Does Bronchoscopic Lung Volume Reduction Reduce Mortality in Patients with Severe Emphysema?

UNLABELLED

ABSTRACT       Objective: To compare the 12-month mortality for patients with severe emphysema who underwent either endobronchial valve (EBV) or coil treatments with those managed with standard of care (SoC). Bronchoscopic lung volume reduction (BLVR) is a useful treatment option in patients with chronic obstructive pulmonary disease (COPD), who have severe emphysema.

STUDY DESIGN

A case-control study.

PLACE AND DURATION OF STUDY

Department of Pulmonology, Yedikule Pulmonary Diseases and Thoracic Surgery Education and Research Hospital, Turkey, between January 2018 and January 2019.

METHODOLOGY

Medical data of patients diagnosed with severe/very severe emphysema between January 2010 and January 2017 were evaluated. One hundred and forty-eight patients with advanced COPD-emphysema phenotype, who met the BLVR treatment criteria, were evaluated. One hundred and twenty-four patients with 12-month follow-up data, 73 patients treated with BLVR, 43 cases of EBV, 30 cases of coil treatment, and 51 patients managed with standard of care (SoC) were analysed for this study.

RESULTS

A total of 20 (16.1%) patients died at the end of 12th month and 4 (3.2%) in the early period. At the end of the 12th month, mortality was found in 7 patients (9.6%) in the BLVR group (3 underwent EBV and 4 received coil treatment, respectively), and 13 (25.5%) patients in the SoC group. There was no statistically significant difference in mortality between groups in the early period, but it was lower in the BLVR group at the end of 12th month.

CONCLUSION

BLVR treatment significantly decreases mortality compared to SoC in patients with advanced emphysema. Key Words: Emphysema, Mortality, Endobronchial valve, Coil, Bronchoscopic lung volume reduction.