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EP25-336-23 Supplemental oxygen in Queen Elizabeth Central Hospital Malawi: a prospective cohort study of patients admitted to medical wards

Thomson, H, Mlaviwa, M, Rylance, Jamie ORCID:, Jones, H, Wang, R, Reuben, M and Stolbrink, M (2020) 'EP25-336-23 Supplemental oxygen in Queen Elizabeth Central Hospital Malawi: a prospective cohort study of patients admitted to medical wards' in THE 51ST UNION WORLD CONFERENCE ON LUNG HEALTH, Online, 20-24th October 2020.

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Background: Oxygen is listed as an essential drug by the World Health Organisation and has been shown to reduce mortality in the context of hypoxia. In low-re- source settings the provision of oxygen seldom meets the demand. This study aims to explore the predictors and the observed time-course of hypoxaemia, and thus bet- ter rationalize distribution of oxygen therapy in lower- middle income countries.
Design/Methods: We conducted a prospective cohort study of adults with hypoxaemia that received oxygen therapy and were admitted to medical wards at a teach- ing hospital in Malawi between January and March 2020. Vital signs and oxygen therapy were recorded dai- ly. Study end-points were death, discharge from hospital or continued inpatient at day 14. Kaplan-Meier and Cox regression analysis was used for time-to-event analysis. Results: 33 patients were included in the study (median age 45years [interquartile range (IQR) 33-61years]). The median oxygen saturations at initiation of oxygen ther- apy was 84% (IQR 76-87%). Oxygen delivery devices were often shared with other patients (10 [33.3%]) and the flow rate was often unknown (14 [46.7%]), mostly because of broken equipment (8 [57%]).
The median length of time receiving oxygen therapy was 3 days (IQR 1-7days). Death was the most common end point (16 [48.5%]) and pneumonia the predominant final diagnosis (14 [42.4%]). The presence of a chest radiograph and being an ex- or never smoker had a re- duced hazard of short oxygen therapy (HR 0.08, 95 % CI 0.02 – 0.30; HR 0.01, 95 % CI 0.00 – 0.22; HR 0.03, 95 % CI 0.00 – 0.78 respectively).
Conclusions: The delivery of oxygen therapy in lower- middle income countries is challenging; there is a lack of functioning equipment to allow delivery of titrated oxygen therapy and limited resources result in devices being shared. Patients receiving oxygen in this setting were relatively young and at a high risk of death.

Item Type: Conference or Workshop Item (Poster)
Additional Information: Published in The International Journal of Tuberculosis and Lung Disease, 'The Abstract Book', Vol 24 No 10 October 2020 Supplement 2
Subjects: WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WF Respiratory System > WF 20 Research (General)
WF Respiratory System > Lungs > WF 600 Lungs
WX Hospitals and Other Health Facilities > WX 20 Research (General)
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Related URLs:
Depositing User: Stacy Murtagh
Date Deposited: 27 Oct 2020 14:13
Last Modified: 11 Nov 2020 12:52


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