Survival of patients with chronic respiratory failure on long-term oxygen therapy and or non-invasive ventilation at home. Issue 4 (August 2015)

• Record Type: Journal Article
• Authors: Cano, Noël J.; Pichard, Claude; Court-Fortune, Isabelle; Costes, Frédéric; Cynober, Luc; Gérard-Boncompain, Michèle; Molano, Luis Carlos; Cuvelier, Antoine; Laaban, Jean-Pierre; Melchior, Jean-Claude; Raphaël, Jean-Claude; France, Julie; Lloret, Thomas; Roth, Hubert; Pison, Christophe; The Clinical Research Group of the Société Francophone Nutrition Clinique et Métabolisme
• Is Part Of: Clinical nutrition. Volume 34:Issue 4(2015:Aug.)
• Page Start: 739
• Page End: 744
• Publication Date: 2015-08
• Subjects: Critically ill -- Nutrition -- Periodicals; Diet therapy -- Periodicals; Parenteral feeding -- Periodicals; Enteral feeding -- Periodicals; Enteral Nutrition -- Periodicals; Parenteral Nutrition -- Periodicals; Metabolism -- Periodicals; Diétothérapie -- Périodiques; Alimentation parentérale -- Périodiques; Alimentation entérale -- Périodiques; Nutrition -- Périodiques; Diet therapy; Enteral feeding; Nutrition; Parenteral feeding; Electronic journals; Periodicals; Electronic journals; 615.854
• DOI: 10.1016/j.clnu.2014.08.011
• Languages: English
• ISSNs: 0261-5614

Abstract

<abstract xml:lang="en" abstract-type="author" id="abs0010"> <title id="sectitle0010">Summary</title> <sec> <title id="sectitle0015">Background & aims</title> <p id="abspara0010">Chronic respiratory failure (CRF) is the common fate of respiratory diseases where systemic effects contribute to outcomes. In a prospective cohort of home-treated patients with CRF, we looked for predictors of long-term survival including respiratory, nutritional and inflammatory dimensions.</p> </sec> <sec> <title id="sectitle0020">Methods</title> <p id="abspara0015">637 stable outpatients with CRF, 397 men, 68 ± 11 years, on long-term oxygen therapy and/or non-invasive ventilation from 21 chest clinics were enrolled and followed over 53 ± 31 months. CRF resulted from Chronic Obstructive Pulmonary Disease (COPD) in 48.5%, restrictive disorders 32%, mixed (obstructive and restrictive patterns) respiratory failure 13.5%, bronchiectasis 6%. Demographic characteristics, smoking habits, underlying respiratory diseases, forced expiratory volume in one second (FEV<sub>1</sub>), forced vital capacity (FVC), arterial blood gases, 6-min walking distance (6MWD), hemoglobin, body mass index (BMI), serum albumin, transthyretin, C-reactive protein (CRP), history of respiratory assistance, antibiotic and oral corticosteroid use during the previous year were recorded.</p> </sec> <sec> <title id="sectitle0025">Results</title> <p id="abspara0020">322 deaths occurred during the follow-up. One-, five- and 8-year actuarial survival was 89%, 56% and 47%. By Cox univariate analysis, age, respiratory disease, PaO<sub>2</sub>, PaCO<sub>2</sub>, FEV<sub>1</sub>/FVC, BMI, 6MWD, activity score, type and length of home respiratory assistance, smoking habits, oral corticosteroid and antibiotic uses, albumin, transthyretin, hemoglobin and CRP levels were associated with survival. Multivariate analysis identified eight independent markers of survival: age, FEV<sub>1</sub>/FVC, PaO<sub>2</sub>, PaCO<sub>2</sub>, 6MWD, BMI, serum transthyretin, CRP ≥ 5 mg/l.</p> </sec> <sec> <title id="sectitle0030">Conclusions</title> <p id="abspara0025">In CRF, whatever the underlying diseases, besides the levels of obstructive ventilatory defect and gas exchange failure, 6MWD, BMI, serum transthyretin and CRP ≥ 5 mg/l predicted long-term survival identifying potential targets for nutritional rehabilitation.</p> </sec> </abstract>