title: Determinants of noninvasive ventilation outcomes during an episode of acute hypercapnic respiratory failure in chronic obstructive pulmonary disease: the effects of comorbidities and causes of respiratory failure.
abstract: OBJECTIVE
  To investigate the effect of the cause of acute respiratory failure and the role of comorbidities both acute and chronic on the outcome of COPD patients admitted to Respiratory Intensive Care Unit (RICU) with acute respiratory failure and treated with NIV.
  
  
  METHODS
  Observational prospective study.
  
  
  METHODS
  176 COPD patients consecutively admitted to our RICU over a period of 3 years and treated with NIV were evaluated. In all patients demographic, clinical, and functional parameters were recorded including the cause of acute respiratory failure, SAPS II score, Charlson comorbidity index, and further comorbidities not listed in the Charlson index. NIV success was defined as clinical improvement leading to discharge to regular ward, while exitus or need for endotracheal intubation was considered failure.
  
  
  RESULTS
  NIV outcome was successful in 134 patients while 42 underwent failure. Univariate analysis showed significantly higher SAP II score, Charlson index, prevalence of pneumonia, and lower serum albumin level in the failure group. Multivariate analysis confirmed a significant predictive value for pneumonia and albumin.
  
  
  CONCLUSIONS
  The most important determinants of NIV outcome in COPD patients are the presence of pneumonia and the level of serum albumin as an indicator of the patient nutritional status.
authors.affiliation: Alma Mater Studiorum, Department of Specialistic, Diagnostic and Experimental Medicine (DIMES), University of Bologna, 40138 Bologna, Italy.
authors.forename: Angela Maria Grazia
authors.initials: AM
authors.lastname: Pacilli
authors.affiliation: Alma Mater Studiorum, Department of Specialistic, Diagnostic and Experimental Medicine (DIMES), University of Bologna, 40138 Bologna, Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Valentini
authors.affiliation: Alma Mater Studiorum, Department of Specialistic, Diagnostic and Experimental Medicine (DIMES), University of Bologna, 40138 Bologna, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Carbonara
authors.affiliation: Alma Mater Studiorum, Department of Specialistic, Diagnostic and Experimental Medicine (DIMES), University of Bologna, 40138 Bologna, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Marchetti
authors.affiliation: Alma Mater Studiorum, Department of Specialistic, Diagnostic and Experimental Medicine (DIMES), University of Bologna, 40138 Bologna, Italy ; Respiratory and Critical Care, Sant'Orsola Malpighi Hospital, Alma Mater Studiorum, Department of Specialistic, Diagnostic and Experimental Medicine (DIMES), University of Bologna, 40138 Bologna, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Nava
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D006801:Humans; D006935:Hypercapnia / Q000473:pathology; D007442:Intubation, Intratracheal / Q000379:methods; D008297:Male; D063087:Noninvasive Ventilation / Q000379:methods*; D011014:Pneumonia / Q000473:pathology / Q000628:therapy*; D029424:Pulmonary Disease, Chronic Obstructive / Q000473:pathology / Q000628:therapy*; D012131:Respiratory Insufficiency / Q000473:pathology*; D016896:Treatment Outcome