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Sökning: WFRF:(Stephan Mark J.) > (2020-2023) > The Effect of Hospi...

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FältnamnIndikatorerMetadata
00006716naa a2200637 4500
001oai:DiVA.org:uu-420801
003SwePub
008201001s2020 | |||||||||||000 ||eng|
0247 a https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-4208012 URI
0247 a https://doi.org/10.1513/AnnalsATS.201912-887OC2 DOI
040 a (SwePub)uu
041 a engb eng
042 9 SwePub
072 7a ref2 swepub-contenttype
072 7a for2 swepub-publicationtype
1001 a Mokhlesi, Babaku Univ Chicago, Dept Med, Chicago, IL 60637 USA.4 aut
2451 0a The Effect of Hospital Discharge with Empiric Noninvasive Ventilation on Mortality in Hospitalized Patients with Obesity Hypoventilation Syndrome An Individual Patient Data Meta-Analysis
264 1b American Thoracic Society,c 2020
338 a print2 rdacarrier
520 a Rationale: Hospitalized patients with acute-on-chronic hypercapnic respiratory failure due to obesity hypoventilation syndrome (OHS) have increased short-term mortality. It is unknown whether prescribing empiric positive airway pressure (PAP) at the time of hospital discharge reduces mortality compared with waiting for an outpatient evaluation (i.e., outpatient sleep study and outpatient PAP titration).Objectives: An international, multidisciplinary panel of experts developed clinical practice guidelines on OHS for the American Thoracic Society. The guideline panel asked whether hospitalized adult patients with acute-on-chronic hypercapnic respiratory failure suspected of having OHS, in whom the diagnosis has not yet been made, should be discharged from the hospital with or without empiric PAP treatment until the diagnosis of OHS is either confirmed or ruled out.Methods: A systematic review with individual patient data meta-analyses was performed to inform the guideline panel’s recommendation. Grading of Recommendations, Assessment, Development, and Evaluation was used to summarize evidence and appraise quality.Results: The literature search identified 2,994 articles. There were no randomized trials. Ten studies met a priori study selection criteria, including two nonrandomized comparative studies and eight nonrandomized noncomparative studies. Individual patient data on hospitalized patients who survived to hospital discharge were obtained from nine of the studies and included a total of 1,162 patients (1,043 discharged with PAP and 119 discharged without PAP). Empiric noninvasive ventilation was prescribed in 91.5% of patients discharged on PAP, and the remainder received empiric continuous PAP. Discharge with PAP reduced mortality at 3 months (relative risk 0.12, 95% confidence interval 0.05–0.30, risk difference −14.5%). Certainty in the estimated effects was very low.Conclusions: Hospital discharge with PAP reduces mortality following acute-on-chronic hypercapnic respiratory failure in patients with OHS or suspected of having OHS. Well-designed clinical trials are needed to confirm this finding.
650 7a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Kardiologi0 (SwePub)302062 hsv//swe
650 7a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Cardiac and Cardiovascular Systems0 (SwePub)302062 hsv//eng
650 7a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Lungmedicin och allergi0 (SwePub)302192 hsv//swe
650 7a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Respiratory Medicine and Allergy0 (SwePub)302192 hsv//eng
653 a positive airway pressure
653 a continuous positive airway pressure
653 a hypercapnia
653 a hypercarbia
653 a Pickwickian
7001 a Masa, Juan Fernandou San Pedro Alcantara Hosp, Resp Dept, Caceres, Spain.;Ctr Invest Biomed Red Enfermedades Resp, Madrid, Spain.4 aut
7001 a Afshar, Majidu Loyola Univ, Dept Hlth Informat & Data Sci, Chicago, IL 60611 USA.4 aut
7001 a Pacheco, Virginia Almadanau Hosp Univ Virgen Macarena, Clin Unit Pneumol, Seville, Spain.4 aut
7001 a Berlowitz, David J.u Austin Hlth, Inst Breathing & Sleep, Heidelberg, Vic, Australia.4 aut
7001 a Borel, Jean-Christianu Univ Grenoble Alpes, HP2 Lab, INSERM U1042, Grenoble, France.4 aut
7001 a Budweiser, Stephanu RoMed Clin Ctr, Div Pulm & Resp Med, Rosenheim, Germany.4 aut
7001 a Carrillo, Andresu Hosp JM Morales Meseguer, Intens Care Unit, Murcia, Spain.4 aut
7001 a Castro-Anon, Olallau Lucus Augusti Univ Hosp, Pneumol Serv, Galicia, Spain.4 aut
7001 a Ferrer, Miquelu Ctr Invest Biomed Red Enfermedades Resp, Madrid, Spain.;Univ Barcelona, Hosp Clin Barcelona, Dept Pneumol, Barcelona, Spain.4 aut
7001 a Gagnadoux, Fredericu Angers Univ Hosp, Dept Resp Dis, Angers, France.;Angers Univ Hosp, INSERM U1063, Angers, France.4 aut
7001 a Golpe, Rafaelu Lucus Augusti Univ Hosp, Pneumol Serv, Galicia, Spain.4 aut
7001 a Hart, Nicholasu Guys & St Thomas NHS Fdn Trust, Lane Fox Resp Serv, London, England.4 aut
7001 a Howard, Mark E.u Austin Hlth, Inst Breathing & Sleep, Heidelberg, Vic, Australia.4 aut
7001 a Murphy, Patrick B.u Guys & St Thomas NHS Fdn Trust, Lane Fox Resp Serv, London, England.4 aut
7001 a Palm, Andreas,d 1971-u Uppsala universitet,Lung- allergi- och sömnforskning4 aut0 (Swepub:uu)andpa501
7001 a de Llano, Luis A. Perezu Lucus Augusti Univ Hosp, Pneumol Serv, Galicia, Spain.4 aut
7001 a Piper, Amanda J.u Royal Prince Alfred Hosp, Camperdown, NSW, Australia.;Univ Sydney, Camperdown, NSW, Australia.4 aut
7001 a Pepin, Jean Louisu Univ Grenoble Alpes, HP2 Lab, INSERM U1042, Grenoble, France.4 aut
7001 a Priou, Pascalineu Angers Univ Hosp, Dept Resp Dis, Angers, France.;Angers Univ Hosp, INSERM U1063, Angers, France.4 aut
7001 a Sanchez-Gomez, Jesus F.u Hosp Univ Virgen Macarena, Clin Unit Pneumol, Seville, Spain.4 aut
7001 a Soghier, Israau Albert Einstein Coll Med, Dept Med, Bronx, NY 10467 USA.4 aut
7001 a Kakazu, Maximiliano Tamaeu Michigan State Univ, Div Pulm & Crit Care Med Spectrum Hlth, Coll Human Med, Grand Rapids, MI USA.4 aut
7001 a Wilson, Kevin C.u Boston Univ, Sch Med, Dept Med, Boston, MA 02118 USA.;Amer Thorac Soc, New York, NY USA.4 aut
7102 a Univ Chicago, Dept Med, Chicago, IL 60637 USA.b San Pedro Alcantara Hosp, Resp Dept, Caceres, Spain.;Ctr Invest Biomed Red Enfermedades Resp, Madrid, Spain.4 org
7730 t Proceedings of the American Thoracic Society onlined : American Thoracic Societyg 17:5, s. 627-637q 17:5<627-637x 1546-3222x 1943-5665
8564 8u https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-420801
8564 8u https://doi.org/10.1513/AnnalsATS.201912-887OC

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