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Similar risk of hospitalization and mortality for patients continuing and discontinuing LTOT

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Titel: Similar risk of hospitalization and mortality for patients continuing and discontinuing LTOT
Autoren: Björklund, Filip, Palm, Andreas, Sundh, Josefin, Khor, Yet H, Ekström, Magnus
Weitere Verfasser: Lund University, Faculty of Medicine, Faculty Office - BMC, The Education Office, Division of Course Administration for the Medical Programme, Teachers at the Medical Programme, Lunds universitet, Medicinska fakulteten, Kansli M, Utbildningsenheten, Avdelningen för läkarprogrammets kursadministration, Lärare vid läkarprogrammet, Originator, Lund University, Faculty of Medicine, Department of Clinical Sciences, Lund, Section II, Respiratory Medicine, Allergology, and Palliative Medicine, Breathlessness and chronic respiratory failure, Lunds universitet, Medicinska fakulteten, Institutionen för kliniska vetenskaper, Lund, Sektion II, Lungmedicin, allergologi och palliativ medicin, Andfåddhet och kronisk andningssvikt, Originator, Lund University, Faculty of Medicine, Department of Clinical Sciences, Lund, Section II, Respiratory Medicine, Allergology, and Palliative Medicine, Lunds universitet, Medicinska fakulteten, Institutionen för kliniska vetenskaper, Lund, Sektion II, Lungmedicin, allergologi och palliativ medicin, Originator, Lund University, Faculty of Medicine, Department of Clinical Sciences, Lund, Section II, Respiratory Medicine, Allergology, and Palliative Medicine, The Institute for Palliative Care, Lunds universitet, Medicinska fakulteten, Institutionen för kliniska vetenskaper, Lund, Sektion II, Lungmedicin, allergologi och palliativ medicin, Palliativt Utvecklingscentrum, Originator, Lund University, Profile areas and other strong research environments, Strategic research areas (SRA), EpiHealth: Epidemiology for Health, Lunds universitet, Profilområden och andra starka forskningsmiljöer, Strategiska forskningsområden (SFO), EpiHealth: Epidemiology for Health, Originator
Quelle: Respiratory Research. 26(1)
Schlagwörter: Medical and Health Sciences, Clinical Medicine, Respiratory Medicine and Allergy, Medicin och hälsovetenskap, Klinisk medicin, Lungmedicin och allergi
Beschreibung: INTRODUCTION: While the characteristics and medical management of patients treated with long-term oxygen therapy (LTOT) have transformed during the last decades, the evidence base for LTOT itself remains largely unchanged. This study aimed to compare the risk of hospitalization and death among hypoxemic patients discontinuing LTOT, with that of controls continuing therapy. METHODS: This was a retrospective observational study of patients with LTOT included in the DISCOVERY cohort, using elements of target trial emulation. Patients who fulfilled LTOT criteria but discontinued treatment with LTOT within 90 days of initiation, not due to improving oxygenation or change of treatment modality, were identified. The risk of hospitalization and death as a composite outcome, and the risks of individual outcomes of hospitalization and death, were compared with age-, sex- and disease type-matched controls who continued LTOT, using Cox regression adjusted for confounders. RESULTS: In total, 79 patients discontinuing LTOT and 395 controls were analyzed, both groups with a mean age of 73 (SD ± 11) years, 72% females, 65% underlying COPD. In adjusted Cox regression models, discontinuing LTOT was not associated with an increased risk of hospitalization or death (hazard ratio (HR) 1.0 95% Confidence interval (CI) 0.78-1.3), hospitalization (HR 0.99 95% CI 0.75-1.3), or death (HR 0.79 95% CI 0.61-1.0). CONCLUSION: In this study, patients fulfilling LTOT initiation criteria who discontinued therapy were not found to be at an increased risk of hospitalization or death, suggesting equipoise for a randomized trial of LTOT discontinuation or non-initiation in selected patient groups.
Zugangs-URL: https://doi.org/10.1186/s12931-025-03417-0
Datenbank: SwePub
Beschreibung
Abstract:INTRODUCTION: While the characteristics and medical management of patients treated with long-term oxygen therapy (LTOT) have transformed during the last decades, the evidence base for LTOT itself remains largely unchanged. This study aimed to compare the risk of hospitalization and death among hypoxemic patients discontinuing LTOT, with that of controls continuing therapy. METHODS: This was a retrospective observational study of patients with LTOT included in the DISCOVERY cohort, using elements of target trial emulation. Patients who fulfilled LTOT criteria but discontinued treatment with LTOT within 90 days of initiation, not due to improving oxygenation or change of treatment modality, were identified. The risk of hospitalization and death as a composite outcome, and the risks of individual outcomes of hospitalization and death, were compared with age-, sex- and disease type-matched controls who continued LTOT, using Cox regression adjusted for confounders. RESULTS: In total, 79 patients discontinuing LTOT and 395 controls were analyzed, both groups with a mean age of 73 (SD ± 11) years, 72% females, 65% underlying COPD. In adjusted Cox regression models, discontinuing LTOT was not associated with an increased risk of hospitalization or death (hazard ratio (HR) 1.0 95% Confidence interval (CI) 0.78-1.3), hospitalization (HR 0.99 95% CI 0.75-1.3), or death (HR 0.79 95% CI 0.61-1.0). CONCLUSION: In this study, patients fulfilling LTOT initiation criteria who discontinued therapy were not found to be at an increased risk of hospitalization or death, suggesting equipoise for a randomized trial of LTOT discontinuation or non-initiation in selected patient groups.
ISSN:14659921
1465993X
DOI:10.1186/s12931-025-03417-0