[New trends in home oxygen therapy (HOT) after the introduction of health insurance coverage in Okinawa and factors contributing to long-term survival].
A total of 179 cases given HOT after introduction of health insurance coverage in 1985 were reported from 12 medical institutes in Okinawa and were compared with 110 cases followed at Okinawa Chubu Hospital during 1976-1985, prior to insurance coverage. The number of patients on HOT have rapidly increased after insurance coverage not only in our institute but also in other institutes in Okinawa and the patients with emphysema formed the largest group. The oxygen enricher is now utilized more than the compressed gas system, accounting for about 70% of all patients compared with the previous figure of 7.3%. Average PaO2 on room air was higher (from 42 Torr to 49 Torr) and the levels of PaO2 maintained by HOT had 2 peaks, one in the 60-65 Torr range and the other in the 75-80 Torr range in patients newly given HOT. The patients with emphysema, who had the worst prognosis in the past, remarkably improved and showed no statistical difference from patients with chronic bronchitis or bronchiectasis in terms of long-term survival. The female patients had better prognosis than males, but the reason is still unclear to us. The absolute volume of FEV1.0 and the presence or absence of cor pulmonale have not affected the long-term survival. A group of the patients with CO2 retention (bronchitic in type) did not benefit from HOT in terms of long-term survival unless their PaO2 levels on room air were below 50 Torr and it was felt that PaO2 levels of 50-59 were too mild in severity for application of HOT.(ABSTRACT TRUNCATED AT 250 WORDS)
Miyagi
S
S
Irei
M
M
Matsumoto
T
T
Jinno
S
S
D000368:Aged; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007348:Insurance, Health; D007564:Japan; D008297:Male; D010102:Oxygen Inhalation Therapy / Q000639:trends*; D011379:Prognosis; D012131:Respiratory Insufficiency / Q000401:mortality / Q000628:therapy*; D012648:Self Care; D012737:Sex Factors; D015996:Survival Rate