Home mechanical ventilation in chronic respiratory failure: 10-year mortality

Background: Home mechanical ventilation (HMV) is used in different patient cohorts with chronic hypercapnic respiratory failure. Clinical trials have evaluated the efficacy of HMV in specific subgroups. There are sparse data comparing outcomes in different disease groups on HMV. Methods: All-cause mortality of patients on HMV was documented between 2008 and 2018 in a large tertiary referral centre. Time on HMV until death was compared between patients with neuromuscular disease/chest wall disease (NMD/CWD), obstructive airway disease (OAD), obesity-related respiratory failure (ORRF), overlap syndrome of OAD and OSA (OVERLAP) and others (e.g. traumatic spinal cord injury). The main outcome was time on HMV until death (median [interquartile range]) in these key groups. Findings: In total, 1,210 deaths of patients on HMV were recorded. Median time until death on HMV was 20 [6-55] months, and differed between groups (Kruskal Wallis p 120] months) and myopathy (n=162, 65 [29->120] months) had a significantly longer survival than those with motor neurone disease (n=262, 7 [3-14] months) (p 4h was associated with longer time until death (p Interpretation: Time lived on HMV varies widely across disease groups. Patients with CWD, myopathy or ORRF live longer on HMV compared to motor neurone disease, neuropathy, OAD or others.