Survival after endoscopic valve therapy in patients with severe emphysema

• Verfasst von: Gompelmann, Daniela [VerfasserIn]
• Verfasst von: Benjamin, Nicola [VerfasserIn]
• Verfasst von: Kontogianni, Konstantina [VerfasserIn]
• Verfasst von: Schuhmann, Maren [VerfasserIn]
• Verfasst von: Hoffmann, Hans [VerfasserIn]
• Verfasst von: Heußel, Claus Peter [VerfasserIn]
• Verfasst von: Herth, Felix [VerfasserIn]
• Verfasst von: Eberhardt, Ralf [VerfasserIn]
• Titel: Survival after endoscopic valve therapy in patients with severe emphysema
• Verf.angabe: Daniela Gompelmann, Nicola Benjamin, Elena Bischoff, Konstantina Kontogianni, Maren Schuhmann, Hans Hoffmann, Claus Peter Heussel, Felix J.F. Herth, Ralf Eberhardt
• Jahr: 2019
• Jahr des Originals: 2018
• Umfang: 8 S.
• Teil: volume:97
• Teil: year:2019
• Teil: number:2
• Teil: pages:145-152
• Teil: extent:8
• Fussnoten: Published online: September 18, 2018 ; Gesehen am 13.05.2019
• Titel Quelle: Enthalten in: Respiration
• Ort Quelle: Basel : Karger, 1944
• Jahr Quelle: 2019
• Band/Heft Quelle: 97(2019), 2, Seite 145-152
• ISSN Quelle: 1423-0356
• DOI: doi:10.1159/000492274
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1665277092

Abstract

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.