Abstract
Elderly patients with polypathology and DNI orders frequently present with acute respiratory failure. There are data supporting the effectiveness of NIV in this context. Our center, a chronic disease hospital, developed in 2010 an integrated care pathway for NIV in acute respiratory failure in the emergency room and wards
AIMS: Assess the outcome of NIV in patients with acute respiratory failure with a DNI order in a subacute care hospital
METHODS: Observational, one year-follow up study. Variables recorded were: demographics, clinical and functional data, performance of daily life activities, dementia, arterial blood gases, readmisisions and 1-year mortality
RESULTS: We included 102 patientes. mean age 81+/-7, with a Charlson Index 3,7+/-1, 22% were institutionalized. The overall mortality during the admission was 33% (n=34). 14 patients (13%) were ventilated outside the protocol indications. In this group mortality was 71%, (p>0.05). One year survival rate was 47%. This survival rate was statistically higher in patients with obesity hypoventilation síndrome (OHS), NIV at discharge and Barthel> 50
Conclusions
NIV is an useful technique in an elderly population with a therapeutic ceiling. Despite their disease severity and comorbidity, acceptable survival rates are achieved. A correct case selection is needed. OHS and those with Barthel index >50 have better prognosis.
- © 2014 ERS