Quebec Heart and Lung Institute, Laval University, Quebec, Canada.
Trois-Rivières Affiliated Hospital, Trois-Rivières, Canada.
Int J Chron Obstruct Pulmon Dis. 2022 Jul 28;17:1685-1693. doi: 10.2147/COPD.S366795. eCollection 2022.
Short-term oxygen therapy (STOT) is often prescribed to allow patients with chronic obstructive pulmonary disease (COPD) to be discharged safely from hospital following an acute illness. This practice is widely accepted without being based on evidence.
Our objective was to describe the characteristics and outcomes of patients with COPD who received STOT.
The study was a secondary analysis of the INOX trial, a 4-year randomised trial of nocturnal oxygen in COPD. The trial indicated that nocturnal oxygen has no significant effect on survival or progression to LTOT, allowing our merging of patients who received nocturnal oxygen and those who received placebo into a single cohort to study the predictors and outcomes of STOT regardless of the treatment received during the trial.
Among the 243 participants in the trial, 60 required STOT on at least one occasion during follow-up. Patients requiring STOT had more severe dyspnoea and lung function impairment, and lower PaO at baseline than those who did not. STOT was associated with subsequent LTOT requirement (hazard ratio [HR]: 4.59; 95% confidence interval [CI]: 2.98-7.07) and mortality (HR: 1.93; 95% CI: 1.15-3.24). The association between STOT and mortality was confounded by age, disease severity and comorbidities. Periods of STOT of more than one month and/or repeated prescriptions of STOT increased the probability of progression to LTOT (OR: 5.07; 95% CI: 1.48-18.8).
Following an acute respiratory illness in COPD, persistent hypoxaemia requiring STOT is a marker of disease progression towards the requirement for LTOT.
短期氧疗（STOT）常用于允许慢性阻塞性肺疾病（COPD）患者在急性疾病后安全出院。这种做法没有基于证据就被广泛接受。
我们的目的是描述接受 STOT 的 COPD 患者的特征和结局。
这项研究是 INOX 试验的二次分析，该试验是一项为期 4 年的 COPD 夜间氧疗随机试验。该试验表明夜间氧疗对生存或向 LTOT 进展没有显著影响，因此我们将接受夜间氧疗和接受安慰剂的患者合并到一个单一队列中，无论在试验期间接受何种治疗，都研究 STOT 的预测因素和结局。
在试验的 243 名参与者中，有 60 名患者在随访期间至少有一次需要 STOT。需要 STOT 的患者在基线时呼吸困难和肺功能损害更严重，且 PaO 更低。STOT 与随后的 LTOT 需求（风险比 [HR]：4.59；95%置信区间 [CI]：2.98-7.07）和死亡率（HR：1.93；95% CI：1.15-3.24）相关。STOT 与死亡率之间的关联受到年龄、疾病严重程度和合并症的混杂。STOT 持续时间超过一个月和/或多次 STOT 处方增加了向 LTOT 进展的可能性（OR：5.07；95% CI：1.48-18.8）。
在 COPD 急性呼吸疾病后，需要 STOT 的持续低氧血症是向 LTOT 需求进展的疾病标志物。
