Highlights
- •We assessed 17 years trends in ventilator support among patients with heart failure.
- •Beside type of ventilator support the clinical profile of patients worsen over time.
- •Over time the use of noninvasive ventilation (NIV) increased significantly.
- •From 2001 to 2017 the use of invasive mechanical ventilation (IMV) decreased.
- •In hospital mortality decreased over time for NIV, NIV+IMM and was stable for IMV.
ABSTRACT
Background
We evaluated seventeen years’ trends (2001-2017) in the utilization of non-invasive
ventilation (NIV), invasive mechanical ventilation (IMV) or both types of ventilator
support (NIV+IMV) among patients hospitalized for heart failure (HF).
Methods
Observational retrospective epidemiological study using the Spanish National Hospital
Discharge Database.
Results
Over a total of 3,634,044 HF hospitalized patients, we identified 164,815 who were
treated with ventilator support. 70.5% received NIV, 24.9% IMV and 4.6% both procedures.
Patients receiving NIV were the oldest and had the highest mean value for Charlson
comorbidity index (CCI) score. For all types of ventilation values of CCI≥3 increased
significantly over the study period (all p<0.001). Patients who received IMV had the
highest IHM (48.1%) followed by those with NIV+IMV (44.7%) and NIV (19.9%). The in
hospital mortality (IHM) decreased significantly in patients with NIV+IMV and NIV
and remained stable in those with IMV. Compared to admissions without ventilation,
the probability of receiving NIV and NIV+IMV increased significantly over time, however
IMV decreased significantly. Factors associated with a greater probability of receiving
NIV vs not being ventilated included higher age, higher CCI and suffering pneumonia
whereas male sex reduced the probability. For IMV and NIV+IMV the factors are the
same than for NIV, except male sex that increased the probability for IMV and NIV+IMV.
Conclusions
We found a significant change in ventilator strategy in hospitalized HF patients over
time. Even if the clinical profile is worsening IHM decreased significantly over time,
but only in HF patients who received NIV and NIV+IMV.
Keywords
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Article info
Publication history
Published online: April 20, 2020
Accepted:
April 4,
2020
Received in revised form:
February 16,
2020
Received:
December 23,
2019
Identification
Copyright
© 2020 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
