{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T19:17:44Z","timestamp":1788635864247,"version":"build-2803163510"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,3,12]],"date-time":"2024-03-12T00:00:00Z","timestamp":1710201600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>This study aimed to evaluate the SpO<jats:sub>2<\/jats:sub> (transcutaneous oxygen saturation) -mortality link in elderly T2DM (diabetes mellitus type 2) patients with cerebral infarction and identify their optimal SpO<jats:sub>2<\/jats:sub> range.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this investigation, we employed a comprehensive approach. Initially, we screened the MIMIC-IV database, identifying elderly T2DM patients with cerebral infarction, utilizing specific ICD-9 and ICD-10 codes. We then harnessed the power of restricted cubic splines to craft a visual representation of the correlation between SpO<jats:sub>2<\/jats:sub> and 1-year mortality. To enhance our analysis, we harnessed Cox multivariate regression, allowing us to compute adjusted hazard ratios (HR) accompanied by 95% confidence intervals (CIs). Additionally, we crafted Cumulative Mortality Curve analyses, augmenting our study by engaging in rigorous subgroup analyses, stratifying our observations based on pertinent covariates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In this study, 448 elderly T2DM patients with cerebral infarction were included. Within 1-year post-discharge, 161 patients (35.94%) succumbed. Employing Restricted Cubic Spline analysis, a statistically significant <jats:italic>U<\/jats:italic>-shaped non-linear relationship between admission ICU SpO<jats:sub>2<\/jats:sub> levels and 1-year mortality was observed (<jats:italic>P<\/jats:italic>-value &amp;lt; 0.05). Further analysis indicated that both low and high SpO<jats:sub>2<\/jats:sub> levels increased the mortality risk. Cox multivariate regression analysis, adjusting for potential confounding factors, confirmed the association of low (\u226494.5%) and high SpO<jats:sub>2<\/jats:sub> levels (96.5\u201398.5%) with elevated 1-year mortality risk, particularly notably high SpO<jats:sub>2<\/jats:sub> levels (&amp;gt;98.5%) [HR = 2.06, 95% CI: 1.29\u20133.29, <jats:italic>P<\/jats:italic>-value = 0.002]. The cumulative mortality curves revealed the following SpO<jats:sub>2<\/jats:sub> subgroups from high to low cumulative mortality at the 365th day: normal levels (94.5% &amp;lt; SpO<jats:sub>2<\/jats:sub> \u2264 96.5%), low levels (SpO<jats:sub>2<\/jats:sub> \u2264 94.5%), high levels (96.5% &amp;lt; SpO<jats:sub>2<\/jats:sub> \u2264 98.5%), and notably high levels (&amp;gt;98.5%). Subgroup analysis demonstrated no significant interaction between SpO<jats:sub>2<\/jats:sub> and grouping variables, including Sex, Age, Congestive heart failure, Temperature, and ICU length of stay (LOS-ICU; <jats:italic>P<\/jats:italic>-values for interaction were &amp;gt;0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Striking an optimal balance is paramount, as fixating solely on lower SpO<jats:sub>2<\/jats:sub> limits or neglecting high SpO<jats:sub>2<\/jats:sub> levels may contribute to increased mortality rates. To mitigate mortality risk in elderly T2DM patients with cerebral infarction, we recommend maintaining SpO<jats:sub>2<\/jats:sub> levels within the range of 94.5\u201396.5%.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2024.1344000","type":"journal-article","created":{"date-parts":[[2024,3,12]],"date-time":"2024-03-12T13:49:12Z","timestamp":1710251352000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Association between SpO2 and the risk of death in elderly T2DM patients with cerebral infarction: a retrospective cohort study"],"prefix":"10.3389","volume":"15","author":[{"given":"Shuo","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaqi","family":"Ji","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siqi","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shu","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeyi","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianmin","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junjie","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,3,12]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e3410","DOI":"10.1002\/dmrr.3410","article-title":"Burden and management of type 2 diabetes mellitus in rural United States","volume":"37","author":"Dugani","year":"2021","journal-title":"Diabetes Metab Res Rev."