title: Use and Outcomes of Noninvasive Ventilation for Acute Respiratory Failure in Different Age Groups.
abstract: BACKGROUND
  The prevalence of chronic disease and do-not-intubate status increases with age. Thus, we aimed to determine characteristics and outcomes associated with noninvasive ventilation (NIV) use for acute respiratory failure (ARF) in different age groups.
  
  
  METHODS
  A database comprising prospective data collected on site on all adult patients with ARF requiring ventilatory support from 8 acute care hospitals in Massachusetts was used.
  
  
  RESULTS
  From a total of 1,225 ventilator starts, overall NIV utilization, success, and in-hospital mortality rates were 22, 54, and 18% in younger (18-44 y); 34, 65, and 13% in middle-aged (45-64 y); 49, 68, and 17% in elderly (65-79 y); and 47, 76, and 24% in aged (≥ 80 y) groups, respectively (P < .001, P = .08, and P = .11, respectively). NIV use for cardiogenic pulmonary edema and subjects with a do-not-intubate order increased significantly with advancing age (25, 57, 57, and 74% and 7, 12, 18, and 31%, respectively, in the 4 age groups [P < .001 and P = .046, respectively]). For subjects receiving NIV with a do-not-intubate order, success and in-hospital mortality rates were similar in different age groups (P = .27 and P = .98, respectively).
  
  
  CONCLUSIONS
  NIV use and a do-not-intubate status are more frequent in subjects with ARF ≥ 65 y than in those <65 y, especially for subjects with cardiogenic pulmonary edema. However, NIV success and mortality rates were similar between age groups. (ClinicalTrials.gov registration NCT00458926.).
authors.affiliation: Department of Pulmonary Disease, Baskent University, Istanbul, Turkey. aozsancak@hotmail.com.
authors.forename: Aylin
authors.initials: A
authors.lastname: Ozsancak Ugurlu
authors.affiliation: Pulmonary Department, Newton-Wellesley Hospital, Newton, Massachusetts.
authors.forename: Samy S
authors.initials: SS
authors.lastname: Sidhom
authors.affiliation: Mass Lung and Allergy PC, Leominster, Massachusetts.
authors.forename: Ali
authors.initials: A
authors.lastname: Khodabandeh
authors.affiliation: Boston Medical Center, Boston, Massachusetts.
authors.forename: Michael
authors.initials: M
authors.lastname: Ieong
authors.affiliation: Cape Cod Health Systems, Hyannis, Massachusetts.
authors.forename: Chester
authors.initials: C
authors.lastname: Mohr
authors.affiliation: Lowell General Hospital, Lowell, Massachusetts.
authors.forename: Denis Y
authors.initials: DY
authors.lastname: Lin
authors.affiliation: Saints Medical Center, Lowell, Massachusetts.
authors.forename: Irwin
authors.initials: I
authors.lastname: Buchwald
authors.affiliation: Steward Morton Hospital, Taunton, Massachusetts.
authors.forename: Imad
authors.initials: I
authors.lastname: Bahhady
authors.affiliation: Jordan Hospital, Plymouth, Massachusetts.
authors.forename: John
authors.initials: J
authors.lastname: Wengryn
authors.affiliation: Pulmonary Associates, Newark, Delaware.
authors.forename: Vinay
authors.initials: V
authors.lastname: Maheshwari
authors.affiliation: Department of Pulmonary, Critical Care, and Sleep Medicine, Tufts Medical Center, Boston, Massachusetts.
authors.forename: Nicholas S
authors.initials: NS
authors.lastname: Hill
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D016223:Advance Directives / Q000706:statistics & numerical data; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006331:Heart Diseases / Q000150:complications; D017052:Hospital Mortality; D006801:Humans; D007442:Intubation, Intratracheal / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D063087:Noninvasive Ventilation / Q000706:statistics & numerical data*; D011654:Pulmonary Edema / Q000209:etiology / Q000628:therapy; D012131:Respiratory Insufficiency / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult
keywords: acute respiratory failure; aged; elderly; middle-aged; noninvasive ventilation