The Home Oxygen Patient, Cigarette Smoking, and Hospital Services

Document Type

Article

Publication Date

10-1-1996

Description

Purpose: To determine the proportion of home oxygen users who continued to smoke after pulmonary rehabilitation and two years of home oxygen use and determine if this habit impacted on outcome. Methods: A retrospective review of the charts of all patients provided supplemental home oxygen for at least two years through the Mountain Home VAMC was conducted. Smokers and nonsmokers were identified by the measured carboxyhemoglobin levels from their semiannual blood gas analyses, using a cut-off level of 2.5%. For each group an analysis of age, serum Hgb, PaCO2, PaO2/PAO2 ratio, and ER visits were compared utilizing the two sample t-test and accepting a p value of 0.05 as statistically significant. Results: 80 patients met the inclusion criteria. 55 patients with COHgb level <2.5% were considered nonsmokers (mean 1.6 and S.D.±0.3), while 25 patients with levels <2.5% were considered smokers (mean 5.8 S.D.±2.5). The only variable that differed significantly between the smokers and nonsmokers was an increased number of ER visits by the smokers (2.6±1.8 vs. 0.9±1.0) (p=0.001). Conclusion: 31.2% of patients continued to smoke cigarettes and more frequently used Emergency Department services. Clinical Implications: The cost of supplemental home oxygen and hospital services for those patients who smoke and use home oxygen could be reduced by identifying these individuals with a direct measure of the COHgb and allow additional pulmonary rehabilitation with emphasis on smoking cessation.

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