BMJ Open Respiratory Research最新文献

{"title":"Biologic therapies targeting type 2 inflammation in chronic obstructive pulmonary disease: a systematic review and meta-analysis of randomised controlled trials.","authors":"Camelia Pescaru, Alexandru Florian Crisan, Monica Marc, Ana Adriana Trusculescu, Septimiu Radu Susa, Adelina Maritescu, Cristian Oancea","doi":"10.1136/bmjresp-2026-004234","DOIUrl":"10.1136/bmjresp-2026-004234","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease, and a subset of patients exhibits type 2 (T2) inflammation. Biologic therapies targeting T2 inflammatory pathways have been evaluated in COPD, but their clinical efficacy remains variable. We performed a systematic review and meta-analysis to assess the efficacy and safety of biologic therapies targeting T2 inflammation in COPD.</p><p><strong>Methods: </strong>Randomised controlled trials evaluating biologic therapies targeting interleukin (IL)-5, IL-5 receptor α, IL-4/IL-13 or thymic stromal lymphopoietin in patients with COPD and biomarker-defined T2 inflammation were systematically identified. Outcomes included moderate or severe COPD exacerbations, lung function (forced expiratory volume in 1 s (FEV₁)), health-related quality of life assessed by the St George's Respiratory Questionnaire (SGRQ) and serious adverse events. Random-effects meta-analyses were conducted when at least two comparable studies were available. Risk of bias was assessed using the Cochrane Risk-of-Bias 2 tool.</p><p><strong>Results: </strong>Seven randomised controlled trials were included in the quantitative synthesis. Biologic therapies targeting T2 inflammation significantly reduced the rate of moderate or severe COPD exacerbations compared with placebo (rate ratio 0.77, 95% CI 0.72 to 0.83; p<0.001; I²=0%). Lung function improved modestly with a pooled increase in FEV₁ of 43 mL (95% CI 12.5 to 73.6; p=0.006; I²=55.3%). SGRQ total scores improved by -2.46 units (95% CI -3.43 to -1.49; p<0.001; I²=0%). Subgroup analyses showed the greatest reduction in exacerbations with IL-4/IL-13-targeting therapy in patients with blood eosinophil counts ≥300 cells/µL. No significant increase in serious adverse events was observed.</p><p><strong>Conclusions: </strong>Biologic therapies targeting T2 inflammation improve clinical outcomes in certain patients with COPD. The most consistent improvements were observed in studies that focused on inhibiting the IL-4/IL-13 pathway. However, variations in patient selection and in T2 enrichment strategies across trials make direct comparisons challenging. These results favour a biomarker-based, personalised approach over the routine use of biologics in unselected populations with COPD.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"13 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13374412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148444267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Too far to care? A cohort study on travel distance and hospital use in children living with respiratory support.","authors":"Johan Florén, Åsa Israelsson-Skogsberg, Magnus Ekström, Berit Lindahl, Agneta Markström, Andreas Palm","doi":"10.1136/bmjresp-2025-003986","DOIUrl":"10.1136/bmjresp-2025-003986","url":null,"abstract":"<p><strong>Aim: </strong>Children aged 0-18 years living with respiratory support represent a growing population worldwide. They have complex medical needs and rely on multidisciplinary care. Transportation is often challenging, and paediatric respiratory support teams are concentrated in a limited number of hospitals. As of 2024, Swedish paediatric long-term respiratory care facilities (PRCF) are centralised at four centres. We aimed to explore the relationship between travel distance from home to PRCF, healthcare utilisation and mortality before centralisation.</p><p><strong>Methods: </strong>A retrospective, population-based cohort study using data from the Swedish Quality Registry for Respiratory Failure (Swedevox) between 2015 and 2021. Multivariable linear regression models and survival analyses were applied to examine the associations between travel distance, healthcare utilisation and mortality.</p><p><strong>Results: </strong>A total of 596 children were included (mean age 5.4±5.1 years). Of these, 76% lived within 60 min of a PRCF (median 19 km, IQR 8-34), while 24% had travel times exceeding 60 min (median 171 km, IQR 105-268). No association was found between travel time to PRCF and healthcare utilisation or death before age 19. Children whose parents had 12+ years of education underwent more hospitalisations annually (R 0.29, 95% CI 0.01 to 0.57), and children in rural areas had fewer emergency visits (R -0.47, 95% CI 0.84 to -0.10).