Survival and long-term follow-up of tracheostomized patients with COPD treated by home mechanical ventilation. A multicenter French study in 259 patients. French Cooperative Study Group.
To define more clearly the value of home mechanical ventilation by tracheostomy (HMVT) in patients with advanced COPD, a retrospective French multicenter study group analyzed the prognostic factors and long-term survival of 259 patients with severe COPD, who were tracheostomized for at least 1 year. Seventy-eight percent of the patients died by the end of the observation period. The actuarial survival rate for the overall study population was, therefore, 70 percent at 2 years, 44 percent at 5 years, and 20 percent at 10 years. These results appear to be better than those of the major published series and compare to the prognosis of COPD patients treated by long-term oxygen therapy (LTO) 15 hr/24 hr. The parameters most closely correlated with a survival for more than 5 years were age < 65 years, use of an uncuffed cannula, and a PaO2 > 55 mm Hg in room air during the 3 months after tracheostomy (p < 0.01). This study, therefore, confirmed the feasibility of HMVT in COPD and should lead to a review of the place of permanent tracheostomy in the long-term prognosis of severe COPD patients.
Service de Pneumologie, Centre Hospitalier Universitaire (Hôpital de Bois-Guillaume), Rouen, France.
J F
JF
Muir
C
C
Girault
J P
JP
Cardinaud
J M
JM
Polu
D000368:Aged; D005260:Female; D006699:Home Care Services; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012121:Respiration, Artificial; D012189:Retrospective Studies; D014139:Tracheostomy