Quality of Life Research

, Volume 18, Issue 3, pp 273–280

Qualify of life and palliation predict survival in patients with chronic alveolar hypoventilation and nocturnal ventilatory support

  • Jan Olofson
  • Catharina Dellborg
  • Marianne Sullivan
  • Bengt Midgren
  • Oscar Caro
  • Bengt Bergman
Article

DOI: 10.1007/s11136-009-9445-7

Cite this article as:
Olofson, J., Dellborg, C., Sullivan, M. et al. Qual Life Res (2009) 18: 273. doi:10.1007/s11136-009-9445-7

Abstract

Objectives

Non-invasive positive pressure ventilation (NPPV) improves health-related quality of life (HRQL) in patients with chronic alveolar hypoventilation (CAH). We studied the prognostic impact of HRQL on survival in relation to clinical factors.

Patients

Forty-four patients with CAH due to post-polio (12), scoliosis (11), post-tb (17) or other diagnoses (4) who received nocturnal NPPV were prospectively studied during 6–10 years.

Measurements

Blood gases and HRQL were analysed at baseline and after 9 months and after 8 years. HRQL was evaluated with measures of functioning (SIP), emotional well-being (HADS and MACL), and global QL.

Results

Blood gases and HRQL measures improved during NPPV. The overall 5-year survival rate was 73%. In multivariate survival analysis, a diagnosis of post-polio and low baseline SIP physical index scores, indicating low levels of physical dysfunction, predicted longer survival (P = 0.02, respectively). Similarly, palliation of physical dysfunction and preserved or improved global QL by 9 months were associated with longer overall survival (P = 0.009 and P = 0.001, respectively; multivariate Cox regression).

Conclusion

Seventy-three percent of patients treated for CAH with NPPV survived more than 5 years. Diagnosis and self-rated physical functioning at pre-treatment were related to survival, as were major improvements in physical functioning and global QL during NPPV.

Keywords

Neuromuscular disorders Restrictive chest wall disorders Non-invasive positive pressure ventilation 

Abbreviation list

ALS

Amyotrofic lateral sclerosis

CAH

Chronic alveolar hypoventilation

CPAP

Continuous positive airway pressure

HADS

Hospital anxiety and depression scale

HRQL

Health-related quality of life

kPa

kilo Pascal

MACL

The mood adjective check list

NPPV

Non-invasive positive pressure ventilation

PaCO2

Arterial carbon dioxide tension

PaO2

Arterial oxygen tension

QL

Quality of life

SIP

Sickness impact profile

SpO2

Percutaneous oxygen saturation

Tb sequel

Tuberculosis sequel

Copyright information

© Springer Science+Business Media B.V. 2009

Authors and Affiliations

  • Jan Olofson
    • 1
  • Catharina Dellborg
    • 1
  • Marianne Sullivan
    • 2
  • Bengt Midgren
    • 3
  • Oscar Caro
    • 4
  • Bengt Bergman
    • 1
  1. 1.Department of Respiratory Medicine and Allergology, Institute of MedicineSahlgrenska University Hospital, The Sahlgrenska Academy at University of GothenburgGothenburgSweden
  2. 2.Health Care Research Unit, Institute of MedicineThe Sahlgrenska Academy at University of GothenburgGothenburgSweden
  3. 3.Department of Respiratory MedicineUniversity Hospital of LundLundSweden
  4. 4.Department of Respiratory MedicineOrebro Univeristy HospitalOrebroSweden

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