Abstract

OBJECTIVES: Domiciliary non-invasive mechanical ventilation (NIMV) is presumed to decrease hospital admissions and mortality in very severe chronic obstructive pulmonary disease (COPD) patients. This study was aimed to investigate the clinical data and mortality among COPD patients receiving domiciliary NIMV treatment.

MATERIAL AND METHODS: A total of 40 COPD patients who were prescribed domiciliary NIMV at discharge between January 2010 and December 2011 were contacted by phone regarding their current health status, and the electronic patient charts of 34 patients who used NIMV regularly were retrospectively reviewed.

RESULTS: The mean age of the patients was 67±15 years and 59% of them were females. The mean length of hospital stay was 14.5±6.82 days. Rate of admission to intensive care unit and use of invasive mechanical ventilation was 56% and 27%, respectively. The median follow up duration was 17 months. The 6-months, 1-year, 2-years and overall mortality rates were 24%, 38%, 50% and 56%, respectively. For patients surviving at least one year after domiciliary NIMV initiation (n=21), the mean number of hospitalizations in the year before-and after-NIMV initiation were 1.38±1.28 and 0.57±0.93 (p=0.003), respectively. Mean daily NIMV use was 8.91±4.46 hours. Mean daily NIMV use of the patients with a lifespan ≤2 years was higher than that of the patients with a lifespan >2 years (11.82±4.02 hours/day versus 6.0±2.62 hours/day, respectively) (p<0.001). Long term oxygen was prescribed for the first time to 62% of the patients using NIMV.

CONCLUSION: Domiciliary NIMV may have numerous beneficial effects such as decreasing hospital admissions for acute COPD exacerbations and related costs. It is very important in the battle against COPD, a disease with significant morbidity, mortality and economic burden.