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Central venous oxygen saturation is not predictive of early complications in cancer patients presenting to the emergency department

  • Olivier Peyrony
  • Guillaume Dumas
  • Léa Legay
  • Alessandra Principe
  • Jessica Franchitti
  • Marie Simonetta
  • Anne Verrat
  • Jihed Amami
  • Hélène Milacic
  • Adélia Bragança
  • Ariane Gillet
  • Matthieu Resche-Rigon
  • Jean-Paul Fontaine
  • Elie Azoulay
EM - ORIGINAL
  • 13 Downloads

Abstract

Central venous oxygen saturation (ScvO2) is easily observable in oncology patients with long-term central venous catheters (CVC), and has been studied as a prognostic factor in patients with sepsis. We sought to investigate the association between ScvO2 and early complications in cancer patients presenting to the ED. We prospectively enrolled adult cancer patients with pre-existing CVC who presented to the ED. ScvO2 was measured on their CVC. The outcome was admission to the intensive care unit (ICU) or mortality by day 7. ScvO2 was first studied as a continuous variable (%) with a ROC analysis and as a categorical variable (cut-off at < 70%) with a multivariate analysis. A total of 210 cancer patients were enrolled. At baseline, ScvO2 showed no significant difference between patients who were admitted to the ICU or died before day 7, and patients who did not (67%; IQR 62–68% vs. 71%; IQR 65–78% respectively, P = 0.3). The ROC analysis showed the absence of discrimination accuracy for ScvO2 to predict the outcome (AUC = 0.56). By multivariate analysis, ScvO2 < 70% was not associated with the outcome (OR 1.67; 95% CI 0.64–4.36). Variables that were associated with ICU admission or death by day 7 included a shock-index (heart rate/systolic blood pressure) > 1 and a performance status > 2 (OR 4.76; 95% CI 1.81–12.52 and OR 6.23, 95% CI 2.40–16.17, respectively). This study does not support the use of ScvO2 to risk stratify cancer patients presenting to the ED.

Keywords

Central venous oxygen saturation (ScvO2Emergency department Cancer Triage Neutropenia 

Notes

Author contributions

OP, GD, JPF and EA made the study concept and design; OP, LL, AP, JF, MS, AV, JA, HM, AB, AG acquired the data; OP analyzed and interpreted the data; OP, JPF and EA drafted the manuscript; LL, AP, JF, MS, AV, JA, HM, AB, AG, MRR, JPF and EA made critical revision of the manuscript for important intellectual content; MRR gave statistical expertise.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Statement of human and animal rights

The study was approved by the regional Ethics Committee.

Informed consent

Informed consent was obtained from all individual participants included in this study.

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Copyright information

© Società Italiana di Medicina Interna 2018

Authors and Affiliations

  • Olivier Peyrony
    • 1
  • Guillaume Dumas
    • 2
  • Léa Legay
    • 1
  • Alessandra Principe
    • 1
  • Jessica Franchitti
    • 1
  • Marie Simonetta
    • 1
  • Anne Verrat
    • 1
  • Jihed Amami
    • 1
  • Hélène Milacic
    • 1
  • Adélia Bragança
    • 1
  • Ariane Gillet
    • 1
  • Matthieu Resche-Rigon
    • 3
    • 4
    • 5
  • Jean-Paul Fontaine
    • 1
  • Elie Azoulay
    • 2
    • 4
    • 5
  1. 1.Emergency DepartmentHôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris (AP-HP)ParisFrance
  2. 2.Intensive Care UnitHôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris (AP-HP)ParisFrance
  3. 3.Biostatistics and Medical Information DepartmentHôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris (AP-HP)ParisFrance
  4. 4.Centre of Research in Epidemiology and Statistics Sorbonne Paris Cité (CRESS-INSERM-UMR1153), ECSTRRA TeamParisFrance
  5. 5.Paris Diderot UniversityParisFrance

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