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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| Main Authors: | , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
2019
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| In: |
Respiration
Year: 2018, Volume: 97, Issue: 2, Pages: 145-152 |
| ISSN: | 1423-0356 |
| DOI: | 10.1159/000492274 |
| Online Access: | Verlag, Volltext: https://doi.org/10.1159/000492274 Verlag, Volltext: https://www.karger.com/Article/FullText/492274 
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| Author Notes: | Daniela Gompelmann, Nicola Benjamin, Elena Bischoff, Konstantina Kontogianni, Maren Schuhmann, Hans Hoffmann, Claus Peter Heussel, Felix J.F. Herth, Ralf Eberhardt |
| Summary: | 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. |
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| Item Description: | Published online: September 18, 2018 Gesehen am 13.05.2019 |
| Physical Description: | Online Resource |
| ISSN: | 1423-0356 |
| DOI: | 10.1159/000492274 |