Research output: Contribution to journal › Article › peer-review
Esther I. Schwarz, Mike Mackie, Nick Weston, Laura Tincknell, Gurpreet Beghal, Michael C. F. Cheng, Michelle Ramsay, Eui-Sik Suh, Georgios Kaltsakas, Hina Pattani, Philip Marino, Patrick B. Murphy, Nicholas Hart, Joerg Steier
Original language | English |
---|---|
Article number | 105877 |
Journal | Respiratory Medicine |
Volume | 162 |
Early online date | 13 Jan 2020 |
DOIs | |
Accepted/In press | 9 Jan 2020 |
E-pub ahead of print | 13 Jan 2020 |
Published | Feb 2020 |
Additional links |
Time-to-death in_SHWARZ_Epub13Jan2020_GREEN AAM
Schwarz_et_al_Mortality_on_HMV_manuscript_revision_clean.pdf, 276 KB, application/pdf
Uploaded date:10 Jan 2020
Version:Accepted author manuscript
Licence:CC BY-NC-ND
Background and objective: Home mechanical ventilation (HMV) is used in heterogeneous conditions underlying chronic hypercapnic respiratory failure, but there are sparse data on long-term clinical outcomes. The aim was to systematically analyse the time and the circumstances of death on HMV. Methods: All-cause mortality data of HMV patients were prospectively collected between 2008 and 2018 in a large tertiary centre. Data were categorised into diagnostic groups including neuromuscular disease (NMD), chest wall disease (CWD), chronic obstructive pulmonary disease (COPD), obesity hypoventilation syndrome (OHS), overlap syndrome of COPD and OSA (overlap) and other group. The primary outcome was time-to-death from initiation of HMV. Results: 1210 deaths were recorded over a 10-year period. Median time-to-death was 19.5 [6–55] months and differed between groups (Kruskal Wallis p < 0.001). CWD (98.5 [23.5–120] months) and slowly progressive NMD (64.5 [28–120] months) had the longest time-to-death on HMV, while OHS (33 [13–75] months) and overlap syndrome (30.5 [14.5–68.5] months) had a longer median time-to-death than COPD (19.5 [7–42.5] months) and motor neurone disease (7 [3–14] months). Daily adherence to HMV of greater than 4 h/night was associated with better outcomes (10 [3–24] vs. 30 [10–76] months; p < 0.001). 43% with confirmed location of death died outside the hospital. Conclusions: The time-to-death on home mechanical ventilation varies widely across disease groups with chronic respiratory failure and seems to be associated with daily usage time. Trial registration: researchregistry.com UIN: researchregistry4122.
King's College London - Homepage
© 2020 King's College London | Strand | London WC2R 2LS | England | United Kingdom | Tel +44 (0)20 7836 5454