Predictors of in-hospital mortality and need for invasive mechanical ventilation in elderly COPD patients presenting with acute hypercapnic respiratory failure

Madkour, Ashraf; Adly, Nermien Naim

doi:10.1016/j.ejcdt.2013.07.003

Cited by 7 publications

(9 citation statements)

References 43 publications

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“…These articles described the development of 408 prognostic models in COPD patients, the external validation of 38 prognostic models, and the application of 20 prognostic models originally developed for health outcomes other than prognosis of COPD patients. One of the eligible papers was identified through the hand search of references from eligible articles 22. The prognostic models were mainly developed in the US (n=91; 22%), Spain (n=57; 14%), and the UK (n=34; 8%), whereas 80 (20%) models were developed in multicentre studies from multiple countries.…”

Section: Resultsmentioning

confidence: 99%

Prognostic models for outcome prediction in patients with chronic obstructive pulmonary disease: systematic review and critical appraisal

Bellou

Belbasis

Konstantinidis

et al. 2019

BMJ

126

121

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Objective To map and assess prognostic models for outcome prediction in patients with chronic obstructive pulmonary disease (COPD). Design Systematic review. Data sources PubMed until November 2018 and hand searched references from eligible articles. Eligibility criteria for study selection Studies developing, validating, or updating a prediction model in COPD patients and focusing on any potential clinical outcome. Results The systematic search yielded 228 eligible articles, describing the development of 408 prognostic models, the external validation of 38 models, and the validation of 20 prognostic models derived for diseases other than COPD. The 408 prognostic models were developed in three clinical settings: outpatients (n=239; 59%), patients admitted to hospital (n=155; 38%), and patients attending the emergency department (n=14; 3%). Among the 408 prognostic models, the most prevalent endpoints were mortality (n=209; 51%), risk for acute exacerbation of COPD (n=42; 10%), and risk for readmission after the index hospital admission (n=36; 9%). Overall, the most commonly used predictors were age (n=166; 41%), forced expiratory volume in one second (n=85; 21%), sex (n=74; 18%), body mass index (n=66; 16%), and smoking (n=65; 16%). Of the 408 prognostic models, 100 (25%) were internally validated and 91 (23%) examined the calibration of the developed model. For 286 (70%) models a model presentation was not available, and only 56 (14%) models were presented through the full equation. Model discrimination using the C statistic was available for 311 (76%) models. 38 models were externally validated, but in only 12 of these was the validation performed by a fully independent team. Only seven prognostic models with an overall low risk of bias according to PROBAST were identified. These models were ADO, B-AE-D, B-AE-D-C, extended ADO, updated ADO, updated BODE, and a model developed by Bertens et al. A meta-analysis of C statistics was performed for 12 prognostic models, and the summary estimates ranged from 0.611 to 0.769. Conclusions This study constitutes a detailed mapping and assessment of the prognostic models for outcome prediction in COPD patients. The findings indicate several methodological pitfalls in their development and a low rate of external validation. Future research should focus on the improvement of existing models through update and external validation, as well as the assessment of the safety, clinical effectiveness, and cost effectiveness of the application of these prognostic models in clinical practice through impact studies. Systematic review registration PROSPERO CRD42017069247

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Section: Resultsmentioning

confidence: 99%

Prognostic models for outcome prediction in patients with chronic obstructive pulmonary disease: systematic review and critical appraisal

Bellou

Belbasis

Konstantinidis

et al. 2019

BMJ

126

121

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“…Ceci peut être expliqué en partie par le rôle du vieillissement pulmonaire et du tabagisme cumulatif dans la physio-pathogénie de la BPCO [ 15 ]. Une nette prédominance masculine (97,9%) a été trouvée dans notre étude, ceci est dû à un tabagisme féminin moindre dans notre pays ainsi que les pays de proximité comme l´Egypte (genre masculin=70%) [ 12 ]. Cette différence diminue nettement dans les pays occidentaux où le tabagisme féminin est développé (genre masculin = 47%) [ 11 ].…”

