Cargando…

Causes of hypercapnic respiratory failure and associated in‐hospital mortality

BACKGROUND AND OBJECTIVE: Hypercapnic respiratory failure (HRF) can occur due to severe respiratory disease but also because of multiple coexistent causes. There are few data on the prevalence of antecedent causes for HRF and the effect of these causes on prognosis, especially where study inclusion...

Descripción completa

Detalles Bibliográficos
Autores principales: Chung, Yewon, Garden, Frances L., Marks, Guy B., Vedam, Hima
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons, Ltd 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10092076/
https://www.ncbi.nlm.nih.gov/pubmed/36210347
http://dx.doi.org/10.1111/resp.14388
_version_ 1785023262668881920
author Chung, Yewon
Garden, Frances L.
Marks, Guy B.
Vedam, Hima
author_facet Chung, Yewon
Garden, Frances L.
Marks, Guy B.
Vedam, Hima
author_sort Chung, Yewon
collection PubMed
description BACKGROUND AND OBJECTIVE: Hypercapnic respiratory failure (HRF) can occur due to severe respiratory disease but also because of multiple coexistent causes. There are few data on the prevalence of antecedent causes for HRF and the effect of these causes on prognosis, especially where study inclusion has not been biased with respect to primary diagnosis, interventions received or clinical outcome. We sought to determine the prevalence of pre‐specified conditions among patients with HRF and to determine the effect of these causes on in‐hospital mortality. METHODS: Cross‐sectional study of patients with HRF from 2013 to 2017. Inclusion criteria were PaCO(2) >45 mm Hg and pH ≤7.45. Causes of interest were identified using diagnosis codes from hospital records. We used directed acyclic graphs to inform logistic regression models for the outcome of in‐hospital death. RESULTS: We identified 873 persons with HRF in the study period. Mean (SD) age was 69 years and 50.4% were males. Acidosis (pH <7.35) was present in 488 (55%) cases. Most (83%) had one or more of the following: obstructive lung disease, lower respiratory tract infection, congestive cardiac failure, sleep disordered breathing, neuromuscular disease, opioid or benzodiazepine use. In‐hospital mortality was 12.8%. Obstructive lung disease and cardiac failure were associated with a lower risk of death, whereas respiratory tract infection and neuromuscular disease were associated with increased risk of death. CONCLUSION: HRF is associated with a range of potentially causative conditions, which significantly impact hospital survival. Systematic evaluation of patients with HRF may increase detection of treatable comorbidities.
format Online
Article
Text
id pubmed-10092076
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher John Wiley & Sons, Ltd
record_format MEDLINE/PubMed
spelling pubmed-100920762023-04-13 Causes of hypercapnic respiratory failure and associated in‐hospital mortality Chung, Yewon Garden, Frances L. Marks, Guy B. Vedam, Hima Respirology ORIGINAL ARTICLES BACKGROUND AND OBJECTIVE: Hypercapnic respiratory failure (HRF) can occur due to severe respiratory disease but also because of multiple coexistent causes. There are few data on the prevalence of antecedent causes for HRF and the effect of these causes on prognosis, especially where study inclusion has not been biased with respect to primary diagnosis, interventions received or clinical outcome. We sought to determine the prevalence of pre‐specified conditions among patients with HRF and to determine the effect of these causes on in‐hospital mortality. METHODS: Cross‐sectional study of patients with HRF from 2013 to 2017. Inclusion criteria were PaCO(2) >45 mm Hg and pH ≤7.45. Causes of interest were identified using diagnosis codes from hospital records. We used directed acyclic graphs to inform logistic regression models for the outcome of in‐hospital death. RESULTS: We identified 873 persons with HRF in the study period. Mean (SD) age was 69 years and 50.4% were males. Acidosis (pH <7.35) was present in 488 (55%) cases. Most (83%) had one or more of the following: obstructive lung disease, lower respiratory tract infection, congestive cardiac failure, sleep disordered breathing, neuromuscular disease, opioid or benzodiazepine use. In‐hospital mortality was 12.8%. Obstructive lung disease and cardiac failure were associated with a lower risk of death, whereas respiratory tract infection and neuromuscular disease were associated with increased risk of death. CONCLUSION: HRF is associated with a range of potentially causative conditions, which significantly impact hospital survival. Systematic evaluation of patients with HRF may increase detection of treatable comorbidities. John Wiley & Sons, Ltd 2022-10-09 2023-02 /pmc/articles/PMC10092076/ /pubmed/36210347 http://dx.doi.org/10.1111/resp.14388 Text en © 2022 The Authors. Respirology published by John Wiley & Sons Australia, Ltd on behalf of Asian Pacific Society of Respirology. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle ORIGINAL ARTICLES
Chung, Yewon
Garden, Frances L.
Marks, Guy B.
Vedam, Hima
Causes of hypercapnic respiratory failure and associated in‐hospital mortality
title Causes of hypercapnic respiratory failure and associated in‐hospital mortality
title_full Causes of hypercapnic respiratory failure and associated in‐hospital mortality
title_fullStr Causes of hypercapnic respiratory failure and associated in‐hospital mortality
title_full_unstemmed Causes of hypercapnic respiratory failure and associated in‐hospital mortality
title_short Causes of hypercapnic respiratory failure and associated in‐hospital mortality
title_sort causes of hypercapnic respiratory failure and associated in‐hospital mortality
topic ORIGINAL ARTICLES
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10092076/
https://www.ncbi.nlm.nih.gov/pubmed/36210347
http://dx.doi.org/10.1111/resp.14388
work_keys_str_mv AT chungyewon causesofhypercapnicrespiratoryfailureandassociatedinhospitalmortality
AT gardenfrancesl causesofhypercapnicrespiratoryfailureandassociatedinhospitalmortality
AT marksguyb causesofhypercapnicrespiratoryfailureandassociatedinhospitalmortality
AT vedamhima causesofhypercapnicrespiratoryfailureandassociatedinhospitalmortality