Author/Authors :
Hong, Yueling Department of Respiratory and Critical Care Medicine - The First Affiliated Hospital of Chongqing Medical University, Chongqing, China , Liu, Qiao Department of Respiratory and Critical Care Medicine - The First Affiliated Hospital of Chongqing Medical University, Chongqing, China , Bai, Linfu Department of Respiratory and Critical Care Medicine - The First Affiliated Hospital of Chongqing Medical University, Chongqing, China , Jiang, Lei Department of Respiratory and Critical Care Medicine - The First Affiliated Hospital of Chongqing Medical University, Chongqing, China , Han, Xiaoli Department of Respiratory and Critical Care Medicine - The First Affiliated Hospital of Chongqing Medical University, Chongqing, China , Huang, Shicong Department of Respiratory and Critical Care Medicine - The First Affiliated Hospital of Chongqing Medical University, Chongqing, China , Hu, Wenhui Department of Respiratory and Critical Care Medicine - The First Affiliated Hospital of Chongqing Medical University, Chongqing, China , Duan, Jun Department of Respiratory and Critical Care Medicine - The First Affiliated Hospital of Chongqing Medical University, Chongqing, China , Liu, Chuanbo Department of Critical Care Medicine -The People’s Hospital of Gaoxin District, Chongqing, China
Abstract :
Background. Head-to-head comparison of treatment failure and costs among chronic obstruct pulmonary disease (COPD)
patients who used noninvasive ventilation (NIV) in the ward versus in the ICU is lacking. Methods. 1is retrospective study was
performed in a department of respiratory and critical care medicine in a teaching hospital. COPD patients who used NIV in the
respiratory ward or respiratory ICU were screened. We enrolled patients with PaCO2 more than 45 mmHg and pH less than 7.35
before the use of NIV. Results. We enrolled 83 patients who initiated NIV in the ward and 319 patients in the ICU. Only 5 (6%)
patients in the ward were required to transfer to ICU for intensive care. 1e vital signs were worse but improved faster within 24 h
of NIV among patients in the ICU than those in the ward. 1e NIV failure, hospital mortality, and the length of stay in hospital did
not differ between the two groups. However, the duration of NIV was shorter (median 4.0 vs. 6.1 days, p < 0.01) and hospital costs
were higher (median 4638 vs. 3093 $USD, p < 0.01) among patients in the ICU than those in the ward. After propensity matching,
42 patients were left in each group, and the baseline data were comparable between the two groups. 1e findings in the overall
cohort were confirmed again in the propensity-matched cohort. Conclusions. Among COPD patients, the use of NIV in the ward
leads to longer duration of NIV, but lower hospital costs, and similar NIV failure and mortality compared with those in the ICU.
