Survival after Endoscopic Valve Therapy in Patients with Severe Emphysema.
Bronchoscopic volume reduction
Bronchoscopy
Chronic obstructive pulmonary disease
Journal
Respiration; international review of thoracic diseases
ISSN: 1423-0356
Titre abrégé: Respiration
Pays: Switzerland
ID NLM: 0137356
Informations de publication
Date de publication:
Historique:
received:
11
06
2018
accepted:
16
07
2018
pubmed:
19
9
2018
medline:
2
4
2020
entrez:
19
9
2018
Statut:
ppublish
Résumé
Endoscopic valve therapy leads to an improvement of lung function, exercise tolerance, and quality of life in a selected cohort of patients with advanced emphysema. So far, only few data exist on the long-term outcome. This analysis evaluated the impact of valve therapy on the survival of emphysema patients. Survival rates of emphysema patients who underwent valve therapy were assessed according to their radiological outcome following valve placement. From 2005 to 2013, 449 emphysema patients (mean age 64 ± 7 years) underwent valve therapy and were followed for a mean time of 37.3 ± 21.3 months. A total of 128 patients (29%) developed complete lobar atelectasis, 34 out of these also experienced a pneumothorax; 50 patients (11%) developed pneumothorax without lobar atelectasis, and 261 patients (58%) target lobe volume reduction or no volume change. Patients with atelectasis showed significantly better baseline forced expiratory volume in 1 second (%), residual volume (L), total lung capacity (L), and transfer factor for carbon monoxide (%; all p < 0.05), but there was no significant difference in the BODE score (p = 0.195). Patients with valve-induced lobar atelectasis had a significant survival benefit compared to patients without atelectasis (p = 0.009; 5-year survival rate 65.3 vs. 43.9%). The advent of pneumothorax in 84 patients did not influence survival (p = 0.52). Lobar atelectasis following endoscopic valve therapy is associated with a survival benefit.
Sections du résumé
BACKGROUND
BACKGROUND
Endoscopic valve therapy leads to an improvement of lung function, exercise tolerance, and quality of life in a selected cohort of patients with advanced emphysema. So far, only few data exist on the long-term outcome.
OBJECTIVES
OBJECTIVE
This analysis evaluated the impact of valve therapy on the survival of emphysema patients.
METHODS
METHODS
Survival rates of emphysema patients who underwent valve therapy were assessed according to their radiological outcome following valve placement.
RESULTS
RESULTS
From 2005 to 2013, 449 emphysema patients (mean age 64 ± 7 years) underwent valve therapy and were followed for a mean time of 37.3 ± 21.3 months. A total of 128 patients (29%) developed complete lobar atelectasis, 34 out of these also experienced a pneumothorax; 50 patients (11%) developed pneumothorax without lobar atelectasis, and 261 patients (58%) target lobe volume reduction or no volume change. Patients with atelectasis showed significantly better baseline forced expiratory volume in 1 second (%), residual volume (L), total lung capacity (L), and transfer factor for carbon monoxide (%; all p < 0.05), but there was no significant difference in the BODE score (p = 0.195). Patients with valve-induced lobar atelectasis had a significant survival benefit compared to patients without atelectasis (p = 0.009; 5-year survival rate 65.3 vs. 43.9%). The advent of pneumothorax in 84 patients did not influence survival (p = 0.52).
CONCLUSIONS
CONCLUSIONS
Lobar atelectasis following endoscopic valve therapy is associated with a survival benefit.
Identifiants
pubmed: 30227420
pii: 000492274
doi: 10.1159/000492274
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
145-152Informations de copyright
© 2018 S. Karger AG, Basel.