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NIPPV linked to increased hospital mortality rates in small group of patients
Date:10/20/2011

e exacerbations in the United States."

The increase is consistent with results reported by investigators in smaller studies, he said.

For this study, researchers from the University of Pittsburgh, Emory University, the University of Illinois at Chicago and the University of Kentucky reviewed clinical patient data gathered by the Healthcare Cost and Utilization Project Nationwide Inpatient Sample (HCUP-NIS) database between 1998 and 2008. The researchers examined changes in the frequency of NIPPV and IMV use from 1998 to 2008, and compared patient demographics, income status, payer type, hospital region and hospital type among patients who initially received NIPPV, IMV or no respiratory support after hospital admission. They also examined in-hospital mortality, length-of-stay and total hospitalization charges, and compared those outcomes among patient groups.

At the completion of the study, they found that although the annual number of hospitalizations for acute exacerbations remained relatively constant during the 10-year period, there was a progressive increase in the use of NIPPV and a progressive decrease in use of IMV; during the entire study period, there was a fourfold increase in the use of NIPPV, which had grown to overtake IMV as the most frequently used form of respiratory support for patients hospitalized with acute exacerbations in the United States.

They also found that despite a steady decline in mortality among most patients studied, patients who used NIPPV and were then transitioned to IMV had significantly higher mortality rates than other patients, and that the mortality rate in these transitioned patients increased during the study period while mortality rates of other groups declined. Patients in this group also experienced the greatest increase in hospital charges and longest hospital length-of-stay.

"The concerning finding in our analysis was the high mortality in the group of patients who, despite initial treatment with NIP
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Contact: Brian Kell
bkell@thoracic.org
212-315-6442
American Thoracic Society
Source:Eurekalert

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