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  1. Mechanical ventilation of patients on long-term oxygen therapy with acute exacerbations of chronic obstructive pulmonary disease : Prognosis and cost-utility analysis.

    Article - En anglais

    Objective 

    To analyze the prognosis and costs of mechanical ventilation in patients with exacerbations of chronic obstructive pulmonary disease (COPD) treated with long-term oxygen therapy.

    Design 

    A prospective cohort study.

    Follow-up at 1 and 5 years.

    Cost utility analysis.

    Setting 

    A medical-surgical intensive care unit (ICU) in a university hospital.

    Patients 

    20 patients with previous COPD treated with long-term oxygen therapy and needing mechanical ventilation due to acute respiratory failure.

    Measurements and main results 

    Mortality in the ICU, in-hospital mortality (ICU plus ward), and mortality at 1 and 5 years, and factors associated with prognosis and cost-utility were assessed.

    The mean Acute Physiology and Chronic Health Evaluation II score was 20 (median 20 range 12-36).

    Cumulative mortality was 35% in the ICU, 50% in hospital, 75% at 1 year, and 85% at 5 years.

    Factors significantly associated with mortality in the ICU were low levels of albumin (p=0.05) and sodium (p=0.01) at admission.

    Patients who died in hospital and in the first year after discharge had a lower forced expiratory volume in 1 s (FEV1) than survivors (p=0.03 and p=0.05, respectively).

    The cost per Quality Adjusted Life Year (QALY) was U. S. $26283 and U. S. $44602 in a « best » (cost/QALY calculated for the life expectancy in Spain) and a « worst case scenario » (cost/QALY calculated for a 68-year life expectancy), respectively. (...)

    Mots-clés Pascal : Bronchopneumopathie obstructive, Oxygénothérapie, Long terme, Ventilation mécanique, Analyse coût efficacité, Pronostic, Homme, Appareil respiratoire pathologie, Poumon pathologie, Bronche pathologie, Ventilation artificielle, Economie santé

    Mots-clés Pascal anglais : Obstructive pulmonary disease, Oxygenotherapy, Long term, Mechanical ventilation, Cost efficiency analysis, Prognosis, Human, Respiratory disease, Lung disease, Bronchus disease, Artificial ventilation, Health economy

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 99-0305270

    Code Inist : 002B27B02. Création : 16/11/1999.