Racial, Ethnic Disparities in ICU Oxygen Supplementation

Patients that are Asian, Black, and Hispanic receive less supplemental oxygen in the intensive care unit (ICU) than patients who are White, according to a recent study.

The researchers aimed to determine if racial and ethnic disparities exist in routine supplemental oxygen administration associated with inconsistent pulse oximeter performance.

A total of 3069 patients were included in the retrospective cohort study that was based on the Medical Information Mart for Intensive Care (MIMIC)-IV critical care data set. Of the total participants, 83 patients were Asian, 207 were Black, 112 were Hispanic, and 2667 were White. The mean age was 66.9 years (SD = 13.5).

To measure the primary outcome, the researchers used multivariable linear regression to evaluate the difference between race and ethnicity in pulse oximeter device performance (SpO₂). Asian patients (coefficient 0.602; 95% CI, 0.263 – 0.941; P = .001), Black patients (coefficient, 0.919; 95% CI, 0.698 - 1.140; P < .001), and Hispanic patients (coefficient, 0.622; 95% CI, 0.329 - 0.915; P < .001) were all associated with an increased SpO₂ for a given hemoglobin oxygen saturation.

Additionally, Asian patients (coefficient, −0.291; 95% CI, −0.546 to −0.035; P = .03), Black patients (coefficient, −0.294; 95% CI, −0.460 to −0.128; P = .001), and Hispanic patients (coefficient, −0.242; 95% CI, −0.463 to −0.020; P = .03) were associated with lower average oxygen delivery rates when compared with White patients.

Race and ethnicity were not associated with oxygen delivery rate when controlling for the discrepancy between average SpO2 and average hemoglobin oxygen saturation.

“In this cohort study, Asian, Black, and Hispanic patients received less supplemental oxygen than White patients, and this was associated with differences in pulse oximeter performance, which may contribute to known race and ethnicity–based disparities in care,” the researchers concluded.

—Jessica Ganga

Reference:

Gottlieb ER, Ziegler J, Morley K, Rush B, Celi LA. Assessment of racial and ethnic differences in oxygen supplementation among patients in the intensive care unit. JAMA Intern Med. Published online July 11, 2022. doi:10.1001/jamainternmed.2022.2587