Positive airway pressure therapies and hospitalization in chronic obstructive pulmonary disease

Background. Hospitalization of patients with chronic obstructive pulmonary disease creates a huge healthcare burden. Positive airway pressure therapy is sometimes used in patients with chronic obstructive pulmonary disease, but the possible impact on hospitalization risk remains controversial. We st...

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Detalhes bibliográficos
Autores: Vasquez, Monica M., McClure, Leslie A., Sherrill, Duane L., Patel, Sanjay R., Krishnan, Jerry, Guerra, Stefano, Parthasarathy, Sairam
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2017
País:España
Recursos:Universitat Pompeu Fabra
Repositorio:Repositorio Digital de la UPF
OAI Identifier:oai:repositori.upf.edu:10230/69206
Acesso em linha:http://hdl.handle.net/10230/69206
http://dx.doi.org/10.1016/j.amjmed.2016.11.045
Access Level:acceso abierto
Palavra-chave:Artificial respiration
Chronic obstructive pulmonary disease
Continuous positive airway pressure
Hospitalization
Positive airway pressure therapy
Sleep
Sleep apnea
Sleep-disordered breathing
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spelling Positive airway pressure therapies and hospitalization in chronic obstructive pulmonary diseaseVasquez, Monica M.McClure, Leslie A.Sherrill, Duane L.Patel, Sanjay R.Krishnan, JerryGuerra, StefanoParthasarathy, SairamArtificial respirationChronic obstructive pulmonary diseaseContinuous positive airway pressureHospitalizationPositive airway pressure therapySleepSleep apneaSleep-disordered breathingBackground. Hospitalization of patients with chronic obstructive pulmonary disease creates a huge healthcare burden. Positive airway pressure therapy is sometimes used in patients with chronic obstructive pulmonary disease, but the possible impact on hospitalization risk remains controversial. We studied the hospitalization risk of patients with chronic obstructive pulmonary disease before and after initiation of various positive airway pressure therapies in a “real-world” bioinformatics study. Methods. We performed a retrospective analysis of administrative claims data of hospitalizations in patients with chronic obstructive pulmonary disease who received or did not receive positive airway pressure therapy: continuous positive airway pressure, bilevel positive airway pressure, and noninvasive positive pressure ventilation using a home ventilator. Results. The majority of 1,881,652 patients with chronic obstructive pulmonary disease (92.5%) were not receiving any form of positive airway pressure therapy. Prescription of bilevel positive airway pressure (1.5%), continuous positive airway pressure (5.6%), and noninvasive positive pressure ventilation (<1%) in patients with chronic obstructive pulmonary disease demonstrated geographic-, sex-, and age-related variability. After adjusting for confounders and propensity score, noninvasive positive pressure ventilation (odds ratio [OR], 0.19; 95% confidence interval [CI], 0.13-0.27), bilevel positive airway pressure (OR, 0.42; 95% CI, 0.39-0.45), and continuous positive airway pressure (OR, 0.70; 95% CI, 0.67-0.72) were individually associated with lower hospitalization risk in the 6 months post-treatment when compared with the 6 months pretreatment but not when compared with the baseline period between 12 and 6 months before treatment initiation. Stratified analysis suggests that comorbid sleep-disordered breathing, chronic respiratory failure, heart failure, and age less than 65 years were associated with greater benefits from positive airway pressure therapy. Conclusion. Initiation of positive airway pressure therapy was associated with reduction in hospitalization among patients with chronic obstructive pulmonary disease, but the causality needs to be determined by randomized controlled trials.Elsevier202520252017info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/69206http://dx.doi.org/10.1016/j.amjmed.2016.11.045reponame:Repositorio Digital de la UPFinstname:Universitat Pompeu FabraInglésThe American Journal of Medicine. 2017 Jul;130(7):809-18© 2017 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).http://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:repositori.upf.edu:10230/692062026-06-12T07:21:37Z
dc.title.none.fl_str_mv Positive airway pressure therapies and hospitalization in chronic obstructive pulmonary disease
title Positive airway pressure therapies and hospitalization in chronic obstructive pulmonary disease
spellingShingle Positive airway pressure therapies and hospitalization in chronic obstructive pulmonary disease
Vasquez, Monica M.
Artificial respiration
