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Prevalence of Stable Hypercapnic Chronic Obstructive Pulmonary Disease (COPD) - Preliminary Data from the Homevent Registry
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A3265 - Prevalence of Stable Hypercapnic Chronic Obstructive Pulmonary Disease (COPD) - Preliminary Data from the Homevent Registry
Author Block: M. Dreher1, P. Neuzeret2, W. Windisch3, D. Busam2, G. B. Hoheisel4, A. Gröschel5, H. Woehrle6, K. Grund7, A. Graml2, T. Köhnlein8; 1Universitätsklinikum, Aachen, Germany, 2ResMed, Martinsried, Germany, 3Merheim Hospital, Cologne, Germany, 4Studienzentrum, Leipzig, Germany, 5MVZ AAZ, Aachen, Germany, 6Lung Center, Baden-Wuerttemberg, Germany, 7The Clinical Research Institute, Munich, Germany, 8Klinikum St. Georg, Leipzig, Germany.
Introduction: Noninvasive ventilation (NIV) significantly improves survival and quality of life in COPD patients with chronic hypercapnic respiratory failure. However, the proportion of patients with chronic hypercapnia is unknown. The HOmeVent registry was set up to determine the prevalence of chronic hypercapnic COPD in an outpatient setting. Methods: HOmeVent is a multicenter, prospective, observational, non-interventional medical device registry that includes COPD patients in GOLD stage 3 or 4. Eligible patients were identified and enrolled in an outpatient setting during routine visits for COPD. The registry was approved by all local ethic committees and patients provided written informed consent. Results: Eight outpatient clinics enrolled patients in the registry. To date, 231 COPD patients have been included (63.4% male; mean age 67.2±9.0 years; mean body mass index 26.2±5.9 kg/m2; 58% and 42% in GOLD stage 3 and 4, respectively). Arterial carbon dioxide pressure (PaCO2) was ≥45 mmHg in 65 patients (28.1%); of these, 23 (10%) had PaCO2 ≥50 mmHg. In the group with PaCO2 ≥45 mmHg (n=65), 26 were in GOLD stage 3 and 39 were in GOLD stage 4; for the 23 patients with PaCO2 ≥50 mmHg, 9 and 14 were in GOLD stage 3 and 4, respectively. Conclusion: A high proportion of COPD patients in GOLD stage 3 and 4 exhibit chronic hypercapnia and might therefore be candidates for long-term domiciliary NIV treatment. Given the documented quality of life and survival benefits associated with use of home NIV targeted to effectively reduce hypercapnia, initiation of treatment has the potential to markedly improve outcomes in the important subgroup of COPD GOLD stage 3 and 4 patients with chronic hypercapnia.
Author Block: M. Dreher1, P. Neuzeret2, W. Windisch3, D. Busam2, G. B. Hoheisel4, A. Gröschel5, H. Woehrle6, K. Grund7, A. Graml2, T. Köhnlein8; 1Universitätsklinikum, Aachen, Germany, 2ResMed, Martinsried, Germany, 3Merheim Hospital, Cologne, Germany, 4Studienzentrum, Leipzig, Germany, 5MVZ AAZ, Aachen, Germany, 6Lung Center, Baden-Wuerttemberg, Germany, 7The Clinical Research Institute, Munich, Germany, 8Klinikum St. Georg, Leipzig, Germany.
Introduction: Noninvasive ventilation (NIV) significantly improves survival and quality of life in COPD patients with chronic hypercapnic respiratory failure. However, the proportion of patients with chronic hypercapnia is unknown. The HOmeVent registry was set up to determine the prevalence of chronic hypercapnic COPD in an outpatient setting. Methods: HOmeVent is a multicenter, prospective, observational, non-interventional medical device registry that includes COPD patients in GOLD stage 3 or 4. Eligible patients were identified and enrolled in an outpatient setting during routine visits for COPD. The registry was approved by all local ethic committees and patients provided written informed consent. Results: Eight outpatient clinics enrolled patients in the registry. To date, 231 COPD patients have been included (63.4% male; mean age 67.2±9.0 years; mean body mass index 26.2±5.9 kg/m2; 58% and 42% in GOLD stage 3 and 4, respectively). Arterial carbon dioxide pressure (PaCO2) was ≥45 mmHg in 65 patients (28.1%); of these, 23 (10%) had PaCO2 ≥50 mmHg. In the group with PaCO2 ≥45 mmHg (n=65), 26 were in GOLD stage 3 and 39 were in GOLD stage 4; for the 23 patients with PaCO2 ≥50 mmHg, 9 and 14 were in GOLD stage 3 and 4, respectively. Conclusion: A high proportion of COPD patients in GOLD stage 3 and 4 exhibit chronic hypercapnia and might therefore be candidates for long-term domiciliary NIV treatment. Given the documented quality of life and survival benefits associated with use of home NIV targeted to effectively reduce hypercapnia, initiation of treatment has the potential to markedly improve outcomes in the important subgroup of COPD GOLD stage 3 and 4 patients with chronic hypercapnia.
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