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Comorbidities and mortality in hypercapnic obese under domiciliary noninvasive ventilation
Jean-Christian Borel1, Benoit Burel, Renaud Tamisier
1INSERM U 1042, HP2 Laboratory, Université Joseph Fourier, Faculté de Médecine, Grenoble, France. j.borel@agiradom.com
Plos One
|January 24, 2013
Summary
Long-term noninvasive ventilation (NIV) improves survival in obesity-associated hypoventilation. Cardiovascular comorbidities, particularly combinations of cardiovascular drugs, significantly increase mortality risk in these patients.
Area of Science:
- Pulmonary Medicine
- Cardiology
- Critical Care
Background:
- Obesity-associated hypoventilation carries a high mortality risk without treatment.
- Long-term noninvasive ventilation (NIV) is a standard treatment, but factors influencing survival require further investigation.
Purpose of the Study:
- To explore the impact of comorbidities, medications, and NIV compliance on survival in patients with obesity-associated hypoventilation.
- To identify predictive factors for mortality in this patient population.
Main Methods:
- An observational cohort study of 107 hypercapnic obese patients initiated on NIV.
- Kaplan-Meier survival analysis and Cox proportional hazards models were used.
- Covariates included anthropometric data, pulmonary function, blood gases, SpO2, comorbidities, medications, and NIV compliance.
Main Results:
- Overall survival rates at 1, 2, and 3 years were 99%, 94%, and 89%, respectively.
- Multivariate analysis identified a combination of cardiovascular agents as the sole independent predictor of increased mortality (HR = 5.3).
- Female gender was associated with a reduced risk of death.
Conclusions:
- Cardiovascular comorbidities are the primary mortality predictor in obesity-associated hypoventilation patients treated with NIV.
- Integrated treatment strategies addressing cardiovascular risk are crucial for improving outcomes in this population.
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