Manmohan K ishna Pandey e al. Pulse Oxime y (SpO₂) Moni o ing as a P ognos ic Indica o in Eme gency
Depa men Pa ien s: A P ospec i e Obse a ional S udy. In . J Med. Pha m. Res., 6 (6): 292‐294, 2025
292
In e na ional Jou nal o Medical
and Pha maceu ical Resea ch
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O iginal A icle
Pulse Oxime y (SpO₂) Moni o ing as a P ognos ic Indica o in Eme gency
Depa men Pa ien s: A P ospec i e Obse a ional S udy
Manmohan K ishna Pandey¹, Pu nima Mi a Pandey2
1 P o esso , Depa men o Medicine, Au onomous S a e Medical College, Gonda, U a P adesh, India
2 Associa e P o esso , Depa men o Pa hology, Au onomous S a e Medical College, Gonda, U a P adesh, India
A B S T R A C T
Co esponding Au ho :
D . Manmohan K ishna Pandey
P o esso , Depa men o
Medicine, Au onomous S a e
Medical College, Gonda, U a
P adesh, India.
Recei ed: 14-10-2025
Accep ed: 29-10-2025
A ailable online: 12-11-2025
Backg ound: Pulse oxime y (SpO₂) is ou inely used in eme gency depa men s
(EDs), bu i s ole as an independen p ognos ic ma ke ac oss di e se eme gency
pa ien s is no well es ablished.
Objec i e: This s udy e alua es admission SpO₂ as a p ognos ic indica o o
mo ali y and c i ical ca e needs.
Me hods: A p ospec i e coho o 2,580 adul ED pa ien s o e one yea was
assessed. Ini ial SpO₂ was eco ded; 30-day mo ali y, ICU admission, and
mechanical en ila ion equi emen s we e acked. Logis ic eg ession and ROC
cu e analyses e alua ed SpO₂’s p edic i e alue.
Resul s: SpO₂ <93% a admission was seen in 16.9% o pa ien s and associa ed
wi h a signi ican inc ease in 30-day mo ali y (16.4% s 4.3%), ICU admission
(19.7% s 5.8%), and en ila ion needs (11.2% s 3.5%) (p<0.001). SpO₂ p edic ed
mo ali y well (AUC = 0.81).
Conclusion: Ini ial SpO₂ measu emen is a simple, non-in asi e, and e ec i e
p ognos ic ool ha should be in eg a ed in o ED iage p o ocols o ea ly isk
s a i ica ion and esou ce alloca ion.
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INTRODUCTION
Pulse oxime y (SpO₂) p o ides a apid, non-in asi e measu e o a e ial oxygen sa u a ion, widely adop ed as a c i ical
i al sign in eme gency medicine. Since i s in oduc ion, pulse oxime y has e olu ionized oxygena ion assessmen ,
enabling con inuous moni o ing wi hou he delays and in asi eness o a e ial blood gas sampling. SpO₂ e lec s oxygen
deli e y e icacy, c ucial o pa ien su i al, pa icula ly in acu e illness. Beyond diagnosing hypoxemia, eme ging da a
sugges SpO₂’s p ognos ic capabili ies, signaling isk o ad e se ou comes in a ied clinical se ings.
Se e al s udies ha e alida ed SpO₂ h esholds below 90-93% as ma ke s o acu e espi a o y ailu e, ICU admission,
and mo ali y, pa icula ly du ing espi a o y pandemics such as COVID-19 [5-7]. Ne e heless, he p ognos ic u ili y o
SpO₂ in unselec ed eme gency popula ions emains unde explo ed. Risk s a i ica ion in ED is challenged by clinical
he e ogenei y and esou ce cons ain s, unde sco ing he alue o eadily ob ainable ma ke s like SpO₂ ha may guide
ea ly, a ge ed in e en ion.
Mo eo e , SpO₂ moni o ing is uni e sally a ailable and easily in e p e able, sugges ing b oad applicabili y i p o en
p ognos ically alid. This s udy aims o p ospec i ely assess he ela ionship be ween ini ial SpO₂ alues a ED
admission and sho - e m ad e se ou comes in a la ge, di e se eme gency pa ien coho . We hypo hesize ha lowe
admission SpO₂ independen ly p edic s highe mo ali y and c i ical ca e esou ce u iliza ion.
