Evaluation of the efficacy of cylinder oxygen therapy in patients admitted to Wangata General Referral Hospital: recovered and deceased patients (DRC): a retrospective cohort study

Abstract

Introduction: Oxygen is an essential medicine, but in rural and peri-urban hospitals in Central Africa, access to oxygen via concentrators is limited. In Wangata (DRC), oxygen therapy relies almost exclusively on cylinders. The aim was to assess the clinical effectiveness of this practice and to identify factors associated with failure.

Methods: A retrospective cohort study including 300 hospitalised patients who received oxygen via cylinders (January–December 2025). Criteria: SpO₂ ≤ 90% on room air, duration ≥ 6 hours. Univariate, bivariate (χ²) and multivariate logistic regression analyses.

Results: 58% of patients had an initial SpO₂ ≤ 85%. The median time to obtain a full cylinder was 4 hours (IQR: 2–7 h). Failure of oxygen therapy (death or SpO₂ < 90% at 48 h) occurred in 32.7% (n=98). In multivariate analysis, the independent predictors of failure were: time to obtain oxygen > 4 hours (OR = 5.2; 95% CI: 2.7–10.1), regulator leak (OR = 4.1; 95% CI: 1.9–8.8), cylinder failure before 12 hours (OR = 3.8; 95% CI: 1.7–8.5), baseline SpO₂ ≤ 85% (OR = 3.0; 95% CI: 1.4–6.2) and absence of a functional pulse oximeter (OR = 2.3; 95% CI: 1.1–4.9).

Conclusion: Oxygen therapy using oxygen cylinders at Wangata is ineffective in one third of cases, due to logistical delays, equipment leaks and cylinder failures. Simple nursing interventions (checking for leaks, pulse oximeters, spare cylinders) could significantly reduce morbidity and mortality.

Keywords: oxygen therapy, oxygen cylinder, nursing care, resource-limited countries, DRC, General Referral Hospital.

Received Date: February 22, 2026

Accepted Date: March 14, 2026

Published Date: April 02, 2026

Available Online at: https://www.ijsrisjournal.com/index.php/ojsfiles/article/view/657