Abstract
BACKGROUND: The prevalence of chronic disease and do-not-intubate status increases with age. Thus, we aimed to determine characteristics and outcomes associated with noninvasive ventilation (NIV) use for acute respiratory failure (ARF) in different age groups.
METHODS: A database comprising prospective data collected on site on all adult patients with ARF requiring ventilatory support from 8 acute care hospitals in Massachusetts was used.
RESULTS: From a total of 1,225 ventilator starts, overall NIV utilization, success, and in-hospital mortality rates were 22, 54, and 18% in younger (18–44 y); 34, 65, and 13% in middle-aged (45–64 y); 49, 68, and 17% in elderly (65–79 y); and 47, 76, and 24% in aged (≥80 y) groups, respectively (P < .001, P = .08, and P = .11, respectively). NIV use for cardiogenic pulmonary edema and subjects with a do-not-intubate order increased significantly with advancing age (25, 57, 57, and 74% and 7, 12, 18, and 31%, respectively, in the 4 age groups [P < .001 and P = .046, respectively]). For subjects receiving NIV with a do-not-intubate order, success and in-hospital mortality rates were similar in different age groups (P = .27 and P = .98, respectively).
CONCLUSIONS: NIV use and a do-not-intubate status are more frequent in subjects with ARF ≥65 y than in those <65 y, especially for subjects with cardiogenic pulmonary edema. However, NIV success and mortality rates were similar between age groups. (ClinicalTrials.gov registration NCT00458926.)
Footnotes
- Correspondence: Aylin Ozsancak Ugurlu, Oymaci sok. No: 2, 34662 Altunizade/Istanbul Turkey. E-mail: aozsancak{at}hotmail.com.
This study was supported in part by an Eli Lilly Distinguished Scholar Award from the Chest Foundation of the American College of Chest Physicians. Dr Hill received research grants from Respironics and Breathe Technologies. Dr Ozsancak Ugurlu received a research grant from the Scientific and Technological Research Council of Turkey (TUBITAK). The other authors have disclosed no conflicts of interest.
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