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Brief report
Prognostic value of nocturnal pulse oximetry in patients with heart failure
Valor pronóstico de la pulsioximetría nocturna en pacientes con insuficiencia cardiaca
Ricardo Rivera-Lópeza,
Corresponding author
Rfriveralopez@gmail.com

Corresponding author.
, Laura Jordán-Martíneza, Silvia López-Fernándeza, Ricardo Rivera-Fernandezb, Luis Tercedora, Germán Sáez-Rocac
a Servicio de Cardiología, Hospital Universitario Virgen de las Nieves, Granada, Spain
b Unidad de Cuidados Intensivos, Complejo Hospitalario de Jaén, Jaén, Spain
c Servicio de Neumología, Hospital Universitario Virgen de las Nieves, Granada, Spain
Received 07 August 2017. Accepted 02 November 2017
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Figures (1)
Tables (4)
Table 1. Baseline characteristics of patients according to pulse oximetry results.
Table 2. Occurrence of events during the follow-up.
Table 3. Variables related to showing the composite endpoint.
Table 4. Multivariate analysis using COX regression model for the composite endpoint.
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Abstract
Introduction and objectives

To analyze the prognostic value of nocturnal hypoxaemia measured with portable nocturnal pulse-oximetry in patients hospitalized due to heart failure and its relation to mortality and hospital readmission.

Methods

We included 38 patients who were admitted consecutively to our unit with the diagnosis of decompensated heart failure.

Pulse-oximetry was considered positive for hypoxaemia when more than 10 desaturations per hour were recorded during sleep.

Follow-up was performed for 30.3 (standard deviation [SD] 14.2) months, the main objective being a combined endpoint of all-cause mortality and hospital readmission due to heart failure.

Results

The average age was 70.7 (SD 10.7) years, 63.3% were males.

Pulse-oximetry was considered positive for hypoxaemia in 27 (71%) patients.

Patients with positive pulse-oximetry had the most frequent endpoint (9.1% [1] vs. 61.5% [16], p=0.003).

After multivariate analysis, continuous nocturnal hypoxaemia was related to the combined endpoint (HR=8.37, 1.19–68.4, p=0.03).

Discussion

Patients hospitalized for heart failure and nocturnal hypoxaemia measured with portable pulse-oximeter have an increased risk of hospital readmission and death.

Keywords:
Factors related to the prognosis
Heart failure
Hypoxaemia
Sleep disordered breathing
Resumen
Introducción y objetivos

Analizar el valor pronóstico de la hipoxemia nocturna, evaluada mediante pulsioximetría nocturna portátil, en pacientes ingresados por insuficiencia cardiaca y su relación con la mortalidad y el reingreso hospitalario.

Métodos

Incluimos a 38 pacientes ingresados de manera consecutiva en nuestra unidad con el diagnóstico de insuficiencia cardiaca descompensada.

La pulsioximetría se consideró positiva para hipoxemia cuando se registraron más de 10 desaturaciones a la hora durante el sueño.

Se realizó seguimiento durante 30,3 (desviación estándar [DE] 14,2) meses, el objetivo principal fue un endpoint combinado de mortalidad por cualquier causa y reingreso por insuficiencia cardiaca.

Resultados

La edad media fue de 70,7 (DE 10,7) años; el 63,3% eran varones.

La pulsioximetría fue considerada positiva para hipoxemia en 27 (71%) pacientes.

Los pacientes con una pulsioximetría positiva presentaron con mayor frecuencia el endpoint combinado (9.1% [1] vs. 61,5% [16]; p=0,003).

Tras el análisis multivariable, la hipoxemia nocturna continuó estando relacionada con el endpoint combinado (HR=8,37; 1,19-68,4; p=0,03).

Discusión

Los pacientes ingresados por insuficiencia cardiaca e hipoxemia nocturna medida con pulsioxímetro portátil presentan un riesgo aumentado de reingreso y muerte.

Palabras clave:
Trastornos respiratorios del sueño
Insuficiencia cardiaca
Hipoxemia nocturna
Factores relacionados con el pronóstico

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