TY - JOUR
T1 - Long-term mortality and health-related quality of life with lower versus higher oxygenation targets in intensive care unit patients with COVID-19 and severe hypoxaemia
AU - Crescioli, Elena
AU - Nielsen, Frederik Mølgaard
AU - Bunzel, Anne-Marie
AU - Eriksen, Anne Sofie Broberg
AU - Siegemund, Martin
AU - Poulsen, Lone Musaeus
AU - Andreasen, Anne Sofie
AU - Bestle, Morten Heiberg
AU - Iversen, Susanne Andi
AU - Brøchner, Anne Craveiro
AU - Grøfte, Thorbjørn
AU - Hildebrandt, Thomas
AU - Laake, Jon Henrik
AU - Kjær, Maj-Brit Nørregaard
AU - Lange, Theis
AU - Perner, Anders
AU - Klitgaard, Thomas Lass
AU - Schjørring, Olav Lilleholt
AU - Rasmussen, Bodil Steen
N1 - © 2024. The Author(s).
PY - 2024/10
Y1 - 2024/10
N2 - PURPOSE: The aim of this study was to evaluate one-year outcomes of lower versus higher oxygenation targets in intensive care unit (ICU) patients with coronavirus disease 2019 (COVID-19) and severe hypoxaemia.METHODS: We conducted pre-planned analyses of one-year mortality and health-related quality of life (HRQoL) in the Handling Oxygenation Targets in COVID-19 trial. The trial randomised 726 ICU patients with COVID-19 and hypoxaemia to partial pressure of arterial oxygen targets of 8 kPa (60 mmHg) versus 12 kPa (90 mmHg) during ICU stay up to 90 days, including readmissions. HRQoL was assessed using EuroQol visual analogue scale (EQ-VAS) and 5-level 5-dimension questionnaire (EQ-5D-5L). Outcomes were analysed in the intention-to-treat population. Non-survivors were assigned the worst possible score (zero), and multiple imputation was applied for missing EQ-VAS values.RESULTS: We obtained one-year vital status for 691/726 (95.2%) of patients and HRQoL data for 642/726 (88.4%). At one year, 117/348 (33.6%) of patients in the lower-oxygenation group had died compared to 134/343 (39.1%) in the higher-oxygenation group (adjusted risk ratio: 0.85; 98.6% confidence interval (CI) 0.66-1.09; p = 0.11). Median EQ-VAS was 50 (interquartile range, 0-80) versus 40 (0-75) (adjusted mean difference: 4.8; 98.6% CI - 2.2 to 11.9; p = 0.09) and EQ-5D-5L index values were 0.61 (0-0.81) in the lower-oxygenation group versus 0.43 (0-0.79) (p = 0.20) in the higher-oxygenation group, respectively.CONCLUSION: Among adult ICU patients with COVID-19 and severe hypoxaemia, one-year mortality results were most compatible with benefit of the lower oxygenation target, which did not appear to result in more survivors with poor quality of life.
AB - PURPOSE: The aim of this study was to evaluate one-year outcomes of lower versus higher oxygenation targets in intensive care unit (ICU) patients with coronavirus disease 2019 (COVID-19) and severe hypoxaemia.METHODS: We conducted pre-planned analyses of one-year mortality and health-related quality of life (HRQoL) in the Handling Oxygenation Targets in COVID-19 trial. The trial randomised 726 ICU patients with COVID-19 and hypoxaemia to partial pressure of arterial oxygen targets of 8 kPa (60 mmHg) versus 12 kPa (90 mmHg) during ICU stay up to 90 days, including readmissions. HRQoL was assessed using EuroQol visual analogue scale (EQ-VAS) and 5-level 5-dimension questionnaire (EQ-5D-5L). Outcomes were analysed in the intention-to-treat population. Non-survivors were assigned the worst possible score (zero), and multiple imputation was applied for missing EQ-VAS values.RESULTS: We obtained one-year vital status for 691/726 (95.2%) of patients and HRQoL data for 642/726 (88.4%). At one year, 117/348 (33.6%) of patients in the lower-oxygenation group had died compared to 134/343 (39.1%) in the higher-oxygenation group (adjusted risk ratio: 0.85; 98.6% confidence interval (CI) 0.66-1.09; p = 0.11). Median EQ-VAS was 50 (interquartile range, 0-80) versus 40 (0-75) (adjusted mean difference: 4.8; 98.6% CI - 2.2 to 11.9; p = 0.09) and EQ-5D-5L index values were 0.61 (0-0.81) in the lower-oxygenation group versus 0.43 (0-0.79) (p = 0.20) in the higher-oxygenation group, respectively.CONCLUSION: Among adult ICU patients with COVID-19 and severe hypoxaemia, one-year mortality results were most compatible with benefit of the lower oxygenation target, which did not appear to result in more survivors with poor quality of life.
KW - Aged
KW - COVID-19/mortality
KW - Female
KW - Humans
KW - Hypoxia/mortality
KW - Intensive Care Units/statistics & numerical data
KW - Male
KW - Middle Aged
KW - Oxygen Inhalation Therapy/methods
KW - Oxygen/blood
KW - Quality of Life
KW - SARS-CoV-2
KW - Covid-19
KW - Mortality
KW - Quality of life
KW - Intensive care units
KW - Oxygen inhalation therapy
U2 - 10.1007/s00134-024-07613-2
DO - 10.1007/s00134-024-07613-2
M3 - Article
C2 - 39235624
SN - 0342-4642
VL - 50
SP - 1603
EP - 1613
JO - Intensive Care Medicine
JF - Intensive Care Medicine
IS - 10
ER -