Weighted Hypoxemia Index: An adaptable method for quantifying hypoxemia severity.
<h4>Objective</h4>To quantitate hypoxemia severity.<h4>Methods</h4>We developed the Weighted Hypoxemia Index to be adapted to different clinical settings by applying 5 steps to the oxygen saturation curve: (1) Identify desaturation/resaturation event [Formula: see text] by se...
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2025-01-01
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| Online Access: | https://doi.org/10.1371/journal.pone.0328214 |
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| author | Diane C Lim Cheng-Bang Chen Ankita Paul Yujie Wang Jinyoung Kim Soonhyun Yook Emily Y Kim Edison Q Kim Anup Das Medhi Wangpaichitr Virend K Somers Chi Hang Lee Phyllis C Zee Toshihiro Imamura Hosung Kim |
| author_facet | Diane C Lim Cheng-Bang Chen Ankita Paul Yujie Wang Jinyoung Kim Soonhyun Yook Emily Y Kim Edison Q Kim Anup Das Medhi Wangpaichitr Virend K Somers Chi Hang Lee Phyllis C Zee Toshihiro Imamura Hosung Kim |
| author_sort | Diane C Lim |
| collection | DOAJ |
| description | <h4>Objective</h4>To quantitate hypoxemia severity.<h4>Methods</h4>We developed the Weighted Hypoxemia Index to be adapted to different clinical settings by applying 5 steps to the oxygen saturation curve: (1) Identify desaturation/resaturation event [Formula: see text] by setting the upper threshold; (2) Exclude events as artifact by setting a lower threshold; (3) Calculate weighted area for each [Formula: see text] as [Formula: see text]; (4) Calculate a normalization factor [Formula: see text] for each subject; (5) Calculate the Weighted Hypoxemia Index as the summation of all weighted areas multiplied by [Formula: see text]. We assessed the Weighted Hypoxemia Index predictive value for all-cause mortality and cardiovascular mortality using the Sleep Heart Health Study (enrollment 1995-1998, 11.1 years mean follow-up).<h4>Results</h4>We set varying upper thresholds at 92%, 90%, 88%, and 86%, a lower threshold of 50%, calculated area under the curve and area above the curve, with and without a linear weighted factor (duration of each event [Formula: see text]), and used the same normalization factor of total sleep time <90% divided by total sleep time. After excluding subjects with missing data, we analyzed 4,509 participants (Alive: N = 3,769; All-cause mortality: N = 1,071; cardiovascular mortality: N = 330). Since the Weighted Hypoxemia Index-Area Under the Curve set at upper threshold of 90% (WHI-AUC90) had the best results in predicting all-cause mortality, we then compared it to the Apnea-Hypopnea Index and Total Sleep Time <90%. WHI-AUC90 showed statistical significance across quintiles for all-cause mortality, but not cardiovascular mortality, in adjusted Cox regression models.<h4>Conclusion</h4>The Weighted Hypoxemia Index offers a versatile and clinically relevant method for quantifying hypoxemia severity, with potential applications to evaluate mechanisms and outcomes across various patient populations. |
| format | Article |
| id | doaj-art-0feb0c5e1a97494f8d18a5e952e69ba2 |
| institution | DOAJ |
| issn | 1932-6203 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Public Library of Science (PLoS) |
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| spelling | doaj-art-0feb0c5e1a97494f8d18a5e952e69ba22025-08-20T03:13:30ZengPublic Library of Science (PLoS)PLoS ONE1932-62032025-01-01207e032821410.1371/journal.pone.0328214Weighted Hypoxemia Index: An adaptable method for quantifying hypoxemia severity.Diane C LimCheng-Bang ChenAnkita PaulYujie WangJinyoung KimSoonhyun YookEmily Y KimEdison Q KimAnup DasMedhi WangpaichitrVirend K SomersChi Hang LeePhyllis C ZeeToshihiro ImamuraHosung Kim<h4>Objective</h4>To quantitate hypoxemia severity.<h4>Methods</h4>We developed the Weighted Hypoxemia Index to be adapted to different clinical settings by applying 5 steps to the oxygen saturation curve: (1) Identify desaturation/resaturation event [Formula: see text] by setting the upper threshold; (2) Exclude events as artifact by setting a lower threshold; (3) Calculate weighted area for each [Formula: see text] as [Formula: see text]; (4) Calculate a normalization factor [Formula: see text] for each subject; (5) Calculate the Weighted Hypoxemia Index as the summation of all weighted areas multiplied by [Formula: see text]. We assessed the Weighted Hypoxemia Index predictive value for all-cause mortality and cardiovascular mortality using the Sleep Heart Health Study (enrollment 1995-1998, 11.1 years mean follow-up).<h4>Results</h4>We set varying upper thresholds at 92%, 90%, 88%, and 86%, a lower threshold of 50%, calculated area under the curve and area above the curve, with and without a linear weighted factor (duration of each event [Formula: see text]), and used the same normalization factor of total sleep time <90% divided by total sleep time. After excluding subjects with missing data, we analyzed 4,509 participants (Alive: N = 3,769; All-cause mortality: N = 1,071; cardiovascular mortality: N = 330). Since the Weighted Hypoxemia Index-Area Under the Curve set at upper threshold of 90% (WHI-AUC90) had the best results in predicting all-cause mortality, we then compared it to the Apnea-Hypopnea Index and Total Sleep Time <90%. WHI-AUC90 showed statistical significance across quintiles for all-cause mortality, but not cardiovascular mortality, in adjusted Cox regression models.<h4>Conclusion</h4>The Weighted Hypoxemia Index offers a versatile and clinically relevant method for quantifying hypoxemia severity, with potential applications to evaluate mechanisms and outcomes across various patient populations.https://doi.org/10.1371/journal.pone.0328214 |
| spellingShingle | Diane C Lim Cheng-Bang Chen Ankita Paul Yujie Wang Jinyoung Kim Soonhyun Yook Emily Y Kim Edison Q Kim Anup Das Medhi Wangpaichitr Virend K Somers Chi Hang Lee Phyllis C Zee Toshihiro Imamura Hosung Kim Weighted Hypoxemia Index: An adaptable method for quantifying hypoxemia severity. PLoS ONE |
| title | Weighted Hypoxemia Index: An adaptable method for quantifying hypoxemia severity. |
| title_full | Weighted Hypoxemia Index: An adaptable method for quantifying hypoxemia severity. |
| title_fullStr | Weighted Hypoxemia Index: An adaptable method for quantifying hypoxemia severity. |
| title_full_unstemmed | Weighted Hypoxemia Index: An adaptable method for quantifying hypoxemia severity. |
| title_short | Weighted Hypoxemia Index: An adaptable method for quantifying hypoxemia severity. |
| title_sort | weighted hypoxemia index an adaptable method for quantifying hypoxemia severity |
| url | https://doi.org/10.1371/journal.pone.0328214 |
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