Survival following lung volume reduction procedures: results from the UK Lung Volume Reduction (UKLVR) registry
Introduction Lung volume reduction surgery (LVRS) and endobronchial valve (EBV) placement can produce substantial benefits in appropriately selected people with emphysema. The UK Lung Volume Reduction (UKLVR) registry is a national multicentre observational study set up to support quality standards...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2024-02-01
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| Series: | BMJ Open Respiratory Research |
| Online Access: | https://bmjopenrespres.bmj.com/content/11/1/e002092.full |
| _version_ | 1797289828394467328 |
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| author | S Jordan M Shackcloth B Naidu S Tenconi T Havelock A Kirk A Lewis A Hussain C E Bolton R Mahadeva R A Lawson M Munavvar S Rathinam P L Shah N S Hopkinson S V Kemp J W Dodd S C Buttery C Kallis A Alzetani K J Curtis A M Habib |
| author_facet | S Jordan M Shackcloth B Naidu S Tenconi T Havelock A Kirk A Lewis A Hussain C E Bolton R Mahadeva R A Lawson M Munavvar S Rathinam P L Shah N S Hopkinson S V Kemp J W Dodd S C Buttery C Kallis A Alzetani K J Curtis A M Habib |
| author_sort | S Jordan |
| collection | DOAJ |
| description | Introduction Lung volume reduction surgery (LVRS) and endobronchial valve (EBV) placement can produce substantial benefits in appropriately selected people with emphysema. The UK Lung Volume Reduction (UKLVR) registry is a national multicentre observational study set up to support quality standards and assess outcomes from LVR procedures at specialist centres across the UK.Methods Data were analysed for all patients undergoing an LVR procedure (LVRS/EBV) who were recruited into the study at participating centres between January 2017 and June 2022, including; disease severity and risk assessment, compliance with guidelines for selection, procedural complications and survival to February 2023.Results Data on 541 patients from 14 participating centres were analysed. Baseline disease severity was similar in patients who had surgery n=244 (44.9%), or EBV placement n=219 (40.9%), for example, forced expiratory volume in 1 s (FEV1) 32.1 (12.1)% vs 31.2 (11.6)%. 89% of cases had discussion at a multidisciplinary meeting recorded. Median (IQR) length of stay postprocedure for LVRS and EBVs was 12 (13) vs 4 (4) days(p=0.01). Increasing age, male gender and lower FEV1%predicted were associated with mortality risk, but survival did not differ between the two procedures, with 50 (10.8%) deaths during follow-up in the LVRS group vs 45 (9.7%) following EBVs (adjusted HR 1.10 (95% CI 0.72 to 1.67) p=0.661)Conclusion Based on data entered in the UKLVR registry, LVRS and EBV procedures for emphysema are being performed in people with similar disease severity and long-term survival is similar in both groups. |
| first_indexed | 2024-03-07T19:11:39Z |
| format | Article |
| id | doaj.art-c56948a9a781443d9e2e3f200ca0ed4b |
| institution | Directory Open Access Journal |
| issn | 2052-4439 |
| language | English |
| last_indexed | 2024-03-07T19:11:39Z |
| publishDate | 2024-02-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Respiratory Research |
| spelling | doaj.art-c56948a9a781443d9e2e3f200ca0ed4b2024-03-01T03:00:07ZengBMJ Publishing GroupBMJ Open Respiratory Research2052-44392024-02-0111110.1136/bmjresp-2023-002092Survival following lung volume reduction procedures: results from the UK Lung Volume Reduction (UKLVR) registryS Jordan0M Shackcloth1B Naidu2S Tenconi3T Havelock4A Kirk5A Lewis6A Hussain7C E Bolton8R Mahadeva9R A Lawson10M Munavvar11S Rathinam12P L Shah13N S Hopkinson14S V Kemp15J W Dodd16S C Buttery17C Kallis18A Alzetani19K J Curtis20A M Habib211University of Colorado and VA GRECC, Aurora, USA4Liverpool Heart and Chest Hospital, Liverpool, UK6Birmingham Heartlands Hospital, Birmingham, UKSheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UKUniversity Hospital Southampton, Southampton, UKGreat North Children′s Hospital, Newcastle-upon-Tyne, UK1Paediatrics, Princess of Wales