Association of non-invasive positive pressure ventilation with short-term clinical outcomes in patients hospitalized for acute decompensated heart failure

Midori Yukino, Yuji Nagatomo, Ayumi Goda, Takashi Kohno, Makoto Takei, Yosuke Nishihata, Mike Saji, Yuichi Toyosaki, Shintaro Nakano, Yukinori Ikegami, Yasuyuki Shiraishi, Shun Kohsaka, Takeshi Adachi, Tsutomu Yoshikawa

Research output: Contribution to journalArticlepeer-review

Abstract

The real-world evidence has been sparse on the impact of non-invasive positive pressure ventilation (NPPV) on the outcomes in acute decompensated heart failure (ADHF) patients. We aim to explore this issue in the prospective multicenter WET-HF registry. Among 3927 patients (77 (67–84) years, male 60%), the NPPV was used in 775 patients (19.7%). The association of NPPV use with in-hospital outcome and length of hospital stay (LOS) was examined by two methods, propensity score (PS) matching and multivariable analysis with adjustment for PS. In these analyses the NPPV group exhibited a lower endotracheal intubation (ETI) rate and a comparable in-hospital mortality, but longer LOS compared to the non-NPPV group. In the stratified analysis, the NPPV group exhibited a significantly lower ETI rate in patients with ischemic etiology, systolic blood pressure (sBP) > 140 mmHg and the Controlling Nutritional Status (CONUT) score ≤ 3, indicating better nutritional status. On the contrary, NPPV use was associated with longer LOS in patients with non-ischemic etiology, sBP < 100 mmHg and CONUT score > 3. In conclusion, NPPV use was associated with a lower incidence of ETI. Particularly, patients with ischemic etiology, high sBP, and better nutritional status might benefit from NPPV use.

Original languageEnglish
Article number5092
JournalJournal of Clinical Medicine
Volume10
Issue number21
DOIs
Publication statusPublished - 2021 Nov 1

Keywords

  • Acute decompensated heart failure
  • Endotracheal intubation
  • Intensive care
  • Ischemic heart disease
  • Length of hospital stay
  • NPPV

ASJC Scopus subject areas

  • Medicine(all)

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