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. 2013:8:215-9.
doi: 10.2147/COPD.S42632. Epub 2013 Apr 26.

Long-term survival for COPD patients receiving noninvasive ventilation for acute respiratory failure

Ingrid L Titlestad  1 , Annmarie T Lassen, Jørgen Vestbo
Affiliations

Long-term survival for COPD patients receiving noninvasive ventilation for acute respiratory failure

Ingrid L Titlestad et al. Int J Chron Obstruct Pulmon Dis. 2013.

Abstract

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.

Keywords: COPD; NIV; acute respiratory failure; long-term survival.

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Figures

Figure 1
Figure 1
Survival plot of patients admitted to a respiratory ward (2005–2007) receiving noninvasive ventilation for the first time. Notes: Total 253 patients (143 female and 110 male). 5-year survival for females 25.7% and males 19.2%. P = 0.25 (logrank).
Figure 2
Figure 2
Survival plot and observation time (years) of COPD patients admitted to a respiratory ward (2005–2007) receiving noninvasive ventilation for the first time. Notes: Total 216 patients (143 female and 110 male). 5-year survival for females 27.9% and males 17.9%. P = 0.083 (logrank).
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