Predictive value of daily living score in acute respiratory failure of COPD patients requiring invasive mechanical ventilation pilot study.

Abstract

BACKGROUND:

Mechanical ventilation (MV) is imperative in many forms of acute respiratory failure (ARF) in COPD patients. Previous studies have shown the difficulty to identify parameters predicting the outcome of COPD patients treated by invasive MV. Our hypothesis was that a non specialized score as the activities daily living (ADL) score may help to predict the outcome of these patients.

METHODS:

We studied the outcome of 25 COPD patients admitted to the intensive care unit for ARF requiring invasive MV. The patients were divided into those weaning success (group A n = 17, 68%) or failure (group B n = 8, 32%). We investigated the correlation between the ADL score and the outcome and mortality.

RESULTS:

The ADL score was higher in group A (5.1 ±1.1 vs 3.7 ± 0.7 in group B, p < 0.01). Weaning was achieved in 76.5% of the cases with an ADL score ≥ 4 and in 23.5% of the cases with an ADL score < 4 (p < 0.05). Pulmonary function test, arterial blood gases collected during period of clinical stability and at admission and nutritional status were similar in both groups. The mortality, at six months, was 36%. The ADL score was a significant predictor of 6-month mortality (80 with an ADL score <4, 20 with an ADL score ≥4, p < 0.01).

CONCLUSION:

Our pilot study demonstrates that the ADL score is predictive of weaning success and mortality at 6 months, suggesting that the assessment of daily activities should be an important component of ARF management in COPD patients.

• Authors: Ketty Langlet, Thierry Van Der Linden, Claire Launois, Caroline Fourdin, Philippe Cabaret, Nadia Kerkeni, Coralie Barbe, François Lebargy, Gaetan Deslée
• Journal: BMC pulmonary medicine (BMC Pulm Med) Vol. 12 Pg. 66 (Oct 18 2012) ISSN: 1471-2466 [Electronic] England
• PMID: 23078114 (Publication Type: Journal Article)

Topics

• Activities of Daily Living
• Acute Disease
• Aged
• Aged, 80 and over
• Female
• Humans
• Intensive Care Units
• Male
• Middle Aged
• Pilot Projects
• Predictive Value of Tests
• Prognosis
• Prospective Studies
• Pulmonary Disease, Chronic Obstructive (complications)
• Respiration, Artificial
• Respiratory Insufficiency (etiology, mortality, therapy)
• Survival Rate
• Treatment Outcome