title: Quadratic function between arterial partial oxygen pressure and mortality risk in sepsis patients: an interaction with simplified acute physiology score.
abstract: Oxygen therapy is widely used in emergency and critical care settings, while there is little evidence on its real therapeutic effect. The study aimed to explore the impact of arterial oxygen partial pressure (PaO2) on clinical outcomes in patients with sepsis. A large clinical database was employed for the study. Subjects meeting the diagnostic criteria of sepsis were eligible for the study. All measurements of PaO2were extracted. The primary endpoint was death from any causes during hospital stay. Survey data analysis was performed by using individual ICU admission as the primary sampling unit. Quadratic function was assumed for PaO2and its interaction with other covariates were explored. A total of 199,125 PaO2samples were identified for 11,002 ICU admissions. Each ICU stay comprised 18 PaO2samples in average. The fitted multivariable model supported our hypothesis that the effect of PaO2on mortality risk was in quadratic form. There was significant interaction between PaO2and SAPS-I (p = 0.007). Furthermore, the main effect of PaO2on SOFA score was nonlinear. The study shows that the effect of PaO2on mortality risk is in quadratic function form, and there is significant interaction between PaO2and severity of illness.
authors.affiliation: Department of emergency medicine, Sir Run-Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310016, China.|Department of critical care medicine, Jinhua municipal central hospital, Jinhua hospital of Zhejiang university, Zhejiang, P.R.China.
authors.forename: Zhongheng
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Department of critical care medicine, Jinhua municipal central hospital, Jinhua hospital of Zhejiang university, Zhejiang, P.R.China.
authors.forename: Xuqing
authors.initials: X
authors.lastname: Ji
mesh_terms: D000368:Aged; D001158:Arteries / Q000378:metabolism / Q000503:physiopathology*; D001784:Blood Gas Analysis / Q000379:methods; D005260:Female; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000378:metabolism*; D012306:Risk; D018805:Sepsis / Q000378:metabolism / Q000401:mortality* / Q000503:physiopathology*; D012720:Severity of Illness Index; D000072878:Simplified Acute Physiology Score
chemical_list: D010100:Oxygen