TY - JOUR
T1 - Long-term survival for COPD patients receiving noninvasive ventilation for acute respiratory failure
AU - Vestbo, Jorgen
AU - Titlestad, Ingrid L.
AU - Lassen, Annmarie T.
AU - Vestbo, Jørgen
PY - 2013/4/24
Y1 - 2013/4/24
N2 - Implementation of noninvasive ventilation (NIV) as an add-on treatment has been routinely used in a non-intensive care setting since 2004 for patients with chronic obstructive pulmonary disease (COPD) and acute hypercapnic respiratory failure at a university hospital in Denmark. Although randomized controlled trials show lowered mortality rates in highly selected patients with acute exacerbation and respiratory failure, there are only few reports on long-term survival after receiving NIV. We present long-term all-cause mortality data from patients receiving NIV for the first time. Method: Data from medical records were retrospectively retrieved from all patients receiving NIV for the first time after being admitted acutely to an acute medical ward and further transfer to a respiratory ward with respiratory failure and a diagnosis of COPD in the period January 1, 2005 to December 31, 2007; patients were followed until January 2012. Demographic data collected included age, sex, diagnoses at discharge, and, when present, FEV1; a "not-to-intubate" order was also registered when listed. Results: In total, 253 patients (143 female, 110 male) received NIV for the first time. The median age was 72 years (range 46-91 years). The 30-day mortality rate was 29.3%. The 5-year survival rate was 23.7%. Women showed a trend towards better survival than men (25.7% vs 19.2%, P = 0.25), and the trend was even more pronounced for patients with COPD. Conclusion: The mortality rate of patients receiving NIV is high, as expected in a real-life setting, but with a 5-year survival rate of 23.7% with a trend towards more female than male long-term survivors. © 2013 Titlestad et al, publisher and licensee Dove Medical Press Ltd.
AB - Implementation of noninvasive ventilation (NIV) as an add-on treatment has been routinely used in a non-intensive care setting since 2004 for patients with chronic obstructive pulmonary disease (COPD) and acute hypercapnic respiratory failure at a university hospital in Denmark. Although randomized controlled trials show lowered mortality rates in highly selected patients with acute exacerbation and respiratory failure, there are only few reports on long-term survival after receiving NIV. We present long-term all-cause mortality data from patients receiving NIV for the first time. Method: Data from medical records were retrospectively retrieved from all patients receiving NIV for the first time after being admitted acutely to an acute medical ward and further transfer to a respiratory ward with respiratory failure and a diagnosis of COPD in the period January 1, 2005 to December 31, 2007; patients were followed until January 2012. Demographic data collected included age, sex, diagnoses at discharge, and, when present, FEV1; a "not-to-intubate" order was also registered when listed. Results: In total, 253 patients (143 female, 110 male) received NIV for the first time. The median age was 72 years (range 46-91 years). The 30-day mortality rate was 29.3%. The 5-year survival rate was 23.7%. Women showed a trend towards better survival than men (25.7% vs 19.2%, P = 0.25), and the trend was even more pronounced for patients with COPD. Conclusion: The mortality rate of patients receiving NIV is high, as expected in a real-life setting, but with a 5-year survival rate of 23.7% with a trend towards more female than male long-term survivors. © 2013 Titlestad et al, publisher and licensee Dove Medical Press Ltd.
KW - Acute respiratory failure
KW - COPD
KW - Long-term survival
KW - Niv
U2 - 10.2147/COPD.S42632
DO - 10.2147/COPD.S42632
M3 - Article
C2 - 23650445
SN - 1176-9106
VL - 8
SP - 215
EP - 219
JO - International Journal of COPD
JF - International Journal of COPD
ER -