PT - JOURNAL ARTICLE AU - Helmy Haja Mydin AU - Stephen Murphy TI - Predictors of mortality in patients treated with non-invasive ventilation for acute hypercapnic respiratory failure due to COPD DP - 2011 Sep 01 TA - European Respiratory Journal PG - p3783 VI - 38 IP - Suppl 55 4099 - http://erj.ersjournals.com/content/38/Suppl_55/p3783.short 4100 - http://erj.ersjournals.com/content/38/Suppl_55/p3783.full SO - Eur Respir J2011 Sep 01; 38 AB - Background: Mortality in patients treated with non-invasive ventilation (NIV) for acute hypercapnic respiratory failure (AHRF) during an acute exacerbation of COPD (AECOPD) is high. For many patients, AHRF is an end-stage process and NIV may be inappropriate. However there is no definitive method of identifying patients who are unlikely to survive.Aim: The aim of study was to identify clinical and laboratory variables predictive of mortality in patients treated with NIV for AHRF due to COPD.Methods: Patients treated with NIV for AHRF due to COPD between 12/09 and 07/10 were included in prospective study. Variables included FEV1, pre-admission treatment, performance status (WHO-PS), clinical observations & composite physiological score (early warning score EWS), routine haematology & biochemistry, and arterial blood gases prior to commencing NIV.Results: N=65 (29M, 36F); mean (SD) age 71 (10.5) yrs. Mortality was 33.8%. On univariate analysis variables associated with mortality were: WHO-PS ≥3 OR 37.78 (7.41-192.53) p<0.0001; long-term oxygen therapy OR 2.99 (1.03-8.66) p<0.05; anaemia OR 5.54 (1.81-16.92) p<0.003, diastolic blood pressure OR 0.96 (0.92-0.99) p<0.03, raised EWS OR 1.45 (1.06-1.99) p<0.03, severe acidosis (ph<7.20) OR 3.65 (1.17-11.37) p<0.03. On multivariate analysis only anaemia OR 5.86 (1.28-26.87) p<0.03 and WHO-PS ≥3 OR 39.08 (6.83-223.61) p<0.0001 were significant. The presence of both predicted 68% of deaths with a specificity of 94%.Conclusion: The presence of anaemia and WHO-PS ≥3 are predictive of mortality in patients on NIV for AECOPD. This should prompt the physician to consider the suitability of NIV as a treatment option.