• Dong Eun Seo, Sang Do Shin, Kyoung Jun Song, Young Sun Ro, Ki Jeong Hong, and Jeong Ho Park.
• Department of Medicine, Seoul National University College of Medicine, Republic of Korea. Electronic address: desotter@snu.ac.kr.
• Am J Emerg Med. 2019 Sep 1; 37 (9): 1709-1715.

ObjectivesThis study aimed to test the association between hypoxia level and outcomes according to shock status in traumatic brain injury (TBI) patients.MethodsAdult TBI patients transported by emergency medical services in 10 provinces were enrolled. Hypoxia was a main exposure; three groups by oxygen saturation (SaO2, non-hypoxia (≥94%), mild hypoxia (90 ≤ SaO2 < 94%)), and severe hypoxia (<90%). Shock status (ResultsOf the 6125 patients, the mortality/disability rates were 49.4%/69.0% in severe hypoxia, 30.7%/46.9% in mild hypoxia, and 18.5%/27.5% in normoxia (p < 0.0001). Mortality/disability rates were 47.1%/57.1% in shock status and 20.5%/31.4% in non-shock status (p < 0.0001). AORs (95% CIs) for worsened disability/mortality compared with normoxia (reference) were 3.23 (2.47-4.21)/2.24 (1.70-2.96) in patients with severe hypoxia and 2.11 (1.63-2.74)/1.84 (1.39-2.45) in those with mild hypoxia. AORs (95% CIs) for worsened disability/mortality was 1.58 (1.20-2.09)/1.33 (1.01-1.76) by severe hypoxia than normoxia in patient with only non-shock status in the interaction analysis.ConclusionsThere was a trend toward worsened outcomes with mild and severe hypoxia in patient with and without shock, however, the only met statistical significance for patients with both severe hypoxia and non-shock status.Copyright © 2018 Elsevier Inc. All rights reserved.

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