title: Predictors of the need to initiate noninvasive ventilation in stable outpatients with acute exacerbation of chronic obstructive pulmonary disease.
abstract: OBJECTIVE
  Predictors of the need to initiate noninvasive ventilation (NIV) in stable COPD outpatients with acute exacerbation of chronic obstructive pulmonary disease (COPD-AE) are insufficiently defined. The objective of this study was to investigate predictors of the need to initiate NIV in stable COPD-AE outpatients.
  
  
  METHODS
  A total of 140 consecutive stable COPD outpatients who were hospitalized for COPD-AE for the first time were retrospectively examined. Demographic and clinical parameters measured in the stable state were evaluated, including data for arterial blood gases, the pulmonary function, body mass index and dyspnea scores.
  
  
  RESULTS
  Of the 140 patients included, NIV was used in 32 (23%) patients. In a univariate Cox proportional hazards analysis, the baseline partial pressure of arterial carbon dioxide (PaCO2) (hazard ratio (HR), 1.14 per mmHg; 95% confidence interval (CI), 1.08-1.21) and forced expiratory volume in one second (FEV1)% predicted (HR, 1.03 per %; 95% CI, 1.01-1.05) were identified to be significant predictors. A multivariate logistic regression analysis showed only the PaCO2 (HR, 1.18 per mmHg; 95% CI, 1.12-1.26) to be a significant predictor.
  
  
  CONCLUSIONS
  Our results suggest that the PaCO2 measured in the stable state is an independent significant predictor of the need to initiate NIV in COPD-AE patients who are hospitalized for the first time.
authors: Department of Respiratory Medicine, Daiyukai General Hospital, Japan.
authors: Shu
authors: S
authors: Taga
authors: Hiroyuki
authors: H
authors: Taniguchi
authors: Naohiro
authors: N
authors: Watanabe
authors: Yasuhiro
authors: Y
authors: Kondoh
authors: Tomoki
authors: T
authors: Kimura
authors: Kensuke
authors: K
authors: Kataoka
authors: Hiromichi
authors: H
authors: Aso
authors: Koji
authors: K
authors: Sakamoto
authors: Yoshinori
authors: Y
authors: Hasegawa
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D063087:Noninvasive Ventilation / Q000379:methods*; D011237:Predictive Value of Tests; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome