Proposed Topic (Most preferred): :
Clinical Safety and Quality Service I (Projects aiming to improve efficiency and effectiveness of care delivery to meet international standards)
Proposed Topic (Second preferred): :
Research and Innovations (new projects / technology / innovations / service models)
Authors (including presenting author) :
Tang KB(1), Suen HK(2), Mak HM(2), Yan WW(1)
Affiliation :
(1)Intensive Care Unit, Pamela Youde Nethersole Eastern Hospital (2)Accident and Emergency Department, Pamela Youde Nethersole Eastern Hospital
Introduction :
Hyperbaric oxygen therapy (HBOT) is administration of nearly 100% oxygen to the patient in a pressurized chamber with the pressure above atmospheric pressure. HBOT is indicated for various medical conditions, including delayed radiation injury, chronic non-healing wounds, decompression sickness, and carbon monoxide poisoning. Pamela Youde Nethersole Eastern Hospital (PYNEH) has been providing HBOT services since 2018, and irradiation cystitis is the commonest indication at our centre.
Objectives :
To review the outcomes of patients with irradiation cystitis treated with HBOT. To find out factors associated with non-responders.
Methodology :
This is a retrospective cohort study in which patients with irradiation cystitis treated with HBOT at our centre between May 2022 and December 2023 were recruited. Patient demographic data, time from referral to treatment, and the number of HBOT sessions were recorded. The severity of symptoms before and after completion of HBOT was measured using the Late Effects Normal Tissues- Subjective, Objective, Management, Analytic (LENT-SOMA) score for irradiation cystitis. Patient case notes during follow up were reviewed after HBOT for residual symptoms and readmission due to gross haematuria. A responder is defined as a patient with post-treatment improvement of the LENT-SOMA score by more than 50%, or a patient with a haematuria score decrease of 2 or more, or a patient with completely resolved haematuria after HBOT.
Result & Outcome :
Forty-three patients were recruited, with a mean LENT-SOMA score of 13.44+/-6.81, and a mean time from referral to the first treatment of 6.3+/-4.2 months. 79.1% of patients responded positively to HBOT, with 66.7% of patients having their haematuria completely resolved after HBOT. The majority of patients who showed improvement (79.4%) remained improved during follow-up. Among patients without haematuria after HBOT, 71.4% remained asymptomatic during follow-up. Nine patients (20.9%) were readmitted due to gross haematuria after HBOT treatment, with a mean time from the last session of HBOT to readmission of 6+/-3.9 months. After regression analysis, high pre-treatment LENT-SOMA scores is the only factor associated with non-responders at the end of HBOT, recurrence of symptoms, and readmission. HBOT is an effective treatment for irradiation cystitis, with an overall cure rate for haematuria of 66.7%. HBOT remains effective after treatment, with most recurrent haematuria episodes being mild. Patients with high pre-treatment LENT-SOMA scores are associated with higher treatment failure, recurrence and readmission rate.