},{"key":"B2","doi-asserted-by":"publisher","first-page":"1185","DOI":"10.7150\/ijms.10001","article-title":"Risk factors contributing to type 2 diabetes and recent advances in the treatment and prevention","volume":"11","author":"Wu","year":"2014","journal-title":"Int J Med Sci."},{"key":"B3","doi-asserted-by":"publisher","first-page":"109119","DOI":"10.1016\/j.diabres.2021.109119","article-title":"IDF Diabetes Atlas: global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045","volume":"183","author":"Sun","year":"2022","journal-title":"Diabetes Res Clin Pract."},{"key":"B4","doi-asserted-by":"publisher","first-page":"780","DOI":"10.1111\/jdi.12932","article-title":"Prevalence of diabetes and its effects on stroke outcomes: a meta-analysis and literature review","volume":"10","author":"Lau","year":"2019","journal-title":"J Diabetes Investig."},{"key":"B5","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/02648725.2023.2207935","article-title":"Analysis on application effect and prognostic factors of medical care combined with nursing in the elderly with T2DM and Cerebral Infarction based on targeted management mode","volume":"2023","author":"Qin","year":"2023","journal-title":"Biotechnol Genet Eng Rev."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1167","DOI":"10.3892\/etm.2019.8326","article-title":"Homocysteine, interleukin-1\u03b2, and fasting blood glucose levels as prognostic markers for diabetes mellitus complicated with cerebral infarction and correlated with carotid intima-media thickness","volume":"19","author":"Dai","year":"2020","journal-title":"Exp Ther Med."},{"key":"B7","doi-asserted-by":"publisher","first-page":"1009","DOI":"10.1007\/s00134-019-05619-9","article-title":"What's new in oxygen therapy?","volume":"45","author":"Girardis","year":"2019","journal-title":"Intensive Care Med."},{"key":"B8","first-page":"11","article-title":"Comparative study of SpO2 in all the fingers of the hands measured by pulse oximeter","volume":"70","author":"An","year":"2022","journal-title":"J Assoc Physicians India."},{"key":"B9","doi-asserted-by":"publisher","first-page":"S2133","DOI":"10.21037\/jtd.2018.06.73","article-title":"Change is in the air: dying to breathe oxygen in acute respiratory distress syndrome?","volume":"10","author":"Geoghegan","year":"2018","journal-title":"J Thorac Dis."},{"key":"B10","doi-asserted-by":"publisher","first-page":"566","DOI":"10.1016\/j.chest.2019.09.015","article-title":"The search for optimal oxygen saturation targets in critically ill patients","volume":"157","author":"Van Den Boom","year":"2020","journal-title":"Chest."},{"key":"B11","doi-asserted-by":"publisher","first-page":"1583","DOI":"10.1001\/jama.2016.11993","article-title":"Effect of conservative vs. conventional oxygen therapy on mortality among patients in an intensive care unit: the oxygen-ICU randomized clinical trial","volume":"316","author":"Girardis","year":"2016","journal-title":"J Am Med Assoc."},{"key":"B12","doi-asserted-by":"publisher","first-page":"335","DOI":"10.4187\/respcare.03451","article-title":"Hyperoxemia in mechanically ventilated, critically ill subjects: incidence and related factors","volume":"60","author":"Itagaki","year":"2015","journal-title":"Respir Care."},{"key":"B13","doi-asserted-by":"publisher","first-page":"386","DOI":"10.1186\/s12871-022-01933-w","article-title":"In-hospital mortality and SpO2 incritical care patients with cerebral injury: data from the MIMIC-IV database","volume":"22","author":"Yin","year":"2022","journal-title":"BMC Anesthesiol."