Five-year experience in providing medical care to patients with bronchopulmonary pathology with chronic hypoxemic respiratory failure

Abstract

Introduction. The article considers the management of medical care for patients with chronic hypoxemic respiratory failure (CHRF), including long-term oxygen therapy (LOT). To achieve this goal in 2013 there was established the St. Petersburg Municipal Pulmonary Center (MPC). The study aimed to assess the results of the MPC activity in 2014 - 2LC138727590CN018. Material and methods. The medical records of patients admitted to the MPC in 2014-2018 were studied. To process the information conventional statistical methods were used. Results. Over the past 5 years, MRC specialists have consulted 13,239 patients, mainly COPD cases. 1,054 patients with CHRF were hospitalized for an additional examination, and 435 cases were indicated to receive LOT. The necessary oxygen concentrator facilities were provided at the expense of the St. Petersburg city budget. Mortality rate accounted for 10.4% by the end of the first year of LOT, 15.1% by the end of the second year, reaching 27.0% and 38.3% by the end of the third and fourth years, respectively. In the group of COPD patients with CHRF (262 patients, 238 men, and 24 women, at the average age of 69 ± 3 years), LOT was accompanied by a decrease in the number of severe exacerbations of the disease (before the LOT - 3 (3; 4) severe exacerbations per year, after a year - 2 (1; 2); p <0.001), as well as cases of referral and duration of stay in the intensive care unit. This led to a decrease in the average cost of inpatient treatment from 264,912 ± 31,277 rubles per year to 134,826 ± 21,277; p <0.001. Conclusion. Early verification and correction of CHRF contribute not only to the decline in the number of exacerbations of respiratory disease but also to the reduction of financial costs necessary for the treatment of such patients.