</p><p><strong>Conclusions: </strong>No associations were found between travel distance and healthcare utilisation or mortality among children with long-term respiratory support. Centralised PRCF may thus be feasible without compromising outcomes, but reforms should recognise possible unintended effects on children and families.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"13 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13374413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148444291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resource impact of bronchiectasis and associated exacerbations: based on a 5-year prospective observational cohort study (BronchUK).","authors":"Carlos Gallego-Moll, Laia Maynou, Phil Mawson, Martin Kelly, Joseph Stuart Elborn, Adam T Hill, Timothy Gatheral, Anita Sullivan, Charles Haworth, John R Hurst, Jeremy Stuart Brown, Mary P Carroll, Michael R Loebinger, Judy M Bradley, Paul Walker, John Steer, Jamie Duckers, James D Chalmers, Richard McNally, Anthony De Soyza, Alistair McGuire","doi":"10.1136/bmjresp-2026-004203","DOIUrl":"10.1136/bmjresp-2026-004203","url":null,"abstract":"<p><strong>Background: </strong>Our objective is to document major healthcare resource use and associated costs in the care of patients with bronchiectasis, with a particular focus on the costs incurred by exacerbations.</p><p><strong>Methods: </strong>We use a unique dataset from the Bronchiectasis Observational Cohort and Biobank UK. The study includes a baseline cohort of 1119 patients with a primary diagnosis of bronchiectasis, followed for up to five years. Data were extracted and linked to centrally held National Health Service (NHS) resource use data.</p><p><strong>Results: </strong>The average age of the cohort was 64 years and 62% were female. The most common bronchiectasis aetiology was idiopathic or post-infectious. Across follow-ups, exacerbations became less frequent: the proportion of patients with no events increased for all settings, while recurrent (≥2) events declined markedly and single-event categories remained largely stable. Exacerbations were predominantly managed in primary care settings. Based on exacerbation frequency and type and applying 2024/2025 NHS reference costs, the estimated total healthcare exacerbation costs for the study population ranged from £2 million to £3.2 million. Disaggregated estimates for the highest cost scenario include: general practitioner (GP)-only exacerbations (n=2824 events; £479 945), emergency department-managed exacerbations (n=311; £260 126) and inpatient-managed exacerbations (n=680; £2 428 291). The average estimated cost per patient over the full period was £1943. This corresponds to a weighted annual average of £495 per patient (including patients with no exacerbations), with most costs attributable to inpatient-managed exacerbations. Specifically, the average cost was £2980 for individuals with one or more exacerbations, £4865 for those with two or more and £5875 for those with three or more.</p><p><strong>Conclusions: </strong>The findings highlight the economic burden of bronchiectasis exacerbations and demonstrate that targeted management strategies to reduce exacerbation rates should increase health benefits and substantially reduce healthcare costs associated with bronchiectasis.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"13 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13374417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148444272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sing-a-Lung 2.0: protocol for a multicentre randomised controlled trial to investigate the effects and mechanisms of online-delivered singing training versus usual care 6-18 months after surgical resection for non-small cell lung cancer (NSCLC).","authors":"Mette Kaasgaard, Morten Borg, Morten Hostrup, Christian Borbjerg Laursen, Lotte Holm Land, Gitte Alstrup, Anne Orholm Nielsen, Julie Kissow Kristensen, Mikkel Bjørck Naver, Ole Hilberg, Uffe Bodtger","doi":"10.1136/bmjresp-2026-004382","DOIUrl":"10.1136/bmjresp-2026-004382","url":null,"abstract":"<p><strong>Introduction: </strong>Patients who have undergone curative surgery for non-small cell lung cancer (NSCLC) often experience long-term reduced quality of life (QoL), high symptom burden, risk of physical deconditioning and comorbidity. Current Danish rehabilitation offers are heterogeneous and not specifically tailored to the disease-specific needs and no long-term targeted support is currently available. Previously, singing-delivered as a structured training modality-has conferred both physiological and psychological improvements in chronic obstructive pulmonary disease, which may likely be transferable to NSCLC, as the two conditions share overlapping symptoms and characteristics. We aim to explore whether a singing-based intervention improves physical function, QoL and symptom burden 6-18 months postsurgery in NSCLC. Moreover, we aim to explore the underpinning physiological mechanisms of singing.