Respiratory Department, Hospital General Universitario Gregorio Marañón, Facultad de Medicina, Universidad Complutense de Madrid (UCM), Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.
Department of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain.
Eur J Intern Med. 2020 Apr;74:67-72. doi: 10.1016/j.ejim.2019.11.023. Epub 2019 Dec 9.
We examined trends in the incidence of ventilator support with noninvasive ventilation (NIV) or invasive mechanical ventilation (IMV) among patients hospitalized in Spain from 2001 to 2015. We also assessed in-hospital mortality (IHM) after receiving these types of ventilator support.
This study was an observational retrospective epidemiological study. Our data source was the Spanish National Hospital Discharge Database.
In total, 1,031,497 patients received ventilator support in Spain over the study period. NIV use increased from 18.8 patients per 100.000 inhabitants in 2001 to 108.7 in 2015. IMV utilization increased significantly from 2001 to 2003 and then decreased from 2003 until 2015. Patients who required NIV had the highest mean Charlson Comorbidity Index (CCI) score. Patients who received IMV had the highest in-hospital mortality. Factors associated with an increased risk for IHM were sex, age, conditions included in the CCI (except for COPD and diabetes), haemodialysis, presence of a peripheral arterial catheter, presence of a central venous catheter, readmission and emergency room admission. Undergoing a surgical procedure was a risk factor only for IMV. IHM decreased significantly from 2001 to 2015 in patients who underwent NIV or IMV.
We identified an increase in the utilization of NIV over time, whereas use of IMV decreased from 2003 until 2015 after an initial increase from 2001 to 2003. We also found a significant decrease in IHM over time.
我们研究了 2001 年至 2015 年期间在西班牙住院的患者中，使用无创通气（NIV）或有创机械通气（IMV）进行通气支持的发生率趋势。我们还评估了接受这些类型通气支持后的院内死亡率（IHM）。
这是一项观察性回顾性流行病学研究。我们的数据来源是西班牙国家住院患者数据库。
在研究期间，共有 1031497 名患者在西班牙接受了通气支持。NIV 的使用从 2001 年的每 10 万人中 18.8 例增加到 2015 年的 108.7 例。IMV 的使用率从 2001 年到 2003 年显著增加，然后从 2003 年到 2015 年下降。需要 NIV 的患者的平均 Charlson 合并症指数（CCI）评分最高。接受 IMV 的患者的院内死亡率最高。与 IHM 风险增加相关的因素包括性别、年龄、CCI 中包含的疾病（COPD 和糖尿病除外）、血液透析、外周动脉导管、中心静脉导管、再入院和急诊入院。接受手术是 IMV 的唯一危险因素。接受 NIV 或 IMV 的患者的 IHM 从 2001 年到 2015 年显著下降。
我们发现随着时间的推移，NIV 的使用率增加，而 IMV 的使用率从 2003 年到 2015 年下降，此前 2001 年到 2003 年有所增加。我们还发现 IHM 随时间显著下降。
