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Burn injury during long-term oxygen therapy in Denmark and Sweden: the potential role of smoking
Lund Univ, Skane Univ Hosp, Dept Resp Med, Lund, Sweden..
Hvidovre Univ Hosp, Resp Dept, Copenhagen, Denmark..
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery. Univ Uppsala Hosp, Burn Ctr, Dept Plast & Maxillofacial Surg, Uppsala, Sweden.ORCID iD: 0000-0002-9735-1434
Lund Univ, Skane Univ Hosp, Dept Resp Med, Lund, Sweden..
2017 (English)In: The International Journal of Chronic Obstructive Pulmonary Disease, ISSN 1176-9106, E-ISSN 1178-2005, Vol. 12, p. 193-197Article in journal (Refereed) Published
Abstract [en]

Background: Long-term oxygen therapy (LTOT) increases life expectancy in patients with COPD and severe hypoxemia. Smoking is the main cause of burn injury during LTOT. Policy regarding smoking while on LTOT varies between countries. In this study, we compare the incidence of burn injury that required contact with a health care specialist, between Sweden (a country with a strict policy regarding smoking while on LTOT) and Denmark (a country with less strict smoking policy). Methods: This was a population-based, cohort study of patients initiating LTOT due to any cause in Sweden and Denmark. Data on diagnoses, external causes, and procedures were obtained from the Swedish and Danish National Patient Registers for inpatient and outpatient care. Patients were followed from January 1, 2000, until the first of the following: LTOT withdrawal, death, or study end (December 31, 2009). The primary end point was burn injury during LTOT. Results: A total of 23,741 patients received LTOT in Denmark and 7,754 patients in Sweden. Most patients started LTOT due to COPD, both in Sweden (74%) and in Denmark (62%). The rate of burn injury while on LTOT was higher in Denmark than in Sweden; 170 (95% confidence interval [CI], 126-225) vs 85 (95% CI, 44-148) per 100,000 person-years; rate ratio 2.0 (95% CI, 1.0-4.1). The risk remained higher after adjustment for gender, age, and diagnosis in multivariate Cox regression, hazard ratio 1.8 (95% CI, 1.0-3.5). Thirty-day mortality after burn injury was 8% in both countries. Conclusion: Compared to Sweden, the rate of burn injury was twice as high in Denmark where smoking is not a contraindication for prescribing LTOT.

Place, publisher, year, edition, pages
2017. Vol. 12, p. 193-197
Keyword [en]
burn injury, COPD, long-term oxygen therapy, smoking
National Category
Public Health, Global Health, Social Medicine and Epidemiology Surgery
Identifiers
URN: urn:nbn:se:uu:diva-315062DOI: 10.2147/COPD.S119949ISI: 000391326600003PubMedID: 28123292OAI: oai:DiVA.org:uu-315062DiVA, id: diva2:1077836
Funder
Swedish Society of MedicineSwedish Heart Lung Foundation
Available from: 2017-03-01 Created: 2017-03-01 Last updated: 2017-11-29Bibliographically approved

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