</p><p><strong>Methods and analysis: </strong>We will conduct a multicentre randomised controlled trial, comparing 10 weeks' online-delivered structured singing training to usual care. Trial outcomes include primary outcome, physical capacity (measure: Six-Minute Walking Test), and secondary outcomes, QoL and symptoms (measures: St. George's Respiratory Questionnaire (SGRQ); the European Organisation for Research and Treatment of Cancer Questionnaire (QLQ-C30; QLQ-LC13); Hospital Anxiety and Depression Scale (HADS) and airway physiology (measure: forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC)). Explorative outcomes include aerobic fitness/maximal oxygen uptake (VO₂-max); exercise-induced adaptations; respiratory muscle strength and control; inflammatory biomarkers.</p><p><strong>Analysis: </strong>Descriptive statistics, stratified analyses, regression models and association and independence between objective and subjective outcomes.</p><p><strong>Ethics and dissemination: </strong>The trial was approved by the Committee on Health Research Ethics (SJ-1027) and the Danish Act on Processing of Personal Data (p-2024-19634). Results will be reported in peer-reviewed scientific journals.</p><p><strong>Trial registration number: </strong>NCT07460999.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"13 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13358242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcomes of paediatric home ventilation in South Korea: liberation and mortality.","authors":"Jae Won Moon, Ji Eun Jang, Min Jeong Lee, Myung Yeon Lee, Kyunghoon Kim, June Dong Park, Ji Weon Lee, Min Sun Kim, Ji Soo Park, Dong In Suh","doi":"10.1136/bmjresp-2025-003817","DOIUrl":"10.1136/bmjresp-2025-003817","url":null,"abstract":"<p><strong>Background: </strong>The number of children receiving home ventilation (HV) has substantially increased, many with neuromuscular diseases (NMDs). Understanding outcomes in this population is critical for guiding care and policy decisions. However, real-world data from South Korea are scarce, limiting evaluation of the 2016 national insurance expansion.</p><p><strong>Objectives: </strong>We aimed to investigate characteristics and outcomes of paediatric HV after insurance expansion, focusing on differences by NMD status and to identify key factors associated with HV liberation and mortality.</p><p><strong>Methods: </strong>We conducted a single-centre retrospective cohort study at Seoul National University Children's Hospital. We included children aged <19 years who received a Health Insurance or Medical Aid Ventilator Prescription between 1 January 2016 and 30 September 2024. Primary outcomes were HV liberation and all-cause mortality. Kaplan-Meier estimates with log-rank tests were used for between-group comparisons. Multivariable Cox regression was applied to identify factors associated with outcomes, reporting adjusted HRs (aHRs) and 95% CIs.</p><p><strong>Results: </strong>Among 316 children, 89 (28.2%) had NMDs. During follow-up, 71 (22.5%) were liberated and 81 (25.6%) died. Reduced likelihood of liberation was associated with NMD, home nursing care and gastrostomy, whereas oxygen use at HV initiation increased likelihood. NMD was not significantly associated with mortality (aHR 0.97 (95% CI 0.48 to 1.96)). Mortality risk was reduced with preterm birth, home nursing care and airway anomalies, but increased with antiseizure medication and continuous ventilation.</p><p><strong>Conclusion: </strong>NMD was linked to lower liberation likelihood but not mortality. Several other clinical factors were associated with outcomes, underscoring the need for individualised care strategies for paediatric HV.