{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:49:17Z","timestamp":1785804557683,"version":"3.56.0"},"reference-count":30,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ther Adv Respir Dis"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Accurate tools for patient stratification by likely outcome are needed to support complex decision-making and improve acute non-invasive ventilation (NIV) delivery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To evaluate the potential of an emerging NIV outcomes (NIVO) score tool to predict in-hospital mortality to aid its validation in a real-world UK hospital population of ward-based NIV for acute exacerbations of chronic obstructive pulmonary disease (AECOPD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>This was a retrospective observational cohort study of all consecutive patient admissions with AECOPD managed with NIV for acute hypercapnic respiratory failure at a teaching hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Clinical parameters were collected as part of an ongoing quality improvement project. Patients were grouped based on their survival status at hospital discharge. First admission of each patient was included in the analysis. NIV failure, defined as NIV withdrawal or intubation requirement due to clinical deterioration on NIV, along with in-hospital mortality, was modelled using logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      There were 249 unique patient AECOPD admissions with ward-based NIV. Across first admissions, NIV failure rate was 37.3%, in-hospital mortality 26.5%, and 1-year mortality 47.0%. NIVO score was significantly associated with both NIV failure and in-hospital mortality, with odds ratios (95% Confidence intervals) of 1.33 (1.13\u20131.58,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and 1.52 (1.26\u20131.86),\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001, respectively. A progressive increase in in-hospital mortality was observed with increasing NIVO scores (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.0001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This study demonstrates that the NIVO score shows promise as a predictive tool for in-hospital mortality in patients with AECOPD receiving ward-based NIV. Furthermore, it suggests that NIVO may be able to support decision-making for enhanced NIV delivery in new clinical pathways to address the growing burden of chronic obstructive pulmonary disease exacerbations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17534666261441160","type":"journal-article","created":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T21:48:28Z","timestamp":1777412908000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Predicting in-hospital mortality in a real-world population of ward-based non-invasive ventilation in acute COPD exacerbations"],"prefix":"10.1177","volume":"20","author":[{"given":"Aylin","family":"Ozsancak Ugurlu","sequence":"first","affiliation":[{"name":"Department of Respiratory Medicine, Birmingham Heartlands Hospital, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6735-2567","authenticated-orcid":false,"given":"Alastair","family":"Watson","sequence":"additional","affiliation":[{"name":"School of Clinical Medicine, University of Cambridge, Cambridge, UK"},{"name":"Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Ellis","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Birmingham Heartlands Hospital, Bordesley Green East, Birmingham, UK"},{"name":"School of Health Sciences, University of Birmingham, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ravi K.","family":"Bange","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Birmingham Heartlands Hospital, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sridivyareddy","family":"Yangannagari","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Birmingham Heartlands Hospital, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madeeha","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Birmingham Heartlands Hospital, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Oakes","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Birmingham Heartlands Hospital, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsty-Anne","family":"Ebbage","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Birmingham Heartlands Hospital, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4466-0660","authenticated-orcid":false,"given":"Rahul","family":"Mukherjee","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Birmingham Heartlands Hospital (part of University Hospitals Birmingham), Birmingham, B9 5SS, UK"},{"name":"School of Health Sciences, University of Birmingham, Birmingham B15 2TT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,4,28]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/resp.12780"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2021-069679"},{"key":"e_1_3_4_4_2","article-title":"Non-invasive ventilation for the management of acute hypercapnic respiratory failure due to exacerbation of chronic obstructive pulmonary disease","volume":"7","author":"Osadnik CR","year":"2017","unstructured":"Osadnik CR, Tee VS, Carson-Chahhoud KV, et al. Non-invasive ventilation for the management of acute hypercapnic respiratory failure due to exacerbation of chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2017; 7: CD004104.","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1183\/23120541.00838-2023"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjresp-2018-000283"},{"key":"e_1_3_4_7_2","unstructured":"National Confidential Enquiry into Patient Outcome and Death. Inspiring change: a review of the quality of care provided to patients receiving acute non-invasive ventilation [Internet]. London: NCEPOD https:\/\/www.ncepod.org.uk\/2017niv.html (2017 accessed 3 November 2025)."},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39371.524271.55"},{"key":"e_1_3_4_9_2","unstructured":"Northumbria Healthcare NHS Foundation Trust. NIV outcomes study [Internet]. London: Health Research Authority https:\/\/www.hra.nhs.uk\/planning-and-improving-research\/application-summaries\/research-summaries\/niv-outcomes-study\/ (2024 accessed 2024)."},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-022-04060-7"},{"key":"e_1_3_4_11_2","article-title":"Impact of HACOR score on noninvasive ventilation failure in non-COPD patients with acute-on-chronic respiratory failure","volume":"2021","author":"Ding M","year":"2021","unstructured":"Ding M, Han X, Bai L, et al. Impact of HACOR score on noninvasive ventilation failure in non-COPD patients with acute-on-chronic respiratory failure. 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Inspiring change: improving the outcomes for patients receiving acute non-invasive ventilation. London: National Confidential Enquiry into Patient Outcome and Death, 2017."},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.14744\/ejp.2024.3001"},{"key":"e_1_3_4_25_2","unstructured":"British Thoracic Society. Respiratory Support Unit National Audit: National Patient-Level Report June 2024 [Internet]. https:\/\/www.brit-thoracic.org.Uk\/media\/q2zdyzkk\/bts-respiratory-support-audit-national-patient-level-report-final-june-2024.pdf (2024 accessed 3 November 2025)."},{"key":"e_1_3_4_26_2","unstructured":"British Thoracic Society. BTS quality standards for acute NIV in adults. [Internet]. https:\/\/www.brit-thoracic.org.uk\/document-library\/quality-standards\/niv\/bts-quality-standards-for-acute-niv-in-adults\/ (2018 accessed 4 June 2025)."},{"key":"e_1_3_4_27_2","doi-asserted-by":"publisher","DOI":"10.1183\/20734735.001618"},{"key":"e_1_3_4_28_2","first-page":"169","article-title":"Response times for acute non-invasive ventilation set-ups","volume":"91","author":"Watson A","year":"2022","unstructured":"Watson A, Barnard H, Shanmugarajah A, et al. Response times for acute non-invasive ventilation set-ups. Ulster Med J 2022; 91: 169.","journal-title":"Ulster Med J"},{"key":"e_1_3_4_29_2","doi-asserted-by":"publisher","DOI":"10.1111\/resp.14156"},{"key":"e_1_3_4_30_2","doi-asserted-by":"publisher","DOI":"10.1159\/000195837"},{"key":"e_1_3_4_31_2","volume-title":"National asthma and chronic obstructive pulmonary disease audit programme (NACAP)","author":"Hurst J","year":"2021","unstructured":"Hurst J, Amusan L, Akinyooye V, et al. 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