Risk Factors for Pneumothorax After Treatment With Endobronchial Valves: A Cohort Study.

IF 6.3 2区医学 Q1 RESPIRATORY SYSTEM

Respirology Pub Date : 2025-10-01 Epub Date: 2025-05-29 DOI:10.1111/resp.70069

Kirstine Hermann Jørgensen, Thomas Decker Christensen, Ingrid Louise Titlestad, Jesper Rømhild Davidsen, Kathrine Bock, Kristine Jensen, Morten Bendixen, Ole Dan Jørgensen, Michael Perch, Elisabeth Bendstrup

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引用次数: 0

Abstract

Background and objectives: Pneumothorax (PTX) is the most prevalent and serious adverse event associated with endobronchial valve (EBV) treatment in chronic obstructive pulmonary disease (COPD) with emphysema. This study aimed to compare preoperative characteristics and 30-day outcomes in patients with COPD with and without PTX.

Method: This retrospective nationwide cohort study included patients treated with EBV between 2017 and 2023 at all EBV centres in Denmark. Data were retrieved from medical records.

Results: A total of 228 patients were included, of whom 46 (20.2%) had PTX. The median time to PTX was 7 h (IQR 2-22) and the median drain treatment duration was 13 days (IQR 8.5-22). The risk of PTX was significantly higher when EBV treatment was performed in the upper lobes than in the lower lobes (adjusted RR 6.32, 95% CI 2.56-15.60). High target lobe volume (adjusted OR pr 100 mL increase 1.12, 95% CI 1.02-1.22) and high residual volume (adjusted OR pr 10%pt. increase 1.11, 95% CI 1.01-1.23) were independent risk factors for PTX. More PTX patients had atelectasis after 2 h compared to patients without PTX. The risk of pneumonia (RR 4.5, 95% CI 1.7-11.8), empyema (p = 0.0047) and ICU admission (RR 9.89, 95% CI 1.98-49.4) were significantly higher in the PTX patients than in the patients without PTX.

Conclusions: PTX was more prevalent when EBV treatment was performed in the upper lobes and with high residual volume and target lobe volume, leading to prolonged hospital admission and risk of hospital-acquired pneumonia.

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支气管内瓣膜治疗后气胸的危险因素：一项队列研究。

背景和目的：气胸（PTX）是慢性阻塞性肺疾病（COPD）合并肺气肿的支气管内瓣膜（EBV）治疗中最常见和最严重的不良事件。本研究旨在比较合并PTX和不合并PTX的COPD患者的术前特征和30天结局。方法：这项回顾性全国队列研究纳入了2017年至2023年在丹麦所有EBV中心接受EBV治疗的患者。数据从医疗记录中检索。结果：共纳入228例患者，其中46例（20.2%）有PTX。到PTX的中位时间为7 h (IQR 2-22)，引流治疗的中位时间为13 d （IQR 8.5-22）。当EBV治疗于上肺叶时，PTX的风险明显高于下肺叶（调整后RR为6.32,95% CI为2.56-15.60）。高目标叶体积（调整后的OR比100 mL增加1.12,95% CI 1.02-1.22）和高残留体积（调整后的OR比为10%）。增加1.11,95% CI 1.01-1.23)是PTX的独立危险因素。与没有PTX的患者相比，PTX患者在2小时后出现更多的肺不张。PTX患者发生肺炎（RR为4.5,95% CI为1.7 ~ 11.8）、脓胸（p = 0.0047）和ICU入院（RR为9.89,95% CI为1.98 ~ 49.4）的风险显著高于未行PTX的患者。结论：当EBV治疗于上肺叶，且残气量和靶肺叶容积较大时，PTX更常见，导致住院时间延长和发生医院获得性肺炎的风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Respirology 医学-呼吸系统

CiteScore

10.60

自引率

5.80%

发文量

225

审稿时长

1 months

期刊介绍： Respirology is a journal of international standing, publishing peer-reviewed articles of scientific excellence in clinical and clinically-relevant experimental respiratory biology and disease. Fields of research include immunology, intensive and critical care, epidemiology, cell and molecular biology, pathology, pharmacology, physiology, paediatric respiratory medicine, clinical trials, interventional pulmonology and thoracic surgery. The Journal aims to encourage the international exchange of results and publishes papers in the following categories: Original Articles, Editorials, Reviews, and Correspondences. Respirology is the preferred journal of the Thoracic Society of Australia and New Zealand, has been adopted as the preferred English journal of the Japanese Respiratory Society and the Taiwan Society of Pulmonary and Critical Care Medicine and is an official journal of the World Association for Bronchology and Interventional Pulmonology.