Non Invasive Ventilation in COPD: Predicting outcome in hospital and assessing quality of life over one year

Conditions

Chronic obstructive pulmonary disease (COPD) Respiratory Chronic obstructive pulmonary disease (COPD)

Nicholas D. Lane, Tom Hartley, John Steer, Mark Elliott, Milind Sovani et al. (14 authors)

2021-09-05

10.1183/13993003.congress-2021.pa1946

S24 Predicting poor outcome at six months following exacerbations of COPD requiring assisted ventilation

ND Lane, TM Hartley, John Steer, MW Elliott, Milind Sovani et al. (14 authors)

2021-01-21

10.1136/thorax-2020-btsabstracts.30

S132 Late failure and relapse in patients receiving non-invasive ventilation for exacerbations of COPD: A UK prospective study

ND Lane, TM Hartley, John Steer, MW Elliott, Milind Sovani et al. (14 authors)

2021-01-21

10.1136/thorax-2020-btsabstracts.137

The Non-Invasive Ventilation Outcomes (NIVO) score in presumed COPD exacerbation without prior spirometry

Nicholas D. Lane, Tom Hartley, John Steer, Mark Elliott, Milind Sovani et al. (14 authors)

2020-09-07

10.1183/13993003.congress-2020.1962

Interventions

Validation study Each patient meeting selection criteria has a dataset collected by their usual care team. This data comprises descriptive indices, the components of our derived tool a

Eligibility

Sex/Gender

All

Inclusion criteria

Inclusion criteria: 1. Age 35 years or older 2. Smoking history greater than or equal to 10 pack years (1 pack per day for 10 years) 3. Obstructive spirometry (FEV1/FVC 6.5)

Exclusion criteria

Exclusion criteria: 1. Previous inclusion in the study 2. Other illness likely to limit survival to less than 1 year

Design outcomes

Primary

Measure	Time frame
Prediction of in-hospital mortality within the validation cohort assessed by the area under the receiver operating characteristic (AUROC) curve for tools developed using: 1. Indices available on admission 2. All indices up to and including the time of deterioration	—

Secondary

Measure	Time frame
In the admitted population: 1. Comparison of the AUROC curves for both novel tools 2. Comparison of the AUROC curves for both novel tools to CAPS, APACHE II and Confalonieri risk chart Among patients surviving to discharge: 1. Mortality to 1 year by review of electronic record, contacting GP or review of patient notes 2. Readmission rates at 30, 90 and 365 days by review of electronic record, contacting GP, review of patient notes 3. Comparison of mortality and clinically significant change in quality of life in patients with, and without pre-defined characteristics: 3.1. Late failure of NIV (recurrent respiratory acidaemia, despite on-going ventilatory support; in-patient mortality will also be captured). 3.2. Persistent hypercapnia. 3.3. Long-term oxygen therapy. 3.4. Long-term ventilation on discharge. 3.5. Eosinopenia (<0.05 109/L) at discharge 4. Longitudinal changes in patient reported outcomes (CAT, eQ-5D-5L, NEADL, HADS) post discharge, quantified by calculating: mean change (relative to the minimum clinically important difference (MCID)); duration maintained above baseline and time taken to reach peak 5. Predictors of a) 6 month mortality and b) poor baseline QoL with a subsequent clinically significant deterioration (poor recovery) 6. Relation between clinically significant anxiety and depression on discharge and: survival, QoL, functional status and readmission rate 7. Examination of patient willingness to undergo ventilation again in the future by direct questioning at baseline and 3 months	—

Measure

Time frame

In the admitted population: 1. Comparison of the AUROC curves for both novel tools 2. Comparison of the AUROC curves for both novel tools to CAPS, APACHE II and Confalonieri risk chart Among patients surviving to discharge: 1. Mortality to 1 year by review of electronic record, contacting GP or review of patient notes 2. Readmission rates at 30, 90 and 365 days by review of electronic record, contacting GP, review of patient notes 3. Comparison of mortality and clinically significant change in quality of life in patients with, and without pre-defined characteristics: 3.1. Late failure of NIV (recurrent respiratory acidaemia, despite on-going ventilatory support; in-patient mortality will also be captured). 3.2. Persistent hypercapnia. 3.3. Long-term oxygen therapy. 3.4. Long-term ventilation on discharge. 3.5. Eosinopenia (<0.05 109/L) at discharge 4. Longitudinal changes in patient reported outcomes (CAT, eQ-5D-5L, NEADL, HADS) post discharge, quantified by calculating: mean change (relative to the minimum clinically important difference (MCID)); duration maintained above baseline and time taken to reach peak 5. Predictors of a) 6 month mortality and b) poor baseline QoL with a subsequent clinically significant deterioration (poor recovery) 6. Relation between clinically significant anxiety and depression on discharge and: survival, QoL, functional status and readmission rate 7. Examination of patient willingness to undergo ventilation again in the future by direct questioning at baseline and 3 months

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Countries

England, United Kingdom, Wales

Contacts

Public ContactVictoria Ferguson

Outcome results

None listed