Trends in the Use and Outcomes of Mechanical Ventilation among Patients Hospitalized with Acute Exacerbations of COPD in Spain, 2001 to 2015

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Miguel Díez, Javier de and Jiménez García, Rodrigo and Hernández-Barrera, V. and Puente Maestu, Luis and Girón Matute, Walther Iván and Miguel Yanes, José María de and Méndez-Bailón, M. and Villanueva Orbaiz, Mª Rosa Rita and Albaladejo Vicente, Romana and López-de-Andrés, A. (2019) Trends in the Use and Outcomes of Mechanical Ventilation among Patients Hospitalized with Acute Exacerbations of COPD in Spain, 2001 to 2015. Journal of Clinical Medicine, 8 (10). p. 1621. ISSN 2077-0383

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Official URL: https://doi.org/10.3390/jcm8101621




Abstract

(1) Background: We examine trends (2001–2015) in the use of non-invasive ventilation (NIV) and invasive mechanical ventilation (IMV) among patients hospitalized for acute exacerbation of chronic obstructive pulmonary disease (AE-COPD). (2) Methods: Observational retrospective epidemiological study, using the Spanish National Hospital Discharge Database. (3) Results: We included 1,431,935 hospitalizations (aged ≥40 years) with an AE-COPD. NIV use increased significantly, from 1.82% in 2001–2003 to 8.52% in 2013–2015, while IMV utilization decreased significantly, from 1.39% in 2001–2003 to 0.67% in 2013–2015. The use of NIV + invasive mechanical ventilation (IMV) rose significantly over time (from 0.17% to 0.42%). Despite the worsening of clinical profile of patients, length of stay decreased significantly over time in all types of ventilation. Patients who received only IMV had the highest in-hospital mortality (IHM) (32.63%). IHM decreased significantly in patients with NIV + IMV, but it remained stable in those receiving isolated NIV and isolated IMV. Factors associated with use of any type of ventilatory support included female sex, lower age, and higher comorbidity. (4) Conclusions: We found an increase in NIV use and a decline in IMV utilization to treat AE-COPD among hospitalized patients. The IHM decreased significantly over time in patients who received NIV + IMV, but it remained stable in patients who received NIV or IMV in isolation.


Item Type:Article
Uncontrolled Keywords:chronic obstructive pulmonary disease; hospitalization; invasive mechanical ventilation; non-invasive mechanical ventilation; trends
Subjects:Medical sciences > Medicine > Public health
ID Code:65890
Deposited On:07 Jun 2021 17:45
Last Modified:08 Jun 2021 18:31

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