Abstract Rationale Patients with obesity hypoventilation syndrome (OHS) have high healthcare utilization and are frequently discharged from the hospital on positive airway pressure (PAP) or non-invasive ventilation (NIV) therapy. Current guidelines recommend initiation of NIV at hospital discharge, particularly after an episode of acute-on-chronic hypercapnic respiratory failure. However, real-world post-discharge management and outcomes of OHS patients started on different PAP modalities remain poorly characterized. Methods We performed a retrospective cohort study of adults (≥18 years) admitted to a tertiary hospital within a large urban integrated health system in Los Angeles over a 12-month period, who were newly discharged with PAP therapy based on a query of durable medical equipment data. Patients are included for analysis as possible OHS based on BMI or HCO3 30. Those discharged to hospice or died during the index hospitalization were excluded. Demographic, clinical, and follow-up data were abstracted from the electronic medical record. Results A total of 37 patients with OHS were included. 14 patients were discharged on continuous positive airway pressure therapy (CPAP) and 23 on bilevel positive airway therapy (BPAP).CPAP group (n = 14): The mean BMI was 66 kg/m², mean serum bicarbonate 31 mEq/L, and mean age 69 years; 9 (64%) were female, and the average Charlson Comorbidity Index (CCI) was 6.5. Five patients (35%) were readmitted within 30 days, and 9 (64%) had outpatient follow-up within an average of 13 days.BPAP group (n = 23): The mean BMI was 43 kg/m², mean serum bicarbonate 33 mEq/L, and mean age 66 years; 8 (35%) were female, and the average CCI was 5. Seven patients (30%) were readmitted within 30 days, and 15 (65%) had outpatient follow-up within an average of 14 days.There was no statistically significant difference in 30-day readmission rates between the CPAP and Bilevel PAP groups (χ² test, p 0.05). Conclusions In this single-center cohort, OHS patients discharged on CPAP demonstrated similar 30-day readmission and follow-up outcomes compared to those discharged on BPAP. Our findings suggest that discharging on CPAP therapy regardless of initial diagnosis may be a reasonable alternative when close outpatient follow-up is ensured. Future evaluation will aim to include a larger cohort within the health system and to examine readmission characteristics over a longer study period. Prospective studies are warranted to validate these findings and optimize transitional care strategies for this high-risk population. This abstract is funded by: None
Kim et al. (Fri,) studied this question.