Indian Journal of Critical Care Medicine

Register      Login



Volume / Issue

Online First

Related articles

VOLUME 28 , ISSUE 7 ( July, 2024 ) > List of Articles

Original Article

Oxygenation Index and Oxygen Saturation Index for Predicting Postoperative Outcome in Patients Undergoing Emergency Surgery: A Prospective Cohort Study

Ruma Thakuria, Emmanuel Easterson Ernest, Apala Roy Chowdhury, Neha Pangasa, Choro Athiphro Kayina, Sulagna Bhattacharjee, Puneet Khanna, Dalim K Baidya, Banupriya Ravichandrane, Souvik Maitra

Keywords : Driving pressure, Emergency surgery, Mortality, Outcome, Oxygenation index, Oxygen saturation index

Citation Information : Thakuria R, Ernest EE, Chowdhury AR, Pangasa N, Kayina CA, Bhattacharjee S, Khanna P, Baidya DK, Ravichandrane B, Maitra S. Oxygenation Index and Oxygen Saturation Index for Predicting Postoperative Outcome in Patients Undergoing Emergency Surgery: A Prospective Cohort Study. Indian J Crit Care Med 2024; 28 (7):645-649.

DOI: 10.5005/jp-journals-10071-24749

License: CC BY-NC 4.0

Published Online: 29-06-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Background: The OI was originally evaluated as a prognostic tool for acute hypoxemic respiratory failure in children and was an independent predictor for mortality in adult patients with acute respiratory distress syndrome (ARDS). Methods: Oxygenation index and OSI of 201 adult patients undergoing emergency surgery were evaluated at different time points. The primary objective of this study was to find the correlation between OI and OSI. The secondary objectives were to find the prognostic utility of OI and OSI for postoperative mechanical ventilation and mortality. Results: Significant statistical correlation was found between OI and OSI both at the beginning (r2 = 0.61; p < 0.001) and immediately after surgery (r2 = 0.47; p < 0.001). Oxygen saturation index at the beginning [area under the receiver operating characteristics curve (AUROC) (95% CI) 0.76 (0.62–0.89); best cutoff 3.9, sensitivity 64% and specificity 45%] and immediately after surgery [AUROC (95% CI) 0.82 (0.72–0.92); best cutoff 3.57, sensitivity 79%, and specificity 62%] were reasonable predictors of the requirement of invasive ventilatory support. Exploratory analysis reported that older age (p = 0.02), higher total leukocyte count (p = 0.002), higher arterial lactate (p = 0.02), and higher driving pressure (p < 0.001) were independently associated with hospital mortality. Conclusion: In adult patients undergoing emergency laparotomy under general anesthesia, OI and OSI were found to be correlated. Both metrics demonstrated reasonable accuracy in predicting the need for invasive ventilatory support beyond 24 hours and hospital mortality.

PDF Share
  1. Trachsel D, McCrindle BW, Nakagawa S, Bohn D. Oxygenation index predicts outcome in children with acute hypoxemic respiratory failure. Am J Respir Crit Care Med 2005;172(2):206–211. DOI: 10.1164/rccm.200405-625OC.
  2. Balzer F, Menk M, Ziegler J, Pille C, Wernecke KD, Spies C, et al. Predictors of survival in critically ill patients with acute respiratory distress syndrome (ARDS): An observational study. BMC Anesthesiol 2016;16(1):108. DOI: 10.1186/s12871-016-0272-4.
  3. Gajic O, Afessa B, Thompson BT, Frutos-Vivar F, Malinchoc M, Rubenfeld GD, et al; Second International Study of Mechanical Ventilation and ARDS-net Investigators. Prediction of death and prolonged mechanical ventilation in acute lung injury. Crit Care 2007;11(3):R53. DOI: 10.1186/cc5909.
  4. Raith EP, Udy AA, Bailey M, McGloughlin S, MacIsaac C, Bellomo R, et al. Australian and New Zealand Intensive Care Society (ANZICS) Centre for Outcomes and Resource Evaluation (CORE). Prognostic accuracy of the SOFA Score, SIRS Criteria, and qSOFA Score for in-hospital mortality among adults with suspected infection admitted to the intensive care unit. JAMA 2017;317(3):290–300. DOI: 10.1001/jama.2016.20328.
  5. Smith PR, Baig MA, Brito V, Bader F, Bergman MI, Alfonso A. Postoperative pulmonary complications after laparotomy. Respiration 2010;80(4):269–274. DOI: 10.1159/000253881.
  6. Fernandez-Bustamante A, Frendl G, Sprung J, Kor DJ, Subramaniam B, Martinez Ruiz R, et al. Postoperative pulmonary complications, early mortality, and hospital stay following noncardiothoracic surgery: A multicenter study by the perioperative research network investigators. JAMA Surg 2017;152(2):157–166. DOI: 10.1001/jamasurg.2016.4065.
  7. DesPrez K, McNeil JB, Wang C, Bastarache JA, Shaver CM, Ware LB. Oxygenation saturation index predicts clinical outcomes in ARDS. Chest 2017;152(6):1151–1158. DOI: 10.1016/j.chest.2017.08.002.
  8. Miskovic A, Lumb AB. Postoperative pulmonary complications. Br J Anaesth 2017;118(3):317–334. DOI: 10.1093/bja/aex002.
  9. Vadi S, Suthar D, Sanwalka N. Correlation and prognostic significance of oxygenation indices in invasively ventilated adults (OXIVA-CARDS) with COVID-19-associated ARDS: A retrospective study. Indian J Crit Care Med 2023;27(11):801–805. DOI: 10.5005/jp-journals- 10071-24560.
  10. Amato MB, Meade MO, Slutsky AS, Brochard L, Costa EL, Schoenfeld DA, et al. Driving pressure and survival in the acute respiratory distress syndrome. N Engl J Med 2015;372(8):747–755. DOI: 10.1056/NEJMsa1410639.
  11. Lanspa MJ, Peltan ID, Jacobs JR, Sorensen JS, Carpenter L, Ferraro JP, et al. Driving pressure is not associated with mortality in mechanically ventilated patients without ARDS. Crit Care 2019;23(1):424. DOI: 10.1186/s13054-019-2698-9.
  12. Agarwal V, Muthuchellappan R, Shah BA, Rane PP, Kulkarni AP. Postoperative outcomes following elective surgery in India. Indian J Crit Care Med 2021;25(5):528–534. DOI: 10.5005/jp-journals-10071-23807.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.