Do patients with moderate hypoxemia require LTOT?

Abstract

Background: Indications for LTOT in patients with moderate hypoxemia (MH) are controversial. Aim: To characterize and compare patients with MH versus patients with severe hypoxemia (SH) with or without access to LTOT. Methods: Patients were added to a registry and were followed up for three years. Main aspects of follow up were mortality, rate of hospitalizations, symptoms and comorbidities. Results: Patients added to the registry were 150 – 39 were with MH and 111 with SH (38 of them were receiving LTOT). Mean age of the patients was 65.7±9.6 years. Men predominated with 81.3%. Patients with SH without access to LTOT (60.3%, p 0.05). Rate of hospitalizations was as follows – 4.9±3.1 for SH patients without LTOT, 3.2±2.0 for SH patients on LTOT and 2.6±1.9 for MH patients (p Symptoms assessed with CAT showed mean score of 28.8±4.3 for SH patients without LTOT, 23.4±4.3 for SH patients on LTOT and 24.1±4.7 for MH patients. There was no difference in comorbidities between SH and MH patients (p>0.05). The main risk factors for increased mortality in MH patients were the presence of CP (OR – 9.5, 95% CI 2.0-43.6, p Conclusion: Patients with MH had better prognosis than patients with SH without access to LTOT. Their mortality profile and symptoms are identical with patients with SH on LTOT. Hence there are no arguments for LTOT in MH patients. The main risk factors for mortality in MH patients were CP or more than 1 hospitalization per year and it is possible that these subgroups could benefit from LTOT.