TY - JOUR
T1 - Long-term mortality and health-related quality of life of lower versus higher oxygenation targets in ICU patients with severe hypoxaemia
AU - Crescioli, Elena
AU - Klitgaard, Thomas Lass
AU - Poulsen, Lone Musaeus
AU - Brand, Bjørn Anders
AU - Siegemund, Martin
AU - Grøfte, Thorbjørn
AU - Keus, Frederik
AU - Pedersen, Ulf Gøttrup
AU - Bäcklund, Minna
AU - Karttunen, Johanna
AU - Morgan, Matthew
AU - Ciubotariu, Andrei
AU - Bunzel, Anne Marie Gellert
AU - Vestergaard, Stine Rom
AU - Jensen, Nicolaj Munch
AU - Jensen, Thomas Steen
AU - Kjær, Maj Brit Nørregaard
AU - Jensen, Aksel Karl Georg
AU - Lange, Theis
AU - Wetterslev, Jørn
AU - Perner, Anders
AU - Schjørring, Olav Lilleholt
AU - Rasmussen, Bodil Steen
N1 - Funding Information:
Supported by a grant (4108-00011A) from Innovation Fund Denmark, by the Aalborg University Hospital, by Grants (EMN-2017-00901 and EMN-2019-01055) from the Regions of Denmark, by a Grant (25457) from the Obel Family Foundation, by the Danish Society of Anesthesiology and Intensive Care Medicine, and by the Intensive Care Symposium Hindsgavl.
Funding Information:
The Dept. of Anaesthesia and Intensive Care, Aalborg University Hospital (EC, BSR, OLS, TLK, AMGB, SRV) receives support for research from the Novo Nordisk Foundation, the Danish Ministry of Higher Education and Science, and AK Pharma. The Dept. of Intensive Care, Rigshospitalet (BB, MNK, AP) receives support for research from the Novo Nordisk Foundation, Sygeforsikringen ‘Danmark’, Pfizer, Fresenius Kabi, and AK Pharma. The Dept. of Anaesthesiology, Zealand University Hospital (LMP, UGP) receives support for research from AK Pharma.
Publisher Copyright:
© 2022, Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2022/6
Y1 - 2022/6
N2 - Purpose: We assessed outcomes after 1 year of lower versus higher oxygenation targets in intensive care unit (ICU) patients with severe hypoxaemia.Methods: Pre-planned analyses evaluating 1-year mortality and health-related quality-of-life (HRQoL) outcomes in the previously published Handling Oxygenation Targets in the ICU trial which randomised 2928 adults with acute hypoxaemia to targets of arterial oxygen of 8 kPa or 12 kPa throughout the ICU stay up to 90 days. One-year all-cause mortality was assessed in the intention-to-treat population. HRQoL was assessed using EuroQol 5 dimensions 5 levels (EQ-5D-5L) questionnaire and EQ visual analogue scale score (EQ-VAS), and analyses were conducted in both survivors only and the intention-to-treat population with assignment of the worst scores to deceased patients.Results: We obtained 1-year vital status for 2887/2928 (98.6%), and HRQoL for 2600/2928 (88.8%) of the trial population. One year after randomisation, 707/1442 patients (49%) in the lower oxygenation group vs. 704/1445 (48.7%) in the higher oxygenation group had died (adjusted risk ratio 1.00; 95% confidence interval 0.93–1.08, p = 0.92). In total, 1189/1476 (80.4%) 1-year survivors participated in HRQoL interviews: median EQ-VAS scores were 65 (interquartile range 50–80) in the lower oxygenation group versus 67 (50–80) in the higher oxygenation group (p = 0.98). None of the five EQ-5D-5L dimensions differed between groups.Conclusion: Among adult ICU patients with severe hypoxaemia, a lower oxygenation target (8 kPa) did not improve survival or HRQoL at 1 year as compared to a higher oxygenation target (12 kPa).
AB - Purpose: We assessed outcomes after 1 year of lower versus higher oxygenation targets in intensive care unit (ICU) patients with severe hypoxaemia.Methods: Pre-planned analyses evaluating 1-year mortality and health-related quality-of-life (HRQoL) outcomes in the previously published Handling Oxygenation Targets in the ICU trial which randomised 2928 adults with acute hypoxaemia to targets of arterial oxygen of 8 kPa or 12 kPa throughout the ICU stay up to 90 days. One-year all-cause mortality was assessed in the intention-to-treat population. HRQoL was assessed using EuroQol 5 dimensions 5 levels (EQ-5D-5L) questionnaire and EQ visual analogue scale score (EQ-VAS), and analyses were conducted in both survivors only and the intention-to-treat population with assignment of the worst scores to deceased patients.Results: We obtained 1-year vital status for 2887/2928 (98.6%), and HRQoL for 2600/2928 (88.8%) of the trial population. One year after randomisation, 707/1442 patients (49%) in the lower oxygenation group vs. 704/1445 (48.7%) in the higher oxygenation group had died (adjusted risk ratio 1.00; 95% confidence interval 0.93–1.08, p = 0.92). In total, 1189/1476 (80.4%) 1-year survivors participated in HRQoL interviews: median EQ-VAS scores were 65 (interquartile range 50–80) in the lower oxygenation group versus 67 (50–80) in the higher oxygenation group (p = 0.98). None of the five EQ-5D-5L dimensions differed between groups.Conclusion: Among adult ICU patients with severe hypoxaemia, a lower oxygenation target (8 kPa) did not improve survival or HRQoL at 1 year as compared to a higher oxygenation target (12 kPa).
KW - Intensive care units
KW - Mortality
KW - Oxygen inhalation therapy
KW - Quality of life
KW - Randomized controlled trial
U2 - 10.1007/s00134-022-06695-0
DO - 10.1007/s00134-022-06695-0
M3 - Article
AN - SCOPUS:85128459024
SN - 0342-4642
VL - 48
SP - 714
EP - 722
JO - Intensive care medicine
JF - Intensive care medicine
ER -