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Breathlessness and exercise performance to predict mortality in long-term oxygen therapy
Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Respiratory Medicine, Allergology, and Palliative Medicine, Lund, Sweden.
Uppsala University, Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala, Sweden; Region of Gävleborg, Gävle Hospital, Centre for Research and Development, Gävle, Sweden.
Department of Medicine, Blekinge Hospital, Karlskrona, Sweden.
Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Respiratory Medicine, Allergology, and Palliative Medicine, Lund, Sweden.
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2023 (English)In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 62, no Suppl. 67, article id PA3762Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Background: Patients with chronic respiratory failure treated with long-term oxygen therapy (LTOT) often have severe breathlessness, impaired exercise performance, and high but variable mortality that is difficult to predict. We aimed to evaluate breathlessness and exercise performance upon starting LTOT as predictors of overall and short-term mortality.

Methods: This was a longitudinal, population-based study of patients who initiated LTOT between 2015-2018 in Sweden. Breathlessness was measured using the Dyspnea Exertion Scale, and exercise performance using the 30s-Sit-To-Stand test. Associations with overall and three-month mortality were analyzed using Cox-regression. Subgroup analyses were performed for patients with COPD and ILD respectively. The predictive capacity of models was assessed using a C-statistic.

Results: A total of 441 patients (57.6% female, aged 75.4±8.3 years) were analyzed. Both breathlessness and exercise performance were independently associated with overall mortality in the crude models, but only exercise performance remained independently associated with overall mortality when models were adjusted for other predictors, when three-month mortality was analyzed, or when breathlessness and exercise capacity were analyzed concurrently. The multivariable model including exercise performance but not breathlessness provided a relatively high predictive capacity for overall mortality, C-statistic 0.756 (95% CI 0.702-0.810). Similar results were seen in the COPD and ILD subgroups.

Conclusion: Exercise performance as measured by the 30s-STS may be useful to identify patients with higher mortality on LTOT for optimized management and follow-up.

Place, publisher, year, edition, pages
European Respiratory Society , 2023. Vol. 62, no Suppl. 67, article id PA3762
National Category
Respiratory Medicine and Allergy
Identifiers
URN: urn:nbn:se:oru:diva-110748DOI: 10.1183/13993003.congress-2023.PA3762ISI: 001109120506313OAI: oai:DiVA.org:oru-110748DiVA, id: diva2:1829501
Conference
ERS International Congress 2023, Milan, Italy, September 9-13, 2023
Available from: 2024-01-19 Created: 2024-01-19 Last updated: 2024-01-19Bibliographically approved

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