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.
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.