Physiological and Computed Tomographic Predictors of Outcome from Lung Volume Reduction Surgery

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dc.contributor.authorWashko, George R.
dc.contributor.authorMartinez, Fernando J.
dc.contributor.authorHoffman, Eric A.
dc.contributor.authorLoring, Stephen H.
dc.contributor.authorEstepar, Raul San Jose
dc.contributor.authorDiaz, Alejandro A.
dc.contributor.authorSciurba, Frank C.
dc.contributor.authorSilverman, Edwin K.
dc.contributor.authorHan, MeiLan K.
dc.contributor.authorDeCamp, Malcolm
dc.contributor.authorReilly, John J.
dc.contributor.authorNatl Emphysema Treatment Trial Res
dc.date.accessioned2024-01-10T13:52:08Z
dc.date.available2024-01-10T13:52:08Z
dc.date.issued2010
dc.description.abstractRationale: Previous investigations have identified several potential predictors of outcomes from lung volume reduction surgery (LVRS). A concern regarding these studies has been their small sample size, which may limit generalizability. We therefore sought to examine radiographic and physiologic predictors of surgical outcomes in a large, multicenter clinical investigation, the National Emphysema Treatment Trial.
dc.description.abstractObjectives: To identify objective radiographic and physiological indices of lung disease that have prognostic value in subjects with chronic obstructive pulmonary disease being evaluated for LVRS.
dc.description.abstractMethods: A subset of the subjects undergoing LVRS in the National Emphysema Treatment Trial underwent preoperative high-resolution computed tomographic (CT) scanning of the chest and measures of static lung recoil at total lung capacity (SRTLC) and inspiratory resistance (R1). The relationship between CT measures of emphysema, the ratio of upper to lower zone emphysema, CT measures of airway disease, SRTLC, R1, the ratio of residual volume to total lung capacity (RV/TLC), and both 6-month postoperative changes in FEV(1) and maximal exercise capacity were assessed.
dc.description.abstractMeasurements and Main Results: Physiological measures of lung elastic recoil and inspiratory resistance were not correlated with improvement in either the FEV(1) (R = -0.03, P = 0.78 and R = -0.17, P = 0.16, respectively) or maximal exercise capacity (R = -0.02, P = 0.83 and R = 0.08, P = 0.53, respectively). The RV/TLC ratio and CT measures of emphysema and its upper to lower zone ratio were only weakly predictive of postoperative changes in both the FEV(1) (R = 0.11, P = 0.01; R = 0.2, P < 0.0001; and R = 0.23, P < 0.0001, respectively) and maximal exercise capacity (R = 0.17, P = 0.0001; R = 0.15, P = 0.002; and R = 0.15, P = 0.002, respectively). CT assessments of airway disease were not predictive of change in FEV(1) or exercise capacity in this cohort.
dc.description.abstractConclusions: The RV/TLC ratio and CT measures of emphysema and its distribution are weak but statistically significant predictors of outcome after LVRS.
dc.description.funderNIH
dc.description.funderParker B. Francis Foundation
dc.description.funderNational Heart, Lung, and Blood Institute
dc.description.funderCenters for Medicare and Medicaid Services (CMS)
dc.description.funderAgency for Healthcare Research and Quality (AHRQ)
dc.description.funderDIVISION OF LUNG DISEASES
dc.description.funderNATIONAL HEART, LUNG, AND BLOOD INSTITUTE
dc.fechaingreso.objetodigital2024-05-20
dc.format.extent7 páginas
dc.fuente.origenWOS
dc.identifier.doi10.1164/rccm.200906-0911OC
dc.identifier.issn1073-449X
dc.identifier.pubmedidMEDLINE:19965810
dc.identifier.urihttps://doi.org/10.1164/rccm.200906-0911OC
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/79646
dc.identifier.wosidWOS:000275176700012
dc.information.autorucMedicina;Díaz A;S/I;104496
dc.issue.numero5
dc.language.isoen
dc.nota.accesocontenido parcial
dc.pagina.final500
dc.pagina.inicio494
dc.publisherAMER THORACIC SOC
dc.revistaAMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE
dc.rightsacceso restringido
dc.subjectSEVERE EMPHYSEMA
dc.subjectPULMONARY-FUNCTION
dc.subjectMEDICAL THERAPY
dc.subjectFOLLOW-UP
dc.subjectIMPROVEMENT
dc.subjectTRIAL
dc.subjectVARIABILITY
dc.subjectMECHANICS
dc.subjectCT
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titlePhysiological and Computed Tomographic Predictors of Outcome from Lung Volume Reduction Surgery
dc.typeartículo
dc.volumen181
sipa.codpersvinculados104496
sipa.indexWOS
sipa.indexScopus
sipa.trazabilidadCarga SIPA;09-01-2024
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