Impact of Demographic and Lifestyle Factors on the Outcome of Non-Invasive Positive Pressure Ventilation in Acute Exacerbation of COPD: An Observational Study

Abstract

INTRODUCTION
Chronic obstructive pulmonary disease (COPD) is a significant contributor to morbidity and mortality globally. Non-invasive positive pressure ventilation (NIPPV) is a recognized treatment for acute exacerbation of COPD (AECOPD) accompanied by type 2 respiratory failure; nevertheless, treatment outcomes differ among individuals. Finding out what demographic and lifestyle factors affect the success or failure of NIPPV is very important for improving care, especially in places like Nepal where resources are scarce.

MATERIAL AND METHODS
This prospective observational study was carried out at Tribhuvan University Teaching Hospital, Kathmandu, involving 246 patients with AECOPD (≥ 40 years) who commenced BiPAP therapy. We used SPSS v26 to look at data on age, sex, smoking exposure, body mass index (BMI), functional status, previous hospitalizations, and long-term oxygen therapy (LTOT). NIPPV success was characterized by clinical enhancement without the necessity of intubation.

RESULTS
NIPPV worked for 84.5% of the patients. Failure was substantially correlated with advanced age (p < 0.05), increased pack-year smoking exposure (p < 0.0001), restricted activities of daily living (p = 0.004), previous hospital admissions (p < 0.0001), and long-term oxygen therapy (LTOT) utilization (p < 0.0001). The inhaler regimen showed no meaningful correlation with results.

CONCLUSION
Older age, high smoking exposure, limited daily activity, frequent prior hospitalizations, and LTOT use were independent predictors of NIPPV failure in patients with AECOPD and type 2 respiratory failure.