Effect of Long-Term Oxygen Therapy on Reducing Rehospitalization of Patients with Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis.

ABSTRACT

INTRODUCTION: The aim of this work is to evaluate whether the addition of home oxygen therapy (HOT) would reduce readmission in chronic obstructive pulmonary disease (COPD) patients. METHODS: PubMed, ScopeMed, Cochrane, Scopus, and Google Scholar databases were searched. The search strategy used the following keywords "chronic obstructive pulmonary disease", the intervention "long-term oxygen therapy", and the outcome "readmission" combined with the AND operator. The Newcastle-Ottawa Scale and Jadad Scale were used for assessing the quality of cohort studies and clinical trials, respectively. A random-effects model was employed in this study after calculating the standard errors by 95% confidence intervals. The I2 statistic and Cochran's Q-test were used to measure heterogeneity. To address heterogeneity, subgroup analyses were carried out according to the length of LTOT, which was classified as "over 8 months" and "under 8 months". RESULTS: Seven studies were included in the analysis. In the pooled analysis, the RR [CI95%, p value], heterogeneity criteria for readmission reduced by 1.542 [1.284-1.851, < 0.001], I2 = 60%, and 1.693 [1.645-1.744, < 0.001], I2 = 60% for patients with a length of LTOT treatment under and above 8 months, respectively. A sensitivity analysis was conducted by systematically omitting each study, and it showed no influential studies. Egger's test indicated no publication bias (p = 0.64). CONCLUSIONS: Based on our results in this systematic review, long-tern oxygen therapy (LTOT) at home was associated with a significantly lower risk ratio of hospital readmission. However, the sample sizes in the studies necessitate larger RCTs to evaluate the effect of LTOT on readmission in COPD patients.