Association of Non-Invasive Positive Pressure Ventilation with Short-Term Clinical Outcomes in Patients Hospitalized for Acute Decompensated Heart Failure

The real-world evidence has been sparse on the impact of non-invasive positive pressure ventilation (NPPV) on the outcomes in acute decompensated heart failure (ADHF) patients. We aim to explore this issue in the prospective multicenter WET-HF registry. Among 3927 patients (77 (67–84) years, male 60...

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Bibliographic Details
Published in:Journal of clinical medicine 2021-10, Vol.10 (21), p.5092
Main Authors: Yukino, Midori, Nagatomo, Yuji, Goda, Ayumi, Kohno, Takashi, Takei, Makoto, Nishihata, Yosuke, Saji, Mike, Toyosaki, Yuichi, Nakano, Shintaro, Ikegami, Yukinori, Shiraishi, Yasuyuki, Kohsaka, Shun, Adachi, Takeshi, Yoshikawa, Tsutomu
Format: Article
Language:English
Subjects:
Cardiology
Clinical medicine
Clinical outcomes
Edema
Heart failure
Hospitalization
Intubation
Mortality
Nutritional status
Patients
Registration
Regression analysis
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Summary:The real-world evidence has been sparse on the impact of non-invasive positive pressure ventilation (NPPV) on the outcomes in acute decompensated heart failure (ADHF) patients. We aim to explore this issue in the prospective multicenter WET-HF registry. Among 3927 patients (77 (67–84) years, male 60%), the NPPV was used in 775 patients (19.7%). The association of NPPV use with in-hospital outcome and length of hospital stay (LOS) was examined by two methods, propensity score (PS) matching and multivariable analysis with adjustment for PS. In these analyses the NPPV group exhibited a lower endotracheal intubation (ETI) rate and a comparable in-hospital mortality, but longer LOS compared to the non-NPPV group. In the stratified analysis, the NPPV group exhibited a significantly lower ETI rate in patients with ischemic etiology, systolic blood pressure (sBP) > 140 mmHg and the Controlling Nutritional Status (CONUT) score ≤ 3, indicating better nutritional status. On the contrary, NPPV use was associated with longer LOS in patients with non-ischemic etiology, sBP < 100 mmHg and CONUT score > 3. In conclusion, NPPV use was associated with a lower incidence of ETI. Particularly, patients with ischemic etiology, high sBP, and better nutritional status might benefit from NPPV use.
ISSN:2077-0383
2077-0383
DOI:10.3390/jcm10215092