Clinical predictors
Diagnostic categories were also significant predictors of NIV outcomes.
Overall, children with upper airway disorders were less likely to
discontinue NIV compared to the other diagnostic categories (0.581 (95%
CI 0.348 to 0.971, Figure 1). Children with CNS disorders had 3.3 times
higher odds of being hospitalized while using NIV. Specific underlying
conditions that were predictors of different NIV outcomes included
children with bronchopulmonary dysplasia, who had higher odds of
improving their breathing status and discontinuing NIV [4.707 (95% CI
1.306 to 16.962)], and children with obesity/metabolic syndrome who
had higher odds of declining NIV therapy [2.077 (95% CI 1.110 to
3.888)].
Parameters of medical complexity including use of other medical
technology, number of co-morbidities, and previous surgeries were also
significant predictors of long-term NIV outcomes. Children requiring any
technology in addition to NIV use had 3.3 (95% CI 2.051 to 5.387) times
higher odds of NIV failure (switch to IMV or death) and 2.6 (95% CI
1.526 to 4.340) times higher odds of hospitalization for each added
technology (Figure 1). They were also less likely to decline NIV, with a
0.417 (95% CI 0.202 to 0.859) reduction in odds ratio for each
additional technology. The presence of comorbidities increased the odds
for hospital admissions by 1.2 (95% CI 1.022 to 1.440) times but was
not a predictor for NIV failure or any other long-term NIV outcomes.
Children who had received a previous adenotonsillectomy surgery had 3.7
times less odds of NIV failure (switching to IMV or dying) compared to
children who did not. The presence of previous major surgeries was not a
significant predictor of long-term outcomes.