Two-year improvement in multidimensional body mass index, airflow obstruction, dyspnea, and exercise capacity index after nonresectional lung volume reduction surgery in awake patients

Eugenio Pompeo, Tommaso C Mineo
Annals of Thoracic Surgery 2007, 84 (6): 1862-9; discussion 1862-9

BACKGROUND: This study analyzed the comprehensive 2-year outcome of nonresectional lung volume reduction surgery (LVRS) in awake patients, including calculation of the multidimensional BODE index (body mass index, degree of airflow obstruction assessed by spirometry, modified Medical Research Council dyspnea grade, and 6-minute walking distance), which has proved a useful predictor of survival in patients with chronic obstructive pulmonary disease.

METHODS: The study cohort included 42 patients undergoing LVRS while awake within a staged bilateral program entailing unilateral LVRS, followed by contralateral treatment performed at the reappearance of disabling symptoms. Outcome measures included hospital stay, procedure-related costs, calculation of the multidimensional BODE index, actuarial survival, and freedom from contralateral LVRS. Results were compared with those of a control group undergoing resectional LVRS under general anesthesia.

RESULTS: The groups were well matched in demographics and baseline measures. There was no operative mortality. Median hospital stay was significantly shorter in the awake group (6 days versus 9 days, p < 0.0001); median procedure-related costs were significantly lower in the awake group (euro5220 versus euro8580; p < 0.0001). At intergroup comparisons of awake versus control group of clinical results, the BODE index improved postoperatively in both groups (-2.24 +/- 1.0 versus -1.95 +/- 1.0, intergroup p = 0.35) and remained improved for up to 2 years (-1.95 +/- 1.3 versus -1.37 +/- 1.4, intergroup p = 0.1); 2-year survival and freedom from contralateral LVRS rates were 87% versus 91% (p = 0.52) and 74% versus 73% (p = 0.71), respectively.

CONCLUSIONS: A significant improvement in the BODE index, satisfactory survival, and high rate of freedom from contralateral LVRS occurred both in the awake and control group, although the awake procedure proved more cost-effective.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Trending Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"