{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T05:17:41Z","timestamp":1788499061677,"version":"build-2803163510"},"reference-count":28,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T00:00:00Z","timestamp":1787961600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: Hypercapnic respiratory failure (HRF) is a serious complication of chronic obstructive pulmonary disease (COPD) and is associated with increased morbidity, mortality, and healthcare utilisation. National HRF trends among patients with COPD remain poorly characterised in Lithuania, and the knowledge of prehospital emergency-care professionals regarding oxygen therapy and hypercapnia has not been evaluated. Methods: This study comprised two components. First, a cross-sectional online survey assessed knowledge of COPD, hypercapnia, and oxygen therapy among prehospital emergency-care professionals (EMS physicians, emergency nurses, EMS paramedics, and paramedics); three questionnaire items whose designated correct answers could not be unambiguously supported were excluded from the knowledge score, and the original 10-item score was retained as a sensitivity analysis. Second, nationwide electronic health record data from the Lithuanian national health record system (ESPBI IS, 2020\u20132023) were analysed retrospectively: patients with COPD and concomitant chronic HRF were identified using ICD-10-AM diagnostic codes, and the number of patients with a recorded J96.11 diagnosis irrespective of underlying disease was obtained as a national denominator. Proportions are reported with 95% confidence intervals and temporal trends as absolute changes in percentage points; multivariable logistic regression was used to estimate odds ratios adjusted for age group and sex. Between-year differences were tested using the \u03c72 test with Holm-adjusted pairwise comparisons, and the association between sex and chronic HRF was expressed as an odds ratio. All tests were two-sided, and p &lt; 0.05 was considered significant. Results: Among the 65 prehospital emergency-care professionals surveyed, knowledge of hypercapnia was relatively high: 78.5% (95% CI 67.0\u201386.7) correctly defined it and 72.3% (95% CI 60.4\u201381.7) identified its symptoms, whereas 58.5% (95% CI 46.3\u201369.6) identified the recommended SpO2 target range of 88\u201392%. Respondents answered a median of 5 of the 7 scored knowledge items correctly (IQR 4\u20136). Total knowledge scores differed by professional role (p = 0.034) but not by years of experience, sex, or frequency of COPD contact; the sensitivity analysis using the original 10-item score gave the same pattern (p = 0.006). In the national electronic health record data, the COPD population increased from 27,239 to 32,446 (+19.1%) between 2020 and 2023, while the number of COPD patients with a recorded chronic HRF diagnosis rose from 160 to 291 (+81.9%). The proportion rose from 0.59% (95% CI 0.50\u20130.69) to 0.90% (95% CI 0.80\u20131.01), an absolute increase of 0.31 percentage points (95% CI 0.17\u20130.45; risk ratio 1.53, 95% CI 1.26\u20131.85). Men had higher odds than women after adjustment for age (adjusted OR 1.55, 95% CI 1.28\u20131.88), and adjusted odds were lowest in patients aged 80 years or older. Across the four annual cross-sections, COPD accounted for 41.5% of patient-year observations with a recorded J96.11 diagnosis nationally. Conclusions: Knowledge of COPD, hypercapnia, and oxygen therapy varied among the prehospital emergency-care professionals surveyed, with one of the lowest proportions of correct responses observed for the recommended target oxygen saturation range. National electronic health record data showed an increase in the proportion of patients with COPD who had a recorded diagnosis of chronic HRF between 2020 and 2023. These components were analysed independently, and no relationship between professional knowledge and temporal trends in recorded diagnoses was assessed. The electronic health record findings support continued monitoring and recognition of chronic HRF in COPD, whereas the survey findings support further evaluation of targeted education on oxygen therapy in the prehospital setting.<\/jats:p>","DOI":"10.3390\/diagnostics16172782","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T04:24:03Z","timestamp":1788150243000},"page":"2782","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Chronic Hypercapnic Respiratory Failure in COPD in Lithuania: National Registry Trends and Prehospital Emergency-Care Professionals\u2019 Knowledge of Hypercapnia and Oxygen Therapy"],"prefix":"10.3390","volume":"16","author":[{"given":"Rasa","family":"Gauronskait\u0117","sequence":"first","affiliation":[{"name":"Clinic of Chest Diseases, Immunology and Allergology, Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, LT-01513 Vilnius, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anrenas","family":"Karvelis","sequence":"additional","affiliation":[{"name":"Department of Health Sciences and Technologies, St. Ignatius Loyola College, LT-44286 Kaunas, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2726-1991","authenticated-orcid":false,"given":"Edvardas","family":"Danila","sequence":"additional","affiliation":[{"name":"Clinic of Chest Diseases, Immunology and Allergology, Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, LT-01513 Vilnius, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rolandas","family":"Zablockis","sequence":"additional","affiliation":[{"name":"Clinic of Chest Diseases, Immunology and Allergology, Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, LT-01513 Vilnius, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e2346598","DOI":"10.1001\/jamanetworkopen.2023.46598","article-title":"Global Burden of Chronic Obstructive Pulmonary Disease Through 2050","volume":"6","author":"Boers","year":"2023","journal-title":"JAMA Netw. 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(In Lithuanian)."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/17\/2782\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T04:34:33Z","timestamp":1788496473000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/17\/2782"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,29]]},"references-count":28,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["diagnostics16172782"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics16172782","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,29]]}}}