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"13 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13358310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low-dose corticosteroids in severe pulmonary infection: a meta-analysis of randomised controlled trials.","authors":"Joanne Lac, Sooyeon Han, Mahmood Ahmad, Harvey Starey, Soham Ganguly, Michael Tett, Oluwatosin Adeyemi, Jonathan J H Bray, Malik T Ahmad, Rui Providência","doi":"10.1136/bmjresp-2025-003934","DOIUrl":"10.1136/bmjresp-2025-003934","url":null,"abstract":"<p><strong>Purpose: </strong>Pulmonary infections are one of the leading causes of intensive care unit (ICU) admission and contribute to high mortality rates. This paper aimed to determine the effect of low-dose corticosteroids on outcomes in patients with severe pulmonary infections, including coronavirus disease of 2019, community-acquired pneumonia (CAP), pneumocystis pneumonia, sepsis, septic shock, and acute respiratory distress syndrome.</p><p><strong>Methods: </strong>We systematically reviewed randomised controlled trials (RCTs) comparing low-dose corticosteroids (≤400 mg hydrocortisone-equivalent daily) to placebo or standard care in adults with severe pulmonary infections. The primary outcome was short-term mortality (≤90 days). Secondary outcomes included 28-day mortality, 30-day mortality, number of patients with at least one serious adverse event, length of hospital stay and ICU stay.</p><p><strong>Results: </strong>We analysed twelve RCTs including 4622 patients and 1203 events. The pooled OR showed a short-term mortality benefit: 0.83 (95% CI 0.70 to 0.98; p=0.029; I²=2.0%; number needed to treat: 37.84; Grading of Recommendations Assessment, Development and Evaluation (GRADE): low certainty). There was a reduction in length of ICU stay in patients with CAP, with a pooled mean difference of -0.78 days (95% CI -1.46 to -0.10, p=0.025). The use of corticosteroids did not significantly affect the length of hospital stay or severe adverse events. A significant difference remained in longer courses of steroids, whereas shorter courses had no significant difference (≤7 days vs >7 days; OR: 0.69; 95% CI 0.53 to 0.89; p=0.039 vs OR: 0.96; 95% CI 0.813 to 1.14; p=0.67; subgroup differences: p=0.03). Subgroup analyses in patients with CAP showed a significant benefit in short-term mortality (OR: 0.72, 95% CI 0.54 to 0.98; p=0.034; number needed to treat: 28.10).</p><p><strong>Conclusion: </strong>We found that low-dose corticosteroids significantly reduce 90-day mortality in severe CAP, although evidence for their benefit in other severe pulmonary infections and at shorter follow-up intervals remains inconclusive.</p><p><strong>Prospero registration number: </strong>CRD42024627881.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"13 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13358306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of a disease-syndrome integrated assessment model for AECOPD severity: protocol for a nationwide multicentre cross-sectional study.","authors":"Hai-Long Zhang, Jia-Min Liu, Ya Li, Long-Yu Wang, Pei-Lin Jia, Zhao-Xu Yao","doi":"10.1136/bmjresp-2025-003781","DOIUrl":"10.1136/bmjresp-2025-003781","url":null,"abstract":"<p><strong>Introduction: </strong>Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) accelerate disease progression and increase mortality. Accurate severity assessment is essential for standardised clinical management. Traditional Chinese Medicine (TCM) shows efficacy in treating AECOPD, but no practical TCM-specific severity assessment tool exists. This study integrates multidimensional Western and TCM variables to develop an AECOPD severity assessment model, aiming to support clinical evaluation, improve treatment efficacy and prognosis and offer methodological insights for related research.</p><p><strong>Methods and analysis: </strong>The overall study design comprises four sequential steps. First, factors influencing AECOPD severity will be preliminarily screened through literature review and the first round of expert questionnaire surveys. Second, a multicentre cross-sectional study will be performed to establish a clinical information database; multiple statistical methods, combined with a second expert questionnaire survey, will be employed to identify the relevant variables associated with disease severity. Third, based on the established clinical database and identified variables, a disease-syndrome integrated AECOPD severity assessment model will be developed using both Classification and Regression Trees and Backpropagation Neural Networks. Fourth, the models will undergo comprehensive evaluation and validation to determine an accurate, practical, reproducible and externally valid disease severity assessment tool.