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Bronchoscopic management of patients with symptomatic airway stenosis and prognostic factors for survival.

Okiror, Lawrence and Jiang, Li and Oswald, Nicola and Bille, Andrea and Rajesh, Pala and Bishay, Ehab and Steyn, Richard and Naidu, Babu and Kalkat, Maninder (2015) Bronchoscopic management of patients with symptomatic airway stenosis and prognostic factors for survival. The Annals of thoracic surgery, 99 (5). pp. 1725-30. ISSN 1552-6259. This article is accessible to all HEFT staff and students via NICE journals and databases http://www.nice.org.uk/about/what-we-do/evidence-services/journals-and-databases by using their HEFT Athens login IDs.

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Official URL: http://www.annalsthoracicsurgery.org/article/S0003...

Abstract

BACKGROUND

Interventional bronchoscopy is effective in the management of patients with symptomatic airway obstruction for both malignant and benign conditions. The main aim of this study is to report our experience with emergency interventional bronchoscopy in patients with symptomatic airway obstruction and identify prognostic factors for survival.

METHODS

This is a retrospective observational study of patients undergoing emergency interventional bronchoscopy over a 4-year period. Survival times were analyzed separately for patients with benign and malignant airway obstruction by the Kaplan-Meier method.

RESULTS

Between June 2009 and July 2013, 168 emergency interventional bronchoscopies were performed in 112 patients for airway obstruction. The median age was 63 years (range, 20 to 86), and 91 patients (54%) patients were female. Seventy-two cases (43%) had airway obstruction due to malignant disease. There were 3 in-hospital deaths (2.7%). Median survival of the study population was 5.6 months (range, 0 to 51) with a median follow-up of 7.3 months (range, 0 to 51). Median survival for patients with malignant airway obstruction was 3.5 months (range, 0 to 21), and 9.8 months (range, 0.1 to 51) for those with benign disease. Airway intervention facilitated palliative chemotherapy in 32 patients (44%) of those with malignant airway obstruction. At multivariate analysis in patients with malignant airway obstruction, presence of stridor (hazard ratio 1.919, 95% confidence interval: 1.082 to 3.404, p = 0.026) and not receiving postprocedure chemotherapy (hazard ratio 2.05, 95% confidence interval: 1.156 to 3.636, p = 0.014) were independent prognostic factors for death.

CONCLUSIONS

Emergency interventional bronchoscopy for airway obstruction is safe, relieved symptoms, and facilitated palliative chemotherapy, which improved survival.

Item Type: Article
Additional Information: This article is accessible to all HEFT staff and students via NICE journals and databases http://www.nice.org.uk/about/what-we-do/evidence-services/journals-and-databases by using their HEFT Athens login IDs.
Subjects: WG Cardiovascular system. Cardiology
Divisions: Planned IP Care > Thoracic Surgery
Related URLs:
Depositing User: Miss Adele Stanton
Date Deposited: 15 Sep 2015 15:05
Last Modified: 15 Sep 2015 15:05
URI: http://www.repository.heartofengland.nhs.uk/id/eprint/1020

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