Long-term effect of hyperoxemia during chronic obstructive pulmonary disease exacerbation managed by emergency medical service and emergency department: a prospective, exploratory study
| Autor: | Marxengel Leonin Asinas-Tan, Marcus Eng Hock Ong, Si Oon Cheah, Hsin Kai Goh, Francis Chun Yue Lee, Yih Ying Ng, Beng Leong Lim |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Acute exacerbation of chronic obstructive pulmonary disease Emergency Medical Services Exacerbation 030204 cardiovascular system & hematology 03 medical and health sciences Pulmonary Disease Chronic Obstructive 0302 clinical medicine Internal medicine Medicine Humans Prospective Studies Prospective cohort study Aged business.industry Mortality rate Hazard ratio Hyperoxemia 030208 emergency & critical care medicine Emergency department medicine.disease Oxygen Cohort Emergency Medicine Disease Progression business Emergency Service Hospital Follow-Up Studies |
| Zdroj: | European journal of emergency medicine : official journal of the European Society for Emergency Medicine. 27(6) |
| ISSN: | 1473-5695 |
| Popis: | Objective Long-term effects of hyperoxemia during acute exacerbation of chronic obstructive pulmonary disease (AECOPD) remained unknown. We aimed to explore these effects of hyperoxemia during AECOPD. Methods This was an exploratory follow-up study of a cohort with AECOPD managed by Emergency Medical Service and two emergency departments (EDs). Patients were classified as hyperoxemic (PaO2 > 65 mmHg) or nonhyperoxemic (PaO2 ≤ 65 mmHg). Patients discharged from ED/inpatient care were followed up prospectively for 1 year. The primary outcome was 1-year all-cause mortality in hyperoxemic vs. nonhyperoxemic groups. Secondary outcomes were 3-month all-cause mortality and median number of repeat AECOPD hospitalizations within 1 year. We generated Kaplan-Meier curves and compared them using log-rank test. The primary outcome was also analyzed using Cox proportional-hazards model. We reported crude and adjusted hazard ratios, their 95% confidence intervals (CIs) and P values. We adjusted for two a priori predictors of delayed mortality; age ≥ 70 years and repeat AECOPD hospitalizations. Results A total of 231 patients were analyzed. One-year mortality rates in hyperoxemic vs. nonhyperoxemic groups were 26/137 (19.0%) and 12/94 (12.8%), respectively (P = 0.693). Although Kaplan-Meier curves showed divergent courses favoring nonhyperoxemic group, log-rank test was not statistically significant (P = 0.203). The crude and adjusted hazard ratios (reference: nonhyperoxemic group) were 1.55 (95% CIs, 0.78-3.08; P = 0.207) and 1.57 (95% CIs, 0.79-3.13; P = 0.196), respectively. Secondary outcomes did not differ. Conclusions Our study reported no effect on 1-year all-cause mortality associated with hyperoxemia during AECOPD. Further studies are needed to prove/disprove our findings. |
| Databáze: | OpenAIRE |
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