmasip@ub.edu
authors: Josep
authors: J
authors: Masip
authors: Maria
authors: M
authors: Gayà
authors: Joaquim
authors: J
authors: Páez
authors: Antoni
authors: A
authors: Betbesé
authors: Francisco
authors: F
authors: Vecilla
authors: Ruben
authors: R
authors: Manresa
authors: Pilar
authors: P
authors: Ruíz
mesh_terms: D000208:Acute Disease; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010092:Oximetry / Q000379:methods*; D010100:Oxygen / Q000097:blood; D011446:Prospective Studies; D012372:ROC Curve; D015203:Reproducibility of Results; D016896:Treatment Outcome
chemical_list: D010100:Oxygen