Positive airway pressure therapies and hospitalization in chronic obstructive pulmonary disease

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• dc.contributor.author Vasquez, Monica M.
• dc.contributor.author McClure, Leslie A.
• dc.contributor.author Sherrill, Duane L.
• dc.contributor.author Patel, Sanjay R.
• dc.contributor.author Krishnan, Jerry
• dc.contributor.author Guerra, Stefano
• dc.contributor.author Parthasarathy, Sairam
• dc.date.accessioned 2025-01-21T07:32:48Z
• dc.date.available 2025-01-21T07:32:48Z
• dc.date.issued 2017
• dc.description.abstract 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.en
• dc.format.mimetype application/pdf
• dc.identifier.citation Vasquez MM, McClure LA, Sherrill DL, Patel SR, Krishnan J, Guerra S, et al. Positive airway pressure therapies and hospitalization in chronic obstructive pulmonary disease. Am J Med. 2017 Jul;130(7):809-18. DOI: 10.1016/j.amjmed.2016.11.045
• dc.identifier.doi http://dx.doi.org/10.1016/j.amjmed.2016.11.045
• dc.identifier.issn 0002-9343
• dc.identifier.uri http://hdl.handle.net/10230/69206
• dc.language.iso eng
• dc.publisher Elsevier
• dc.relation.ispartof The American Journal of Medicine. 2017 Jul;130(7):809-18
• dc.rights © 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/).
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/4.0/
• dc.subject.keyword Artificial respirationen
• dc.subject.keyword Chronic obstructive pulmonary diseaseen
• dc.subject.keyword Continuous positive airway pressureen
• dc.subject.keyword Hospitalizationen
• dc.subject.keyword Positive airway pressure therapyen
• dc.subject.keyword Sleepen
• dc.subject.keyword Sleep apneaen
• dc.subject.keyword Sleep-disordered breathingen
• dc.title Positive airway pressure therapies and hospitalization in chronic obstructive pulmonary diseaseen
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion