Background. This study analyzed the comprehensive 2-year outcome of nonresectional lung volume reduction surgery (LVRS) in awake patients, including calculation of the multidimensional BODE index (body mass index,degree of airflow obstruction assessed by spirometry,modified Medical Research Council dyspnea grade, and 6-minute walking distance), which has proved a useful predictor of survival in patients with chronic obstructive pulmonary disease. Methods. The study cohort included 42 patients undergoing LVRS while awake within a staged bilateral program entailing unilateral LVRS, followed by contralateral treatment performed at the reappearance of disabling symptoms. Outcome measures included hospital stay, procedure-related costs, calculation of the multidimensional BODE index, actuarial survival, and freedom from contralateral LVRS. Results were compared with those of a control group undergoing resectional LVRS under general anesthesia. Results. The groups were well matched in demographics and baseline measures. There was no operative mortality. Median hospital stay was significantly shorter in the awake group (6 days versus 9 days, p < 0.0001); median procedurerelated costs were significantly lower in the awake group (€5220 versus €8580; p < 0.0001). At intergroup comparisons of awake versus control group of clinical results, the BODE index improved postoperatively in both groups ( 2.24 1.0 versus 1.95 1.0, intergroup p 0.35) and remained improved for up to 2 years ( 1.95 1.3 versus 1.37 1.4, intergroup p 0.1); 2-year survival and freedom from contralateral LVRS rates were 87% versus 91% (p 0.52) and 74% versus 73% (p 0.71), respectively. Conclusions. A significant improvement in the BODE index, satisfactory survival, and high rate of freedom from contralateral LVRS occurred both in the awake and control group, although the awake procedure proved more cost-effective.

Pompeo, E. (2007). Two-year Improvement in Multidimensional BODE Index after Awake Nonresectional Lung Volume Reduction Surgery. ??????? it.cilea.surplus.oa.citation.tipologie.CitationProceedings.prensentedAt ??????? 42nd Annual Meeting of the Society of Thoracic Surgeons, San Diego (California,USA).

Two-year Improvement in Multidimensional BODE Index after Awake Nonresectional Lung Volume Reduction Surgery

POMPEO, EUGENIO
2007

Abstract

Background. This study analyzed the comprehensive 2-year outcome of nonresectional lung volume reduction surgery (LVRS) in awake patients, including calculation of the multidimensional BODE index (body mass index,degree of airflow obstruction assessed by spirometry,modified Medical Research Council dyspnea grade, and 6-minute walking distance), which has proved a useful predictor of survival in patients with chronic obstructive pulmonary disease. Methods. The study cohort included 42 patients undergoing LVRS while awake within a staged bilateral program entailing unilateral LVRS, followed by contralateral treatment performed at the reappearance of disabling symptoms. Outcome measures included hospital stay, procedure-related costs, calculation of the multidimensional BODE index, actuarial survival, and freedom from contralateral LVRS. Results were compared with those of a control group undergoing resectional LVRS under general anesthesia. Results. The groups were well matched in demographics and baseline measures. There was no operative mortality. Median hospital stay was significantly shorter in the awake group (6 days versus 9 days, p < 0.0001); median procedurerelated costs were significantly lower in the awake group (€5220 versus €8580; p < 0.0001). At intergroup comparisons of awake versus control group of clinical results, the BODE index improved postoperatively in both groups ( 2.24 1.0 versus 1.95 1.0, intergroup p 0.35) and remained improved for up to 2 years ( 1.95 1.3 versus 1.37 1.4, intergroup p 0.1); 2-year survival and freedom from contralateral LVRS rates were 87% versus 91% (p 0.52) and 74% versus 73% (p 0.71), respectively. Conclusions. A significant improvement in the BODE index, satisfactory survival, and high rate of freedom from contralateral LVRS occurred both in the awake and control group, although the awake procedure proved more cost-effective.
42nd Annual Meeting of the Society of Thoracic Surgeons
San Diego (California,USA)
2007
42
Society of Thoracic Surgeons
Rilevanza internazionale
contributo
1-feb-2007
Settore MED/21 - Chirurgia Toracica
English
LVRS, emphysema, awake anesthesia, thoracoscopy, BODE
Intervento a convegno
Pompeo, E. (2007). Two-year Improvement in Multidimensional BODE Index after Awake Nonresectional Lung Volume Reduction Surgery. ??????? it.cilea.surplus.oa.citation.tipologie.CitationProceedings.prensentedAt ??????? 42nd Annual Meeting of the Society of Thoracic Surgeons, San Diego (California,USA).
Pompeo, E
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2108/13455
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