Abstract 13010: Trends and Predictors in Noninvasive and Invasive Ventilation in Patients With Heart Failure
Background: Mechanical ventilation in heart failure. However, trends and predictors of mechanical ventilation in heart failure are not well defined.
Methods: We analyzed patients in the Nationwide Inpatient Sample (NIS) between 2002-2011 with primary discharge diagnosis of Heart Failure (CHF) and procedure diagnosis of noninvasive and invasive mechanical ventilation. Primary outcome was trend in noninvasive and invasive ventilation in CHF. Secondary outcome was predictors of mechanical ventilation in heart failure and their outcomes.
Results: Among 10,475,928 weighted discharges with primary diagnosis of CHF, 532,701 discharges underwent mechanical ventilation. Among these patients 272,806(2.6%) had noninvasive while 259,894(2.5%) had invasive ventilation. We saw steady increase in use of mechanical ventilation over the last ten years (4.9% in 2002 to 7.1% in 2011,P<0.001). This was driven by steady increase in rates of noninvasive ventilation (1.1% in 2002 to 5.2% in 2011, p<0.001) with decline in rates of invasive ventilation (3.8% in 2002 to 1.9% in 2011, P<0.001). Risk adjusted yearly odds of noninvasive ventilation showed a steady increase over the last 10 years (OR 1.325 in 2003 to 3.064 in 2011 with 2002 as index year) with obesity (OR 1.85) and chronic lung disease(OR 1.80) as independent predictors of utilization. On the other hand risk adjusted yearly odds of invasive ventilation showed a steady decline (OR 0.9 in 2003 to 0.18 in 2011 with 2002 as index year) with heart valve disease (OR 2.4), weight loss (OR 1.67), coagulopathy (OR 1.63) and electrolyte abnormality(OR 1.65) as positive predictors of need for invasive ventilation.
Conclusions: There is an increasing trend in utilization of mechanical ventilation in heart failure. This is mainly driven by increase in noninvasive ventilation with decline in rates of invasive ventilation over the last ten years.
Author Disclosures: N. Gupta: None. V. Muppidi: None. M. Shahreyar: None. N. Gaglianello: None. M.P. Cinquegrani: None.
- © 2014 by American Heart Association, Inc.