RT Journal Article
SR Electronic
T1 Non-invasive mechanical ventilation and mortality in immunocompromised patients hospitalized with pneumonia
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P239
VO 44
IS Suppl 58
A1 Christopher Johnson
A1 Mark Metersky
A1 Antonio Anzueto
A1 Eric Mortensen
YR 2014
UL http://erj.ersjournals.com/content/44/Suppl_58/P239.abstract
AB Background: The use of non-invasive mechanical ventilation for patients with severe pneumonia may provide beneficial outcomes while circumventing potential complications associated with invasive mechanical ventilation. The aim of our study was to determine if the use of non-invasive mechanical ventilation in elderly immunocompromised patients with pneumonia is associated with higher all-cause mortality.Methods: In this retrospective cohort study, data were obtained from the United States Department of Veterans Affairs administrative databases. We included veterans age >65 years who were immunocompromised and hospitalized due to pneumonia. Multilevel logistic regression analysis was used to determine the relationship between the use of invasive versus non-invasive mechanical ventilation and 30-day and 90-day mortality.Results: Of 1,946 patients in our cohort, 717 received non-invasive mechanical ventilation and 1,229 received invasive mechanical ventilation. There was no significant association between all-cause 30-day mortality and non-invasive versus invasive mechanical ventilation in our adjusted model (odds ratio 0.85, 95% confidence interval 0.66-1.10). However, those patients who received non-invasive mechanical ventilation had decreased 90-day mortality (0.66, 0.52-0.84). Additionally, receipt of guideline-concordant antibiotics was significantly associated with decreased odds of 30-day mortality (0.31, 0.24-0.39) and 90-day mortality (0.41, 0.31-0.53).Conclusions: Our findings suggest that physicians should consider the use of non-invasive mechanical ventilation, when appropriate, for elderly immunocompromised patients hospitalized with pneumonia.