Outcome of non-invasive domiciliary ventilation in elderly patients

Introduction: The lower life expectancy in elderly patients (> 75 years) with chronic respiratory failure has been argued as possible limiting the use of Non-invasive domiciliary ventilation (NIDV). The aim of this study was to evaluate the outcome-including long term effects of NIDV- in our elderly patients. Methods: Prospective study of patients who started NIDV at 75 years of older. Data recorded included: demographic data, comorbidities, compliance, admissions and survival at the end of follow-up. Analysis of survival was undertaken using Kaplan-Meier method and Cox regression. Results: 82 patients were included (72% women, mean age: 79.9 ±3, 7 years). Diagnosis included: Obesity hypoventilation Syndrome (65,9 %) and restrictive diseases (17,1 %). Significants improvements were obtained in diurnal blood gases at discharge and in the follow-up as well as a significant decrease in the number of hospital admissions. The compliance at home was considered poor in 50 %. At the end of the follow-up the mortality was 63,4 %. The estimated survival at 1o year, 2 o year and 3 o year was 62 %, 53 % and 43 %, respectively. It was independently associated with: good compliance (OR: 0,46; CI 95 %: 0,24-0,87), restrictive disease (OR: 0,36; CI95 %: 0,16-0,82), EPAP level (OR: 1,6; CI 95 %: 1,1-2,3) and dyspnea level (mMRC) in the follow-up (OR 2,1; IC95 %: 1,2-3,6). Conclusions: 1.-In our experience, the results of the NIDV in elderly patients were satisfactory improving arterial blood gases and readmissions. 2. Global compliance was poor (50%). In spite of that, NIDV obtained long survival in these patients. 3. Survival was better in “good compliance” patients, in restrictive diseases and with less functional impairment.