Torres-Castro Rodrigo, Hinojosa Williams, Martínez-Meñaca Amaya, Sala Llinas Ernest, Jiménez Arjona Josefa, Rueda Soriano Joaquín, Aurtenetxe Agueda, Barberà Joan Albert, Escribano-Subías Pilar, Blanco Isabel
Department of Pulmonary Medicine, Hospital Clínic, University of Barcelona, Barcelona, Spain.
Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer (FRCB-IDIBAPS), University of Barcelona, Barcelona, Spain.
Respirology. 2025 Jan;30(1):70-79. doi: 10.1111/resp.14821. Epub 2024 Aug 29.
Patients with pulmonary hypertension (PH) may present with hypoxaemia at rest or during daily activities. There is no epidemiological data on the prescription of long-term oxygen therapy (LTOT) in patients with PH. The study sought to analyse the prevalence and incidence of LTOT prescription among patients with pulmonary arterial hypertension (PAH) or chronic thromboembolic pulmonary hypertension (CTEPH) in Spain and to determine predictors for this prescription.
A retrospective analysis was performed from the Spanish Registry of Pulmonary Arterial Hypertension (REHAP). Collected data included demographics and anthropometric measurements, functional class (FC), arterial blood gases, pulmonary function tests, haemodynamic measurements, six-minute walking distance (6MWD) and LTOT prescription. In addition, we assessed the prevalence and incidence of LTOT prescription by PH group and subtype and potential predictors for LTOT initiation in the first 5 years after diagnosis.
We analysed 4533 patients (69.9% PAH and 30.1% CTEPH), mostly female (64.5%), with a mean age of 53.0 ± 18.3 years. The prevalence of LTOT was 19.3% for all patients. The incidence of LTOT prescriptions decreased from 5.6% to 1.6% between 2010 and 2019, respectively. Predictors for LTOT prescription, excluding those that represent the indication for oxygen therapy were: FC (HR: 1.813), 6MWD (HR: 1.002), mean pulmonary arterial pressure (mPAP) (HR: 1.014), cardiac index (CI) (HR: 1.253), pulmonary vascular resistance (PVR) (HR: 1.023) and diffusing capacity of carbon monoxide (DL) (HR: 1.294).
The prevalence of LTOT in PAH and CTEPH patients is close to 20%. FC, 6MWD, mPAP, CI, PVR and DL were predictors for LTOT prescription.
肺动脉高压（PH）患者在静息状态或日常活动中可能出现低氧血症。目前尚无关于PH患者长期氧疗（LTOT）处方的流行病学数据。本研究旨在分析西班牙肺动脉高压（PAH）或慢性血栓栓塞性肺动脉高压（CTEPH）患者中LTOT处方的患病率和发病率，并确定该处方的预测因素。
对西班牙肺动脉高压注册研究（REHAP）进行回顾性分析。收集的数据包括人口统计学和人体测量学指标、功能分级（FC）、动脉血气分析、肺功能测试、血流动力学测量、六分钟步行距离（6MWD）和LTOT处方。此外，我们按PH组和亚型评估了LTOT处方的患病率和发病率，以及诊断后前5年LTOT起始的潜在预测因素。
我们分析了4533例患者（69.9%为PAH，30.1%为CTEPH），大多数为女性（64.5%），平均年龄为53.0±18.3岁。所有患者中LTOT的患病率为19.3%。2010年至2019年间，LTOT处方的发病率分别从5.6%降至1.6%。LTOT处方的预测因素（不包括那些代表氧疗指征的因素）为：FC（风险比：1.813）、6MWD（风险比：1.002）、平均肺动脉压（mPAP）（风险比：1.014）、心脏指数（CI）（风险比：1.253）、肺血管阻力（PVR）（风险比：1.023）和一氧化碳弥散量（DL）（风险比：1.294）。
PAH和CTEPH患者中LTOT的患病率接近20%。FC、6MWD、mPAP、CI、PVR和DL是LTOT处方的预测因素。
