美国特发性肺纤维化患者机械通气的使用：一项全国性回顾性队列分析。
The use of mechanical ventilation in patients with idiopathic pulmonary fibrosis in the United States: A nationwide retrospective cohort analysis.
作者信息
Rush Barret, Wiskar Katie, Berger Landon, Griesdale Donald
机构信息
Division of Critical Care Medicine, Department of Medicine, Vancouver General Hospital, University of British Columbia, Room 2438, Jim Pattison Pavilion, 2nd Floor, 855 West 12th Avenue, Vancouver, BC, V5Z 1M9, Canada; Harvard T.H. Chan School of Public Health, Harvard University, 677 Huntington Ave, Boston, MA 02115, USA.
Division of Critical Care Medicine, Department of Medicine, Vancouver General Hospital, University of British Columbia, Room 2438, Jim Pattison Pavilion, 2nd Floor, 855 West 12th Avenue, Vancouver, BC, V5Z 1M9, Canada.
出版信息
Respir Med. 2016 Feb;111:72-6. doi: 10.1016/j.rmed.2015.12.005. Epub 2015 Dec 21.
OBJECTIVE
To investigate the mortality of patients with Idiopathic Pulmonary Fibrosis (IPF) who undergo mechanical ventilation (MV) and non-invasive mechanical ventilation (NIMV) in the United States.
METHODS
We performed a retrospective cohort study using data from the Nationwide Inpatient Sample, isolating patients with a diagnosis of IPF who underwent MV and NIMV between 2006 and 2012.
RESULTS
We analyzed 55,208,382 hospitalizations and identified 17,770 patients with IPF, of whom 1703 received MV and 778 received NIMV. Those receiving MV had higher mortality (51.6 vs. 30.9%, p < 0.0001), were younger (66.3 years, SD 12.8 vs. 70.2 years, SD 12.9) and had longer hospital stays (13.3 days, IQR 16 vs. 6.5 days, IQR 7, p < 0.0001), compared to those receiving NIMV. The mortality of IPF patients treated with MV decreased from 58.4% in 2006 to 49.3% in 2012 (p = 0.03). There were 149 (8.7%) patients in the mechanical ventilation group who were also receiving home oxygen therapy. They experienced an overall mortality of 48.1%, which was not significantly different than patients who did not rely on home oxygen (p = 0.35).
CONCLUSIONS
In a large national cohort, the in-hospital mortality of patients with IPF who are mechanically ventilated is approximately 50%.
目的
调查美国特发性肺纤维化（IPF）患者接受机械通气（MV）和无创机械通气（NIMV）后的死亡率。
方法
我们使用全国住院患者样本数据进行了一项回顾性队列研究，筛选出2006年至2012年间诊断为IPF并接受MV和NIMV的患者。
结果
我们分析了55,208,382例住院病例，确定了17,770例IPF患者，其中1703例接受了MV，778例接受了NIMV。与接受NIMV的患者相比，接受MV的患者死亡率更高（51.6%对30.9%，p<0.0001），年龄更小（66.3岁，标准差12.8对70.2岁，标准差12.9），住院时间更长（13.3天，四分位间距16对6.5天，四分位间距7，p<0.0001）。接受MV治疗的IPF患者死亡率从2006年的58.4%降至2012年的49.3%（p=0.03）。机械通气组中有149例（8.7%）患者也在接受家庭氧疗。他们的总死亡率为48.1% , 与不依赖家庭氧疗的患者相比无显著差异（p=0.35）。
结论
在一个大型全国队列中，接受机械通气的IPF患者的院内死亡率约为50%。
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