Research Article

Characteristics of Obese Patients with Acute Hypercapnia Respiratory Failure Admitted in the Department of Pneumology: An Observational Study of a North African Population

Table 1

Clinical, functional, and therapeutic characteristics of patients.

Total sample ()Nm-OHS ()M-OHS ()

Age66.5 (10.9)64.8 (9.6)69.6 (12.7)0.17
Sex, M/F (%)11(25)/33(75)7(24.1)/22(75.9)4(26.7)/11(73.3)1
BMI, kg/m241.1 (6.8)37.5 (30–60)45 (40–50)<0.001
Active or ex smoking, (%)12 (27.3)7 (24.1)5 (33.3)0.72
Charlson comorbidity score (median, IQR)4 (1–10)4 (1–9)4.5 (1–10)0.33
Previous LTOT, (%)7 (15.9)5 (17.2)2 (13.3)1
Previous home CPAP, (%)11 (25)7 (24.1)4 (26.7)1
Previous home BIPAP, (%)0
Previous ICU hospitalization, (%)11 (25)7 (24.1)4 (26.7)1
Previous ward hospitalization, (%)23 (52.3)14 (48.3)9 (60)0.46
Respiratory tests
FEV1
Ml (median, IQR)1160 (400–2550)1170 (400–2550)1080 (760–2330)0.98
% pred61 (20.7)61 (20–122)73 (27–94)0.13
FVC
Ml (median, IQR)1390 (480–3840)1390 (480–3840)1160 (1000–2890)0.93
% pred (mean, SD)59.6 (18.6)59.1 (19.4)60.8 (18.1)0.87
FEV1/FVC, % (mean, SD)81.6 (7)80.4 (6.7)83.8 (7.3)0.2
Cardiac function
LVEF, % (median, IQR)60 (40–65)60 (40–65)61 (48–65)0.22
LV diastolic dysfunction, (%)10 (25.6)8 (32)2 (14.3)0.28
LV mass index, g/m (median, IQR)233 (145–408)233 (155–408)251 (145–380)0.33
sPAP, mmHg (median, IQR)31 (20–75)32 (20–60)31 (20–75)0.89
Dilated right heart cavities, (%)19 (48.7)13 (52)6 (42.9)0.58
Overnight type 3 PSG data
AHI, h-148.6 (9–125.7)56.9 (30.6)50.5 (37.2)0.59
T90%, (median, IQR)85.2 (6.5–99.8)85.2 (6.5–99.5)87.8 (42–99.8)0.97
Origin,(%)
Emergency room30 (68.2)22 (75.9)8 (53.3)0.17
Ward5 (11.4)2 (6.9)3 (20)0.32
ICU3 (6.8)1 (3.4)2 (13.3)0.26
AHRF cause,(%)
APE16 (36.4)10 (34.5)6 (40)0.72
Viral bronchitis12 (27.3)8 (27.6)4 (26.7)1
Pneumonia5 (11.4)3 (10.3)2 (13.3)1
Other11 (25)8 (27.6)3 (20)1
Ventilatory treatment during AHRF
IPAP, cmH2O (median, IQR)16.3 (12–25)17 (12–24)15 (14–25)0.31
EPAP, cmH2O (median, IQR)6 (4–9)6 (4–9)6 (4–8)0.53
Duration, h/day (median, IQR)9 (1.3–20)8 (1.3–20)10 (6–18)0.01
Failure rate, (%)1 (2.3)1 (3.4)0 (0)1
Length of hospital stay, days (median, SIQ)20.5 (3–90)22 (3–90)18 (10–66)0.35
Home treatment after discharge,(%)
CPAP16 (38.1)11 (39.3)5 (35.7)0.82
BIPAP26 (61.9)17 (60.7)9 (64.3)0.82
LTOT9 (21.4)7 (25)2 (14.3)0.69

Nm-OHS: nonmalignant obesity hypoventilation syndrome; M-OHS: malignant OHS; : value; M: male; F: female; LTOT: long-term oxygen therapy; CPAP: continuous positive airway pressure; BIPAP: bilevel positive airway pressure; ICU: intensive care unit; FEV1: forced expiratory volume first second; FVC: forced vital capacity; Pred: predicted; LVEF: left ventricular ejection fraction; LV: left ventricular; sPAP: systolic pulmonary artery pressure; AHI: apnea hypopnea index; TST90%: total sleep time with nSpO2 was less than 90%; AHRF: acute hypercapnic respiratory failure; APE: acute pulmonary oedema; IPAP: inspiratory positive airway pressure; EPAP: expiratory positive airway pressure. : mean (standard deviation). : median (interquartile range). BMI: body mass index.