Non-invasive mechanical ventilation and mortality in elderly immunocompromised patients hospitalized with pneumonia: a retrospective cohort study
نویسندگان
چکیده
BACKGROUND Mortality after pneumonia in immunocompromised patients is higher than for immunocompetent patients. The use of non-invasive mechanical ventilation for patients with severe pneumonia may provide beneficial outcomes while circumventing potential complications associated with invasive mechanical ventilation. The aim of our study was to determine if the use of non-invasive mechanical ventilation in elderly immunocompromised patients with pneumonia is associated with higher all-cause mortality. METHODS In this retrospective cohort study, data were obtained from the Department of Veterans Affairs administrative databases. We included veterans age ≥65 years who were immunocompromised and hospitalized due to pneumonia. Multilevel logistic regression analysis was used to determine the relationship between the use of invasive versus non-invasive mechanical ventilation and 30-day and 90-day mortality. RESULTS Of 1,946 patients in our cohort, 717 received non-invasive mechanical ventilation and 1,229 received invasive mechanical ventilation. There was no significant association between all-cause 30-day mortality and non-invasive versus invasive mechanical ventilation in our adjusted model (odds ratio (OR) 0.85, 95% confidence interval (CI) 0.66-1.10). However, those patients who received non-invasive mechanical ventilation had decreased 90-day mortality (OR 0.66, 95% CI 0.52-0.84). Additionally, receipt of guideline-concordant antibiotics in our immunocompromised cohort was significantly associated with decreased odds of 30-day mortality (OR 0.31, 95% CI 0.24-0.39) and 90-day mortality (OR 0.41, 95% CI 0.31-0.53). CONCLUSIONS Our findings suggest that physicians should consider the use of non-invasive mechanical ventilation, when appropriate, for elderly immunocompromised patients hospitalized with pneumonia.
منابع مشابه
Non-Invasive Mechanical Ventilation and Mortality in Immunocompromised Patients Hospitalized with Pneumonia: A Retrospective Cohort Study
متن کامل
Invasive and Non-invasive Mechanical Ventilation in Pediatric Patients with COVID-19: A Systematic Review
Background and purpose: In the last months of 2019, the new coronavirus infection (COVID-19) spread worldwide. This study investigated the need for mechanical ventilation in children who were admitted for COVID-19. Materials and methods: This article provides a systematic review of studies about children with COVID-19 requiring invasive or non-invasive mechanical ventilation. Electronic databa...
متن کاملRelationship between Vitamin D, Vitamin C, and Selenium Intake and Disease Severity and Outcomes in Patients Hospitalized with COVID-19: A Retrospective Study
Background and purpose: COVID-19 is a viral respiratory disease that results in high mortality. Evidence suggests that micronutrients affect viral and bacterial infections. This study was performed to evaluate the effectiveness of micronutrients (vitamin D, vitamin C, and selenium) on the disease severity in patients hospitalized with COVID-19. Materials and methods: This retrospective cross-...
متن کاملReview Paper: The Bed Incline and Prevention of Ventilator-Associated Pneumonia
Background: Ventilator-Associated Pneumonia (VAP) is the most common nosocomial (hospital acquired) infection among patients undergoing mechanical ventilation. It increases mortality rate, duration of mechanical intubated ventilation, and hospitalization in the Intensive Care Units (ICUs). This review study aims to determine the proper gradient of a hospital bed in preventing VAP in patients ho...
متن کاملThe mortality risk factor of community acquired pneumonia patients with chronic obstructive pulmonary disease: a retrospective cohort study
BACKGROUND Chronic obstructive pulmonary disease (COPD) is one of the most common comorbidities in community acquired pneumonia (CAP) patients. We aimed to investigate the characteristics and mortality risk factors of COPD patients hospitalized with CAP. METHODS A retrospective cohort study was conducted at Shanghai Pulmonary Hospital and Shanghai Dahua Hospital. Clinical and demographic data...
متن کامل