Long-term outcome with focus on pulmonary hypertension in Obesity Hypoventilation Syndrome.
Long-term survival
chronic hypoventilation
chronic respiratory failure
prognostic factors
pulmonary hypertension
Journal
The clinical respiratory journal
ISSN: 1752-699X
Titre abrégé: Clin Respir J
Pays: England
ID NLM: 101315570
Informations de publication
Date de publication:
Oct 2020
Oct 2020
Historique:
received:
02
01
2019
revised:
21
05
2020
accepted:
28
05
2020
pubmed:
9
6
2020
medline:
19
8
2021
entrez:
8
6
2020
Statut:
ppublish
Résumé
Pulmonary Hypertension (PH) is a frequent comorbidity in Obesity Hypoventilation Syndrome (OHS). We investigated long-term outcome of OHS with a particular emphasis on PH. In a prospective design, 64 patients with OHS and established noninvasive positive pressure ventilation (NPPV), were assessed by serum biomarkers, right heart catheterization, blood gases analysis, lung function, Epworth-Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), World Health Organization-functional class (WHO-FC) and health-related quality of life (HRQL) via the Severe Respiratory Insufficiency (SRI) questionnaire. After a planned follow-up of 5 years patients were reassessed regarding vital status, WHO-FC, ESS, SRI, PSQI, body mass index (BMI) and NPPV use. Prognostic markers were explored using univariate and multivariate Cox regression analyses. At the 5-year follow-up, BMI tended to decrease (P = 0.05), while WHO-FC, ESS and PSQI remained unchanged. HRQL deteriorated in terms of SRI summary score and most subdomains (P < .05 each). NPPV adherence still was high (89%), while daily NPPV use increased from 6.7 (5.1; 8.0) h/d to 8.2 (7.4; 9.0) h/d (P < .05). After a 5-year follow-up, mortality was 25.8%. In univariate regression analyses only age > 69.5 years (HR = 4.145, 95%-CI = 1.180-14.565, P = 0.016), NT-proBNP > 1256 pg/mL (HR = 5.162, 95%-CI = 1.136-23.467, P = 0.018), diffusion capacity for carbon monoxide (DLCO, %pred) (HR = 0.341, 95%-CI = 0.114-1.019, P = 0.043) and higher oxygen use during daytime (HR = 5.236, 95%-CI = 1.489-18.406, P = 0.004) predicted mortality. No independent factor predicting mortality was detected in multivariate analysis. Despite a high long-term NPPV use HRQL worsened. Age, oxygen use at baseline, DLCO (%pred) and NT-proBNP, as a surrogate parameter for PH, were related to long-term survival.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
940-947Informations de copyright
© 2020 John Wiley & Sons Ltd.
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