Chronic obstructive pulmonary disease
Continuous positive airway pressure
Hospitalization
Positive airway pressure therapy
Sleep
Sleep apnea
Sleep-disordered breathing
title_short Positive airway pressure therapies and hospitalization in chronic obstructive pulmonary disease
title_full Positive airway pressure therapies and hospitalization in chronic obstructive pulmonary disease
title_fullStr Positive airway pressure therapies and hospitalization in chronic obstructive pulmonary disease
title_full_unstemmed Positive airway pressure therapies and hospitalization in chronic obstructive pulmonary disease
title_sort Positive airway pressure therapies and hospitalization in chronic obstructive pulmonary disease
dc.creator.none.fl_str_mv Vasquez, Monica M.
McClure, Leslie A.
Sherrill, Duane L.
Patel, Sanjay R.
Krishnan, Jerry
Guerra, Stefano
Parthasarathy, Sairam
author Vasquez, Monica M.
author_facet Vasquez, Monica M.
McClure, Leslie A.
Sherrill, Duane L.
Patel, Sanjay R.
Krishnan, Jerry
Guerra, Stefano
Parthasarathy, Sairam
author_role author
author2 McClure, Leslie A.
Sherrill, Duane L.
Patel, Sanjay R.
Krishnan, Jerry
Guerra, Stefano
Parthasarathy, Sairam
author2_role author
author
author
author
author
author
dc.subject.none.fl_str_mv Artificial respiration
Chronic obstructive pulmonary disease
Continuous positive airway pressure
Hospitalization
Positive airway pressure therapy
Sleep
Sleep apnea
Sleep-disordered breathing
topic Artificial respiration
Chronic obstructive pulmonary disease
Continuous positive airway pressure
Hospitalization
Positive airway pressure therapy
Sleep
Sleep apnea
Sleep-disordered breathing
description Background. Hospitalization of patients with chronic obstructive pulmonary disease creates a huge healthcare burden. Positive airway pressure therapy is sometimes used in patients with chronic obstructive pulmonary disease, but the possible impact on hospitalization risk remains controversial. We studied the hospitalization risk of patients with chronic obstructive pulmonary disease before and after initiation of various positive airway pressure therapies in a “real-world” bioinformatics study. Methods. We performed a retrospective analysis of administrative claims data of hospitalizations in patients with chronic obstructive pulmonary disease who received or did not receive positive airway pressure therapy: continuous positive airway pressure, bilevel positive airway pressure, and noninvasive positive pressure ventilation using a home ventilator. Results. The majority of 1,881,652 patients with chronic obstructive pulmonary disease (92.5%) were not receiving any form of positive airway pressure therapy. Prescription of bilevel positive airway pressure (1.5%), continuous positive airway pressure (5.6%), and noninvasive positive pressure ventilation (<1%) in patients with chronic obstructive pulmonary disease demonstrated geographic-, sex-, and age-related variability. After adjusting for confounders and propensity score, noninvasive positive pressure ventilation (odds ratio [OR], 0.19; 95% confidence interval [CI], 0.13-0.27), bilevel positive airway pressure (OR, 0.42; 95% CI, 0.39-0.45), and continuous positive airway pressure (OR, 0.70; 95% CI, 0.67-0.72) were individually associated with lower hospitalization risk in the 6 months post-treatment when compared with the 6 months pretreatment but not when compared with the baseline period between 12 and 6 months before treatment initiation. Stratified analysis suggests that comorbid sleep-disordered breathing, chronic respiratory failure, heart failure, and age less than 65 years were associated with greater benefits from positive airway pressure therapy. Conclusion. Initiation of positive airway pressure therapy was associated with reduction in hospitalization among patients with chronic obstructive pulmonary disease, but the causality needs to be determined by randomized controlled trials.
publishDate 2017
dc.date.none.fl_str_mv 2017
2025
2025
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10230/69206
http://dx.doi.org/10.1016/j.amjmed.2016.11.045
url http://hdl.handle.net/10230/69206
http://dx.doi.org/10.1016/j.amjmed.2016.11.045
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv The American Journal of Medicine. 2017 Jul;130(7):809-18
dc.rights.none.fl_str_mv http://creativecommons.org/licenses/by-nc-nd/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv reponame:Repositorio Digital de la UPF
instname:Universitat Pompeu Fabra
instname_str Universitat Pompeu Fabra
reponame_str Repositorio Digital de la UPF
collection Repositorio Digital de la UPF
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,812429

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