Does Age Affect Care Outcomes in Patients With COPD on NIV?

TOPLINE:

Health-related quality of life (HRQOL) did not differ significantly between younger and older patients with chronic obstructive pulmonary disease (COPD) suffering from chronic hypercapnic respiratory failure receiving long-term noninvasive ventilation (NIV), despite a higher comorbidity burden in older patients.

METHODOLOGY:

• Researchers conducted a prospective, observational study to investigate the differences in HRQOL between younger and older patients with COPD and chronic hypercapnic respiratory failure receiving long-term NIV.
• They enrolled 237 patients between June 2015 and October 2021, with 41.8% enrolled as inpatients and 58.2% as outpatients, categorized into two age groups: younger (< 65 years) and older (≥ 65 years).
• HRQOL was assessed using the severe respiratory insufficiency (SRI) questionnaire, and factors affecting HRQOL — including anemia, autonomy impairment, exacerbation history, and comorbidities — were evaluated.
• A five-tier scale categorized autonomy impairments by severity with level 1 denoting minor impairments and level 5 indicating the most severe loss of independence or ability, which pose substantial challenges for nursing care.

TAKEAWAY:

• No significant differences were found in SRI summary scores between age groups, despite older patients having a significantly higher burden of comorbidities (P = .014).
• Exacerbation frequency had a significant negative impact on SRI scores in both younger and older patients.
• Anemia was linked to a significant reduction in SRI scores only in younger patients, in whom it was more prevalent (29.1% vs 17.5%; P = .045).
• Any level of autonomy impairment negatively affected HRQOL in younger patients, whereas only higher levels (level of care ≥ 2) affected HRQOL in older patients.

IN PRACTICE:

“Understanding of COPD with comprehensive care plans that address both medical and functional aspects, patient outcomes, and HRQOL might be improved,” the authors wrote.

SOURCE:

This study was led by Maximilian Zimmermann, Department of Pneumology, Witten/Herdecke University, Cologne, Germany. It was published online on June 7, 2025, in BMC Pulmonary Medicine.

LIMITATIONS:

The heterogeneity of the study cohort, due to inclusion of both inpatients and outpatients, may have led to variability in clinical status and care settings. Additionally, patients were eligible after 1 month of NIV, most had been on long-term therapy prior to inclusion, which could have influenced the assessment of HRQOL. Because the study was conducted at a single center, the results may not be applied to broader populations.

DISCLOSURES:

This study did not receive any research funding. The authors reported having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.