PMID- 36525684 OWN - NLM STAT- MEDLINE DCOM- 20221220 LR - 20231221 IS - 1833-3516 (Print) IS - 2209-1491 (Electronic) IS - 1833-3516 (Linking) VI - 52 IP - 4 DP - 2022 Dec 20 TI - Delayed treatment for decompression illness: factors associated with long treatment delays and treatment outcome. PG - 271-276 LID - 10.28920/dhm52.4.271-276 [doi] AB - INTRODUCTION: Effectiveness of delayed hyperbaric oxygen treatment (HBOT) for decompression illness (DCI) and factors affecting treatment delays have not been studied in large groups of patients. METHODS: This retrospective study included 546 DCI patients treated in Finland in the years 1999-2018 and investigated factors associated with recompression delay and outcome. Treatment outcome was defined as fully recovered or presence of residual symptoms on completion of HBOT. The symptoms, use of first aid oxygen, number of recompression treatments needed and characteristics of the study cohort were also addressed. RESULTS: Delayed HBOT (> 48 h) remained effective with final outcomes similar to those treated within 48 h. Cardio-pulmonary symptoms were associated with a shorter treatment delay (median 15 h vs 28 h without cardiopulmonary symptoms, P < 0.001), whereas mild sensory symptoms were associated with a longer delay (48 vs 24 h, P < 0.001). A shorter delay was also associated with only one required HBOT treatment (median 24 h vs 34 h for those requiring multiple recompressions) ( P = 0.002). Tinnitus and hearing impairment were associated with a higher proportion of incomplete recoveries (78 and 73% respectively, P < 0.001), whereas a smaller proportion of cases with tingling/itching (15%, P = 0.03), nausea (27%, P = 0.03), motor weakness (33%, P = 0.05) and visual disturbances (36%, P = 0.04) exhibited residual symptoms. Patients with severe symptoms had a significantly shorter delay than those with mild symptoms (median 24 h vs 36 h respectively, P < 0.001), and a lower incidence of complete recovery. CONCLUSIONS: Delayed HBOT remains an effective and useful intervention. A shorter delay to recompression is associated with fewer recompressions required to achieve recovery or recovery plateau. CI - Copyright: This article is the copyright of the authors who grant Diving and Hyperbaric Medicine a non-exclusive licence to publish the article in electronic and other forms. FAU - Sokolowski, Sofia A AU - Sokolowski SA AD - University of Eastern Finland, Kuopio, Finland. FAU - Raisanen-Sokolowski, Anne K AU - Raisanen-Sokolowski AK AD - Department of Pathology, Helsinki University, Helsinki, Finland. AD - HUSLAB, Pathology, Helsinki University Hospital, Helsinki, Finland. FAU - Tuominen, Laura J AU - Tuominen LJ AD - Department of Pathology, Helsinki University, Helsinki, Finland. AD - Department of Anaesthesia, Tampere University Hospital, Tampere, Finland. FAU - Lundell, Richard V AU - Lundell RV AD - Department of Pathology, Helsinki University, Helsinki, Finland. AD - Diving Medical Centre, Centre for Military Medicine, Finnish Defence Forces, Helsinki, Finland. AD - Corresponding author: Dr Richard V Lundell, Diving Medical Centre, Centre for Military Medicine, Finnish Defence Forces, Helsinki, Finland, richard.lundell@helsinki.fi. LA - eng PT - Journal Article PL - Australia TA - Diving Hyperb Med JT - Diving and hyperbaric medicine JID - 101282742 SB - IM MH - Humans MH - *Decompression Sickness/therapy/diagnosis MH - Time-to-Treatment MH - Retrospective Studies MH - *Hyperbaric Oxygenation MH - Treatment Outcome MH - Decompression PMC - PMC10026386 OTO - NOTNLM OT - Decompression sickness OT - Epidemiology OT - First aid oxygen OT - Hyperbaric oxygen treatment OT - Remote locations OT - Treatment sequelae COIS- Conflict of interest and funding: nil EDAT- 2022/12/17 06:00 MHDA- 2022/12/21 06:00 PMCR- 2023/12/20 CRDT- 2022/12/16 18:02 PHST- 2022/03/31 00:00 [received] PHST- 2022/08/18 00:00 [accepted] PHST- 2022/12/16 18:02 [entrez] PHST- 2022/12/17 06:00 [pubmed] PHST- 2022/12/21 06:00 [medline] PHST- 2023/12/20 00:00 [pmc-release] AID - 10.28920/dhm52.4.271-276 [doi] PST - ppublish SO - Diving Hyperb Med. 2022 Dec 20;52(4):271-276. doi: 10.28920/dhm52.4.271-276.