Oxygen use and survival in patients with advanced cancer and low oxygen saturation in home care: a preliminary retrospective cohort study
Abstract Background The role of oxygen therapy in end-of-life care for patients with advanced cancer is incompletely understood. We aimed to evaluate the association between oxygen use and survival in patients with advanced cancer and low oxygen saturation in home care. Methods We conducted a retros...
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| Format: | Article |
| Language: | English |
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BMC
2020-01-01
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| Series: | BMC Palliative Care |
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| Online Access: | https://doi.org/10.1186/s12904-019-0511-9 |
| _version_ | 1819057465839321088 |
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| author | Hiroshi Igarashi Motoharu Fukushi Naoki Nago |
| author_facet | Hiroshi Igarashi Motoharu Fukushi Naoki Nago |
| author_sort | Hiroshi Igarashi |
| collection | DOAJ |
| description | Abstract Background The role of oxygen therapy in end-of-life care for patients with advanced cancer is incompletely understood. We aimed to evaluate the association between oxygen use and survival in patients with advanced cancer and low oxygen saturation in home care. Methods We conducted a retrospective cohort study at a primary care practice in suburban Tokyo. Adult patients in home care with advanced cancer demonstrating first low oxygen saturation (less than 90%) detected in home visits were consecutively included in the study. Cox proportional hazards regression was used to investigate the effect of oxygen use on overall survival and survival at home, adjusted for systolic blood pressure, decreased level of consciousness, dyspnea, oral intake, performance status, and cardiopulmonary comorbidity. Results Of 433 identified patients with advanced cancer, we enrolled 137 patients (oxygen use, n = 35; no oxygen use, n = 102) who developed low oxygen saturation. In multivariable analysis, the adjusted hazard ratio (HR) of oxygen use was 0.68 (95% confidence interval 0.39–1.17) for death and 0.70 (0.38–1.27) for death at home. In patients with dyspnea, the HR was 0.35 (0.13–0.89) for death and 0.33 (0.11–0.96) for death at home; without dyspnea, it was 1.03 (0.49–2.17) for death and 0.84 (0.36–1.96) for death at home. Conclusions Oxygen use was not significantly associated with survival in patients with advanced cancer and low oxygen saturation, after adjusting for potential confounders. It may not be necessary to use oxygen for prolongation of survival in such patients, particularly in those without dyspnea. |
| first_indexed | 2024-12-21T13:39:45Z |
| format | Article |
| id | doaj.art-e7e79ba6f0d048f0893be34471b5ec58 |
| institution | Directory Open Access Journal |
| issn | 1472-684X |
| language | English |
| last_indexed | 2024-12-21T13:39:45Z |
| publishDate | 2020-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Palliative Care |
| spelling | doaj.art-e7e79ba6f0d048f0893be34471b5ec582022-12-21T19:02:03ZengBMCBMC Palliative Care1472-684X2020-01-0119111010.1186/s12904-019-0511-9Oxygen use and survival in patients with advanced cancer and low oxygen saturation in home care: a preliminary retrospective cohort studyHiroshi Igarashi0Motoharu Fukushi1Naoki Nago2Musashi Kokubunji Park ClinicMusashi Kokubunji Park ClinicMusashi Kokubunji Park ClinicAbstract Background The role of oxygen therapy in end-of-life care for patients with advanced cancer is incompletely understood. We aimed to evaluate the association between oxygen use and survival in patients with advanced cancer and low oxygen saturation in home care. Methods We conducted a retrospective cohort study at a primary care practice in suburban Tokyo. Adult patients in home care with advanced cancer demonstrating first low oxygen saturation (less than 90%) detected in home visits were consecutively included in the study. Cox proportional hazards regression was used to investigate the effect of oxygen use on overall survival and survival at home, adjusted for systolic blood pressure, decreased level of consciousness, dyspnea, oral intake, performance status, and cardiopulmonary comorbidity. Results Of 433 identified patients with advanced cancer, we enrolled 137 patients (oxygen use, n = 35; no oxygen use, n = 102) who developed low oxygen saturation. In multivariable analysis, the adjusted hazard ratio (HR) of oxygen use was 0.68 (95% confidence interval 0.39–1.17) for death and 0.70 (0.38–1.27) for death at home. In patients with dyspnea, the HR was 0.35 (0.13–0.89) for death and 0.33 (0.11–0.96) for death at home; without dyspnea, it was 1.03 (0.49–2.17) for death and 0.84 (0.36–1.96) for death at home. Conclusions Oxygen use was not significantly associated with survival in patients with advanced cancer and low oxygen saturation, after adjusting for potential confounders. It may not be necessary to use oxygen for prolongation of survival in such patients, particularly in those without dyspnea.https://doi.org/10.1186/s12904-019-0511-9CancerDyspneaHypoxiaOxygenPrognosisSurvival |
| spellingShingle | Hiroshi Igarashi Motoharu Fukushi Naoki Nago Oxygen use and survival in patients with advanced cancer and low oxygen saturation in home care: a preliminary retrospective cohort study BMC Palliative Care Cancer Dyspnea Hypoxia Oxygen Prognosis Survival |
| title | Oxygen use and survival in patients with advanced cancer and low oxygen saturation in home care: a preliminary retrospective cohort study |
| title_full | Oxygen use and survival in patients with advanced cancer and low oxygen saturation in home care: a preliminary retrospective cohort study |
| title_fullStr | Oxygen use and survival in patients with advanced cancer and low oxygen saturation in home care: a preliminary retrospective cohort study |
| title_full_unstemmed | Oxygen use and survival in patients with advanced cancer and low oxygen saturation in home care: a preliminary retrospective cohort study |
| title_short | Oxygen use and survival in patients with advanced cancer and low oxygen saturation in home care: a preliminary retrospective cohort study |
| title_sort | oxygen use and survival in patients with advanced cancer and low oxygen saturation in home care a preliminary retrospective cohort study |
| topic | Cancer Dyspnea Hypoxia Oxygen Prognosis Survival |
| url | https://doi.org/10.1186/s12904-019-0511-9 |
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