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dc.creatorJohnson, Christopher S.en
dc.creatorFrei, Christopher R.en
dc.creatorMetersky, Mark L.en
dc.creatorAnzueto, Antonio R.en
dc.creatorMortensen, Eric M.en
dc.date.accessioned2014-12-15T17:10:53Zen
dc.date.available2014-12-15T17:10:53Zen
dc.date.issued2014-01-27en
dc.identifier.citationJohnson, Christopher S., Christopher R. Frei, Mark L. Metersky, Antonio R. Anzueto, and Eric M. Mortensen. “Non-Invasive Mechanical Ventilation and Mortality in Elderly Immunocompromised Patients Hospitalized with Pneumonia: A Retrospective Cohort Study.” BMC Pulmonary Medicine 14, no. 1 (January 27, 2014): 7. doi:10.1186/1471-2466-14-7.en
dc.identifier.urihttp://hdl.handle.net/2152/27947en
dc.descriptionChristopher S. Johnson and Eric M. Mortensen are with the University of Texas Southwestern Medical Center and the VA North Texas Health Care System, Dallas VA Medical Center -- Christopher R. Frei and Antonio R. Anzueto are with the South Texas Veterans Health Care System and the University of Texas Health Science Center at San Antonio -- Christopher R. Frei is with the University of Texas at Austin, -- Mark L Metersky is with the University of Connecticut School of Medicineen
dc.description.abstractBackground: Mortality after pneumonia in immunocompromised patients is higher than for immunocompetent patients. The use of non-invasive mechanical ventilation for patients with severe pneumonia may provide beneficial outcomes while circumventing potential complications associated with invasive mechanical ventilation. The aim of our study was to determine if the use of non-invasive mechanical ventilation in elderly immunocompromised patients with pneumonia is associated with higher all-cause mortality. Methods: In this retrospective cohort study, data were obtained from the Department of Veterans Affairs administrative databases. We included veterans age ≥65 years who were immunocompromised and hospitalized due to pneumonia. Multilevel logistic regression analysis was used to determine the relationship between the use of invasive versus non-invasive mechanical ventilation and 30-day and 90-day mortality. Results: Of 1,946 patients in our cohort, 717 received non-invasive mechanical ventilation and 1,229 received invasive mechanical ventilation. There was no significant association between all-cause 30-day mortality and non-invasive versus invasive mechanical ventilation in our adjusted model (odds ratio (OR) 0.85, 95% confidence interval (CI) 0.66-1.10). However, those patients who received non-invasive mechanical ventilation had decreased 90-day mortality (OR 0.66, 95% CI 0.52-0.84). Additionally, receipt of guideline-concordant antibiotics in our immunocompromised cohort was significantly associated with decreased odds of 30-day mortality (OR 0.31, 95% CI 0.24-0.39) and 90-day mortality (OR 0.41, 95% CI 0.31-0.53). Conclusions: Our findings suggest that physicians should consider the use of non-invasive mechanical ventilation, when appropriate, for elderly immunocompromised patients hospitalized with pneumonia.en
dc.description.sponsorshipen
dc.language.isoEnglishen
dc.publisherBMC Pulmonary Medicineen
dc.rightsAdministrative deposit of works to UT Digital Repository: This works author(s) is or was a University faculty member, student or staff member; this article is already available through open access at http://www.biomedcentral.com. The public license is specified as CC-BY: http://creativecommons.org/licenses/by/4.0/. The library makes the deposit as a matter of fair use (for scholarly, educational, and research purposes), and to preserve the work and further secure public access to the works of the University.en
dc.subjectmechanical ventilationen
dc.subjectmortalityen
dc.subjectimmunocompromiseden
dc.subjectpneumoniaen
dc.titleNon-invasive mechanical ventilation and mortality in elderly immunocompromised patients hospitalized with pneumonia: a retrospective cohort studyen
dc.typeArticleen
dc.description.departmentPharmacyen
dc.description.catalogingnoteeric.mortensen@utsouthwestern.eduen
dc.identifier.Filename1471-2466-14-7.pdfen
dc.identifier.doidoi:10.1186/1471-2466-14-7en


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