Home non-invasive ventilation use following acute hypercapnic respiratory failure in COPD.

RATIONALE Patients with COPD and hypercapnic respiratory failure have a worse prognosis and experience a faster deterioration in their pulmonary function. The benefit of home NPPV following an acute exacerbation of COPD with hypercapnic respiratory failure is not well understood. OBJECTIVES To evaluate the effect of home NPPV use in patients following a hospitalization for AECOPD with acute hypercapnic respiratory failure on event-free survival after an index admission. METHODS We conducted a retrospective, single-center, chart review on patients hospitalized in 2011 with a diagnosis of AECOPD, hypercapnia, and used NPPV during hospitalization. 166 patients were included and were divided into two groups: patients who used NPPV post discharge and patients who did not. RESULTS Patients in the NPPV post discharge group demonstrated superior event-free survival compared to the no-NPPV post discharge group (y2 = 23.8, p < 0.0001). The NPPV post discharge group had a statistically significant reduction in hospital readmissions (40% versus 75%, p < 0.0001) through 180 days from the index admission. CONCLUSIONS Patients who used NPPV following an admission for AECOPD with hypercapnic respiratory failure had lower readmission rates and improved event-free survival after 180 days from an index admission compared to patients who did not use NPPV post discharge.