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dc.contributor.authorAnderson, J
dc.contributor.authorHoang, T
dc.contributor.authorHay, K
dc.contributor.authorTay, G
dc.date.accessioned2021-06-15T04:14:48Z
dc.date.available2021-06-15T04:14:48Z
dc.date.issued2021
dc.identifier.issn1444-0903
dc.identifier.doi10.1111/imj.15070
dc.identifier.urihttp://hdl.handle.net/10072/405132
dc.description.abstractBackground: High concentration oxygen therapy in hypercapnic chronic obstructive pulmonary disease (COPD) is associated with increased mortality. In ward-based patients with acute exacerbation of COPD and hypercapnia, this study examines oxygen prescription and the association between high concentration oxygen therapy and adverse outcome. Aims: To investigate the association between over-oxygenation and in-hospital adverse events. Methods: Inpatients with acute exacerbation of hypercapnic COPD at a tertiary Australian hospital over a 1-year period were retrospectively identified. Oxygen prescription and therapy was determined based on chart review. Over-oxygenation was defined as ≥10% of nursing chart observations recording oxygen delivery with oxygen saturation above 92%. A composite adverse outcome was defined as medical emergency team response, recommencement of non-invasive ventilation or death. The association between over-oxygenation and adverse outcome was assessed using survival analysis and conditional logistic regression modelling. Results: The study cohort comprised 106 unique patients and 157 admissions. Oxygen prescription was recorded in 132 (84%) and over-oxygenation occurred in 97 (62%) admissions. Over-oxygenation was higher in non-respiratory ward admissions (76% vs 57%, P = 0.03) and those without any form of oxygen prescription (84% vs 58%, P = 0.01). During follow up, 23 (22%) patients experienced an adverse event. Cox proportional hazards modelling found weak evidence for increased risk of an adverse event in over-oxygenated patients (hazard ratio 2.5; 95% confidence interval 0.8–7.3, P = 0.10). Conditional logistic regression, after matching on age, Charlson comorbidity category and length of follow up, found a similar estimate of association (hazard ratio 2.6; 95% confidence interval 0.8–8.7, P = 0.12). Conclusions: Over-oxygenation to hypercapnic COPD inpatients is common and rates of oxygen prescription are suboptimal. We found weak evidence of association between over-oxygenation and adverse events, likely due to low statistical power. Larger prospective studies are needed.
dc.description.peerreviewedYes
dc.languageeng
dc.publisherWiley
dc.relation.ispartofpagefrom654
dc.relation.ispartofpageto659
dc.relation.ispartofissue5
dc.relation.ispartofjournalInternal Medicine Journal
dc.relation.ispartofvolume51
dc.subject.fieldofresearchCardiovascular medicine and haematology
dc.subject.fieldofresearchClinical sciences
dc.subject.fieldofresearchHealth services and systems
dc.subject.fieldofresearchPublic health
dc.subject.fieldofresearchcode3201
dc.subject.fieldofresearchcode3202
dc.subject.fieldofresearchcode4203
dc.subject.fieldofresearchcode4206
dc.subject.keywordschronic obstructive
dc.subject.keywordshypercapnia
dc.subject.keywordsoxygen
dc.subject.keywordsoxygen inhalation therapy
dc.subject.keywordspulmonary disease
dc.titleEvaluation of inpatient oxygen therapy in hypercapnic chronic obstructive pulmonary disease
dc.typeJournal article
dc.type.descriptionC1 - Articles
dcterms.bibliographicCitationAnderson, J; Hoang, T; Hay, K; Tay, G, Evaluation of inpatient oxygen therapy in hypercapnic chronic obstructive pulmonary disease, Internal Medicine Journal, 2021, 51 (5), pp. 654-659
dcterms.dateAccepted2020-09-14
dc.date.updated2021-06-15T00:12:57Z
gro.hasfulltextNo Full Text
gro.griffith.authorAnderson, James


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