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Randomized Controlled Trial
. 2022 Jul 28:17:1685-1693.
doi: 10.2147/COPD.S366795. eCollection 2022.

Short-Term Oxygen Therapy Outcomes in COPD

Thibaud Soumagne  1 , François Maltais  1 , François Corbeil  2 , Bruno Paradis  3 , Marc Baltzan  4 , Paula Simão  5 , Araceli Abad Fernández  6 , Richard Lecours  7 , Sarah Bernard  1 , Yves Lacasse  1 ; INOX Trial Group
Affiliations
Randomized Controlled Trial

Short-Term Oxygen Therapy Outcomes in COPD

Thibaud Soumagne et al. Int J Chron Obstruct Pulmon Dis. .

Abstract

Rationale: 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.

Purpose: Our objective was to describe the characteristics and outcomes of patients with COPD who received STOT.

Patients and methods: 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.

Results: 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 PaO2 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).

Conclusion: Following an acute respiratory illness in COPD, persistent hypoxaemia requiring STOT is a marker of disease progression towards the requirement for LTOT.

Keywords: chronic obstructive pulmonary disease; long-term; mortality; oxygen therapy; short-term.

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Conflict of interest statement

T Soumagne has no conflict of interest to disclose. F Maltais reports grants from GlaxoSmithKline, AstraZeneca, Sanofi, Novartis, Boehringer Ingelheim, and Grifols, and personal fees for serving on speaker bureaus and consultation panels from GlaxoSmithKline, Boehringer Ingelheim, Grifols, and Novartis; he is financially involved with OxyNov, a company which is developing an oxygen delivery system. F Corbeil, B Paradis, M Baltzan, P Simão, A Abad Fernández, R Lecours and S Bernard have no conflict of interest to disclose. Y Lacasse reports participation in Innovair, a company that holds shares in OxyNov, the owner of FreeO2, an automated oxygen delivery system.

Figures

Figure 1
Figure 1
Patient flow diagram. See for more details.
Figure 2
Figure 2
Kaplan–Meier analyses of LTOT requirement and mortality. (A) Shows the results for the requirement for long-term oxygen therapy (LTOT) according to the Nocturnal Oxygen Therapy Trial criteria. (B) Shows the results for the separate component of death. Data were censored at the date of dis-continuation of the intervention or last visit.
See this image and copyright information in PMC

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