Analysis of risk factors for failure of non-invasive ventilation in elderly patients with acute hypercapnic respiratory failure / 中华老年医学杂志

ABSTRACT

Objective:To investigate risk factors for failure of non-invasive ventilation(NIV)in elderly patients with acute hypercapnic respiratory failure(AHRF).Methods:Retrospective analysis was performed on the data of 100 elderly patients hospitalized for NIV treatment for AHRF at Beijing Hospital between August 2015 and August 2017.The patients were divided into an NIV failure group and an NIV success group according to patient treatment results.Logistic regression was used to analyze the related factors of NIV treatment failure in elderly patients with AHRF.Results:Of the 100 patients, there were 53 men(53.0%), with an age of(79.4±6.4)years, and 43(43.0%)failed with NIV treatment.Before NIV treatment, concurrent severe pneumonia( OR=5.109, 95% CI 1.203-21.702, P=0.027), chest X-ray showing lesion infiltration≥3 quadrants( OR=5.903, 95% CI 1.514-23.013, P=0.011)and a simplified acute physiology score Ⅱ(SAPS Ⅱ)≥34 points( OR=7.046, 95% CI 2.164-22.944, P=0.001)were independent risk factors for failure of NIV treatment in elderly patients with AHRF. Conclusions:Elderly patients with AHRF face the risk of failure with NIV therapy.Before NIV treatment, concurrent severe pneumonia, chest X-ray showing lesion infiltration ≥3 quadrants and SAPS Ⅱ≥34 points are independent risk factors for failure of NIV treatment in elderly patients with AHRF.Evaluation before NIV therapy is important to prevent NIV treatment failure.