%0 Journal Article
%T Patterns of use, survival and prognostic factors in patients receiving home mechanical ventilation in Western Australia: A single centre historical cohort study
%A Bhajan Singh
%A Clare Siobhan Rea
%A Geak Poh Tan
%A Jane Douglas
%A Nigel McArdle
%A Satvinder Singh Dhaliwal
%J Chronic Respiratory Disease
%@ 1479-9731
%D 2018
%R 10.1177/1479972318755723
%X Home mechanical ventilation (HMV) is used in a wide range of disorders associated with chronic hypoventilation. We describe the patterns of use, survival and predictors of death in Western Australia. We identified 240 consecutive patients (60% male; mean age 58 years and body mass index 31 kg mˋ2) referred for HMV between 2005 and 2010. The patients were grouped into four categories: motor neurone disorders (MND; 39%), pulmonary disease (PULM; 25%, mainly chronic obstructive pulmonary disease), non-MND neuromuscular and chest wall disorders (NMCW; 21%) and the obesity hypoventilation syndrome (OHS; 15%). On average, the patients had moderate ventilatory impairment (forced vital capacity: 51%predicted), sleep apnoea (apnoea-hypopnea index: 25 events hˋ1), sleep-related hypoventilation (transcutaneous carbon dioxide rise of 20 mmHg) and daytime hypercarbia (PCO2: 54 mmHg). Median durations of survival from HMV initiation were 1.0, 4.2, 9.9 and >11.5 years for MND, PULM, NMCW and OHS, respectively. Independent predictors of death varied between primary indications for HMV; the predictors included (a) age in all groups except for MND (hazard ratios (HRs) 1.03每1.10); (b) cardiovascular disease (HR: 2.35, 95% confidence interval (CI): 1.08每5.10) in MND; (c) obesity (HR: 0.28, 95% CI: 0.13每0.62) and oxygen therapy (HR: 0.33, 95% CI: 0.14每0.79) in PULM; and (d) forced expiratory volume in 1 s (%predicted; HR: 0.93, 95% CI: 0.88每1.00) in OHS
%K Neuromuscular disease
%K non-invasive ventilation
%K obesity hypoventilation syndrome
%K respiratory insufficiency
%K survival
%U https://journals.sagepub.com/doi/full/10.1177/1479972318755723