title: Obesity might be a good prognosis factor for COPD patients using domiciliary noninvasive mechanical ventilation.
abstract: Cachexia is known to be a deteriorating factor for survival of patients with chronic obstructive pulmonary disease (COPD), but data related to obesity are limited. We observed that obese patients with COPD prescribed long-term noninvasive mechanical ventilation (NIMV) had better survival rate compared to nonobese patients. Therefore, we conducted a retrospective observational cohort study. Archives of Thoracic Diseases Training Hospital were sought between 2008 and 2013. All the subjects were prescribed domiciliary NIMV for chronic respiratory failure secondary to COPD. Subjects were grouped according to their body mass index (BMI). The first group consisted of subjects with BMI between 20 and 30 kg/m(2), and the second group consisted of subjects with BMI >30 kg/m(2). Data obtained at the first month's visit for the following parameters were recorded: age, sex, comorbid diseases, smoking history, pulmonary function test, 6-minute walk test (6-MWT), and arterial blood gas analysis. Hospital admissions were recorded before and after the domiciliary NIMV usage. Mortality rate was searched from the electronic database. Overall, 118 subjects were enrolled. Thirty-eight subjects had BMI between 20 and 30 kg/m(2), while 80 subjects had BMI >30 kg/m(2). The mean age was 65.8±9.4 years, and 81% were male. The median follow-up time was 26 months and mortality rates were 32% and 34% for obese and nonobese subjects (P=0.67). Improvement in 6-MWT was protective against mortality. In conclusion, survival of obese patients with COPD using domiciliary NIMV was found to be better than those of nonobese patients, and the improvement in 6-MWT in such patients was found to be related to a better survival.
authors: Pulmonary Division, Acibadem University School of Medicine.
authors: Hilal
authors: H
authors: Altinoz
authors: Sureyyapasa Thoracic Diseases and Thoracic Surgery Training Hospital, Istanbul, Turkey.
authors: Nalan
authors: N
authors: Adiguzel
authors: Sureyyapasa Thoracic Diseases and Thoracic Surgery Training Hospital, Istanbul, Turkey.
authors: Cuneyt
authors: C
authors: Salturk
authors: Sureyyapasa Thoracic Diseases and Thoracic Surgery Training Hospital, Istanbul, Turkey.
authors: Gokay
authors: G
authors: Gungor
authors: Sureyyapasa Thoracic Diseases and Thoracic Surgery Training Hospital, Istanbul, Turkey.
authors: Ozlem
authors: O
authors: Mocin
authors: Sureyyapasa Thoracic Diseases and Thoracic Surgery Training Hospital, Istanbul, Turkey.
authors: Huriye
authors: H
authors: Berk Takir
authors: Sureyyapasa Thoracic Diseases and Thoracic Surgery Training Hospital, Istanbul, Turkey.
authors: Feyza
authors: F
authors: Kargin
authors: Sureyyapasa Thoracic Diseases and Thoracic Surgery Training Hospital, Istanbul, Turkey.
authors: Merih
authors: M
authors: Balci
authors: Pulmonary Division, Acibadem University School of Medicine.
authors: Oner
authors: O
authors: Dikensoy
authors: Sureyyapasa Thoracic Diseases and Thoracic Surgery Training Hospital, Istanbul, Turkey.
authors: Zuhal
authors: Z
authors: Karakurt
mesh_terms: D000368:Aged; D015992:Body Mass Index; D017079:Exercise Tolerance; D005260:Female; D006699:Home Care Services; D006801:Humans; D053208:Kaplan-Meier Estimate; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D063087:Noninvasive Ventilation / Q000009:adverse effects / Q000401:mortality; D009765:Obesity / Q000150:complications* / Q000401:mortality / Q000503:physiopathology; D016016:Proportional Hazards Models; D065840:Protective Factors; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D020127:Recovery of Function; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014421:Turkey; D000070857:Walk Test
keywords: body mass index; chronic respiratory failure; mortality; survival; therapy