Clinical impact of active smoking in patients treated with home non invasive ventilation

Background: Active smoking is a relative contraindication of home non invasive ventilation (NIV), although there is scarce evidence of its consequences in a real world scenario. Aim: To determine the clinical impact of active smoking in patients treated with home NIV. Methods: Observational and retrospective study of the cohort of patients treated with home NIV from June 2009 to October 2018. ALS and invasive mechanical ventilation patients were excluded. Outcomes were mortality, hospitalizations of any cause, ER visits and acute-on-chronic hypercapnic respiratory failure. Multivariate logistic regression models and Kaplan-Meier curves were performed to determine the association of active smoking with the cited outcomes. Results: A total of 318 patients were included, 165 were men (51.2%), with a mean age of 67.1 ± 14.7 years. Active smoking was observed in 82 patients (25.8%), and no differences were found in mortality compared with former or never smokers (Figure 1). Multivariate logisitic regression showed an increased probability of ER visits in active smokers (Table 1), no differences were found when the other outcomes were considered. Conclusions: Active smoking was related to an increased probability of ER visits in home NIV patients. No differences were found in terms of mortality, acute-on-chronic hypercapnic respiratory failure or hospitalizations of any cause.