Outcomes of patients aged ≥80 years with respiratory failure initially treated with non-invasive ventilation in European intensive care units before and during COVID-19 pandemic
Polok, Kamil (Jagiellonian University Medical College)
Fronczek, Jakub (Jagiellonian University Medical College)
Guidet, Bertrand (Sorbonne Universités)
Artigas Raventós, Antoni (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
De Lange, Dylan W. (University Utrecht)
Fjølner, Jesper (Viborg Regional Hospital)
Leaver, Susannah (St George's Hospital)
Beil, Michael (Hadassah Medical Center)
Sviri, Sigal (Hebrew University of Jerusalem)
Bruno, Raphael Romano (Heinrich-Heine-University Duesseldorf)
Wernly, Bernhard (Paracelsus Medical University)
Pinto, Bernardo Bollen (Geneva University Hospitals)
Schefold, Joerg C. (University of Bern)
Studzińska, Dorota (Jagiellonian University Medical College)
Joannidis, Michael (Medical University Innsbruck)
Oeyen, Sandra (Universitair Ziekenhuis Gent)
Marsh, Brian (Mater Misericordiae University Hospital)
Andersen, Finn H. (Norwegian University of Science and Technology)
Moreno, Rui (Universidade da Beira Interior)
Cecconi, Maurizio (Humanitas Research Hospital (Itàlia))
Flaatten, Hans (University of Bergen)
Jung, Christian (Heinrich-Heine-University Duesseldorf)
Szczeklik, Wojciech (Jagiellonian University Medical College)
Universitat Autònoma de Barcelona

Date:	2023
Abstract:	Non-invasive ventilation (NIV) has been commonly used to treat acute respiratory failure due to COVID-19. In this study we aimed to compare outcomes of older critically ill patients treated with NIV before and during the COVID-19 pandemic. We analysed a merged cohort of older adults admitted to intensive care units (ICUs) due to respiratory failure. Patients were enrolled into one of two prospective observational studies: before COVID-19 (VIP2-2018 to 2019) and admitted due to COVID-19 (COVIP-March 2020 to January 2023). The outcomes included: 30-day mortality, intubation rate and NIV failure (death or intubation within 30 days). The final cohort included 1986 patients (1292 from VIP2, 694 from COVIP) with a median age of 83 years. NIV was used as a primary mode of respiratory support in 697 participants (35. 1%). ICU admission due to COVID-19 was associated with an increased 30-day mortality (65. 5% vs. 36. 5%, HR 2. 18, 95% CI 1. 71 to 2. 77), more frequent intubation (36. 9% vs. 17. 5%, OR 2. 63, 95% CI 1. 74 to 3. 99) and NIV failure (76. 2% vs. 45. 3%, OR 4. 21, 95% CI 2. 84 to 6. 34) compared to non-COVID causes of respiratory failure. Sensitivity analysis after exclusion of patients in whom life supporting treatment limitation was introduced during primary NIV confirmed higher 30-day mortality in patients with COVID-19 (52. 5% vs. 23. 4%, HR 2. 64, 95% CI 1. 83 to 3. 80). The outcomes of patients aged ≥80 years treated with NIV during COVID-19 pandemic were worse compared then those treated with NIV in the pre-pandemic era. The online version contains supplementary material available at 10. 1186/s13613-023-01173-2.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	COVID-19 ; Intensive care unit ; Non-invasive ventilation ; Older patients ; Respiratory failure
Published in:	Annals of Intensive Care, Vol. 13 (september 2023) , ISSN 2110-5820

DOI: 10.1186/s13613-023-01173-2
PMID: 37698708

10 p, 1.1 MB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Parc Taulí Research and Innovation Institute (I3PT
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