Abstract
Introduction:
Community-acquired pneumonia (CAP) is a common presenting condition in primary care. Assessment of oxygenation status using pulse oximetry is increasingly available, but its precise role in disease severity assessment is unknown.
Aims:
To inform the use of pulse oximetry in patients with CAP, including the utility of different oxygenation thresholds, patient subgroups, and interaction with existing severity scores.
Methods:
A prospective cohort study of adults with CAP admitted to a UK teaching hospital trust. Oxygen saturations (SpO2) and the fraction of inspired oxygen were recorded on admission. The value of different SpO2 thresholds (<88%, ≤90%, ≤92%, and <95%) in predicting 30-day mortality and critical care admission was analysed.
Results:
467 patients had SpO2 measured on room air. Admission SpO2 ≤90% was observed in 28% of patients and had reasonable specificity (76%) for 30-day mortality or critical care admission, but low sensitivity (46%). Specificity was particularly good for adults <50 years of age (90%) or those with asthma (92.3%).
Conclusions:
SpO2 ≤90% has good specificity but low sensitivity for adverse outcomes in CAP. It complements rather than replaces clinical severity scoring.
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Bewick, T., Greenwood, S. & Lim, W. What is the role of pulse oximetry in the assessment of patients with community-acquired pneumonia in primary care?. Prim Care Respir J 19, 378–382 (2010). https://doi.org/10.4104/pcrj.2010.00049
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DOI: https://doi.org/10.4104/pcrj.2010.00049
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