Long-term mortality and health-related quality of life of lower versus higher oxygenation targets in ICU patients with severe hypoxaemia

Elena Crescioli; Thomas Lass Klitgaard; Lone Musaeus Poulsen; Bjørn Anders Brand; Martin Siegemund; Thorbjørn Grøfte; Frederik Keus; Ulf Gøttrup Pedersen; Minna Bäcklund; Johanna Karttunen; Matthew Morgan; Andrei Ciubotariu; Anne-Marie Gellert Bunzel; Stine Rom Vestergaard; Nicolaj Munch Jensen; Thomas Steen Jensen; Maj-Brit Nørregaard Kjær; Aksel Karl Georg Jensen; Theis Lange; Jørn Wetterslev; Anders Perner; Olav Lilleholt Schjørring; Bodil Steen Rasmussen

doi:10.1007/s00134-022-06695-0

Long-term mortality and health-related quality of life of lower versus higher oxygenation targets in ICU patients with severe hypoxaemia

Elena Crescioli, Thomas Lass Klitgaard, Lone Musaeus Poulsen, Bjørn Anders Brand, Martin Siegemund, Thorbjørn Grøfte, Frederik Keus, Ulf Gøttrup Pedersen, Minna Bäcklund, Johanna Karttunen, Matthew Morgan, Andrei Ciubotariu, Anne-Marie Gellert Bunzel, Stine Rom Vestergaard, Nicolaj Munch Jensen, Thomas Steen Jensen, Maj-Brit Nørregaard Kjær, Aksel Karl Georg Jensen, Theis Lange, Jørn WetterslevAnders Perner, Olav Lilleholt Schjørring, Bodil Steen Rasmussen^*

^*Corresponding author af dette arbejde

Anæstesiologisk Afdeling

Publikation: Bidrag til tidsskrift › Artikel › Forskning › peer review

Abstract

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).

Originalsprog	Engelsk
Sider (fra-til)	714-722
Antal sider	9
Tidsskrift	Intensive Care Medicine
Vol/bind	48
Udgave nummer	6
Tidlig onlinedato	20 apr. 2022
DOI	https://doi.org/10.1007/s00134-022-06695-0
Status	Udgivet - jun. 2022

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10.1007/s00134-022-06695-0

Citationsformater

Crescioli, E., Klitgaard, T. L., Poulsen, L. M., Brand, B. A., Siegemund, M., Grøfte, T., Keus, F., Pedersen, U. G., Bäcklund, M., Karttunen, J., Morgan, M., Ciubotariu, A., Bunzel, A-M. G., Vestergaard, S. R., Jensen, N. M., Jensen, T. S., Kjær, M-B. N., Jensen, A. K. G., Lange, T., ... Rasmussen, B. S. (2022). Long-term mortality and health-related quality of life of lower versus higher oxygenation targets in ICU patients with severe hypoxaemia. Intensive Care Medicine, 48(6), 714-722. https://doi.org/10.1007/s00134-022-06695-0

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title = "Long-term mortality and health-related quality of life of lower versus higher oxygenation targets in ICU patients with severe hypoxaemia",

abstract = "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).",

author = "Elena Crescioli and Klitgaard, {Thomas Lass} and Poulsen, {Lone Musaeus} and Brand, {Bj{\o}rn Anders} and Martin Siegemund and Thorbj{\o}rn Gr{\o}fte and Frederik Keus and Pedersen, {Ulf G{\o}ttrup} and Minna B{\"a}cklund and Johanna Karttunen and Matthew Morgan and Andrei Ciubotariu and Bunzel, {Anne-Marie Gellert} and Vestergaard, {Stine Rom} and Jensen, {Nicolaj Munch} and Jensen, {Thomas Steen} and Kj{\ae}r, {Maj-Brit N{\o}rregaard} and Jensen, {Aksel Karl Georg} and Theis Lange and J{\o}rn Wetterslev and Anders Perner and Schj{\o}rring, {Olav Lilleholt} and Rasmussen, {Bodil Steen}",

note = "{\textcopyright} 2022. Springer-Verlag GmbH Germany, part of Springer Nature.",

year = "2022",

month = jun,

doi = "10.1007/s00134-022-06695-0",

language = "English",

volume = "48",

pages = "714--722",

journal = "Intensive Care Medicine",

issn = "0342-4642",

publisher = "Springer Verlag",

number = "6",

}

Crescioli, E, Klitgaard, TL, Poulsen, LM, Brand, BA, Siegemund, M, Grøfte, T, Keus, F, Pedersen, UG, Bäcklund, M, Karttunen, J, Morgan, M, Ciubotariu, A, Bunzel, A-MG, Vestergaard, SR, Jensen, NM, Jensen, TS, Kjær, M-BN, Jensen, AKG, Lange, T, Wetterslev, J, Perner, A, Schjørring, OL & Rasmussen, BS 2022, 'Long-term mortality and health-related quality of life of lower versus higher oxygenation targets in ICU patients with severe hypoxaemia', Intensive Care Medicine, bind 48, nr. 6, s. 714-722. https://doi.org/10.1007/s00134-022-06695-0

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

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).

U2 - 10.1007/s00134-022-06695-0

DO - 10.1007/s00134-022-06695-0

M3 - Article

C2 - 35441849

SN - 0342-4642

VL - 48

SP - 714

EP - 722

JO - Intensive Care Medicine

JF - Intensive Care Medicine

IS - 6

ER -

Long-term mortality and health-related quality of life of lower versus higher oxygenation targets in ICU patients with severe hypoxaemia

Abstract

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