Trial reportAnnals of the American Thoracic Society2015
Hospital patterns of mechanical ventilation for patients with exacerbations of COPD.
Trial report in Annals of the American Thoracic Society, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 50 citations in OpenAlex.
- High-flow nasal cannula versus conventional oxygen therapy in acute COPD exacerbation with mild hypercapnia: a multicenter randomized controlled trial.Critical care (London, England) · 2022Trial
- Validation of a charge-based algorithm for identifying days receiving invasive mechanical ventilation.Annals of the American Thoracic Society · 2026Article
- Census Tract Variability in COPD Emergency Department, Hospitalization, and Readmission Rates in Travis County, Texas.Chronic obstructive pulmonary diseases (Miami, Fla.) · 2026Article
- [Focus on ventilation, oxygen therapy and weaning 2022-2024 : Summary of selected intensive care studies].Die Anaesthesiologie · 2024Article
- The Association between Non-Invasive Ventilation and the Rate of Ventilator-Associated Pneumonia.Diseases (Basel, Switzerland) · 2023Article
- Real-World Treatment of Patients Newly Diagnosed with Chronic Obstructive Pulmonary Disease: A Retrospective German Claims Data Analysis.International journal of chronic obstructive pulmonary disease · 2022Article
- A scoring system derived from electronic health records to identify patients at high risk for noninvasive ventilation failure.BMC pulmonary medicine · 2021Article
- Article
- Protocol for two-arm pragmatic cluster randomized hybrid implementation-effectiveness trial comparing two education strategies for improving the uptake of noninvasive ventilation in patients with severe COPD exacerbation.Implementation science communications · 2020Article
- ICU Utilization for Patients With Acute Exacerbation of Chronic Obstructive Pulmonary Disease Receiving Noninvasive Ventilation.Critical care medicine · 2019Article
- Acute non-invasive ventilation - getting it right on the acute medical take.Clinical medicine (London, England) · 2019Article
- Specialist emergency care and COPD outcomes.BMJ open respiratory research · 2018Article
- Noninvasive ventilation with helium-oxygen mixture in hypercapnic COPD exacerbation: aggregate meta-analysis of randomized controlled trials.Annals of intensive care · 2017Review
- Successful Use of Noninvasive Ventilation in Chronic Obstructive Pulmonary Disease. How Do High-Performing Hospitals Do It?Annals of the American Thoracic Society · 2017Article
- Hospital Volume and Outcomes of Noninvasive Ventilation in Patients Hospitalized With an Acute Exacerbation of Chronic Obstructive Pulmonary Disease.Critical care medicine · 2017Article
- Hospital Noninvasive Ventilation Case Volume and Outcomes of Acute Exacerbations of Chronic Obstructive Pulmonary Disease.Annals of the American Thoracic Society · 2016Article
- Hospitals' Patterns of Use of Noninvasive Ventilation in Patients With Asthma Exacerbation.Chest · 2016Article
- Association Between Rural Residence and In-Hospital and 30-Day Mortality Among Veterans Hospitalized with COPD Exacerbations.International journal of chronic obstructive pulmonary diseaseArticle
- Hospital Variation in Non-Invasive Ventilation Use for Acute Respiratory Failure Due to COPD Exacerbation.International journal of chronic obstructive pulmonary diseaseArticle
Corrections and comments
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Authors and funding
6 authors at 5 institutions in 1 country.
Funding
Abstract
rationaleRandomized trials have shown that noninvasive ventilation (NIV) can reduce the need for intubation and improve the survival of patients with severe exacerbations of chronic obstructive pulmonary disease (COPD); however, it is not known whether hospitals with greater use of NIV achieve lower rates of intubation and better patient outcomes.
objectivesTo describe patterns of mechanical ventilation use for patients with COPD across a large sample of hospitals, and to analyze the relationship between use of NIV and other outcomes.
methodsCross-sectional analysis of 77,576 patients hospitalized for COPD between June 2009 and June 2011 at 386 U.S. hospitals. MEASUREMENTS AND MAIN
resultsUsing hierarchical modeling, we estimated hospital risk-standardized percentages of ventilator starts that were noninvasive (RS-NIV%). We examined the association between RS-NIV% and other outcomes, including risk-standardized rates of invasive ventilation and NIV failure, total ventilation, in-hospital mortality, length of stay, and costs. At the hospital level, the median RS-NIV% was 75.1% (range: 9.2-94.1%). Smaller hospitals and those located in rural areas had higher RS-NIV%. When stratified into quartiles on the basis of the RS-NIV%, hospitals in the highest quartile had lower risk-standardized rates of invasive mechanical ventilation (Q4 vs. Q1: 4.0% vs. 13.3%, P<0.01) and modestly higher risk-standardized total rates of ventilation (Q4 vs. Q1: 23.9% vs. 22.0%, P=0.03). Hospitals with the highest RS-NIV% had lower risk-standardized mortality among ventilated patients who received ventilation (Q4 vs. Q1: 8.5% vs. 9.0%, P=0.01) and marginally lower mortality rates among all patients with COPD (Q4 vs. Q1: 2.2% vs. 2.3%, P=0.03) compared with hospitals with the lowest RS-NIV%. Higher RS-NIV% was associated with lower hospital costs (Q4 vs. Q1: $11,148 vs. $14,032, P<0.001), shorter length of stay (Q4 vs. Q1: 5.5 vs. 6.8 d, P<0.001), and lower NIV failure rates (Q4 vs. Q1: 12.8 vs. 32.5%, P<0.001).
conclusionsUse of NIV as the initial ventilation strategy for patients with COPD varies considerably across hospitals. Institutions with greater use of NIV have lower rates of invasive mechanical ventilation and better patient outcomes.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.