Abstract
Objective
We evaluated a soft tissue oxygen saturation (Sto2) measurement at triage for predicting
admission to the hospital in adults presenting to the emergency department (ED) in
addition to data routinely gathered at triage.
Methods
This was a prospective, observational, single center study of adults presenting to
the ED for evaluation. Research assistants obtained thenar eminence Sto2 measurements
on subjects in ED triage. ED providers not involved in the study then made all management
and disposition decisions. We prospectively collected data on each subject's final
ED disposition (admission versus discharge). We identified the optimal Sto2 cutoff
value for predicting admission. We then used logistic regression modeling to describe
the added predictive value of Sto2 beyond routinely collected triage data including
Emergency Severity Index level, age, and vital signs.
Results
We analyzed 2588 adult (>17 years) subjects with 743 subjects (28.7%) admitted to the hospital. Sto2 < 76% was the optimal diagnostic cutoff for predicting admission. Of subjects with Sto2 < 76%, 158 of 384 (41.1%) underwent admission versus 585 of 2204 (26.5%) subjects with
Sto2 ≥ 76. After controlling for age, vital signs, and ESI level in the logistic regression
analysis, Sto2 < 76% had an odds ratio of 1.54 (95% confidence interval (CI), 1.19 to 1.98) for predicting
admission.
Conclusions
Sto2 may provide additional prognostic data to routine triage assessment regarding
the disposition for undifferentiated adult patients presenting to the ED.
Abbreviations:
Sto2 (soft tissue oxygen saturation), NIRS (near-infrared spectroscopy), MODS (multi-organ dysfunction syndrome), ESI (Emergency Severity Index), CI (confidence interval)Keywords
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Article Info
Publication History
Published online: March 09, 2017
Accepted:
March 9,
2017
Received in revised form:
February 10,
2017
Received:
December 21,
2016
Identification
Copyright
Published by Elsevier Inc.
