• Angela Maria Grazia Pacilli, Ilaria Valentini, Paolo Carbonara, Antonio Marchetti, and Stefano Nava.
• Alma Mater Studiorum, Department of Specialistic, Diagnostic and Experimental Medicine (DIMES), University of Bologna, 40138 Bologna, Italy.
• Biomed Res Int. 2014 Jan 1;2014:976783.

ObjectivesTo investigate the effect of the cause of acute respiratory failure and the role of comorbidities both acute and chronic on the outcome of COPD patients admitted to Respiratory Intensive Care Unit (RICU) with acute respiratory failure and treated with NIV.DesignObservational prospective study.Patients And Methods176 COPD patients consecutively admitted to our RICU over a period of 3 years and treated with NIV were evaluated. In all patients demographic, clinical, and functional parameters were recorded including the cause of acute respiratory failure, SAPS II score, Charlson comorbidity index, and further comorbidities not listed in the Charlson index. NIV success was defined as clinical improvement leading to discharge to regular ward, while exitus or need for endotracheal intubation was considered failure.ResultsNIV outcome was successful in 134 patients while 42 underwent failure. Univariate analysis showed significantly higher SAP II score, Charlson index, prevalence of pneumonia, and lower serum albumin level in the failure group. Multivariate analysis confirmed a significant predictive value for pneumonia and albumin.ConclusionsThe most important determinants of NIV outcome in COPD patients are the presence of pneumonia and the level of serum albumin as an indicator of the patient nutritional status.

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