Our hypothesis was that patients managed with noninvasive ventilation (NIV) on the wards could be risk-stratified with initial pulse oximetry/fraction of inspired oxygen (SpO 2 /FiO 2 ) ratios and tidal volumes (Vte). A prospective study of consecutive patients with acute respiratory failure requiring NIV on the wards was conducted. A multivariate logistic regression model and a negative binomial regression model were used. A total of 403 patients (55.8% women) had a mean age of 65.0 ± 14.9 years with a mean body mass index of 32.1 ± 11.1 kg/m 2 . The 28-day mortality was 14.1%, and the intubation rate was 16.1%. Pneumonia was associated with the highest 28-day mortality (22.5%) and rate of intubation (36.7%) when compared with chronic obstructive pulmonary disease (4.4% and 7.3%) or congestive heart failure (22.2% and 13.4%). The SpO 2 /FiO 2 groups were <214 (26.6%), 214 -357 (66.0%), and 357 (7.4%). Those in the SpO 2 /FiO 2 < 214 group had a higher 28-day mortality rate (odds ratio [OR] ¼ 8.19; 95% confidence interval [CI] 1.02 -65.7), intubation rate (OR ¼ 3.7; 95% CI 1.1 -12.1), intensive care unit admission rate (OR ¼ 2.9; 95% CI 1.2 -7.4), and length of stay (relative risk ¼ 2.0; 95% CI 1.3 -3.0). A Vte/predicted body weight <7.7 mL/kg was associated with increased intubations (OR ¼ 3.1; 95% CI 1.3 -7.4), intensive care unit admissions (OR ¼ 2.5; 95% CI 1.3 -4.6), and 30-day readmissions (OR ¼ 2.9; 95% CI 1.2 -6.8). In conclusion, in patients without acute respiratory distress syndrome who had acute respiratory failure managed with noninvasive ventilation on the wards, severe hypoxemia as assessed by a simple SpO 2 /FiO 2 214 was associated with poor outcomes.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.