</p><p><strong>Ethics and dissemination: </strong>The study protocol and all required documents have been submitted for review and approval to the Independent Ethics Committees of all the participating sites. All participants will provide their written informed consent on study entry, and all the recorded data will be treated as confidential. Ethical approval for this study was granted by the Institutional Review Board of the First Affiliated Hospital of Henan University of Chinese Medicine (Approval No. 2025HL-342) TRIAL REGISTRATION NUMBER: NCT06918353.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"13 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13358278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic value of ventilatory efficiency in hypersensitivity pneumonitis.","authors":"Worawat Chumpangern, Paolo Spagnolo, Pailin Ratanawatkul, Michael P Mohning, Evans R Fernández Pérez","doi":"10.1136/bmjresp-2026-004221","DOIUrl":"10.1136/bmjresp-2026-004221","url":null,"abstract":"<p><strong>Background: </strong>Ventilatory efficiency (VE) from cardiopulmonary exercise testing (CPET) is a valuable prognostic metric for evaluating cardiopulmonary diseases. However, its relationship with clinical outcomes in hypersensitivity pneumonitis (HP) remains unclear. We aimed to determine whether VE correlates with disease severity and predicts mortality in HP.</p><p><strong>Research question: </strong>In patients with HP, does VE correlate with disease severity and predict mortality?</p><p><strong>Methods: </strong>This retrospective cohort study (2009-2019) included patients with non-fibrotic (nfHP) and fibrotic HP (fHP) and idiopathic pulmonary fibrosis (IPF), which served as the comparison group. CPET variables, including VE/carbon dioxide (VE/VCO₂), were assessed across various forced vital capacity (FVC%) and diffusing capacity for carbon monoxide (DLCO%) ranges. Multivariate logistic regression identified predictors of 5-year mortality and survival was assessed with Kaplan-Meier plots.</p><p><strong>Results: </strong>164 patients were analysed (mean age of 65.6±12.0 years, 54.3% male). 25 had nfHP, 66 fHP and 73 IPF. Overall, an increase in the VE/VCO₂ slope and nadir was observed as the DLCO% decreased, but not with a decrease in FVC%, while the intercept remained unchanged. Patients with pulmonary hypertension (35%, 57/164) and fHP or IPF had significantly higher VE/VCO₂ slope and nadir when compared with patients without pulmonary hypertension or nfHP, respectively. A VE/VCO₂ slope ≥42 predicted survival (HR 3.65; 95% CI 1.04 to 12.80). Restricting the analysis to patients with HP showed similar results (HR 5.49; 95% CI 1.19 to 33.54).</p><p><strong>Interpretation: </strong>In patients with HP, elevated VE/VCO₂ is associated with the presence of pulmonary fibrosis, PH, reduced DLCO and a higher mortality risk. A VE/VCO₂ slope threshold of 42 may serve as a practical prognostic marker for stratification.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"13 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13358302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-reported outcomes after surgical resection for non-small cell lung cancer and perceptions of postsurgical rehabilitation programmes.","authors":"Mette Kaasgaard, Morten Borg, Jens Pers Kaltoft, Gitte Alstrup, Anne Orholm Nielsen, Pernille Kristiansen, Lise Stensen Bhatia, Jens-Ulrik Stæhr Jensen, René Horsleben Petersen, Erik Jakobsen, Ole Hilberg, Uffe Bodtger","doi":"10.1136/bmjresp-2025-003865","DOIUrl":"10.1136/bmjresp-2025-003865","url":null,"abstract":"<p><strong>Background: </strong>Surgical resection is essential in the treatment of early-stage non-small cell lung cancer (NSCLC), followed by rehabilitation with physical exercise training to improve physical capacity, quality of life (QoL) and symptom burden. In Denmark, rehabilitation is municipality-based and not disease-specific and without a maintenance model. We aimed to investigate QoL and symptoms 6-12 months after NSCLC surgery, hypothesising impaired QoL and symptom levels. Moreover, we explored rehabilitation attendance.