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. 2024 May 31;29(1):304.
doi: 10.1186/s40001-024-01902-8.

Association between prehospital ROX index with 30-day mortality among septic shock

Romain Jouffroy  1   2   3 , Tristan Fabre  4   5 , Basile Gilbert  6 , Stéphane Travers  7 , Emmanuel Bloch-Laine  8   9 , Patrick Ecollan  10 , Josiane Boularan  11 , Vincent Bounes  6 , Benoît Vivien  12 , Papa Gueye  4   5   13
Affiliations

Association between prehospital ROX index with 30-day mortality among septic shock

Romain Jouffroy et al. Eur J Med Res. .

Abstract

Purpose: Respiratory dysfunction is one of the most frequent symptoms observed during sepsis reflecting hypoxemia and/or acidosis that may be assessed by the ROX index (ratio of oxygen saturation by pulse oximetry/fraction of inspired oxygen to respiratory rate). This study aimed to describe the relationship between the prehospital ROX index and 30-day mortality rate among septic shock patients cared for in the prehospital setting by a mobile intensive care unit (MICU).

Methods: From May 2016 to December 2021, 530 septic shock patients cared for by a prehospital MICU were retrospectively analysed. Initial ROX index value was calculated at the first contact with MICU. A Cox regression analysis after propensity score matching was performed to assess the relationship between 30-day mortality rate and a ROX index ≤ 10.

Results: Pulmonary, digestive and urinary sepsis were suspected among 43%, 25% and 17% patients, respectively. The 30-day overall mortality reached 31%. Cox regression analysis showed a significant association between 30-day mortality and a ROX index ≤ 10: adjusted hazard ratio of 1.54 [1.08-2.31], p < 0.05.

Conclusions: During the prehospital stage of septic shock patients cared for by a MICU, ROX index is significantly associated with 30-day mortality. A prehospital ROX ≤ 10 value is associated with a 1.5-fold 30-day mortality rate increase. Prospective studies are needed to confirm the ability of prehospital ROX to predict sepsis outcome since the prehospital setting.

Keywords: Mortality; Prehospital setting; ROX index; Septic shock.

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Conflict of interest statement

No author have conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
Absolute mean differences between patients with prehospital ROX ≤ 10 and prehospital ROX > 10 after matching
Fig. 2
Fig. 2
Kaplan–Meier curves of 30-day survival between prehospital ROX ≤ 10 and prehospital ROX > 10 after matching
See this image and copyright information in PMC

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