Impact of home mechanical ventilation on health-related quality of life

¹ Dept of Pneumology, University Hospital Freiburg, Germany
² Members of the "quality of life in home ventilation" study group: Barchfeld, Thomas; Fachkrankenhaus Kloster Grafschaft/Schmallenberg, Germany, Freidel, Klaus; St.-Josefs Hospital Wiesbaden, Germany (statistician), Geiseler, Jens; Asklepios Fachkliniken München-Gauting, Germany, Heinemann, Frank; Krankenhaus Donaustauf, Germany, Kalbitz, Frank; Städtisches Krankenhaus Martha – Maria Halle-Dölan, Germany, Köhnlein, Thomas; Universitätsklinik Magdeburg, Germany, Raffenberg, Manfred; Lungenfachklinik Heckeshorn/Berlin, Germany, Petermann, Franz; Universität Bremen, Germany, Schild, Klaus; Ev. Krankenhaus Göttingen-Weende e.V. Lenglern, Germany, Schucher, Bernd; Krankenhaus Großhansdorf, Germany, Windisch, Wolfram; Universitätsklinik Freiburg, Germany

^* To whom correspondence should be addressed. E-mail: wolfram.windisch{at}uniklinik-freiburg.de.

	Abstract

This multicentre study was aimed at comparably assessing benefits and burdens gained by home mechanical ventilation (HMV).

Hospitalisation, side effects and health-related quality of life (HRQL) were assessed one month and one year following HMV establishment using the MOS 36-Item Short-Form Health Status Survey (SF-36, general HRQL) and the Severe Respiratory Insufficiency (SRI) Questionnaire (condition-specific HRQL).

Eighty-five (27 COPD, 29 restrictive thoracic, 17 neuromuscular, 9 obesity hypoventilation syndrome, 3 miscellaneous) out of 135 eligible patients completed the study. Mean SRI-Summary Scale (range 0–100) improved significantly and comparatively in all 85 patients from 49±15 at baseline to 61±15 at one month and to 61±16 at one year, but improvements of subscale scores differed amongst subgroups. SF-36 scores also improved, but the SRI was superior in detecting HRQL changes. Facial soreness and dry throat were the most commonly reported side effects. Patients spent a mean of 12±6 days in hospital at baseline and 3±3 days at each follow-up visit. Only four patients required unplanned hospitalisation.

Overall general and condition-specific HRQL aspects improve following HMV establishment independently from the underlying disease, which, however, has an impact on changes within specific HRQL domains. The need for hospitalization is low, once HMV is carefully established.

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