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Home oxygen therapy reduces risk of hospitalisation in patients with chronic obstructive pulmonary disease: a population-based retrospective cohort study, 2005-2012

Authors
 Kyoung Hee Cho  ;  Young Sam Kim  ;  Chung Mo Nam  ;  Tae Hyun Kim  ;  Sun Jung Kim  ;  Kyu-Tae Han  ;  Eun-Cheol Park 
Citation
 BMJ OPEN, Vol.5(11) : e009065, 2015 
Journal Title
 BMJ OPEN 
Issue Date
2015
MeSH
Aged ; Cohort Studies ; Female ; Home Care Services* ; Hospitalization/statistics & numerical data ; Humans ; Male ; Middle Aged ; Oxygen Inhalation Therapy* ; Pulmonary Disease, Chronic Obstructive/physiopathology ; Pulmonary Disease, Chronic Obstructive/therapy* ; Retrospective Studies ; Risk ; Time Factors
Keywords
PRIMARY CARE ; RESPIRATORY MEDICINE (see Thoracic Medicine)
Abstract
OBJECTIVE: This study evaluated the effect of home oxygen therapy (HOT) on hospital admissions in chronic obstructive pulmonary disease (COPD) patients. DESIGN AND SETTING: Using nationwide health insurance claims from 2002-2012, we conducted a longitudinal population-based retrospective cohort study. PARTICIPANTS: Individuals who were aged 40 years or above and newly diagnosed with COPD in 2005. OUTCOME MEASURES: The primary outcome was total number of hospitalisations during the study period. Participants were matched using HOT propensity scores and were stratified by respiratory impairment (grade 1: FEV1 ≤25% or PaO2 ≤55 mm Hg; grade 2: FEV1 ≤30% or PaO2 56-60 mm Hg; grade 3: FEV1 ≤40% or PaO2 61-65 mm Hg; 'no grade': FEV1 or PaO2 unknown), then a negative binomial regression analysis was performed for each group. RESULTS: Of the 36,761 COPD patients included in our study, 1330 (3.6%) received HOT. In a multivariate analysis of grade 1 patients performed before propensity score matching, the adjusted relative risk of hospitalisation for patients who did not receive HOT was 1.27 (95% CI 1.01 to 1.60). In a multivariate analysis of grade 1 patients performed after matching, the adjusted relative risk for patients who did not receive HOT was 1.65 (95% CI 1.25 to 2.18). In grade 2 or grade 3 patients, no statistical difference in hospital admission risk was detected. In the 'no grade' group of patients, HOT was associated with an increased risk of hospitalisation. CONCLUSIONS: HOT reduces the risk of hospital admission in COPD patients with severe hypoxaemia. However, apart from these patients, HOT use is not associated with hospital admissions.
Files in This Item:
T201504762.pdf Download
DOI
10.1136/bmjopen-2015-009065
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
4. Graduate School of Public Health (보건대학원) > Graduate School of Public Health (보건대학원) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Young Sam(김영삼) ORCID logo https://orcid.org/0000-0001-9656-8482
Kim, Tae Hyun(김태현) ORCID logo https://orcid.org/0000-0003-1053-8958
Nam, Chung Mo(남정모) ORCID logo https://orcid.org/0000-0003-0985-0928
Park, Eun-Cheol(박은철) ORCID logo https://orcid.org/0000-0002-2306-5398
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/156847
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