Long-term survival in elderly patients with a do-not-intubate order treated with noninvasive mechanical ventilation

Autor: Paolo Amboni, Chiara Pravettoni, Serena Bencini, Gian Galeazzo Riario-Sforza, Monica Bernareggi, Roberta Cattaneo, Cristiano Bonacina, Giuseppe di Franco, Chiara Melacini, Walter Casali, Cristoforo Incorvaia, Pierfranco Usai, Stefania Raschi, G. Passalacqua, Paolo Scarpazza
Jazyk: angličtina
Rok vydání: 2011
Předmět:
Male
medicine.medical_specialty
Time Factors
medicine.medical_treatment
Population
mortality rate
International Journal of Chronic Obstructive Pulmonary Disease
Risk Assessment
Risk Factors
Oxygen therapy
Intubation
Intratracheal
medicine
COPD
Humans
education
Survival rate
Original Research
Aged
Resuscitation Orders
Aged
80 and over
lcsh:RC705-779
Mechanical ventilation
education.field_of_study
acute respiratory failure
Chi-Square Distribution
business.industry
Mortality rate
respiratory failure
Age Factors
Oxygen Inhalation Therapy
lcsh:Diseases of the respiratory system
General Medicine
Emergency department
medicine.disease
Home Care Services
Respiration
Artificial
Survival Analysis
Surgery
Survival Rate
Logistic Models
Treatment Outcome
Italy
Respiratory failure
Anesthesia
Acute Disease
Female
Respiratory Insufficiency
business
Zdroj: International Journal of COPD, Vol 2011, Iss default, Pp 253-257 (2011)
International Journal of Chronic Obstructive Pulmonary Disease
ISSN: 1178-2005
Popis: Paolo Scarpazza1, Cristoforo Incorvaia2, Paolo Amboni3, Giuseppe di Franco1, Stefania Raschi1, Pierfranco Usai1, Monica Bernareggi1, Cristiano Bonacina1, Chiara Melacini1, Roberta Cattaneo1, Serena Bencini1, Chiara Pravettoni2, Gian Galeazzo Riario-Sforza2, Gianni Passalacqua4, Walter Casali11Divisione di Broncopneumotisiologia, Ospedale Civile, Vimercate, Italy; 2Pulmonary Rehabilitation, Istituti Clinici di Perfezionamento, Milan, Italy; 3Clinical Chemistry Laboratory, Ospedali Riuniti, Bergamo, Italy; 4Allergy and Respiratory Diseases, University Of Genoa, Genoa, ItalyBackground: Noninvasive mechanical ventilation (NIMV) is an effective tool in treating patients with acute respiratory failure (ARF), since it reduces both the need for endotracheal intubation and the mortality in comparison with nonventilated patients. A particular issue is represented by the outcome of NIMV in patients referred to the emergency department for ARF and with a do-not-intubate (DNI) status because of advanced age or excessively critical conditions. This study evaluated long-term survival in a group of elderly patients with acute hypercapnic ARF who had a DNI order and who were successfully treated by NIMV.Methods: The population consisted of 54 patients with a favorable outcome after NIMV for ARF. They were followed up for 3 years by regular control visits, with at least one visit every 4 months, or as needed according to the patient’s condition. Of these, 31 continued NIMV at home and 23 were on long-term oxygen therapy (LTOT) alone.Results: A total of 16 of the 52 patients had not survived at the 1-year follow-up, and another eight patients died during the 3-year observation, with an overall mortality rate of 30.8% after 1 year and 46.2% after 3 years. Comparing patients who continued NIMV at home with those who were on LTOT alone, 9 of the 29 patients on home NIMV died (6 after 1 year and 3 after 3 years) and 15 of the 23 patients on LTOT alone died (10 after 1 year and 5 after 3 years).Conclusion: These results show that elderly patients with ARF successfully treated by NIMV following a DNI order have a satisfactory long-term survival.Keywords: COPD, acute respiratory failure, mortality rate, respiratory failure
Databáze: OpenAIRE
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