Hospital, Bridgend, UK4Zia Medical Center L.L.C, Dubai, UNITED ARAB EMIRATESDepartment of Respiratory Medicine, Cardiff University, Cardiff, Wales, UK3Cambridge University Hospitals NHS Foundation Trust1Institute of Neuroscience and Newcastle University Institute for Ageing, Newcastle University, Newcastle upon Tyne, UK9Lancashire Teaching Hospitals NHS Foundation Trust, Lancashire, UK1University Hospitals of Leicester NHS Trust, Leicester, UKDepartment of Respiratory Medicine, Royal Brompton Hospital, London, UKNIHR Respiratory Biomedical Research Unit at the Royal Brompton Hospital and National Heart and Lung Institute, Imperial College, London, UKDepartment of Respiratory Medicine, Royal Brompton Hospital, London, UKSt George`s University of London, London, UK11Royal Brompton and Harefiled NHS Foundation Trust and Imperial College, NIHR Respiratory Biomedical Research Unit, London, UKMedical Statistics Unit, London School of Hygiene and Tropical Medicine, London, UKUniversity Hospital Southampton, Southampton, UKUniversity Hospitals Bristol and Weston, Bristol, UKNew Cross Hospital, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UKIntroduction Lung volume reduction surgery (LVRS) and endobronchial valve (EBV) placement can produce substantial benefits in appropriately selected people with emphysema. The UK Lung Volume Reduction (UKLVR) registry is a national multicentre observational study set up to support quality standards and assess outcomes from LVR procedures at specialist centres across the UK.Methods Data were analysed for all patients undergoing an LVR procedure (LVRS/EBV) who were recruited into the study at participating centres between January 2017 and June 2022, including; disease severity and risk assessment, compliance with guidelines for selection, procedural complications and survival to February 2023.Results Data on 541 patients from 14 participating centres were analysed. Baseline disease severity was similar in patients who had surgery n=244 (44.9%), or EBV placement n=219 (40.9%), for example, forced expiratory volume in 1 s (FEV1) 32.1 (12.1)% vs 31.2 (11.6)%. 89% of cases had discussion at a multidisciplinary meeting recorded. Median (IQR) length of stay postprocedure for LVRS and EBVs was 12 (13) vs 4 (4) days(p=0.01). Increasing age, male gender and lower FEV1%predicted were associated with mortality risk, but survival did not differ between the two procedures, with 50 (10.8%) deaths during follow-up in the LVRS group vs 45 (9.7%) following EBVs (adjusted HR 1.10 (95% CI 0.72 to 1.67) p=0.661)Conclusion Based on data entered in the UKLVR registry, LVRS and EBV procedures for emphysema are being performed in people with similar disease severity and long-term survival is similar in both groups.https://bmjopenrespres.bmj.com/content/11/1/e002092.full |
| spellingShingle | S Jordan M Shackcloth B Naidu S Tenconi T Havelock A Kirk A Lewis A Hussain C E Bolton R Mahadeva R A Lawson M Munavvar S Rathinam P L Shah N S Hopkinson S V Kemp J W Dodd S C Buttery C Kallis A Alzetani K J Curtis A M Habib Survival following lung volume reduction procedures: results from the UK Lung Volume Reduction (UKLVR) registry BMJ Open Respiratory Research |
| title | Survival following lung volume reduction procedures: results from the UK Lung Volume Reduction (UKLVR) registry |
| title_full | Survival following lung volume reduction procedures: results from the UK Lung Volume Reduction (UKLVR) registry |
| title_fullStr | Survival following lung volume reduction procedures: results from the UK Lung Volume Reduction (UKLVR) registry |
| title_full_unstemmed | Survival following lung volume reduction procedures: results from the UK Lung Volume Reduction (UKLVR) registry |
| title_short | Survival following lung volume reduction procedures: results from the UK Lung Volume Reduction (UKLVR) registry |
| title_sort | survival following lung volume reduction procedures results from the uk lung volume reduction uklvr registry |
| url | https://bmjopenrespres.bmj.com/content/11/1/e002092.full |
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