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Study Suggests African-American Veterans More Likely than White Veterans to Receive Mechanical Ventilation for COPD


African-American patients are more likely than white patients to prefer and receive life-sustaining interventions in advanced stages of disease. However, little is known about potential racial differences in the use of mechanical ventilation and the newer modality of non-invasive ventilation (NIV) in the treatment of chronic obstructive pulmonary disease (COPD). Using VA data, investigators in this study sought to determine if rates of mechanical ventilation and NIV use differ among African-American (n=5,479) and white Veterans (n=31,537) admitted to 153 VA hospitals for COPD exacerbation.

Findings show that African-American Veterans with COPD exacerbation in VA hospitals are more likely than white Veterans to receive mechanical ventilation, and this difference is not explained by available clinical or demographic variables. By contrast, African-American and white Veterans are equally likely to receive NIV when being treated for COPD exacerbation. Authors suggest that there is no underuse of mechanical ventilation and NIV in the treatment of racial minorities in this patient population; however, unmeasured factors, such as patient preferences or disease severity may be affecting the use of mechanical ventilation, and thus warrant further investigation.

PubMed Logo Cannon K, Vaughan Sarrazin M, Rosenthal G, Curtis A, Thomas K, Kaldjian L. Use of mechanical and non-invasive ventilation in black and white COPD patients within the VA healthcare system. Medical Care January 2009;47(1):129-33.

Drs. Cannon and Curtis are supported by the VA Quality Scholars Fellowship and are part of HSR&D’s Center for Research in the Implementation of Innovative Strategies in Practice (CRIISP). Drs. Sarrazin, Rosenthal, and Kaldjian also are part of CRIISP.

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What are HSR&D Publication Briefs?

HSR&D requires notification by HSR&D-funded investigators about all articles accepted for publication. These journal articles are reviewed by HSR&D and publication briefs or summaries are written for a select number of articles that are then forwarded to VHA Central Office leadership to keep them informed about important findings or information. Articles to be summarized are selected by HSR&D based on timeliness of the findings, interest of leadership, or potential impact on the organization. Publication briefs are written for only a small number of HSR&D published articles. Visit the HSR&D citations database for a complete listing of HSR&D articles and presentations.