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

COVIP & VIP2 study groups, Kamil Polok, Jakub Fronczek, Bertrand Guidet, Antonio Artigas, Dylan W De Lange, Jesper Fjølner, Susannah Leaver, Michael Beil, Sigal Sviri, Raphael Romano Bruno, Bernhard Wernly (Co-Autor/-in), Bernardo Bollen Pinto, Joerg C Schefold, Dorota Studzińska, Michael Joannidis, Sandra Oeyen, Brian Marsh, Finn H Andersen, Rui MorenoMaurizio Cecconi, Hans Flaatten, Christian Jung, Wojciech Szczeklik

Publikation: Beitrag in FachzeitschriftOriginalarbeitBegutachtung

5 Quellenangaben (Web of Science)

Abstract

BACKGROUND: 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.

METHODS: 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).

RESULTS: 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).

CONCLUSION: 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.

OriginalspracheEnglisch
Aufsatznummer82
Seiten (von - bis)82
Seitenumfang10
FachzeitschriftANNALS OF INTENSIVE CARE
Jahrgang13
Ausgabenummer1
DOIs
PublikationsstatusVeröffentlicht - 12 Sept. 2023

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