Non-invasive ventilation in hypercapnic COPD exacerbation: Predictors of mortality

Background: Long-term survival after non-invasive ventilation (NIV) in patients with chronic obstructive pulmonary disease (COPD) and acute hypercapnic respiratory failure is a significant outcome.Objective: To determine mortality at 1, 2 and 5 years after NIV and analyze the possible factors related to mortality in patients with COPD and hypercapnic respiratory failure.Methods: Retrospective study of patients with COPD requiring NIV in the emergency department of a general hospital between 1997 and 2002.Mortality to discharge at 1, 2 and 5 years and related factors were determined.Results: NIV failed in 18 (8.7%) of 207 included patients.Hospital mortality was 8.2%, and 1-, 2-and 5-year mortality after discharge was 24.6%, 31% and 47.3%, respectively.The best mortality predictor model at five years was FEV1, SAPS II score and home oxygen therapy, with an area under the curve of 0.83 (95% CI 0.75-0.91).Conclusions: Mortality at five years in patients with COPD exacerbations undergoing NIV was less than 50% and predictive factors were SAPS II, home oxygen therapy and FEV [1].