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Obesity might be a good prognosis factor for COPD patients using domiciliary noninvasive mechanical ventilation

Authors Altinoz H, Adıgüzel N, Saltürk C, Gungor G, Yazıcıoğlu Moçin, Berk Takır H, Kargin F, Balci M, Dikensoy O, Karakurt Z

Received 19 March 2016

Accepted for publication 10 June 2016

Published 19 August 2016 Volume 2016:11(1) Pages 1895—1901


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Richard Russell

Hilal Altinoz,1 Nalan Adiguzel,2 Cuneyt Salturk,2 Gokay Gungor,2 Ozlem Mocin,2 Huriye Berk Takir,2 Feyza Kargin,2 Merih Balci,2 Oner Dikensoy,1 Zuhal Karakurt2

1Pulmonary Division, Acibadem University School of Medicine, 2Sureyyapasa Thoracic Diseases and Thoracic Surgery Training Hospital, Istanbul, Turkey

Abstract: Cachexia is known to be a deteriorating factor for survival of patients with chronic obstructive pulmonary disease (COPD), but data related to obesity are limited. We observed that obese patients with COPD prescribed long-term noninvasive mechanical ventilation (NIMV) had better survival rate compared to nonobese patients. Therefore, we conducted a retrospective observational cohort study. Archives of Thoracic Diseases Training Hospital were sought between 2008 and 2013. All the subjects were prescribed domiciliary NIMV for chronic respiratory failure secondary to COPD. Subjects were grouped according to their body mass index (BMI). The first group consisted of subjects with BMI between 20 and 30 kg/m2, and the second group consisted of subjects with BMI >30 kg/m2. Data obtained at the first month’s visit for the following parameters were recorded: age, sex, comorbid diseases, smoking history, pulmonary function test, 6-minute walk test (6-MWT), and arterial blood gas analysis. Hospital admissions were recorded before and after the domiciliary NIMV usage. Mortality rate was searched from the electronic database. Overall, 118 subjects were enrolled. Thirty-eight subjects had BMI between 20 and 30 kg/m2, while 80 subjects had BMI >30 kg/m2. The mean age was 65.8±9.4 years, and 81% were male. The median follow-up time was 26 months and mortality rates were 32% and 34% for obese and nonobese subjects (P=0.67). Improvement in 6-MWT was protective against mortality. In conclusion, survival of obese patients with COPD using domiciliary NIMV was found to be better than those of nonobese patients, and the improvement in 6-MWT in such patients was found to be related to a better survival.

Keywords: chronic respiratory failure, survival, body mass index, mortality, therapy

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