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慢性低氧血症门诊患者长期氧疗使用缺乏符合国际指南的医学标准。

Lack of Medical Criteria for Long-Term Oxygen Therapy Usage According to International Guidance in Outpatients With Chronic Hypoxemia.

作者信息

Perez-Malagon Carlos David, Barrera Raul

机构信息

Centro de Ciencias Biomedicas, Universidad Autónoma de Aguascalientes, Aguascalientes, MEX.

Clinical Service Rotation, Unidades Médicas de Atención Ambulatoria, Instituto Mexicano del Seguro Social, Aguascalientes, MEX.

出版信息

Cureus. 2021 Nov 16;13(11):e19634. doi: 10.7759/cureus.19634. eCollection 2021 Nov.

Abstract

Background Benefits of long-term oxygen therapy (LTOT) have been observed in hypoxemic respiratory patients. Reports have shown the lack of observance among healthcare professionals of LTOT. Thus, this study aimed to determine the demographic characteristics and observance of the medical indication of LTOT according to the international guidelines. Methodology A cross-sectional study was conducted on patients who attended the Medical Unit in Aguascalientes, Mexico to re-evaluate the need for LTOT. Data are presented as mean ± standard deviation. Statistical analyses were performed using the chi-square test or unpaired t-tests. P-values of <0.05 were considered statistically significant. Results From 813 outpatients attended to re-evaluate whether they met the medical criteria to use LTOT, 93 outpatients were excluded, and the remaining 714 outpatients were enrolled. The mean age of the patients was 70.0 ± 15.1 years, with a female gender predominance (59.1 %). The mean PaO level in room air was 7.9 ± 2.3 kPa. Hemoglobin and hematocrit levels were 14.9 ± 4.1 g/dL and 44.7 ± 8.4%, respectively. The mean levels of PaO were higher in female patients (8.1 ± 2.5 kPa vs. 7.6 ± 1.9 kPa; p = 0.01). The most common diagnosis was chronic obstructive pulmonary disorder (60.5%). Moreover, the specialty that most indicated the use of LTOT was pulmonology (57.8%); however, 36.8% of patients who used LTOT did not have any criteria according to international guidelines. Conclusions Although a significant percentage of patients do not use LTOT correctly, the most important finding is that the medical indication of LTOT by physicians is not always correct, leading to an excessive prescription of oxygen.

摘要

背景 长期氧疗(LTOT)对低氧血症呼吸患者的益处已得到观察。报告显示医疗保健专业人员对LTOT的依从性不足。因此,本研究旨在根据国际指南确定LTOT的人口统计学特征和医学指征的依从情况。方法 对前往墨西哥阿瓜斯卡连特斯医疗科重新评估LTOT需求的患者进行了横断面研究。数据以平均值±标准差表示。使用卡方检验或不成对t检验进行统计分析。P值<0.05被认为具有统计学意义。结果 在813名前来重新评估是否符合使用LTOT医学标准的门诊患者中,93名门诊患者被排除,其余714名门诊患者被纳入研究。患者的平均年龄为70.0±15.1岁,女性占主导(59.1%)。室内空气中的平均PaO水平为7.9±2.3 kPa。血红蛋白和血细胞比容水平分别为14.9±4.1 g/dL和44.7±8.4%。女性患者的平均PaO水平较高(8.1±2.5 kPa对7.6±1.9 kPa;p = 0.01)。最常见的诊断是慢性阻塞性肺疾病(60.5%)。此外,最常建议使用LTOT的专科是肺病学(57.8%);然而,根据国际指南,36.8%使用LTOT的患者没有任何标准。结论 尽管相当比例的患者未正确使用LTOT,但最重要的发现是医生对LTOT的医学指征并不总是正确的,导致氧气处方过多。

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