对于继续和停止LTOT治疗的患者来说,住院和死亡的风险类似
Filip Björklund1, Andreas Palm2, Josefin Sundh3
1Department of Clinical Sciences Lund, Faculty of Medicine, Respiratory Medicine, Allergology, and Palliative Medicine, Lund University, Lund, Sweden. filip.bjorklund@med.lu.se.
Respiratory research
|November 15, 2025
概括
停止长期氧气治疗 (LTOT) 的患者没有增加住院或死亡的风险. 这一发现表明,在选择的低血量患者中调查LTOT中止的试验中,可能存在均衡的可能性.
科学领域:
- 肺部医学 肺部医学
- 临床研究 临床研究
- 健康结果的健康结果.
背景情况:
- 长期氧气疗法 (LTOT) 是低血症患者的基石治疗,但支持其持续使用的证据尚未显著发展.
- 尽管在患者管理方面取得了进展,但关于停止LTOT相关风险的可靠数据有限.
研究的目的:
- 为了比较停用LTOT和继续治疗的低血量患者之间的住院和死亡风险.
- 在现实环境中评估LTOT停药的安全性.
主要方法:
- 在DISCOVERY队列中使用目标试验模拟的回顾性观察性研究.
- 确定了在开始90天内停止LTOT治疗的患者 (不包括有氧化改善或治疗改变的患者).
- 结果与年龄,性别和疾病匹配的对照进行了比较,使用调整后的Cox回归继续LTOT.
主要成果:
- 分析了79名终止LTOT治疗的患者和395名对照患者 (平均年龄73岁,72%为女性,65%为COPD).
- 停止使用LTOT与复合住院或死亡风险的增加无关 (HR 1.0,95% CI 0.78-1.3).
- 没有观察到住院治疗 (HR 0.99,95% CI 0.75-1.3) 或死亡 (HR 0.79,95% CI 0.61-1.0) 的显著增加.
结论:
- 符合LTOT标准的低血症患者停止治疗并没有面临住院或死亡的更高风险.
- 这些发现表明平衡,支持在精心挑选的患者组中对LTOT停止或不启动进行随机试验的需要.
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