{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T07:43:50Z","timestamp":1769240630008,"version":"3.49.0"},"reference-count":44,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2013,2,11]],"date-time":"2013-02-11T00:00:00Z","timestamp":1360540800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Hospital Medicine"],"published-print":{"date-parts":[[2013,4]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Limited evidence exists on the comparative effectiveness of noninvasive ventilation (<jats:styled-content style=\"fixed-case\">NIV<\/jats:styled-content>) vs invasive mechanical ventilation (<jats:styled-content style=\"fixed-case\">IMV<\/jats:styled-content>) in acute exacerbation of chronic obstructive pulmonary disease (<jats:styled-content style=\"fixed-case\">AECOPD<\/jats:styled-content>) patients with respiratory failure.<\/jats:p><\/jats:sec><jats:sec><jats:title>OBJECTIVES<\/jats:title><jats:p>To characterize the use of <jats:styled-content style=\"fixed-case\">NIV<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">IMV<\/jats:styled-content>, and to compare the effectiveness of <jats:styled-content style=\"fixed-case\">NIV<\/jats:styled-content> vs <jats:styled-content style=\"fixed-case\">IMV<\/jats:styled-content> in <jats:styled-content style=\"fixed-case\">AECOPD<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>DESIGN AND PATIENTS<\/jats:title><jats:p>Retrospective cohort study using data from the 2006\u20132008 Nationwide Emergency Department Sample. Emergency department visits for AECOPD with acute respiratory failure were identified with codes from the International Classification of Diseases, Ninth Revision, Clinical Modification.<\/jats:p><\/jats:sec><jats:sec><jats:title>MEASURES<\/jats:title><jats:p>The outcome measures were inpatient mortality, hospital length of stay, hospital charges, and complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>There were an estimated 101,000 visits annually for AECOPD with acute respiratory failure; 96% were admitted to the hospital. Of these, NIV use increased from 14% in 2006 to 16% in 2008 (<jats:italic>P<\/jats:italic>=0.049). Use of NIV, however, varied widely between hospitals, ranging from 0% to 100% with a median of 11%. Noninvasive ventilation was more often used in higher\u2013case volume, Northeastern hospitals. In a propensity score analysis, NIV use, compared with IMV, was associated with lower inpatient mortality (risk ratio: 0.54, 95% confidence interval [CI]: 0.50\u20100.59), shortened hospital length of stay (\u22123.2 days; 95% CI: \u22123.4 to \u22122.9 days), lower hospital charges (\u2212$35,012; 95% CI: \u2212$36,848 to \u2212$33,176), and lower risk of iatrogenic pneumothorax (0.05% vs 0.5%, <jats:italic>P<\/jats:italic>&lt;0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Although <jats:styled-content style=\"fixed-case\">NIV<\/jats:styled-content> use is increasing in US hospitals, its adoption remains low and varies widely between hospitals. Our observational study suggests <jats:styled-content style=\"fixed-case\">NIV<\/jats:styled-content> appears to be more effective and safer than <jats:styled-content style=\"fixed-case\">IMV<\/jats:styled-content> for <jats:styled-content style=\"fixed-case\">AECOPD<\/jats:styled-content> in the real\u2010world setting. <jats:italic>Journal of Hospital Medicine<\/jats:italic> 2013;8:165\u2013172. \u00a9 2013 Society of Hospital Medicine<\/jats:p><\/jats:sec>","DOI":"10.1002\/jhm.2014","type":"journal-article","created":{"date-parts":[[2013,2,11]],"date-time":"2013-02-11T15:03:13Z","timestamp":1360594993000},"page":"165-172","source":"Crossref","is-referenced-by-count":29,"title":["Comparative Effectiveness of Noninvasive Ventilation vs Invasive Mechanical Ventilation in Chronic Obstructive Pulmonary Disease Patients With Acute Respiratory Failure"],"prefix":"10.1002","volume":"8","author":[{"given":"Chu\u2010Lin","family":"Tsai","sequence":"first","affiliation":[{"name":"Division of Epidemiology Human Genetics and Environmental Sciences University of Texas School of Public Health Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wen\u2010Ya","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Epidemiology Human Genetics and Environmental Sciences University of Texas School of Public Health Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George L.","family":"Delclos","sequence":"additional","affiliation":[{"name":"Division of Epidemiology Human Genetics and Environmental Sciences University of Texas School of Public Health Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicola A.","family":"Hanania","sequence":"additional","affiliation":[{"name":"Section of Pulmonary and Critical Care Medicine Department of Medicine Baylor College of Medicine Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr","given":"Carlos A.","family":"Camargo","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Massachusetts General Hospital, Harvard Medical School Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,2,11]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"Centers for Disease Control and Prevention National Center for Health Statistics. 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