Survival of patients with kyphoscoliosis receiving mechanical ventilation or oxygen at home

• BACKGROUND: Home mechanical ventilation (HMV) and long-term oxygen therapy (LTOT) are the two treatment alternatives when treating respiratory insufficiency in patients with kyphoscoliosis. We aimed to study the effect on survival with regard to HMV or LTOT alone in patients with respiratory insufficiency due to kyphoscoliosis. METHODS: Swedish patients with nonparalytic kyphoscoliosis (ie, scoliosis not related to neuromuscular disorders) who started LTOT or HMV between 1996 and 2004 were followed up prospectively until February 14, 2006, with death as the primary outcome. Treatment modality, arterial blood gas levels, the presence of concomitant respiratory diseases, and age were recorded at the onset of treatment. No patient was lost to follow-up. RESULTS: One hundred patients received HMV, and 144 patients received oxygen therapy alone. Patients treated with HMV experienced better survival, even when adjusting for age, gender, concomitant respiratory diseases, and blood gas levels, with a hazard ratio of 0.30 (95% confidence interval, 0.18 to 0.51). CONCLUSION: The survival of patients with kyphoscoliosis receiving HMV was better than that of patients treated with LTOT alone. We suggest HMV and not oxygen therapy alone as the primary therapy for patients with respiratory failure due to kyphoscoliosis, regardless of gender, age, and the occurrence of concomitant respiratory diseases.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Lungmedicin och allergi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Respiratory Medicine and Allergy (hsv//eng)

Nyckelord

Aged

Aged

80 and over

Confidence Intervals

Female

Follow-Up Studies

*Home Care Services

Hospital-Based

Humans

Kyphosis/*complications/mortality

Long-Term Care

Male

Middle Aged

*Oxygen Inhalation Therapy

Proportional Hazards Models

Prospective Studies

*Respiration

Artificial

Respiratory Insufficiency/mortality/*therapy

Scoliosis/*complications/mortality

Survival Analysis

long-term oxygen therapy

kyphoscoliosis

mechanical ventilation

survival

respiratory failure

treatment

Swedevox

Aged

Publikations- och innehållstyp

ref (ämneskategori)

art (ämneskategori)