Respiratory failure & ventilation
Temporal dimensions of oxygen saturation exposure and clinical outcomes in critically ill patients: a retrospective multi-database cohort study
Authors' conclusion
Our study confirms a U-shaped relationship between SpO2 and outcomes, emphasizing that oxygenation assessments should consider both intensity and duration.
Study context
- Population
- Critically ill patients
- Participants
- 121,758 patients · 3 databases
- Exposure
- SpO2 exposure patterns
- SICdbn = 11,324
- MIMIC-IVn = 50,110
- eICUn = 60,324
- Outcome
- 28-day mortality
- Follow-up
- 28 days
Methodological detailsmulti-database, external validation
- Multi-database
- External validation
Main finding
As reported in the abstract
28-day mortality by SpO2 exposure
Hazard ratio (95% CI)P value
SpO2 96-97%strongest protection (Cox regression)
0.714(0.694–0.733)
P < 0.001- SpO2 < 93.5% · increased mortality risk
- HR 1.236; P < 0.001
- Heatmap analysis: optimal SpO2
- 93.5-97%
Observational data: associations, not effects.
Further findings
External validation (eICU)
- External validation confirmed findings; AUC
- 0.813
Prolonged exposure to SpO2 > 98%
- Diminishing effect
Optimal SpO2 range (heatmap analysis)
- SpO2 of 93.5-97% optimal
Original publication
Temporal dimensions of oxygen saturation exposure and clinical outcomes in critically ill patients: a retrospective multi-database cohort study. Crit Care. Published 25 September 2025. doi:10.
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