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Causes of hypercapnic respiratory failure: a population-based case-control study

OBJECTIVE: There are no population-based data on the relative importance of specific causes of hypercapnic respiratory failure (HRF). We sought to quantify the associations between hospitalisation with HRF and potential antecedent causes including chronic obstructive pulmonary disease (COPD), obstru...

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Autores principales: Chung, Yewon, Garden, Frances L., Marks, Guy B., Vedam, Hima
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10503117/
https://www.ncbi.nlm.nih.gov/pubmed/37710243
http://dx.doi.org/10.1186/s12890-023-02639-6
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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 OBJECTIVE: There are no population-based data on the relative importance of specific causes of hypercapnic respiratory failure (HRF). We sought to quantify the associations between hospitalisation with HRF and potential antecedent causes including chronic obstructive pulmonary disease (COPD), obstructive sleep apnea, and congestive cardiac failure. We used data on the prevalence of these conditions to estimate the population attributable fraction for each cause. METHODS: A case–control study was conducted among residents aged ≥ 40 years from the Liverpool local government area in Sydney, Australia. Cases were identified from hospital records based on PaCO(2) > 45 mmHg. Controls were randomly selected from the study population using a cluster sampling design. We collected self-reported data on medication use and performed spirometry, limited-channel sleep studies, venous sampling for N-terminal pro-brain natriuretic peptide (NT-proBNP) levels, and sniff nasal inspiratory pressure (SNIP) measurements. Logistic regression analyses were performed using directed acyclic graphs to identify covariates. RESULTS: We recruited 42 cases and 105 controls. HRF was strongly associated with post-bronchodilator airflow obstruction, elevated NT-proBNP levels, reduced SNIP measurements and self-reported opioid medication use. There were no differences in the apnoea-hypopnea index or oxygen desaturation index between groups. COPD had the highest population attributable fraction (42%, 95% confidence interval 18% to 59%). CONCLUSIONS: COPD, congestive cardiac failure, and self-reported use of opioid medications, but not obstructive sleep apnea, are important causes of HRF among adults over 40 years old. No single cause accounts for the majority of cases based on the population attributable fraction. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12890-023-02639-6.
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spelling pubmed-105031172023-09-16 Causes of hypercapnic respiratory failure: a population-based case-control study Chung, Yewon Garden, Frances L. Marks, Guy B. Vedam, Hima BMC Pulm Med Research OBJECTIVE: There are no population-based data on the relative importance of specific causes of hypercapnic respiratory failure (HRF). We sought to quantify the associations between hospitalisation with HRF and potential antecedent causes including chronic obstructive pulmonary disease (COPD), obstructive sleep apnea, and congestive cardiac failure. We used data on the prevalence of these conditions to estimate the population attributable fraction for each cause. METHODS: A case–control study was conducted among residents aged ≥ 40 years from the Liverpool local government area in Sydney, Australia. Cases were identified from hospital records based on PaCO(2) > 45 mmHg. Controls were randomly selected from the study population using a cluster sampling design. We collected self-reported data on medication use and performed spirometry, limited-channel sleep studies, venous sampling for N-terminal pro-brain natriuretic peptide (NT-proBNP) levels, and sniff nasal inspiratory pressure (SNIP) measurements. Logistic regression analyses were performed using directed acyclic graphs to identify covariates. RESULTS: We recruited 42 cases and 105 controls. HRF was strongly associated with post-bronchodilator airflow obstruction, elevated NT-proBNP levels, reduced SNIP measurements and self-reported opioid medication use. There were no differences in the apnoea-hypopnea index or oxygen desaturation index between groups. COPD had the highest population attributable fraction (42%, 95% confidence interval 18% to 59%). CONCLUSIONS: COPD, congestive cardiac failure, and self-reported use of opioid medications, but not obstructive sleep apnea, are important causes of HRF among adults over 40 years old. No single cause accounts for the majority of cases based on the population attributable fraction. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12890-023-02639-6. BioMed Central 2023-09-14 /pmc/articles/PMC10503117/ /pubmed/37710243 http://dx.doi.org/10.1186/s12890-023-02639-6 Text en © Crown 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Chung, Yewon
Garden, Frances L.
Marks, Guy B.
Vedam, Hima
Causes of hypercapnic respiratory failure: a population-based case-control study
title Causes of hypercapnic respiratory failure: a population-based case-control study
title_full Causes of hypercapnic respiratory failure: a population-based case-control study
title_fullStr Causes of hypercapnic respiratory failure: a population-based case-control study
title_full_unstemmed Causes of hypercapnic respiratory failure: a population-based case-control study
title_short Causes of hypercapnic respiratory failure: a population-based case-control study
title_sort causes of hypercapnic respiratory failure: a population-based case-control study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10503117/
https://www.ncbi.nlm.nih.gov/pubmed/37710243
http://dx.doi.org/10.1186/s12890-023-02639-6
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