},{"key":"B14","doi-asserted-by":"publisher","first-page":"e000371","DOI":"10.1136\/bmjoq-2018-000371","article-title":"Can we improve the prescribing and delivery of oxygen on a respiratory ward in accordance with new British Thoracic Society oxygen guidelines?","volume":"7","author":"Choudhury","year":"2018","journal-title":"Br Med J Open Qual."},{"key":"B15","doi-asserted-by":"publisher","first-page":"101343","DOI":"10.1016\/j.arr.2021.101343","article-title":"Hypoxia and brain aging: neurodegeneration or neuroprotection?","volume":"68","author":"Burtscher","year":"2021","journal-title":"Ageing Res Rev."},{"key":"B16","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1186\/s40478-020-01051-z","article-title":"Mild hypoxia triggers transient blood-brain barrier disruption: a fundamental protective role for microglia","volume":"8","author":"Halder","year":"2020","journal-title":"Acta Neuropathol Commun."},{"key":"B17","doi-asserted-by":"publisher","first-page":"3048","DOI":"10.1080\/15548627.2020.1851897","article-title":"Autophagy alleviates hypoxia-induced blood-brain barrier injury via regulation of CLDN5 (claudin 5)","volume":"17","author":"Yang","year":"2021","journal-title":"Autophagy."},{"key":"B18","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1159\/000094249","article-title":"Impact of female gender on prognosis in type 2 diabetic patients with ischemic stroke","volume":"56","author":"Arboix","year":"2006","journal-title":"Eur Neurol."},{"key":"B19","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1111\/1753-0407.12180","article-title":"Prevalence and associated factors of obstructive sleep apnea in hospitalized patients with type 2 diabetes in Beijing, China 2","volume":"7","author":"Zhang","year":"2015","journal-title":"J Diabetes."},{"key":"B20","doi-asserted-by":"publisher","first-page":"1138","DOI":"10.1016\/j.mayocp.2020.04.006","article-title":"Association between hypoxemia and mortality in patients with COVID-19","volume":"95","author":"Xie","year":"2020","journal-title":"Mayo Clin Proc."},{"key":"B21","doi-asserted-by":"publisher","first-page":"1427","DOI":"10.5664\/jcsm.9772","article-title":"Association of obstructive sleep apnea and nocturnal hypoxemia with all-cancer incidence and mortality: a systematic review and meta-analysis","volume":"18","author":"Tan","year":"2022","journal-title":"J Clin Sleep Med Off Publ Am Acad Sleep Med."},{"key":"B22","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1186\/s12890-020-1178-y","article-title":"Chronic obstructive pulmonary disease, lung function and risk of type 2 diabetes: a systematic review and meta-analysis of cohort studies","volume":"20","author":"Peng","year":"2020","journal-title":"BMC Pulm Med."},{"key":"B23","doi-asserted-by":"publisher","first-page":"567","DOI":"10.2147\/COPD.S236305","article-title":"Do benefits outweigh risks for corticosteroid therapy in acute exacerbation of chronic obstructive pulmonary disease in people with diabetes mellitus?","volume":"15","author":"Aldibbiat","year":"2020","journal-title":"Int J Chron Obstruct Pulmon Dis."},{"key":"B24","doi-asserted-by":"publisher","first-page":"1317","DOI":"10.1007\/s00109-007-0280-4","article-title":"Hypoxia and chronic lung disease","volume":"85","author":"Tuder","year":"2007","journal-title":"J Mol Med Berl Ger."},{"key":"B25","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1016\/j.freeradbiomed.2018.03.042","article-title":"Hypoxia, oxidative stress and inflammation","volume":"125","author":"McGarry","year":"2018","journal-title":"Free Radic Biol Med."},{"key":"B26","doi-asserted-by":"publisher","first-page":"2187","DOI":"10.15252\/embj.201696150","article-title":"Endothelial cell metabolism in health and disease: impact of hypoxia","volume":"36","author":"Wong","year":"2017","journal-title":"EMBO J."