The effect of oxygen on dyspnea in patients who are terminally ill has not been established. ![]() The potential influence of oxygen use on survival in patients with terminal cancer and low oxygen saturation may have important implications for end-of-life decision-making. Studies have found that patients, caregivers, and healthcare providers perceive oxygen as life-sustaining. However, it is not uncommon that the family hopes for prolonged survival, or healthcare providers recommend that oxygen be used for fear that not using it hastens death, especially in patients with low oxygen saturation. The use of oxygen is sometimes intended to alleviate dyspnea in patients with terminal cancer. Low oxygen saturation is a common finding in patients with terminal cancer and thus supplemental oxygen is frequently provided to patients with terminal cancer. It may not be necessary to use oxygen for prolongation of survival in such patients, particularly in those without dyspnea. ![]() Oxygen use was not significantly associated with survival in patients with advanced cancer and low oxygen saturation, after adjusting for potential confounders. In multivariable analysis, the adjusted hazard ratio (HR) of oxygen use was 0.68 (95% confidence interval 0.39–1.17) for death and 0.70 (0.38–1.27) for death at home. Of 433 identified patients with advanced cancer, we enrolled 137 patients (oxygen use, n = 35 no oxygen use, n = 102) who developed low oxygen saturation. Cox proportional hazards regression was used to investigate the effect of oxygen use on overall survival and survival at home, adjusted for systolic blood pressure, decreased level of consciousness, dyspnea, oral intake, performance status, and cardiopulmonary comorbidity. Adult patients in home care with advanced cancer demonstrating first low oxygen saturation (less than 90%) detected in home visits were consecutively included in the study. ![]() We conducted a retrospective cohort study at a primary care practice in suburban Tokyo. We aimed to evaluate the association between oxygen use and survival in patients with advanced cancer and low oxygen saturation in home care. The role of oxygen therapy in end-of-life care for patients with advanced cancer is incompletely understood.
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