Survival after endoscopic valve therapy in patients with severe emphysema

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: This analysis evaluated the impact of valve therapy on th...

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Hauptverfasser: Gompelmann, Daniela (VerfasserIn) , Benjamin, Nicola (VerfasserIn) , Kontogianni, Konstantina (VerfasserIn) , Schuhmann, Maren (VerfasserIn) , Hoffmann, Hans (VerfasserIn) , Heußel, Claus Peter (VerfasserIn) , Herth, Felix (VerfasserIn) , Eberhardt, Ralf (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 2019
In: Respiration
Year: 2018, Jahrgang: 97, Heft: 2, Pages: 145-152
ISSN:1423-0356
DOI:10.1159/000492274
Online-Zugang:Verlag, Volltext: https://doi.org/10.1159/000492274
Verlag, Volltext: https://www.karger.com/Article/FullText/492274
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Verfasserangaben:Daniela Gompelmann, Nicola Benjamin, Elena Bischoff, Konstantina Kontogianni, Maren Schuhmann, Hans Hoffmann, Claus Peter Heussel, Felix J.F. Herth, Ralf Eberhardt
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Zusammenfassung: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: This analysis evaluated the impact of valve therapy on the survival of emphysema patients. Methods: Survival rates of emphysema patients who underwent valve therapy were assessed according to their radiological outcome following valve placement. 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: Lobar atelectasis following endoscopic valve therapy is associated with a survival benefit.
Beschreibung:Published online: September 18, 2018
Gesehen am 13.05.2019
Beschreibung:Online Resource
ISSN:1423-0356
DOI:10.1159/000492274