Predictors of Outcome for Patients With COPD Requiring Invasive Mechanical Ventilation

Nevins, Michael L.; Epstein, Scott K.

doi:10.1378/chest.119.6.1840

Cited by 192 publications

(147 citation statements)

References 51 publications

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“…33 The crude mortality rates found in the 2 Italian RHDCU surveys are similar to those reported for COPD exacerbations managed with NIV (10 -25%). [34][35][36] However, those data were obtained from hospital discharge sheets, which lack information about important confounders such as disease severity, comorbidities, and interventions.…”

Section: Interventions Diseases and Outcomesmentioning

confidence: 99%

Increased Number and Expertise of Italian Respiratory High-Dependency Care Units: The Second National Survey

Scala¹,

Corrado

Confalonieri

et al. 2011

Respir Care

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.03), and the physician-to-patient mean ratio and the nurse-to-patient mean ratio per shift were lower (P ‫؍‬ .001 and P ‫؍‬ .002, respectively). Admissions for only monitoring decreased (P < .001), and admissions for active interventions increased: noninvasive ventilation (P ‫؍‬ .002), invasive ventilation (P < .001), weaning from invasive ventilation (P < .001), and tracheal decannulation (P < .001). The complexity of RHDCU patients' conditions increased: there was a reduction in the percentage of COPD patients (P < .001) and an increase in the percentage of patients with neuromyopathies (P < .001) and de novo hypoxemia (P ‫؍‬ .006). CONCLUSIONS: Between 1997 and 2007 there was an increase in the number and expertise of Italian RHDCUs, with a shift toward less expensive care, and greater complexity of interventions and patient dysfunctions. These findings support the crucial role of RHDCUs in the management of respiratory critical patients.

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Section: Interventions Diseases and Outcomesmentioning

confidence: 99%

Increased Number and Expertise of Italian Respiratory High-Dependency Care Units: The Second National Survey

Scala¹,

Corrado

Confalonieri

et al. 2011

Respir Care

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“…The prognosis for such patients has been related to multiple factors, including pulmonary function test results, blood gas analysis results, degree of pulmonary hypertension, age, nutritional status, need for ventilatory support, and APACHE II score at ICU admission. (6,9,(16)(17)(18)(19) The reintegration of such patients into society, in terms of their ability to maintain adequate social interaction or perform their activities satisfactorily, has yet to be thoroughly investigated. (12)(13)(14)(15) There are few data regarding the need for hospital readmissions, the degree of dependence, the ability to remain self-sufficient, and the ability to resume work activities.…”

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confidence: 99%

Exacerbação aguda da DPOC: mortalidade e estado funcional dois anos após a alta da UTI

et al. 2011

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Objective: To assess ICU patients with COPD, in terms of in-hospital characteristics, two-year mortality and two-year functional status of survivors. Methods: A prospective cohort study involving patients with acute exacerbation of COPD admitted to the ICUs of two hospitals in the city of Porto Alegre, Brazil, between July of 2005 and July of 2006. At two years after discharge, survivors were interviewed by telephone in order to determine Karnofsky scores and scores on a scale regarding activities of daily living (ADL). Results: The sample comprised 231 patients. In-hospital mortality was 37.7%, and two-year post-discharge mortality was 30.3%. Of the 74 survivors, 66 were interviewed (89%). The mean age at ICU admission was 74 ± 10 years, and the mean Acute Physiology and Chronic Health Evaluation II score was 18 ± 7. Two or more comorbidities were present in 87.8% of the patients. Of the 66 interviewees, 57 (86.3%) lived at home, 58 (87.8%) were self-sufficient, 12 (18.1%) required oxygen therapy, and 4 (6.1%) still required ventilatory support. There was a significant reduction in the quality of life and autonomy of the survivors, as evidenced by the Karnofsky scores (85 ± 9 vs. 79 ± 11, p = 0.03) and ADL scale scores (29 ± 5 vs. 25 ± 7; p = 0.01), respectively. Conclusions: In this patient sample, two-year mortality was quite high. Although there was a noticeable reduction in the functional status of the survivors, they remained self-sufficient.Keywords: Pulmonary disease, chronic obstructive/mortality; Quality of life; Intensive care units. ResumoObjetivo: Determinar a taxa de mortalidade de pacientes com DPOC e avaliar o estado funcional dos sobreviventes dois anos após a alta da UTI. Métodos: Estudo de coorte prospectiva realizada nas UTIs de dois hospitais na cidade de Porto Alegre (RS) com pacientes com exacerbação aguda de DPOC e internados em UTI entre julho de 2005 e julho de 2006. Dois anos após a alta, os sobreviventes foram entrevistados via telefone. Os dados obtidos foram utilizados na determinação dos escores da escala de Karnofsky e de uma escala de atividades de vida diária (AVD). Resultados: Foram incluídos 231 pacientes. A mortalidade hospitalar foi de 37,7% e a mortalidade extra-hospitalar foi de 30,3%. Dos 74 sobreviventes, foram entrevistados 66 (89%). A média de idade dos pacientes no momento da internação na UTI era de 74 ± 10 anos e a do escore Acute Physiology and Chronic Health Evaluation II era de 18 ± 7. Tinham duas ou mais comorbidades 87,8% dos pacientes. Dos 66 entrevistados, 57 (86,3%) viviam em suas casas, 58 (87,8%) eram capazes de realizar seu autocuidado, 12 (18,1%) utilizavam oxigenoterapia, e 4 (6,1%) necessitavam suporte ventilatório. Houve uma significante redução na qualidade de vida e na autonomia, segundo os escores da escala de Karnofsky (85 ± 9 vs. 79 ± 11; p = 0,03) e de AVD (29 ± 5 vs. 25 ± 7; p = 0,01), respectivamente. Conclusões: A mortalidade desta amostra de pacientes foi muito elevada nos primeiros dois anos. Embora houvesse evidente redução do esta...

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“…Czynniki, które powinny być brane pod uwagę przy podejmowaniu decyzji o rozpoczęciu IWM u chorych w końcowym stadium POChP, to potencjalna odwracalność czynnika powodującego zaostrzenie [163][164][165][166], decyzja chorego wynikająca z jakości życia w okresie przed zaostrzeniem oraz dostęp-ność intensywnej opieki medycznej.…”

Section: Inwazyjna Wentylacja Mechanicznaunclassified

Zalecenia Polskiego Towarzystwa Chorób Płuc Dotyczące Rozpoznawania i Leczenia Przewlekłej Obturacyjnej Choroby Płuc

Śliwiński

Górecka

Jassem

et al. 2014

Advances in Respiratory Medicine

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Predictors of Outcome for Patients With COPD Requiring Invasive Mechanical Ventilation

Cited by 192 publications

References 51 publications

Increased Number and Expertise of Italian Respiratory High-Dependency Care Units: The Second National Survey

Increased Number and Expertise of Italian Respiratory High-Dependency Care Units: The Second National Survey

Exacerbação aguda da DPOC: mortalidade e estado funcional dois anos após a alta da UTI

Zalecenia Polskiego Towarzystwa Chorób Płuc Dotyczące Rozpoznawania i Leczenia Przewlekłej Obturacyjnej Choroby Płuc

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