},{"key":"B27","doi-asserted-by":"publisher","first-page":"1","DOI":"10.26402\/jpp.2019.6.01","article-title":"Oxidative stress and inflammatory markers in prediabetes and diabetes","volume":"70","author":"Luc","year":"2019","journal-title":"J Physiol Pharmacol Off J Pol Physiol Soc"},{"key":"B28","doi-asserted-by":"publisher","first-page":"1914","DOI":"10.3390\/ijms18091914","article-title":"Comparative response of brain to chronic hypoxia and hyperoxia","volume":"18","author":"Terraneo","year":"2017","journal-title":"Int J Mol Sci."},{"key":"B29","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1097\/JXX.0000000000000143","article-title":"An exploration of the deleterious effects of hyperoxemia on the morbidity and mortality of hospitalized adult patients","volume":"31","author":"Cimino","year":"","journal-title":"J Am Assoc Nurse Pract"},{"key":"B30","doi-asserted-by":"publisher","first-page":"853","DOI":"10.23736\/S0375-9393.22.16449-7","article-title":"The effects of exposure to severe hyperoxemia on neurological outcome and mortality after cardiac arrest","volume":"88","author":"LA Via","year":"2022","journal-title":"Minerva Anestesiol."},{"key":"B31","doi-asserted-by":"publisher","first-page":"1027","DOI":"10.1007\/s12028-021-01423-w","article-title":"The effect of hyperoxemia on neurological outcomes of adult patients: a systematic review and meta-analysis","volume":"36","author":"Hirunpattarasilp","year":"2022","journal-title":"Neurocrit Care."},{"key":"B32","doi-asserted-by":"publisher","first-page":"E7","DOI":"10.3171\/2021.12.FOCUS21660","article-title":"Effects of hyperoxemia on aneurysmal subarachnoid hemorrhage outcomes: a systematic review and meta-analysis","volume":"52","author":"Ahn","year":"2022","journal-title":"Neurosurg Focus."},{"key":"B33","doi-asserted-by":"publisher","first-page":"930701","DOI":"10.3389\/fsurg.2022.930701","article-title":"Correlation between serum \u03b22-GPI\/oxLDL and the risk of cerebral infarction in patients with T2DM","volume":"9","author":"Kuang","year":"2022","journal-title":"Front Surg."},{"key":"B34","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1097\/ACO.0000000000000559","article-title":"Oxygen in the critically ill: friend or foe?","volume":"31","author":"Damiani","year":"2018","journal-title":"Curr Opin Anaesthesiol."},{"key":"B35","doi-asserted-by":"publisher","first-page":"2090","DOI":"10.3390\/nu11092090","article-title":"Oxidative stress in cardiovascular diseases: still a therapeutic target?","volume":"11","author":"Senoner","year":"2019","journal-title":"Nutrients."},{"key":"B36","doi-asserted-by":"publisher","first-page":"4527","DOI":"10.1042\/BCJ20160503C","article-title":"Molecular mechanisms of ROS production and oxidative stress in diabetes","volume":"473","author":"Newsholme","year":"2016","journal-title":"Biochem J."},{"key":"B37","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1038\/sj.ejcn.1602940","article-title":"Dietary carbohydrate: relationship to cardiovascular disease and disorders of carbohydrate metabolism","volume":"61","author":"Mann","year":"2007","journal-title":"Eur J Clin Nutr."},{"key":"B38","doi-asserted-by":"publisher","first-page":"16582","DOI":"10.1038\/s41598-021-95712-1","article-title":"miR-181c-5p mediates apoptosis of vascular endothelial cells induced by hyperoxemia via ceRNA crosstalk","volume":"11","author":"Wu","year":"2021","journal-title":"Sci Rep."},{"key":"B39","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1007\/s12028-020-01136-6","article-title":"Hyperoxemia and cerebral vasospasm in aneurysmal subarachnoid hemorrhage","volume":"35","author":"Reynolds","year":"2021","journal-title":"Neurocrit Care."}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2024.1344000\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,12]],"date-time":"2024-03-12T13:49:19Z","timestamp":1710251359000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2024.1344000\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,12]]},"references-count":39,"alternative-id":["10.3389\/fneur.2024.1344000"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2024.1344000","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,12]]},"article-number":"1344000"}}