Résumé :
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The Respiratory Insufficiency Outcome (RIO) project consists in a French multicenter prospective cohort of patients with chronic obstructive pulmonary disease (COPD) undergoing domiciliary noninvasive positive pressure ventilation (NIPPV). We present the first results for the Grenoble center. All patients with COPD who were established on NIPPV at the French University Hospital of Grenoble from January 2002 were eligible for the study. Patients suffering from neuromuscular disease prior to the set up of the ventilation were excluded. Data are presented as mean ± SD after testing for normal distribution. If the normal distribution failed, the median values are given. Univariate prognostic factors were assessed by using statistics for censored data. One hundred and forty-height patients were included. Three quarters of them were male (n=112). The median age was 68.8 years (range, 47 to 87 years). The mean body mass index (BMI) was 30.9 ± 6.6 kg/m2 (range, 17 to 47 kg/m2). Patients had a median cumulative tobacco consumption of 50 pack-years (range, 0 to 120 pack-years).Main comorbidities were : sleep apnoea syndrome (43%), systemic hypertension (38.5%), obesity (31%), heart failure (22%), and diabetes (17%). Median NIV compliance over the 6 first months after NIV initiation was 5.7 hours per day (range, 0 to 14 hours per day). The median length of follow-up was 27.8 months. The 12, 24 and 36-month estimates of survival were respectively 0.91 (standard error, 0.02), 0.84 (0.03) and 0.81 (0.04). Variables associated with a good prognosis were : obesity (HR=0.13, p=0.006), sleep apnoea syndrome (HR=0.37, p=0.03). Hypercapnia at the time the ventilation was set up was associated with a bad prognosis (HR=3.8, p=0.048). Other variables did not influence the prognosis. After a careful quality control, a multivariate analysis taking into account the compliance with NIPPV will be done.
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