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Need of help in activities of daily living is associated to survival in obesity-hypoventilation patients using noninvasive ventilation

Background: Noninvasive ventilation (NIV) is used in many diseases causing hypoventilation. The need for NIV is not necessarily a marker of poor survival as life expectancy may differ depending on the underlying disease. We studied the factors associated with survival in an unselected patient group starting NIV. Methods: We conducted a retrospective study including 221 patients initiating NIV in Tampere University Hospital during 1.1.2012-31.12.2015 and followed up until 31.12.2017. Results: The most frequent diseases causing the need for NIV were obesity-hypoventilation syndrome (OHS) and chronic obstructive pulmonary disease (COPD). Patients with OHS had more comorbidities (Charlson comorbidity index median 2.0, IQR 1.0-2.3) than COPD patients (1.0 IQR 0.0-2.0, P=0.001). The patients needing help in activities of daily living (ADL) had shorter survival (median 3.2 years) compared to others (P=0.001). During the follow-up, 26% and 59% of the patients with OHS and COPD died, respectively (P Conclusions: Survival of the patients starting NIV varies greatly depending on the diagnosis. OHS patients suffer from multimorbidity, which indicates comprehensive approach when taking care of these patients. Patients who need help in ADL are at risk of dying in about three years suggesting close follow-up and timely integrated palliative care.