TY - JOUR
T1 - Neural respiratory drive predicts long-term outcome following admission for exacerbation of COPD
T2 - A post hoc analysis
AU - Patout, Maxime
AU - Meira, Leonor
AU - D'Cruz, Rebecca
AU - Lhuillier, Elodie
AU - Kaltsakas, Georgios
AU - Arbane, Gill
AU - Suh, Eui Sik
AU - Hart, Nicholas
AU - Murphy, Patrick Brian
PY - 2019/9/1
Y1 - 2019/9/1
N2 - Neural respiratory drive (NRD), as reflected by change in parasternal muscle electromyogram (EMGpara), predicts clinical deterioration and safe discharge in patients admitted to hospital with an acute exacerbation of COPD (AECOPD). The clinical utility of NRD to predict the long-term outcome of patients following hospital admission with an AECOPD is unknown. We undertook a post hoc analysis of a previously published prospective observational cohort study measuring NRD in 120 patients with AECOPD. Sixty-nine (57.5%) patients died during follow-up (median 3.6 years). Respiratory failure was the most common cause of death (n=29; 42%). In multivariate analysis, factors independently associated with an increased mortality included NRD (HR 2.14, 95% CI 1.29 to 3.54, p=0.003), age (HR 2.03, 95% CI 1.23 to 3.34, p=0.006), PaCO 2 at admission (HR 1.83, 95% CI 1.06 to 3.06, p=0.022) and long-term oxygen use (HR 2.98, 95% CI 1.47 to 6.03, p=0.002). NRD at hospital discharge could be measured in order to assess efficacy of interventions targeted to optimise COPD and reduce mortality following an AECOPD. Original clinicaltrial.gov number: NCT01361451
AB - Neural respiratory drive (NRD), as reflected by change in parasternal muscle electromyogram (EMGpara), predicts clinical deterioration and safe discharge in patients admitted to hospital with an acute exacerbation of COPD (AECOPD). The clinical utility of NRD to predict the long-term outcome of patients following hospital admission with an AECOPD is unknown. We undertook a post hoc analysis of a previously published prospective observational cohort study measuring NRD in 120 patients with AECOPD. Sixty-nine (57.5%) patients died during follow-up (median 3.6 years). Respiratory failure was the most common cause of death (n=29; 42%). In multivariate analysis, factors independently associated with an increased mortality included NRD (HR 2.14, 95% CI 1.29 to 3.54, p=0.003), age (HR 2.03, 95% CI 1.23 to 3.34, p=0.006), PaCO 2 at admission (HR 1.83, 95% CI 1.06 to 3.06, p=0.022) and long-term oxygen use (HR 2.98, 95% CI 1.47 to 6.03, p=0.002). NRD at hospital discharge could be measured in order to assess efficacy of interventions targeted to optimise COPD and reduce mortality following an AECOPD. Original clinicaltrial.gov number: NCT01361451
KW - COPD exacerbations
KW - respiratory measurement
KW - respiratory muscles
UR - http://www.scopus.com/inward/record.url?scp=85065296366&partnerID=8YFLogxK
U2 - 10.1136/thoraxjnl-2018-212074
DO - 10.1136/thoraxjnl-2018-212074
M3 - Article
C2 - 31028235
AN - SCOPUS:85065296366
SN - 0040-6376
VL - 74
JO - Thorax
JF - Thorax
IS - 9
ER -