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Differential pulse oximetry readings between ethnic groups and delayed transfer to intensive care units

Crooks, Colin J; West, Joe; Morling, Joanne R; Simmonds, Mark; Juurlink, Irene; Briggs, Steve; Cruickshank, Simon; Hammond-Pears, Susan; Shaw, Dominick; Card, Timothy R; Fogarty, Andrew W

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Authors

JOE WEST JOE.WEST@NOTTINGHAM.AC.UK
Professor of Epidemiology

JOANNE MORLING JOANNE.MORLING@NOTTINGHAM.AC.UK
Clinical Associate Professor

Mark Simmonds

Irene Juurlink

Steve Briggs

Simon Cruickshank

Susan Hammond-Pears

Dr TIM CARD tim.card@nottingham.ac.uk
Clinical Associate Professor

ANDREW FOGARTY ANDREW.FOGARTY@NOTTINGHAM.AC.UK
Clinical Associate Professor & Reader in Clinical Epidemiology



Abstract

Summary Background Pulse oximeters are widely used to monitor blood oxygen saturations, although concerns exist that they are less accurate in individuals with pigmented skin. Aims This study aimed to determine if patients with pigmented skin were more severely unwell at the period of transfer to intensive care units than individuals with White skin. Methods Using data from a large teaching hospital, measures of clinical severity at the time of transfer of patients with Covid-19 infection to intensive care units were assessed, and how this varied by ethnic group. Results Data were available on 748 adults. Median pulse oximetry demonstrated similar oxygen saturations at the time of transfer to intensive care units (Kruskal Wallis test, p = 0.51), although median oxygen saturation measurements from arterial blood gases at this time demonstrated lower oxygen saturations in patients classified as Indian/Pakistani ethnicity (91.6%) and Black/Mixed ethnicity (93.0%), compared to those classified as a White ethnicity (94.4%, Kruskal Wallis test, p = 0.005). There were significant differences in mean respiratory rates in these patients (p < 0.0001), ranging from 26 breaths/minute in individuals with White ethnicity to 30 breaths/minute for those classified as Indian/Pakistani ethnicity and 31 for those who were classified as Black/Mixed ethnicity. Conclusions These data are consistent with the hypothesis that differential measurement error for pulse oximeter readings negatively impact on the escalation of clinical care in individuals from other than White ethnic groups. This has implications for healthcare in Africa and South-East Asia, and may contribute to differences in health outcomes across ethnic groups globally.

Citation

Crooks, C. J., West, J., Morling, J. R., Simmonds, M., Juurlink, I., Briggs, S., …Fogarty, A. W. (2023). Differential pulse oximetry readings between ethnic groups and delayed transfer to intensive care units. QJM: An International Journal of Medicine, 116(1), 63-67. https://doi.org/10.1093/qjmed/hcac218

Journal Article Type Article
Acceptance Date Sep 1, 2022
Online Publication Date Sep 6, 2022
Publication Date 2023-01
Deposit Date Sep 16, 2022
Publicly Available Date Sep 7, 2023
Journal QJM: An International Journal of Medicine
Print ISSN 1460-2725
Electronic ISSN 1460-2393
Publisher Oxford University Press (OUP)
Peer Reviewed Peer Reviewed
Volume 116
Issue 1
Pages 63-67
DOI https://doi.org/10.1093/qjmed/hcac218
Keywords General Medicine
Public URL https://nottingham-repository.worktribe.com/output/11199415
Publisher URL https://academic.oup.com/qjmed/advance-article-abstract/doi/10.1093/qjmed/hcac218/6692791?redirectedFrom=fulltext&login=false

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