Section: Discussionunclassified

“…Cette différence diminue nettement dans les pays occidentaux où le tabagisme féminin est développé (genre masculin = 47%) [ 11 ]. La prévalence de la VMI lors des EABPCO rapportée dans la littérature est très hétérogène, et elle varie de 9,8% à 84,1% [ 4 , 12 , 13 , 16 ]. Dans notre étude, le taux de recours à la VMI est de 11,6%.…”

Section: Discussionunclassified

“…Dans l´étude de Khilnani et al .les patients ayant eu une VMI avaient un âge plus avancé [ 14 ]. Mais dans notre étude, ainsi que dans d´autres études similaires, l´âge n´apparait pas comme un facteur prédictif de recours à la VMI [ 4 , 12 , 13 ]. Par contre, plusieurs études ont identifié l´âge comme un facteur prédictif de mortalité chez les patients ayant une VMI [ 17 - 19 ].…”

Section: Discussionunclassified

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Facteurs prédictifs de la ventilation mécanique invasive chez les patients atteints de Broncho-Pneumopathie Chronique obstructive (BPCO)

Loued¹,

Saad²,

Migaou³

et al. 2021

Pan Afr Med J

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Introduction le recours à la ventilation mécanique invasive (VMI) au cours des exacerbations aiguës de la broncho-pneumopathie chronique obstructive (EABPCO) constitue un tournant évolutif péjoratif de la maladie. L'intérêt de notre travail est de déterminer les facteurs prédictifs de la VMI lors des EABPCO. Méthodes il s´agissait d´une étude rétrospective sur les dossiers des patients hospitalisés dans notre service pour EABPCO durant une période de 18 ans (2000-2017). Nous avons comparé 2 groupes: G1: patients ayant au moins une VMI pour EABPCO et G2: patients qui n´ont jamais eu une VMI suite à une EABPCO. Résultats l´étude a inclus 1152 patients BPCO, 133 dans le Groupe G1 (11,5%), et 1019 dans le Groupe G2 (88,5%). Les patients de G1 étaient plus symptomatiques (p < 0,001) avec une obstruction bronchique plus sévère (p < 0,001). Les patients de G1 faisaient plus d´exacerbations (p < 0,001), plus d´hospitalisations et plus de recours à la ventilation non invasive (VNI) (p < 0,001). De même, les patients de G1 développaient plus d´insuffisance respiratoire chronique (IRC) (p < 0,001) et avaient une survie significativement plus basse. Les facteurs de risque indépendants associés à la VMI étaient l´hypercapnie et la baisse du pH lors des EABPCO sévères, l´antécédent de recours à la VNI, et l'état d´IRC. Conclusion l´altération de la fonction respiratoire, la sévérité de l´exacerbation, et le recours à la VNI lors d´un épisode antérieur constituent des facteurs prédictifs d´une VMI avec des conséquences péjoratives.

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“…However, most of the studies primarily focus only on the chronic obstructive pulmonary disease. [ 7 – 9 ]…”

Section: Introductionmentioning

confidence: 99%

Risk of acute respiratory failure among hospitalized patients with various admission serum albumin levels

et al. 2020

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Predictors of in-hospital mortality and need for invasive mechanical ventilation in elderly COPD patients presenting with acute hypercapnic respiratory failure

Cited by 7 publications

References 43 publications

Prognostic models for outcome prediction in patients with chronic obstructive pulmonary disease: systematic review and critical appraisal

Prognostic models for outcome prediction in patients with chronic obstructive pulmonary disease: systematic review and critical appraisal

Facteurs prédictifs de la ventilation mécanique invasive chez les patients atteints de Broncho-Pneumopathie Chronique obstructive (BPCO)

Risk of acute respiratory failure among hospitalized patients with various admission serum albumin levels

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