METHODS
S udy Design and Se ing
Manmohan K ishna Pandey e al. Pulse Oxime y (SpO₂) Moni o ing as a P ognos ic Indica o in Eme gency
Depa men Pa ien s: A P ospec i e Obse a ional S udy. In . J Med. Pha m. Res., 6 (6): 292‐294, 2025
293
This p ospec i e obse a ional coho s udy was conduc ed a a e ia y ca e hospi al’s eme gency depa men om
Oc obe 2024 o Sep embe 2025. The ins i u ional e iew boa d app o ed he p o ocol.
Pa icipan s
All consen ing adul pa ien s (≥18 yea s) iaged in he ED du ing he s udy pe iod we e eligible (n=2,580). Exclusion
c i e ia included incomple e eco ds, ans e wi hin 24 hou s, o do-no - esusci a e s a us on a i al.
Da a Collec ion
Admission SpO₂ was measu ed using s anda d pulse oxime y de ices a iage. Demog aphic, clinical his o y, and
p esen ing complain s we e documen ed. P ima y ou comes included all-cause 30-day mo ali y, ICU admission, and
mechanical en ila ion equi emen du ing hospi aliza ion.
S a is ical Analysis
SpO₂ was ca ego ized: <90%, 90-92%, 93-95%, >95%. Ou comes among ca ego ies we e compa ed using chi-squa e
es s. Mul i a iable logis ic eg ession adjus ed o con ounde s. ROC cu e analysis quan i ied SpO₂’s abili y o p edic
30-day mo ali y, wi h a ea unde he cu e (AUC) as a summa y measu e. A p- alue <0.05 was signi ican .
RESULTS
Among 2,580 pa ien s (mean age 49 ± 17 yea s; 54% male), 437 (16.9%) had admission SpO₂ <93%. These pa ien s
exhibi ed:
30-day mo ali y: 16.4% s 4.3% o SpO₂ ≥93%, p<0.001
ICU admission: 19.7% s 5.8%, p<0.001
Mechanical en ila ion: 11.2% s 3.5%, p<0.001
Logis ic eg ession con i med SpO₂ <93% as an independen p edic o o mo ali y (adjus ed OR 3.8; 95% CI 2.7-5.3).
The SpO₂ ROC cu e o mo ali y p edic ion demons a ed an AUC o 0.81 (95% CI, 0.78-0.85), indica ing s ong
disc imina ion.
DISCUSSION
This s udy es ablishes admission SpO₂ as a obus , independen p ognos ic indica o o ad e se ou comes in unselec ed
ED pa ien s. Pa ien s p esen ing wi h SpO₂ below 93% we e a signi ican ly ele a ed isk o dea h o equi ing in ensi e
ca e in e en ions, consis en wi h exis ing li e a u e associa ing hypoxemia wi h poo p ognosis in c i ical illness.
Ou indings ex end p io disease-speci ic obse a ions—such as ARDS o sepsis coho s— o a b oade eme gency
popula ion, unde sco ing he gene alizabili y and clinical u ili y o ou ine SpO₂ assessmen in ED iage. The p edic i e
pe o mance o SpO₂ equaled o exceeded ha o o he commonly used i al signs and sco ing sys ems, ein o cing i s
p agma ic alue.
The non-in asi e, immedia e a ailabili y, and cos -e ec i eness o pulse oxime y make i an ideal ool o ea ly isk
s a i ica ion. Inco po a ing SpO₂ h esholds in o iage sys ems can expedi e iden i ica ion o high- isk pa ien s,
op imizing c i ical ca e esou ce alloca ion and po en ially imp o ing ou comes h ough ea lie in e en ions.
Limi a ions include single-cen e design, absence o de ailed como bidi y adjus men s, and inabili y o cap u e complex
disease-speci ic se e i y sco es. Fu u e mul icen e p ospec i e s udies and in e en ional ials in eg a ing SpO₂-guided
iage p o ocols a e wa an ed o alida e hese e ec s and e alua e impac on clinical wo k low and pa ien -cen e ed
ou comes.
CONCLUSION
Ini ial SpO₂ measu ed on ED admission is a powe ul, non-in asi e p ognos ic ma ke o 30-day mo ali y and c i ical
ca e needs. I s uni e sal a ailabili y and p edic i e accu acy suppo he in eg a ion o SpO₂ in o ED iage p o ocols o
enhance pa ien isk s a i ica ion and managemen decisions.
Decla a ions
E hics App o al: Ob ained om ins i u ional e iew boa d.
Funding: None.
Con lic s o In e es : None decla ed.
Da a A ailabili y: A ailable on easonable eques .
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