Postoperative mortality in patients requiring home oxygen therapy: a nationwide hospital-based database study

To identify the postoperative mortality in patients requiring home oxygen therapy (HOT).

This descriptive study used a nationwide hospital-based database constructed by JMDC Inc. (Tokyo, Japan). Patients aged ≥ 18 years requiring HOT who underwent surgery between January 2014 and June 2022 were included. The study outcomes were in-hospital and 30-day postoperative mortality rates and other complications. We established a non-HOT group matched by age, sex, procedure, and surgical urgency for contrast and analyzed mortality in subgroups based on the reason for HOT, surgical department, and urgency.

Among the 3349 patients receiving HOT who underwent surgery, 293 (8.7%) in-hospital mortalities and 213 (6.4%) 30-day mortalities were reported. Postoperative pulmonary complications were observed in 359 (10.7%) patients, and 227 (6.8%) had non-respiratory complications. Furthermore, 123 (3.7%) in-hospital mortalities and 74 (2.2%) 30-day mortalities were also reported in the non-HOT group (3323 patients). The subgroup analysis indicated no significant differences in mortality or complications based on the reason for HOT. Higher mortality rates were reported in gastroenterology (9.3%), dermatology (14.7%), respiratory (11.8%), otolaryngology (36.5%), and neurosurgery (16.3%) departments. In-hospital and 30-day mortalities for emergency surgeries in the HOT group were 17.3 and 13.4%, respectively.

Among patients requiring HOT, in-hospital and 30-day mortalities were 8.7 and 6.4%, respectively. In addition, emergency surgeries may contribute to higher postoperative mortalities. Future research should identify specific mortality risk factors and develop perioperative management strategies to reduce these risks.