title: COPD: Mortality and Readmissions in Relation to Number of Admissions with Noninvasive Ventilation.
abstract: In severe COPD, patients having survived acute hypercapnic respiratory failure (AHRF) treated with noninvasive ventilation (NIV) have a high mortality and risk of readmissions. The aim was to analyze the prognosis for patients with COPD having survived AHRF and to assess whether previous admissions with NIV predict new ones.We conducted a retrospective follow-up analysis of 201 patients two years after NIV treatment of AHRF. Comparison of time-to-event in patients previously treated with NIV versus patients with no previous NIV treatment. We found a one-year mortality of 33.8% and high risks of: readmission (53.2%), any event (67.7%), and life-threatening events (49.8%). Patients with previous NIV treatments had an increased hazard ratio for life-threatening events: 1.60, p = 0.023 despite having lower in-hospital mortality than patients with no previous NIV treatment (18.9% vs. 33.1%, p = 0.043). We found that having survived one episode of AHRF considerably worsened the prognosis for the affected patients.The prognosis for patients having survived AHRF with NIV treatment is poor: the prognosis worsens with additional episodes of AHRF. Future research and treatment should focus on patients with repeated episodes of AHRF.
authors.affiliation: a Department of Pulmonary Medicine , Gentofte Hospital , Kildegårdsvej, Hellerup , Denmark.
authors.forename: Kasper Linde
authors.initials: KL
authors.lastname: Ankjærgaard
authors.affiliation: b Department of Internal Medicine , Næstved Hospital , Ringstedgade, Næstved , Denmark.
authors.forename: Daniel Bech
authors.initials: DB
authors.lastname: Rasmussen
authors.affiliation: c Department of Respiratory Medicine , University Hospital of Copenhagen , Bispebjerg Bakke , NV , Denmark.
authors.forename: Signe Høyer
authors.initials: SH
authors.lastname: Schwaner
authors.affiliation: c Department of Respiratory Medicine , University Hospital of Copenhagen , Bispebjerg Bakke , NV , Denmark.
authors.forename: Helle Frost
authors.initials: HF
authors.lastname: Andreassen
authors.affiliation: c Department of Respiratory Medicine , University Hospital of Copenhagen , Bispebjerg Bakke , NV , Denmark.
authors.forename: Ejvind Frausing
authors.initials: EF
authors.lastname: Hansen
authors.affiliation: a Department of Pulmonary Medicine , Gentofte Hospital , Kildegårdsvej, Hellerup , Denmark.
authors.forename: Jon Torgny
authors.initials: JT
authors.lastname: Wilcke
mesh_terms: D000368:Aged; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D006935:Hypercapnia / Q000209:etiology / Q000628:therapy*; D008297:Male; D063087:Noninvasive Ventilation / Q000706:statistics & numerical data*; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000401:mortality* / Q000628:therapy*; D012008:Recurrence; D012131:Respiratory Insufficiency / Q000209:etiology / Q000628:therapy*; D012189:Retrospective Studies
keywords: Exacerbations; follow-up; prognosis; ventilatory failure