TY - JOUR T1 - Long term non-invasive ventilation (LT-NIV) reduces mortality and the risk of hospital readmission in systemic COPD patients JF - European Respiratory Journal JO - Eur Respir J VL - 42 IS - Suppl 57 SP - P2473 AU - Jean-Christian Borel AU - Jean-Louis Pepin AU - Christophe Pison AU - Aurélien Vesin AU - Jésus Gonzalez-Bermejo AU - Isabelle Court-Fortune AU - Jean-François Timsit Y1 - 2013/09/01 UR - http://erj.ersjournals.com/content/42/Suppl_57/P2473.abstract N2 - Aim: COPD is a heterogeneous condition with different phenotypes leading to distinctive causes of hospitalization and mortality. We hypothesized that LT-NIV would differently impact on the prognosis of “respiratory” COPD with severe airflow obstruction and “systemic” COPD with a milder airflow obstruction but higher rates of obesity and co-morbidities.Methods: Multicentre prospective cohort of COPD patients treated by home LT-NIV. Co-morbidities, clinical conditions, respiratory parameters were recorded at NIV initiation. Follow-up data included vital status, daily use of NIV and hospitalizations. The impact of daily use of NIV on mortality/hospitalization for acute exacerbations was tested by an adjusted Cox model.Results: 213 patients (59% respiratory COPD) were included (median follow-up 47 months). 44% patients died during the study. After adjustment on other prognostic risk factors, respiratory COPD was associated with a higher rate of death or readmission than systemic COPD [70 vs 42%]. For the whole group, a daily use of NIV > 9h/day was associated with an increased risk of death or hospital readmission [HR=1.7; 95 CI: 1.1; 2.5]. Figure 1, displaying a U-shape, shows that intermediate daily NIV use was associated with a better prognosis only in systemic COPD [>5 h/day: HR=0.4; 95CI: 0.2; 0.9].Conclusion: LT-NIV improves prognosis only in adherent systemic COPD. ER -