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Hypoxemia severity and survival in ILD and COPD on long-term oxygen therapy – The population-based DISCOVERY study

Palm, Andreas and Ekström, Magnus LU orcid (2021) In Respiratory Medicine 189.
Abstract

Background and aim: Whether long-term oxygen therapy (LTOT) improves survival in interstitial lung disease (ILD) is unclear. A recent study reported similar survival in ILD patients with severe hypoxemia on LTOT vs. moderate hypoxemia without LTOT, and proposed that LTOT could be indicated in ILD already at moderate hypoxemia. The aim of this study was to compare survival by severity of hypoxemia in patients with ILD and COPD, respectively, treated with LTOT. Methods: A population-based, longitudinal study of adults starting LTOT for ILD or COPD 1987–2018. Transplant-free survival was compared between moderate (PaO2 7.4–8.7 kPa) and severe (PaO2<7.4 kPa) hypoxemia using Cox regression, adjusted for age, sex, BMI, smoking status, WHO... (More)

Background and aim: Whether long-term oxygen therapy (LTOT) improves survival in interstitial lung disease (ILD) is unclear. A recent study reported similar survival in ILD patients with severe hypoxemia on LTOT vs. moderate hypoxemia without LTOT, and proposed that LTOT could be indicated in ILD already at moderate hypoxemia. The aim of this study was to compare survival by severity of hypoxemia in patients with ILD and COPD, respectively, treated with LTOT. Methods: A population-based, longitudinal study of adults starting LTOT for ILD or COPD 1987–2018. Transplant-free survival was compared between moderate (PaO2 7.4–8.7 kPa) and severe (PaO2<7.4 kPa) hypoxemia using Cox regression, adjusted for age, sex, BMI, smoking status, WHO performance status, year of starting LTOT, diagnosis of heart failure, ischemic heart disease and diabetes mellitus. Results: In total, 17,084 patients were included, with ILD and moderate (n = 470) or severe hypoxemia (n = 2,408), and COPD with moderate (n = 2,087) or severe hypoxemia (n = 12,119). Compared with in COPD, ILD patients on LTOT had lower transplant-free survival after one year (41.9 vs. 67.1%) and two years (20.3 vs. 46.5%). In COPD worse hypoxemia was associated with slightly increased risk of death/lung transplantation, aHR 1.07 (1.00–1.14), a difference not shown in ILD, aHR 0.91 (0.80–1.03). Conclusion: Transplant-free survival did not differ in ILD patients between moderate and severe hypoxia despite LTOT.

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Please use this url to cite or link to this publication:
author
and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
COPD, Hypoxemia, ILD, Mortality
in
Respiratory Medicine
volume
189
article number
106659
publisher
Elsevier
external identifiers
  • scopus:85117729306
  • pmid:34700206
ISSN
0954-6111
DOI
10.1016/j.rmed.2021.106659
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2021 The Author(s)
id
6528f6f5-a7e3-458b-956f-97d8ee9ddd85
date added to LUP
2021-11-19 13:11:32
date last changed
2024-06-15 20:43:44
@article{6528f6f5-a7e3-458b-956f-97d8ee9ddd85,
  abstract     = {{<p>Background and aim: Whether long-term oxygen therapy (LTOT) improves survival in interstitial lung disease (ILD) is unclear. A recent study reported similar survival in ILD patients with severe hypoxemia on LTOT vs. moderate hypoxemia without LTOT, and proposed that LTOT could be indicated in ILD already at moderate hypoxemia. The aim of this study was to compare survival by severity of hypoxemia in patients with ILD and COPD, respectively, treated with LTOT. Methods: A population-based, longitudinal study of adults starting LTOT for ILD or COPD 1987–2018. Transplant-free survival was compared between moderate (PaO2 7.4–8.7 kPa) and severe (PaO2&lt;7.4 kPa) hypoxemia using Cox regression, adjusted for age, sex, BMI, smoking status, WHO performance status, year of starting LTOT, diagnosis of heart failure, ischemic heart disease and diabetes mellitus. Results: In total, 17,084 patients were included, with ILD and moderate (n = 470) or severe hypoxemia (n = 2,408), and COPD with moderate (n = 2,087) or severe hypoxemia (n = 12,119). Compared with in COPD, ILD patients on LTOT had lower transplant-free survival after one year (41.9 vs. 67.1%) and two years (20.3 vs. 46.5%). In COPD worse hypoxemia was associated with slightly increased risk of death/lung transplantation, aHR 1.07 (1.00–1.14), a difference not shown in ILD, aHR 0.91 (0.80–1.03). Conclusion: Transplant-free survival did not differ in ILD patients between moderate and severe hypoxia despite LTOT.</p>}},
  author       = {{Palm, Andreas and Ekström, Magnus}},
  issn         = {{0954-6111}},
  keywords     = {{COPD; Hypoxemia; ILD; Mortality}},
  language     = {{eng}},
  publisher    = {{Elsevier}},
  series       = {{Respiratory Medicine}},
  title        = {{Hypoxemia severity and survival in ILD and COPD on long-term oxygen therapy – The population-based DISCOVERY study}},
  url          = {{http://dx.doi.org/10.1016/j.rmed.2021.106659}},
  doi          = {{10.1016/j.rmed.2021.106659}},
  volume       = {{189}},
  year         = {{2021}},
}