Evidence map›Paper›PMID 30874483›Full record

ArticleTherapeutic advances in respiratory disease

Interventional therapy in patients with severe emphysema: evaluation of contraindications and their incidence.

Markus Polke, Matthias Rötting, Nilab Sarmand, Johannes Krisam, Ralf Eberhardt, Felix J F Herth, Daniela Gompelmann

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Therapeutic advances in respiratory disease. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.0field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
  2. Article
  3. Patient Selection for Bronchoscopic Lung Volume Reduction.International journal of chronic obstructive pulmonary disease · 2020
    Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

Markus PolkePneumology and Critical Care Medicine, Thoraxklinik at University of Heidelberg, Röntgenstr. 1, 69126 Heidelberg, Germany.ORCID 0000-0002-9498-7066
Matthias RöttingPneumology and Critical Care Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany.
Nilab SarmandPneumology and Critical Care Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany.
Johannes KrisamInstitute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany.
Ralf EberhardtPneumology and Critical Care Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany, and Translational Lung Research Center Heidelberg (TLRCH, German Center for Lung Research), Heidelberg, Germany.
Felix J F HerthPneumology and Critical Care Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany, and Translational Lung Research Center Heidelberg (TLRCH, German Center for Lung Research), Heidelberg, Germany.
Daniela GompelmannPneumology and Critical Care Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany, and Translational Lung Research Center Heidelberg (TLRCH, German Center for Lung Research), Heidelberg, Germany.
Heidelberg University · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEndoscopic and surgical interventions may be beneficial for selected patients with emphysema. Rates of treatment failure decrease when the predictors for successful therapy are known. The aim of the study was to evaluate the number of patients with severe emphysema who were not eligible for any intervention, and the reasons for their exclusion.

methodsThe study was a retrospective analysis of 231 consecutive patients with advanced emphysema who were considered for interventional therapy in 2016 at the Thoraxklinik, Heidelberg, Germany. The reasons for not receiving valve or coil therapy were assessed for all patients who did not receive any therapy.

resultsOf the 231 patients, 50% received an interventional therapy for lung volume reduction (LVR) (82% valve therapy, 6% coil therapy, 4.3% polymeric LVR or bronchial thermal vapour ablation, 4.3% total lung denervation, and 3.4% lung volume reduction surgery [LVRS]). A total of 115 patients did not undergo LVR. Out of these, valve or coil therapy was not performed due to one or more of the following reasons: incomplete fissure in 37% and 0%; missing target lobe in 31% and 30%; personal decision in 18% and 28%; pulmonary function test results in 8% and 15%; ventilatory failure in 4% and 4%; missing optimal standard medical care and/or continued nicotine abuse in 4% and 3%; general condition too good in less than 1% and 3%; cardiovascular comorbidities in 0% and 3%; age of patient in 0% and less than 1%. Both techniques were not performed due to one or more of the following reasons: solitary pulmonary nodule(s)/consolidation in 27%; bronchopathy in 7%; neoplasia in 2%; destroyed lung in 2%; prior LVRS in less than 1%.

conclusionsThe main reason for not placing valves was an incomplete fissure and for coils a missing target lobe. Numerous additional contraindications that may exclude a patient from interventional emphysema therapy should be respected.

Indexed as

Patient SelectionAdultAgedAged, 80 and overContraindicationsFemaleGermanyHumansIncidenceMaleMiddle AgedPneumonectomyPulmonary EmphysemaRespiratory Function TestsRetrospective StudiesSeverity of Illness Indexchronic obstructive pulmonary diseaseemphysemaendoscopic lung volume reduction

Identifiers

PMID30874483
PMCPMC6421604
OpenAlexW2922133689

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.