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Daily duration of long-term oxygen therapy and risk of hospitalization in oxygen-dependent COPD patients

Sundh, Josefin; Ahmadi, Zainab LU and Ekström, Magnus LU (2018) In International Journal of COPD 13. p.2623-2628
Abstract

Introduction: Long-term oxygen therapy (LTOT) improves survival and may reduce hospital admissions in patients with chronic obstructive pulmonary disease (COPD) and severe hypoxemia, but the impact of daily duration of LTOT on hospitalization rate is unknown. We aimed to estimate the association between the daily duration of LTOT (24 vs 15 h/d) and hospital admissions in patients with LTOT due to COPD. Materials and methods: A population-based, cohort study included patients who started LTOT due to COPD between October 1, 2005 and June 30, 2009 in the Swedish national register for respiratory failure (Swedevox). Time to first hospitalization from all causes and from respiratory or nonrespiratory disease, using the National Patient... (More)

Introduction: Long-term oxygen therapy (LTOT) improves survival and may reduce hospital admissions in patients with chronic obstructive pulmonary disease (COPD) and severe hypoxemia, but the impact of daily duration of LTOT on hospitalization rate is unknown. We aimed to estimate the association between the daily duration of LTOT (24 vs 15 h/d) and hospital admissions in patients with LTOT due to COPD. Materials and methods: A population-based, cohort study included patients who started LTOT due to COPD between October 1, 2005 and June 30, 2009 in the Swedish national register for respiratory failure (Swedevox). Time to first hospitalization from all causes and from respiratory or nonrespiratory disease, using the National Patient Registry, was analyzed using Fine–Gray regression, adjusting for potential confounders. Results: A total of 2,249 patients with COPD (59% women) were included. LTOT 24 h/d was prescribed to 539 (24%) and LTOT 15–16 h/d to 1,231 (55%) patients. During a median follow-up of 1.1 years (interquartile range, 0.6–2.1 years), 1,702 (76%) patients were hospitalized. No patient was lost to follow-up. The adjusted rate of all-cause hospitalization was similar between LTOT 24 and 15–16 h/d (subdistribution hazard ratio [SHR] 0.96; [95% CI] 0.84–1.08), as was cause-specific hospitalizations analyzed for respiratory disease (SHR: 1.00; 95% CI: 0.86–1.17) and nonrespiratory disease (SHR: 0.92; 95% CI: 0.75–1.14). Conclusion: LTOT prescribed for 24 h/d was not associated with decreased hospitalization rates compared with LTOT for 15–16 h/d in patients with oxygen-dependent COPD. The results should be validated in a randomized controlled trial.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Chronic obstructive pulmonary disease, Cohort study, Duration, Hospital admission, Hospitalization, Hypoxemia, Long-term oxygen therapy, Nonrespiratory disease, Respiratory disease
in
International Journal of COPD
volume
13
pages
6 pages
publisher
Dove Press
external identifiers
  • scopus:85058495365
ISSN
1176-9106
DOI
10.2147/COPD.S167523
language
English
LU publication?
yes
id
70d0e400-1b5c-47aa-b5b2-616b3055f82e
date added to LUP
2019-01-10 08:17:00
date last changed
2019-02-20 11:42:21
@article{70d0e400-1b5c-47aa-b5b2-616b3055f82e,
  abstract     = {<p>Introduction: Long-term oxygen therapy (LTOT) improves survival and may reduce hospital admissions in patients with chronic obstructive pulmonary disease (COPD) and severe hypoxemia, but the impact of daily duration of LTOT on hospitalization rate is unknown. We aimed to estimate the association between the daily duration of LTOT (24 vs 15 h/d) and hospital admissions in patients with LTOT due to COPD. Materials and methods: A population-based, cohort study included patients who started LTOT due to COPD between October 1, 2005 and June 30, 2009 in the Swedish national register for respiratory failure (Swedevox). Time to first hospitalization from all causes and from respiratory or nonrespiratory disease, using the National Patient Registry, was analyzed using Fine–Gray regression, adjusting for potential confounders. Results: A total of 2,249 patients with COPD (59% women) were included. LTOT 24 h/d was prescribed to 539 (24%) and LTOT 15–16 h/d to 1,231 (55%) patients. During a median follow-up of 1.1 years (interquartile range, 0.6–2.1 years), 1,702 (76%) patients were hospitalized. No patient was lost to follow-up. The adjusted rate of all-cause hospitalization was similar between LTOT 24 and 15–16 h/d (subdistribution hazard ratio [SHR] 0.96; [95% CI] 0.84–1.08), as was cause-specific hospitalizations analyzed for respiratory disease (SHR: 1.00; 95% CI: 0.86–1.17) and nonrespiratory disease (SHR: 0.92; 95% CI: 0.75–1.14). Conclusion: LTOT prescribed for 24 h/d was not associated with decreased hospitalization rates compared with LTOT for 15–16 h/d in patients with oxygen-dependent COPD. The results should be validated in a randomized controlled trial.</p>},
  author       = {Sundh, Josefin and Ahmadi, Zainab and Ekström, Magnus},
  issn         = {1176-9106},
  keyword      = {Chronic obstructive pulmonary disease,Cohort study,Duration,Hospital admission,Hospitalization,Hypoxemia,Long-term oxygen therapy,Nonrespiratory disease,Respiratory disease},
  language     = {eng},
  pages        = {2623--2628},
  publisher    = {Dove Press},
  series       = {International Journal of COPD},
  title        = {Daily duration of long-term oxygen therapy and risk of hospitalization in oxygen-dependent COPD patients},
  url          = {http://dx.doi.org/10.2147/COPD.S167523},
  volume       = {13},
  year         = {2018},
}