Department of Respiratory Medicine, Odense University Hospital, University of Southern Denmark, Odense, Denmark.
Int J Chron Obstruct Pulmon Dis. 2013;8:215-9. doi: 10.2147/COPD.S42632. Epub 2013 Apr 26.
Implementation of noninvasive ventilation (NIV) as an add-on treatment has been routinely used in a non-intensive care setting since 2004 for patients with chronic obstructive pulmonary disease (COPD) and acute hypercapnic respiratory failure at a university hospital in Denmark. Although randomized controlled trials show lowered mortality rates in highly selected patients with acute exacerbation and respiratory failure, there are only few reports on long-term survival after receiving NIV. We present long-term all-cause mortality data from patients receiving NIV for the first time.
Data from medical records were retrospectively retrieved from all patients receiving NIV for the first time after being admitted acutely to an acute medical ward and further transfer to a respiratory ward with respiratory failure and a diagnosis of COPD in the period January 1, 2005 to December 31, 2007; patients were followed until January 2012. Demographic data collected included age, sex, diagnoses at discharge, and, when present, FEV1; a "not-to-intubate" order was also registered when listed.
In total, 253 patients (143 female, 110 male) received NIV for the first time. The median age was 72 years (range 46-91 years). The 30-day mortality rate was 29.3%. The 5-year survival rate was 23.7%. Women showed a trend towards better survival than men (25.7% vs 19.2%, P = 0.25), and the trend was even more pronounced for patients with COPD.
The mortality rate of patients receiving NIV is high, as expected in a real-life setting, but with a 5-year survival rate of 23.7% with a trend towards more female than male long-term survivors.
自 2004 年以来，丹麦一所大学医院的慢性阻塞性肺疾病（COPD）和急性高碳酸血症呼吸衰竭患者在非重症监护病房常规使用无创通气（NIV）作为附加治疗。虽然随机对照试验显示在急性加重和呼吸衰竭的高度选择患者中降低了死亡率，但关于接受 NIV 后的长期生存情况仅有少数报道。我们报告了首次接受 NIV 治疗的患者的长期全因死亡率数据。
从所有于 2005 年 1 月 1 日至 2007 年 12 月 31 日期间因急性呼吸衰竭入住急性内科病房并进一步转入呼吸科病房接受首次 NIV 治疗的 COPD 患者的病历中回顾性检索数据；患者随访至 2012 年 1 月。收集的人口统计学数据包括年龄、性别、出院时的诊断，以及存在时的 FEV1；当列出“不插管”医嘱时也进行登记。
共有 253 名患者（143 名女性，110 名男性）首次接受 NIV。中位年龄为 72 岁（范围 46-91 岁）。30 天死亡率为 29.3%。5 年生存率为 23.7%。女性的生存率趋势好于男性（25.7%比 19.2%，P=0.25），COPD 患者的趋势更为明显。
在真实环境中，接受 NIV 治疗的患者死亡率高，但预期的是，5 年生存率为 23.7%，且女性长期幸存者比例高于男性。
