Survival and quality of life of patients treated by long term noninvasive ventilation (NIV). Results from a prospective cohort study

The number of patients treated with NIV at home for chronic respiratory failure (CRF) is steadily increasing. Historical indications for long-term NIV were unsettled by obesity hypoventilation syndrome (OHS) and chronic obstructive pulmonary disease (COPD) with controversial results. Ten years after the results of the last major cohorts, we investigated both health-related quality of life (HRQL) and survival of home ventilated patients in a French area. HRQL was assessed by 36-items Short-Form Health Survey (SF-36) at baseline and 12 months after NIV initiation. From September 2009 to December 2015, 451 patients were included in this prospective and multicenter cohort study. CRF resulted from: COPD (n=56), COPD and obesity (n=107), OHS (n=161), neuromuscular (NM) disease (n=35), amyotrophic lateral sclerosis (n=41), others (n=51). Median length of follow-up was 608±653 [0;2281] days. Overall survival at 4 years was 66%. NM patients had the best survival. No survival difference between OHS, COPD and COPD obese patients was found. In COPD patients, NIV did not improve subscales of SF-36 at 12 months. NIV increased all subscales and mental composite score in OHS patients, while 5 subscales were improved in COPD obese patients (p