</p><p><strong>Methods: </strong>An observational, cross-sectional, survey-based study was conducted from March to June 2025 across two Danish regions in patients after surgery for stage I or II NSCLC and without adjuvant oncological treatment (preregistration: osf.io/vmpft). Each site contacted their own eligible patients via digital mail. Registry data from the Danish Lung Cancer Registry and electronic patient registries: socio-demographics, disease-specific characteristics and surgical procedure. Survey data: QoL and symptoms burden (measure: The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30; Reporting: Raw and transformed scores and dichotomised according to defined thresholds and cut-offs for clinical importance) and self-reported information about rehabilitation attendance.</p><p><strong>Data analyses: </strong>descriptive and stratified analyses.</p><p><strong>Results: </strong>We identified 168 patients, 94 (56% of 168) were eligible and 67 (71% of 94) responded to the survey. No differences were found in baseline characteristics and overall mean time since surgery was 8.9±1.8 months. Current QoL and symptoms were clinically impaired (eg, physical functioning: 51%; dyspnoea: 70%). Around half (54%) reported having attended a rehabilitation programme and those having attended were more likely to have clinically impaired physical functioning and dyspnoea at present.</p><p><strong>Conclusions: </strong>QoL and symptoms were impaired 6-12 months after NSCLC surgery, and the current level did not seem to be related to having attended a postsurgical rehabilitation programme. Disease-specific challenges should be addressed in future rehabilitation and maintenance models.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"13 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13347808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148410502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective analysis of acute admissions for interstitial lung disease suggests a complex, multifactorial association between social deprivation and 90-day all-cause mortality: data from the North West of England.","authors":"Laura J White, Jonathon Shaw, Bethan Powell, Nyan M Kyi, Alicia Sou, Gareth Edward Hughes, Dilanka Tilakaratne, Conal Hayton, Trishala Raj, Vi Truong, Nashwah Ismail, Nawat Khanijoun, Rebecca Huang, Emma Hardy, Mahzaib Babar, Naayaab Khan, Martin Regan, Oby Okpala, Ragavilasini Suresh, Jerome Mcintosh, Amsal Amjad, Mahum Sohail, Zainab Aslam, Amy Gadoud, Timothy Gatheral, Georges Ng Man Kwong","doi":"10.1136/bmjresp-2025-003944","DOIUrl":"10.1136/bmjresp-2025-003944","url":null,"abstract":"<p><strong>Background: </strong>Social deprivation impacts chronic disease and acute admission outcomes. In interstitial lung disease (ILD), prior British Thoracic Society registry data for idiopathic pulmonary fibrosis have shown high deprivation was associated with poorer long-term outcomes. However, its impact on acute admissions in ILD is not known.</p><p><strong>Methods: </strong>We undertook a multicentre, retrospective study of ILD-related admissions between 1 January 2017 and 31 December 2019 across 11 hospitals in the North West of England, using available real-world data. We determined social deprivation geographically by the 2019 English Indices of Deprivation deciles. The primary outcome was 90-day all-cause mortality.</p><p><strong>Results: </strong>999 admissions met the inclusion criteria. 327/999 (32.7%) of admissions came from individuals geographically in the most deprived 20%. Across 999 admissions, in unadjusted survival analysis, we observed a non-linear relationship between deprivation and 90-day all-cause mortality. In complete case multivariate modelling, deprivation demonstrated borderline significant association with all-cause mortality (HR 1.038, 95% CI 1.00 to 1.077, p=0.050). However, this effect was lost in pooled analysis using multiple imputation (HR 1.001, 95% CI 0.971 to 1.033, p=0.924). Male sex and pre-admission long-term oxygen were consistently associated with increased 90-day all-cause mortality across both models. Lower transfer factor for carbon monoxide values were significantly associated with increased 90-day mortality in pooled analysis.</p><p><strong>Conclusion: </strong>We observe a high burden of acute ILD-related hospital admission among the most deprived 20%, suggesting geographical deprivation may impact acute healthcare seeking behaviours. Once admitted, the impact of deprivation appears more complex and multifactorial. Further studies which assess geographical and individual-level deprivation are needed to validate our findings.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"13 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13347911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148410534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}