title: Predictors of outcome for patients with severe respiratory failure requiring non invasive mechanical ventilation.
abstract: OBJECTIVE
  Failure to identify patients in whom non-invasive ventilation (NIV) would be unsuccessful may cause inappropriate delay in intubation. Aim of this study was to determine predictors of NIV failure.
  
  
  METHODS
  We retrospectively evaluated COPD patients, undergoing NIV for at least 12h because of hypercapnic acute respiratory failure. Univariable and multivariable analyses were performed on: age, gender, APACHE II and GCS, gas exchange at admission, during NIV and at discharge/death, length of stay. ROC analysis for pH START and APACHE II were performed.
  
  
  RESULTS
  Among 201 individuals enrolled, NIV failed in 50. In the logistic regression model only APACHE II was found to have an independent effect on the outcome (p < 0.0001, OR 1.179, 95% CI 1.101-1.263 as quantitative variable; p < 0.0001, OR 3.753, 95% CI 1.798-7.835, as qualitative variable, > 20.5).
  
  
  CONCLUSIONS
  APACHE II may be a crucial parameter in predicting NIV failure; further multicentric studies are needed to better define NIV indications.
authors.affiliation: Department of Respiratory Diseases, IRCCS San Raffaele - Pisana, Rome Italy. vittoria.conti@gmail.com.
authors.forename: V
authors.initials: V
authors.lastname: Conti
authors.forename: G
authors.initials: G
authors.lastname: Paone
authors.forename: C
authors.initials: C
authors.lastname: Mollica
authors.forename: A
authors.initials: A
authors.lastname: Sebastiani
authors.forename: A
authors.initials: A
authors.lastname: Mannocci
authors.forename: G
authors.initials: G
authors.lastname: La Torre
authors.forename: V
authors.initials: V
authors.lastname: Cardaci
authors.forename: I
authors.initials: I
authors.lastname: Cammarella
authors.forename: G
authors.initials: G
authors.lastname: Puglisi
authors.forename: G
authors.initials: G
authors.lastname: Brunetti
authors.forename: M G
authors.initials: MG
authors.lastname: Alma
authors.forename: C
authors.initials: C
authors.lastname: Terzano
mesh_terms: D018806:APACHE; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D010351:Patient Discharge / Q000639:trends; D011237:Predictive Value of Tests; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis* / Q000628:therapy*; D012121:Respiration, Artificial / Q000379:methods*; D012131:Respiratory Insufficiency / Q000175:diagnosis* / Q000628:therapy*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome