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- Title
Long-term outcomes after acute hypercapnic COPD exacerbation.
- Authors
Fazekas, Andreas S.; Aboulghaith, Mei; Kriz, Ruxandra C.; Urban, Matthias; Breyer, Marie-Kathrin; Breyer-Kohansal, Robab; Burghuber, Otto-Chris; Hartl, Sylvia; Funk, Georg-Christian
- Abstract
Background: Non-invasive ventilation (NIV) is used to treat acute hypercapnic respiratory failure (AHRF) in patients with chronic obstructive pulmonary disease (COPD); however, long-term outcomes following discharge are largely unknown. This study aimed to characterize long-term outcomes and identify associated markers in patients with COPD after surviving the first episode of HRF requiring NIV.Methods: This study retrospectively analyzed 122 patients, mean age 62 ± 8 years, 52% female and forced expiratory volume in 1 s (FEV1) predicted 30 ± 13%, admitted with an acute hypercapnic exacerbation of COPD and receiving a first-ever NIV treatment between 2000 and 2012.Results: A total of 40% of the patients required hospital readmission due to respiratory reasons within 1 year. Persistent hypercapnia leading to the prescription of domiciliary NIV, older age and lower body mass index (BMI) were risk factors for readmission due to respiratory reasons. Survival rates were 79% and 63% at 1 and 2 years after discharge, respectively. A shorter time to readmission and recurrent hypercapnic failure, lower BMI and acidemia on the first admission, as well as hypercapnia at hospital discharge were correlated with a decreased long-term survival.Conclusion: Patients with COPD surviving their first episode of AHRF requiring NIV are at high risk for readmission and death. Severe respiratory acidosis, chronic respiratory failure and a lower BMI imply shorter long-term survival.
- Subjects
NONINVASIVE ventilation; RESPIRATORY insufficiency; OBSTRUCTIVE lung diseases; HYPERCAPNIA; MEDICAL care
- Publication
Wiener Klinische Wochenschrift, 2018, Vol 130, Issue 19/20, p561
- ISSN
0043-5325
- Publication type
Article
- DOI
10.1007/s00508-018-1364-6