P066 Long-term outcomes from home invasive mechanical ventilation in Queensland

Abstract Home invasive mechanical ventilation (HIMV) is an uncommon but life-sustaining therapy for patients with chronic respiratory failure. However, the published literature on patient outcomes is inconsistent, reflecting varied practices. Moreover, local Australian data and detailed therapy outcomes are scarce. A retrospective review of patients treated with HIMV at a single tertiary centre between 01/01/2005 and 18/05/2024 was conducted. The primary outcome was the time from HIMV initiation to cessation or death. Secondary outcomes included diagnostic group, cause of death, number of hospitalisations and length of stay. Patient demographics were recorded. 31 patients were identified, with 26 meeting the inclusion criteria. The median age at injury was 35 years (9-77), with n=15 (57) male. Diagnostic groups included 13 (50%) spinal cord injuries, 4 (15%) brain injuries, 2 (8%) restrictive thoracic, 5 (19%) neuromuscular including 2 motor neuron disease and 2 (8%) other conditions. The mean survival on HIMV therapy was 19.6 years (95th CI 13.8-25.4). There was no significant difference in survival between patients with or without spinal cord injuries. Cause of death was predominantly respiratory failure (36%) and cardiovascular disease (27%). Median hospital encounters per patient-year on HIMV included 1.7 emergency department presentations, 1.4 hospital admissions, and 8.1 days of hospital stay. This study reported the longest mean survival on HIMV compared with international datasets. This may be due to low sample size, younger population, lower proportions of diagnostic groups with known poorer prognoses and heterogenous prior research.