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

Gustafson, T.Umeå universitet,Institutionen för folkhälsa och klinisk medicin (author)

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.

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Lungmedicin och allergi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Respiratory Medicine and Allergy hsv//eng
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

Franklin, KarlUmeå universitet,Institutionen för folkhälsa och klinisk medicin(Swepub:umu)kafr0021 (author)
Midgren, B. (author)
Pehrsson, KerstinLund University,Lunds universitet,Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för invärtesmedicin,Institute of Medicine, Department of Internal Medicine,Lungmedicin, allergologi och palliativ medicin,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Respiratory Medicine, Allergology, and Palliative Medicine,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine(Swepub:lu)lung-kpe (author)
Ranstam, J. (author)
Ström, K. (author)
Umeå universitetInstitutionen för folkhälsa och klinisk medicin (creator_code:org_t)

By the author/editor: Gustafson, T.; Franklin, Karl; Midgren, B.; Pehrsson, Kersti ...; Ranstam, J.; Ström, K.

About the subject

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Respiratory Medi ...

By the university: University of Gothenburg; Lund University; Umeå University

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