• Matthew R Lammi, Nathaniel Marchetti, Shari Barnett, and Gerard J Criner.
• Department of Internal Medicine, Section of Pulmonary and Critical Care Medicine, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA. mlammi@lsuhsc.edu
• Ann. Thorac. Surg. 2013 Jun 1;95(6):1905-11.

BackgroundDespite its benefit, lung volume reduction surgery (LVRS) is underused, partially because of the heterogeneous responses and lack of recent outcomes data.MethodsData from 59 consecutive emphysema patients who underwent LVRS were analyzed. The proportion of patients responding based on 6-minute walk distance (6-MWD), exercise capacity (watts), and forced expiratory volume in 1 second (FEV1) were calculated. Baseline variables were correlated with improvements in 6-MWD, maximal watts, and FEV1.ResultsEighty-eight percent of patients responded to LVRS, with a higher proportion of FEV1 and 6-MWD responders in our cohort compared with similar patients from the National Emphysema Treatment Trial. Significant associations existed between lower baseline 6-MWD and increased 6-MWD after operation (r = -0.423), more extensive emphysema and increased FEV1 (r = 0.491), and hyperinflation and increased maximal watts (r = 0.438). The probability of survival was 0.93 at 90 days, 0.90 at 1 year, and 0.80 (3 years). The lowest exercise group (<20 watts on baseline testing) had an increased risk for death (RR 13.3, p = 0.001).ConclusionsThere were durable improvements in FEV1 and exercise capacity in patients meeting the National Emphysema Treatment Trial criteria. Survival was comparable to that in similar patients from the National Emphysema Treatment Trial; response rates were higher in our cohort for FEV1 and 6-MWD. Those with lower 6-MWD, more emphysema, and more hyperinflation at baseline were most likely to respond to LVRS. Those with lowest exercise capacity at baseline may have a higher risk of death after LVRS.Copyright © 2013 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

28 keywords...

hide…