Newer COPD Oxygen Prescriptions More Likely to Lead to Burn Injuries

Patients with a burn injury were twice as likely to have been prescribed oxygen in the previous 90 days.

Chronic obstructive pulmonary disease (COPD) patients with newer home oxygen prescriptions (within the previous 90 days) are more likely to sustain burn injuries, according to research published in the Mayo Clinic Proceedings.

Researchers from the University of Texas Medical Branch at Galveston (UTMB) retrospectively observed about 2600 COPD patients aged 66 years and older and between January 2001 and December 2010 in order to quantify the risk of brain injury associated with home oxygen use. Additionally, the researchers noted the importance of identifying and examining the risk factors associated with the development of this type of injury.

The patients were targeted based on their risks for burn injury — about 2000 patients had not sustained a burn injury and there were 685 patients included in the analysis who did sustain a burn injury. The researchers noted that, barring smoking cessation, no other COPD intervention is more helpful for patients than continuous oxygen therapy.

However, they continued, oxygen therapy is dangerous for patients who still smoke due to risk of fire hazard. The authors wrote that the number of active smokers who are prescribed oxygen is estimated to be at 15 to 25%, and that a heat source or an open flame near the oxygen gas tank may ignite a fire.

Patients with a burn injury were twice as likely to have been prescribed oxygen in the previous 90 days, compared to those without a burn injury. The burns were likely to have occurred on the face, neck, or hands. During a 22 month period, the absolute risk of burn injury in patients prescribed oxygen therapy was 2.98 per 1000 patients compared to 1.69 per 1000 patients not prescribed oxygen, the researchers said.

For patients prescribed oxygen therapy, the excess risk of a burn injury was 0.704 per 1000 patients per year, meaning that one out of every 1421 patients with COPD who are prescribed oxygen sustain a burn injury each year. The burn injury patients had a 10 fold greater mortality rate than COPD patients who had not sustained a burn injury.

“The benefits of oxygen in COPD patients outweigh the modest risks of burn injury,” senior author Alexander Duarte, MD, who is also a professor in the UTMB’s internal medicine division of pulmonary critical care and sleep medicine, explained in a press release. “However, health care professionals should educate and counsel patients and their families on the potential risk of burn injury and attempt to decrease this risk before prescribing home oxygen therapy.”

The authors added that factors more highly associated with burn injury were male sex, low socioeconomic status, oxygen therapy use, and the presence of 3 or more comorbidities.