Long-term prognostic factors of clinical success after interventional bronchoscopy in patients with scarring central airway stenosis
Abstract Background Scarring central airway stenosis (SCAS) is a potentially life-threatening condition with debilitating symptoms. Interventional bronchoscopy is increasingly used to relieve symptoms in patients with SCAS, but recurrent stenosis is frequently observed. Little data exist on the long...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-03-01
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| Series: | BMC Pulmonary Medicine |
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| Online Access: | https://doi.org/10.1186/s12890-021-01434-5 |
| _version_ | 1818910479877144576 |
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| author | Kunyan Sun Hong Zhang Wei Zhang Yuan Cheng Guangfa Wang |
| author_facet | Kunyan Sun Hong Zhang Wei Zhang Yuan Cheng Guangfa Wang |
| author_sort | Kunyan Sun |
| collection | DOAJ |
| description | Abstract Background Scarring central airway stenosis (SCAS) is a potentially life-threatening condition with debilitating symptoms. Interventional bronchoscopy is increasingly used to relieve symptoms in patients with SCAS, but recurrent stenosis is frequently observed. Little data exist on the long-term prognosis of interventional bronchoscopy for SCAS. We aimed to assess the prognostic factors of bronchoscopic interventions in patients with SCAS to optimize treatment. Methods This was a retrospective study that enrolled 119 consecutive patients with SCAS from January 2010 to April 2019 at our institution. Long-term clinical success was defined as airway stenosis < 50%, no limitation of physical activity, and a stable condition for > 12 months after the last interventional procedure. We compared patients’ demographics, airway stenosis characteristics, and interventional procedures between the successful and unsuccessful groups, and identified significant predictors of long-term outcome with univariate and multivariate logistic regression. Results A total of 119 patients with 577 therapeutic bronchoscopies were included. Seventy-five (63%) patients were considered to have long-term clinical success. Older age, male gender, smoking, elevated C-reactive protein level, subglottic stenosis, stent or T-tube implantation, previous interventional treatment, and multiple procedures per year were potentially associated with unsuccessful long-term outcomes in the univariate analysis. Current smoker status (odds ratio [OR] 5.70, 95% confidence interval [CI] 1.35–24.17, P = 0.018), subglottic stenosis (OR 4.35, 95% CI 1.31–14.46, P = 0.017), and stent implantation (OR 4.96, 95% CI 1.33–18.48, P = 0.017) were associated with decreased odds of long-term success in the multivariate logistic regression analysis. Of note, there was no significant difference in odds of success between former smokers and nonsmokers. Conclusions Current smoker status, subglottic stenosis, and stent implantation are independent factors associated with reduced long-term efficacy of interventional bronchoscopy for SCAS. Smoking cessation should be encouraged to improve the outcome of therapeutic bronchoscopy. |
| first_indexed | 2024-12-19T22:43:28Z |
| format | Article |
| id | doaj.art-324e3d0507304856a1b6463e8d71bf63 |
| institution | Directory Open Access Journal |
| issn | 1471-2466 |
| language | English |
| last_indexed | 2024-12-19T22:43:28Z |
| publishDate | 2021-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pulmonary Medicine |
| spelling | doaj.art-324e3d0507304856a1b6463e8d71bf632022-12-21T20:03:00ZengBMCBMC Pulmonary Medicine1471-24662021-03-012111910.1186/s12890-021-01434-5Long-term prognostic factors of clinical success after interventional bronchoscopy in patients with scarring central airway stenosisKunyan Sun0Hong Zhang1Wei Zhang2Yuan Cheng3Guangfa Wang4Department of Respiratory and Critical Care Medicine, Peking University First HospitalDepartment of Respiratory and Critical Care Medicine, Peking University First HospitalDepartment of Respiratory and Critical Care Medicine, Peking University First HospitalDepartment of Respiratory and Critical Care Medicine, Peking University First HospitalDepartment of Respiratory and Critical Care Medicine, Peking University First HospitalAbstract Background Scarring central airway stenosis (SCAS) is a potentially life-threatening condition with debilitating symptoms. Interventional bronchoscopy is increasingly used to relieve symptoms in patients with SCAS, but recurrent stenosis is frequently observed. Little data exist on the long-term prognosis of interventional bronchoscopy for SCAS. We aimed to assess the prognostic factors of bronchoscopic interventions in patients with SCAS to optimize treatment. Methods This was a retrospective study that enrolled 119 consecutive patients with SCAS from January 2010 to April 2019 at our institution. Long-term clinical success was defined as airway stenosis < 50%, no limitation of physical activity, and a stable condition for > 12 months after the last interventional procedure. We compared patients’ demographics, airway stenosis characteristics, and interventional procedures between the successful and unsuccessful groups, and identified significant predictors of long-term outcome with univariate and multivariate logistic regression. Results A total of 119 patients with 577 therapeutic bronchoscopies were included. Seventy-five (63%) patients were considered to have long-term clinical success. Older age, male gender, smoking, elevated C-reactive protein level, subglottic stenosis, stent or T-tube implantation, previous interventional treatment, and multiple procedures per year were potentially associated with unsuccessful long-term outcomes in the univariate analysis. Current smoker status (odds ratio [OR] 5.70, 95% confidence interval [CI] 1.35–24.17, P = 0.018), subglottic stenosis (OR 4.35, 95% CI 1.31–14.46, P = 0.017), and stent implantation (OR 4.96, 95% CI 1.33–18.48, P = 0.017) were associated with decreased odds of long-term success in the multivariate logistic regression analysis. Of note, there was no significant difference in odds of success between former smokers and nonsmokers. Conclusions Current smoker status, subglottic stenosis, and stent implantation are independent factors associated with reduced long-term efficacy of interventional bronchoscopy for SCAS. Smoking cessation should be encouraged to improve the outcome of therapeutic bronchoscopy.https://doi.org/10.1186/s12890-021-01434-5Airway obstructionBronchoscopyOutcomeSubglottic stenosisSmoking |
| spellingShingle | Kunyan Sun Hong Zhang Wei Zhang Yuan Cheng Guangfa Wang Long-term prognostic factors of clinical success after interventional bronchoscopy in patients with scarring central airway stenosis BMC Pulmonary Medicine Airway obstruction Bronchoscopy Outcome Subglottic stenosis Smoking |
| title | Long-term prognostic factors of clinical success after interventional bronchoscopy in patients with scarring central airway stenosis |
| title_full | Long-term prognostic factors of clinical success after interventional bronchoscopy in patients with scarring central airway stenosis |
| title_fullStr | Long-term prognostic factors of clinical success after interventional bronchoscopy in patients with scarring central airway stenosis |
| title_full_unstemmed | Long-term prognostic factors of clinical success after interventional bronchoscopy in patients with scarring central airway stenosis |
| title_short | Long-term prognostic factors of clinical success after interventional bronchoscopy in patients with scarring central airway stenosis |
| title_sort | long term prognostic factors of clinical success after interventional bronchoscopy in patients with scarring central airway stenosis |
| topic | Airway obstruction Bronchoscopy Outcome Subglottic stenosis Smoking |
| url | https://doi.org/10.1186/s12890-021-01434-5 |
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