Home oxygen therapy reduces risk of hospitalisation in patients with chronic obstructive pulmonary disease: a population-based retrospective cohort study, 2005–2012

Abstract

ObjectiveThis study evaluated the effect of home oxygen therapy (HOT) on hospital admissions in chronic obstructive pulmonary disease (COPD) patients.Design and settingUsing nationwide health insurance claims from 2002–2012, we conducted a longitudinal population-based retrospective cohort study.ParticipantsIndividuals who were aged 40 years or above and newly diagnosed with COPD in 2005.Outcome measuresThe primary outcome was total number of hospitalisations during the study period. Participants were matched using HOT propensity scores and were stratified by respiratory impairment (grade 1: FEV1 ≤25% or PaO2 ≤55 mm Hg; grade 2: FEV1 ≤30% or PaO2 56–60 mm Hg; grade 3: FEV1 ≤40% or PaO2 61–65 mm Hg; ‘no grade’: FEV1 or PaO2 unknown), then a negative binomial regression analysis was performed for each group.ResultsOf the 36 761 COPD patients included in our study, 1330 (3.6%) received HOT. In a multivariate analysis of grade 1 patients performed before propensity score matching, the adjusted relative risk of hospitalisation for patients who did not receive HOT was 1.27 (95% CI 1.01 to 1.60). In a multivariate analysis of grade 1 patients performed after matching, the adjusted relative risk for patients who did not receive HOT was 1.65 (95% CI 1.25 to 2.18). In grade 2 or grade 3 patients, no statistical difference in hospital admission risk was detected. In the ‘no grade’ group of patients, HOT was associated with an increased risk of hospitalisation.ConclusionsHOT reduces the risk of hospital admission in COPD patients with severe hypoxaemia. However, apart from these patients, HOT use is not associated with hospital admissions.

Paraoxonase 1 and Chronic Obstructive Pulmonary Disease: A Meta-Analysis

“…Of the 119 initially identified articles, 100 articles were excluded after screening of titles and abstracts. After screening of full-texts, six studies were excluded because six studies did not focus on PON1 activity of patients with COPD [ 22 , 23 , 24 , 25 , 26 , 27 ]. One study [ 28 ] was excluded because it included the same population as another study [ 29 ].…”

Post-Hospitalization Short-Term Oxygen Therapy: Use of a Clinical Management Pathway and Long-Term Follow-Up

“…Although hospital readmission rates in patients with exacerbations of COPD have been reported to be reduced with the use of oxygen therapy as part of a post-hospitalization multicomponent care program, 23 there are conflicting results from retrospective studies on the impact of long-term oxygen therapy on hospitalization rates. [24][25][26][27] Nevertheless, some health care professionals perceive that oxygen therapy may prevent potential hospital readmissions by improving recovery or managing relapses at home. It is possible that the use of home oxygen therapy may result in increased health care utilization for support or due to falls or oxygen toxicity as a result of its use.…”

Annual decline in arterial blood oxygen predicts development of chronic respiratory failure in COPD with mild hypoxaemia: A 6‐year follow‐up study

“…Chronic respiratory failure (CRF) with hypoxaemia impairs activities of daily living (ADL) and leads to poor outcomes in patients with chronic obstructive pulmonary disease (COPD) . Long‐term oxygen therapy (LTOT) is an effective therapy; however, this therapy remains problematic due to its high cost and its deleterious impact on patient lifestyles and quality of life . As CRF is rarely reversible, preventing disease progression is essential for the management of patients with COPD, and identifying the factors associated with CRF development is of considerable importance.…”

“…1 Long-term oxygen therapy (LTOT) is an effective therapy; however, this therapy remains problematic due to its high cost and its deleterious impact on patient lifestyles and quality of life. [2][3][4][5][6] As CRF is rarely reversible, preventing disease progression is essential for the management of patients with…”