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Qualify of life and palliation predict survival in patients with chronic alveolar hypoventilation and nocturnal ventilatory support

Olofson, Jan; Dellborg, Catharina; Sullivan, Marianne; Midgren, Bengt LU ; Caro, Oscar and Bergman, Bengt (2009) In Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation 18(3). p.273-280
Abstract
Non-invasive positive pressure ventilation (NPPV) improves health-related quality of life (HRQL) in patients with chronic alveolar hypoventilation (CAH). We studied the prognostic impact of HRQL on survival in relation to clinical factors. Forty-four patients with CAH due to post-polio (12), scoliosis (11), post-tb (17) or other diagnoses (4) who received nocturnal NPPV were prospectively studied during 6-10 years. Blood gases and HRQL were analysed at baseline and after 9 months and after 8 years. HRQL was evaluated with measures of functioning (SIP), emotional well-being (HADS and MACL), and global QL. Blood gases and HRQL measures improved during NPPV. The overall 5-year survival rate was 73%. In multivariate survival analysis, a... (More)
Non-invasive positive pressure ventilation (NPPV) improves health-related quality of life (HRQL) in patients with chronic alveolar hypoventilation (CAH). We studied the prognostic impact of HRQL on survival in relation to clinical factors. Forty-four patients with CAH due to post-polio (12), scoliosis (11), post-tb (17) or other diagnoses (4) who received nocturnal NPPV were prospectively studied during 6-10 years. Blood gases and HRQL were analysed at baseline and after 9 months and after 8 years. HRQL was evaluated with measures of functioning (SIP), emotional well-being (HADS and MACL), and global QL. Blood gases and HRQL measures improved during NPPV. The overall 5-year survival rate was 73%. In multivariate survival analysis, a diagnosis of post-polio and low baseline SIP physical index scores, indicating low levels of physical dysfunction, predicted longer survival (P = 0.02, respectively). Similarly, palliation of physical dysfunction and preserved or improved global QL by 9 months were associated with longer overall survival (P = 0.009 and P = 0.001, respectively; multivariate Cox regression). Seventy-three percent of patients treated for CAH with NPPV survived more than 5 years. Diagnosis and self-rated physical functioning at pre-treatment were related to survival, as were major improvements in physical functioning and global QL during NPPV. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Non-invasive, Neuromuscular disorders, Restrictive chest wall disorders, positive pressure ventilation
in
Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation
volume
18
issue
3
pages
273 - 280
publisher
Springer
external identifiers
  • wos:000264266400001
  • scopus:62349096239
ISSN
1573-2649
DOI
10.1007/s11136-009-9445-7
language
English
LU publication?
yes
id
3bc11f03-24d8-47fc-bd12-f27f44b167cf (old id 1401694)
date added to LUP
2009-06-15 10:35:11
date last changed
2017-01-01 05:30:06
@article{3bc11f03-24d8-47fc-bd12-f27f44b167cf,
  abstract     = {Non-invasive positive pressure ventilation (NPPV) improves health-related quality of life (HRQL) in patients with chronic alveolar hypoventilation (CAH). We studied the prognostic impact of HRQL on survival in relation to clinical factors. Forty-four patients with CAH due to post-polio (12), scoliosis (11), post-tb (17) or other diagnoses (4) who received nocturnal NPPV were prospectively studied during 6-10 years. Blood gases and HRQL were analysed at baseline and after 9 months and after 8 years. HRQL was evaluated with measures of functioning (SIP), emotional well-being (HADS and MACL), and global QL. Blood gases and HRQL measures improved during NPPV. The overall 5-year survival rate was 73%. In multivariate survival analysis, a diagnosis of post-polio and low baseline SIP physical index scores, indicating low levels of physical dysfunction, predicted longer survival (P = 0.02, respectively). Similarly, palliation of physical dysfunction and preserved or improved global QL by 9 months were associated with longer overall survival (P = 0.009 and P = 0.001, respectively; multivariate Cox regression). Seventy-three percent of patients treated for CAH with NPPV survived more than 5 years. Diagnosis and self-rated physical functioning at pre-treatment were related to survival, as were major improvements in physical functioning and global QL during NPPV.},
  author       = {Olofson, Jan and Dellborg, Catharina and Sullivan, Marianne and Midgren, Bengt and Caro, Oscar and Bergman, Bengt},
  issn         = {1573-2649},
  keyword      = {Non-invasive,Neuromuscular disorders,Restrictive chest wall disorders,positive pressure ventilation},
  language     = {eng},
  number       = {3},
  pages        = {273--280},
  publisher    = {Springer},
  series       = {Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation},
  title        = {Qualify of life and palliation predict survival in patients with chronic alveolar hypoventilation and nocturnal ventilatory support},
  url          = {http://dx.doi.org/10.1007/s11136-009-9445-7},
  volume       = {18},
  year         = {2009},
}