Research
Print page Print page
Switch language
Hvidovre Hospital - a part of Copenhagen University Hospital
Published

NIV for acute respiratory failure in COPD: high in-hospital mortality is determined by patient selection

Research output: Contribution to journalJournal articleResearchpeer-review

  1. The Danish severe asthma register: an electronic platform for severe asthma management and research

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Automatic oxygen titration with O2matic® to patients admitted with COVID-19 and hypoxemic respiratory failure

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Behandling af indlæggelseskrævende COVID-19

    Research output: Contribution to journalReviewpeer-review

  2. Udredning og opfølgning af indlæggelseskrævende COVID-19

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Automatic oxygen titration with O2matic® to patients admitted with COVID-19 and hypoxemic respiratory failure

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. CPAP for patients with COVID-19

    Research output: Contribution to journalReviewpeer-review

  • Caroline Hedsund
  • Kasper Linde Ankjærgaard
  • Daniel Bech Rasmussen
  • Signe Høyer Schwaner
  • Helle Frost Andreassen
  • Ejvind Frausing Hansen
  • Jon Torgny Wilcke
View graph of relations

Introduction: Hospital mortality among chronic obstructive pulmonary disease (COPD) patients receiving NIV for acute respiratory failure has shown to be significantly higher in clinical settings than in the randomized trials (RCTs) which clinical guidelines are based on. This may be due to the quality of care of NIV or patient selection. In daily clinical practice, we include patients with terminal pulmonary disease with a do-not-intubate (DNI) or a do-not-resuscitate (DNR) order with a high mortality risk compared to highly selected patients in RCTs. The aim of this study was to determine the role of patient selection for in-hospital mortality among patients receiving NIV for acute respiratory failure of COPD. Methods: We conducted a retrospective study including all patients receiving acute NIV due to acute respiratory failure at the respiratory wards in 2012-2013 at two hospitals in Greater Copenhagen. Results: Overall in-hospital mortality rate was 30%. In patients with a DNI/DNR order, mortality was 59% and in patients with no limitations in treatment 2%. Patients who fulfilled the exclusion criteria of the RCT by Plant et al. had a mortality of 41% compared to 25% in the remaining population. Conclusions: High overall in-hospital mortality reflects that patient selection in clinical practice is very different from RCT. Quality of acute NIV treatment seems acceptable in clinical practice for patients with less severe COPD and no limitations in treatment. Higher mortality in patients with DNI/DNR order may be due to inefficient NIV treatment for these patients with more severe COPD.

Original languageEnglish
JournalEuropean Clinical Respiratory Journal
Volume6
Issue number1
Pages (from-to)1571332
ISSN2001-8525
DOIs
Publication statusPublished - Jan 2019

ID: 56497454