SURVIVAL AND LONG-TERM FOLLOW-UP OF TRACHEOSTOMIZED PATIENTS WITH COPD TREATED BY HOME MECHANICAL VENTILATION - A MULTICENTER FRENCH STUDY IN 259 PATIENTS

To define more clearly the value of home mechanical ventilation by tra cheostomy(HMVT) in patients with advanced COPD, a retrospective French multicenter study group analyzed the prognostic factors and long-term survival of 259 patients with severe COPD, who were tracheostomized f or at least 1 year. Seventy-eight percent of the patients died by the end of the observation period. The actuarial survival rate for the ove rall study population was, therefore, 70 percent at 2 years, 44 percen t at 5 years, and 20 percent at 10 years. These results appear to be b etter than those of the major published series and compare to the prog nosis of COPD patients treated by long-term oxygen therapy (LTO) 15 hr /24 hr. The parameters most closely correlated with a survival for mor e than 5 years were age <65 years, use of an uncuffed cannula, and a P aO2 >55 mm Hg in room air during the 3 months after tracheostomy (p<0. 01). This study, therefore, confirmed the feasibility of HMVT in COPD and should lead to a review of the place of permanent tracheostomy in the long-term prognosis of severe COPD patients.