Cargando…

Long-term prognostic factors of clinical success after interventional bronchoscopy in patients with scarring central airway stenosis

BACKGROUND: Scarring central airway stenosis (SCAS) is a potentially life-threatening condition with debilitating symptoms. Interventional bronchoscopy is increasingly used to relieve symptoms in patients with SCAS, but recurrent stenosis is frequently observed. Little data exist on the long-term pr...

Descripción completa

Detalles Bibliográficos
Autores principales: Sun, Kunyan, Zhang, Hong, Zhang, Wei, Cheng, Yuan, Wang, Guangfa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7923499/
https://www.ncbi.nlm.nih.gov/pubmed/33648488
http://dx.doi.org/10.1186/s12890-021-01434-5
_version_ 1783658915210199040
author Sun, Kunyan
Zhang, Hong
Zhang, Wei
Cheng, Yuan
Wang, Guangfa
author_facet Sun, Kunyan
Zhang, Hong
Zhang, Wei
Cheng, Yuan
Wang, Guangfa
author_sort Sun, Kunyan
collection PubMed
description BACKGROUND: Scarring central airway stenosis (SCAS) is a potentially life-threatening condition with debilitating symptoms. Interventional bronchoscopy is increasingly used to relieve symptoms in patients with SCAS, but recurrent stenosis is frequently observed. Little data exist on the long-term prognosis of interventional bronchoscopy for SCAS. We aimed to assess the prognostic factors of bronchoscopic interventions in patients with SCAS to optimize treatment. METHODS: This was a retrospective study that enrolled 119 consecutive patients with SCAS from January 2010 to April 2019 at our institution. Long-term clinical success was defined as airway stenosis < 50%, no limitation of physical activity, and a stable condition for > 12 months after the last interventional procedure. We compared patients’ demographics, airway stenosis characteristics, and interventional procedures between the successful and unsuccessful groups, and identified significant predictors of long-term outcome with univariate and multivariate logistic regression. RESULTS: A total of 119 patients with 577 therapeutic bronchoscopies were included. Seventy-five (63%) patients were considered to have long-term clinical success. Older age, male gender, smoking, elevated C-reactive protein level, subglottic stenosis, stent or T-tube implantation, previous interventional treatment, and multiple procedures per year were potentially associated with unsuccessful long-term outcomes in the univariate analysis. Current smoker status (odds ratio [OR] 5.70, 95% confidence interval [CI] 1.35–24.17, P = 0.018), subglottic stenosis (OR 4.35, 95% CI 1.31–14.46, P = 0.017), and stent implantation (OR 4.96, 95% CI 1.33–18.48, P = 0.017) were associated with decreased odds of long-term success in the multivariate logistic regression analysis. Of note, there was no significant difference in odds of success between former smokers and nonsmokers. CONCLUSIONS: Current smoker status, subglottic stenosis, and stent implantation are independent factors associated with reduced long-term efficacy of interventional bronchoscopy for SCAS. Smoking cessation should be encouraged to improve the outcome of therapeutic bronchoscopy. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12890-021-01434-5.
format Online
Article
Text
id pubmed-7923499
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-79234992021-03-02 Long-term prognostic factors of clinical success after interventional bronchoscopy in patients with scarring central airway stenosis Sun, Kunyan Zhang, Hong Zhang, Wei Cheng, Yuan Wang, Guangfa BMC Pulm Med Research Article BACKGROUND: Scarring central airway stenosis (SCAS) is a potentially life-threatening condition with debilitating symptoms. Interventional bronchoscopy is increasingly used to relieve symptoms in patients with SCAS, but recurrent stenosis is frequently observed. Little data exist on the long-term prognosis of interventional bronchoscopy for SCAS. We aimed to assess the prognostic factors of bronchoscopic interventions in patients with SCAS to optimize treatment. METHODS: This was a retrospective study that enrolled 119 consecutive patients with SCAS from January 2010 to April 2019 at our institution. Long-term clinical success was defined as airway stenosis < 50%, no limitation of physical activity, and a stable condition for > 12 months after the last interventional procedure. We compared patients’ demographics, airway stenosis characteristics, and interventional procedures between the successful and unsuccessful groups, and identified significant predictors of long-term outcome with univariate and multivariate logistic regression. RESULTS: A total of 119 patients with 577 therapeutic bronchoscopies were included. Seventy-five (63%) patients were considered to have long-term clinical success. Older age, male gender, smoking, elevated C-reactive protein level, subglottic stenosis, stent or T-tube implantation, previous interventional treatment, and multiple procedures per year were potentially associated with unsuccessful long-term outcomes in the univariate analysis. Current smoker status (odds ratio [OR] 5.70, 95% confidence interval [CI] 1.35–24.17, P = 0.018), subglottic stenosis (OR 4.35, 95% CI 1.31–14.46, P = 0.017), and stent implantation (OR 4.96, 95% CI 1.33–18.48, P = 0.017) were associated with decreased odds of long-term success in the multivariate logistic regression analysis. Of note, there was no significant difference in odds of success between former smokers and nonsmokers. CONCLUSIONS: Current smoker status, subglottic stenosis, and stent implantation are independent factors associated with reduced long-term efficacy of interventional bronchoscopy for SCAS. Smoking cessation should be encouraged to improve the outcome of therapeutic bronchoscopy. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12890-021-01434-5. BioMed Central 2021-03-01 /pmc/articles/PMC7923499/ /pubmed/33648488 http://dx.doi.org/10.1186/s12890-021-01434-5 Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Sun, Kunyan
Zhang, Hong
Zhang, Wei
Cheng, Yuan
Wang, Guangfa
Long-term prognostic factors of clinical success after interventional bronchoscopy in patients with scarring central airway stenosis
title Long-term prognostic factors of clinical success after interventional bronchoscopy in patients with scarring central airway stenosis
title_full Long-term prognostic factors of clinical success after interventional bronchoscopy in patients with scarring central airway stenosis
title_fullStr Long-term prognostic factors of clinical success after interventional bronchoscopy in patients with scarring central airway stenosis
title_full_unstemmed Long-term prognostic factors of clinical success after interventional bronchoscopy in patients with scarring central airway stenosis
title_short Long-term prognostic factors of clinical success after interventional bronchoscopy in patients with scarring central airway stenosis
title_sort long-term prognostic factors of clinical success after interventional bronchoscopy in patients with scarring central airway stenosis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7923499/
https://www.ncbi.nlm.nih.gov/pubmed/33648488
http://dx.doi.org/10.1186/s12890-021-01434-5
work_keys_str_mv AT sunkunyan longtermprognosticfactorsofclinicalsuccessafterinterventionalbronchoscopyinpatientswithscarringcentralairwaystenosis
AT zhanghong longtermprognosticfactorsofclinicalsuccessafterinterventionalbronchoscopyinpatientswithscarringcentralairwaystenosis
AT zhangwei longtermprognosticfactorsofclinicalsuccessafterinterventionalbronchoscopyinpatientswithscarringcentralairwaystenosis
AT chengyuan longtermprognosticfactorsofclinicalsuccessafterinterventionalbronchoscopyinpatientswithscarringcentralairwaystenosis
AT wangguangfa longtermprognosticfactorsofclinicalsuccessafterinterventionalbronchoscopyinpatientswithscarringcentralairwaystenosis