COPD: no clear benefit from home oxygen with moderate hypoxia

Clinical bottom line (level 1b-)

  1. Patients with COPD and moderate hypoxia who receive home oxygen were not clearly less likely to die than patients who did not.
Gorecka et al: Thorax 1997; 52: 674-679
Expires November 2003

The study

Unblinded ?concealed randomised trial with intention-to-treat
Setting: 9 long-term oxygen therapy centres, Poland

135 patients (aged 40 to 79; mean 61, 76% male) with COPD (FEV1/FVC < 70%) and moderate hypoxia (pO2 7.4 to 8.7 kPa)

Excluded if
  • serious disease others than lungs that might affect survival
  • aged < 40 or > 80


    • Control Group: (n = 67, 67 analysed): conventional therapy
    Experimental Group: (n = 68, 68 analysed): conventional therapy and oxygen for at least 17 hours a day to maintain paO 2 > 8.7 pKa. Patients spent on average 14 hours a day breathing oxygen.
    All patients were advised to give up smoking and all declared to be non-smokers at the time of prescription of oxygen.
    100% followed for 3 years

    The evidence

    Outcome Time to outcome CEREERRRR
    (95% CI)    		ARR
    (95% CI)    		NNT
    (95% CI)
    death 3 years 32
    (47.8%)    		 38
    (55.9%)    		 -17%
    (-62% to 16%)    		 -8.12%
    (-24.9% to 8.68%)    		 -12
    (NNT = 12 to infinity;
    NNH = 4 to infinity)

    Comments

    1. The study is too small to show any difference between the two groups.
    2. Once reaching the final stages of COPD the place of oxygen therapy has to be reserved for the end phase of the disease.

    Citation

    1. Gorecka D, Gorzela K, Sliwinski P, et al: effect of long term oxygen therapy on survival in patients with chronic obstructive pulmonary disease with moderate hypoxia. Thorax 1997; 52: 674-679
    Search Terms:
    Contributor: Chris Ball and Clare Wotton, November 1999
    Reviewer: Chris van Weel

    Clinical Question.
    Patient COPD with moderate hypoxia
    Intervention or Exposure home oxygen
    Comparison no oxygen
    Outcome death