Long-term survival following initiation of home non-invasive ventilation: a European study

被引：54

作者：

Patout, Maxime ^{[1
,2
,3
,4
]}

Lhuillier, Elodie ^{[1
,2
,3
,4
,5
]}

Kaltsakas, Georgios ^{[3
,4
]}

Benattia, Amira ^{[1
,2
]}

Dupuis, Johan ^{[6
]}

Arbane, Gill ^{[3
,4
]}

Declercq, Pierre-Louis ^{[1
,2
]}

Ramsay, Michelle ^{[3
,4
]}

Marino, Philip ^{[3
,4
]}

Molano, Luis-Carlos ^{[1
,2
]}

Artaud-Macari, Elise ^{[1
,2
]}

Viacroze, Catherine ^{[1
,2
]}

Steier, Joerg ^{[3
,4
,7
]}

Douiri, Abdel ^{[8
,9
]}

Muir, Jean-Francois ^{[1
,2
]}

Cuvelier, Antoine ^{[1
,2
]}

Murphy, Patrick Brian ^{[3
,4
,7
]}

Hart, Nicholas ^{[3
,4
,7
]}

机构：

[1] UNIRouen, EA3830 GRHV, Inst Res & Innovat Biomed IRIB, Normandie Univ, F-76000 Rouen, France

[2] UNIRouen, Rouen Univ Hosp, Serv Pneumol Oncol Thorac & Soins Intensifs Resp, Normandie Univ, F-76000 Rouen, France

[3] Guys & St Thomas NHS Fdn Trust, Lane Fox Clin Resp Physiol Res Ctr, London SE1 7EH, England

[4] Guys & St Thomas NHS Fdn Trust, Lane Fox Resp Serv, London, England

[5] Ctr Henri Becquerel, Unite Rech Clin, Rouen, Haute Normandie, France

[6] ASTEN Sante, Isneauville, France

[7] Kings Coll London, Ctr Human & Appl Physiol Sci, London, England

[8] Guys & St Thomas NHS Trust, London, England

[9] Kings Coll London, Natl Inst Hlth Res Comprehens Biomed Res Ctr, London, England

来源：

THORAX | 2020年 / 75卷 / 11期

关键词：

non invasive ventilation; sleep apnoea; OBESITY-HYPOVENTILATION SYNDROME; OBSTRUCTIVE PULMONARY-DISEASE; POSITIVE-PRESSURE VENTILATION; CHRONIC RESPIRATORY-FAILURE; GERMAN NATIONAL GUIDELINE; MECHANICAL VENTILATION; HYPERCAPNIC COPD; AIRWAY PRESSURE; OXYGEN-THERAPY; HIGH-INTENSITY;

D O I：

10.1136/thoraxjnl-2019-214204

中图分类号：

R56 [呼吸系及胸部疾病];

学科分类号：

摘要：

Introduction Although home non-invasive ventilation (NIV) is increasingly used to manage patients with chronic ventilatory failure, there are limited data on the long-term outcome of these patients. Our aim was to report on home NIV populations and the long-term outcome from two European centres. Methods Cohort analysis including all patients established on home NIV from two European centres between 2008 and 2014. Results Home NIV was initiated in 1746 patients to treat chronic ventilatory failure caused by (1) obesity hypoventilation syndrome +/- obstructive sleep apnoea (OHS +/- OSA) (29.5%); (2) neuromuscular disease (NMD) (22.7%); and (3) obstructive airway diseases (OAD) (19.1%). Overall cohort median survival following NIV initiation was 6.6 years. Median survival varied by underlying aetiology of respiratory failure: rapidly progressive NMD 1.1 years, OAD 2.7 years, OHS +/- OSA >7 years and slowly progressive NMD >7 years. Multivariate analysis demonstrated higher mortality in patients with rapidly progressive NMD (HR 4.78, 95% CI 3.38 to 6.75), COPD (HR 2.25, 95% CI 1.64 to 3.10), age >60 years at initiation of home NIV (HR 2.41, 95% CI 1.92 to 3.02) and NIV initiation following an acute admission (HR 1.38, 95% CI 1.13 to 1.68). Factors associated with lower mortality were NIV adherence >4 hours per day (HR 0.64, 95% CI 0.51 to 0.79), OSA (HR 0.51, 95% CI 0.31 to 0.84) and female gender (HR 0.79, 95% CI 0.65 to 0.96). Conclusion The mortality rate following initiation of home NIV is high but varies significantly according to underlying aetiology of respiratory failure. In patients with chronic respiratory failure, initiation of home NIV following an acute admission and low levels of NIV adherence are poor prognostic features and may be amenable to intervention.

引用

页码：965 / 973

页数：9