Evidence map›Paper›PMID 39521377›Full record

ArticleChest2025

Lessons Learned: Risk Factors and Clinical Impact of Severe Pneumothorax After Endoscopic Lung Volume Reduction With Endobronchial Valves.

Judith Maria Brock, Susanne Annemarie Dittrich, Florian Eichhorn, Kai Schlamp, Konstantina Kontogianni, Felix J F Herth

Abstract read
In one paragraph

Article in Chest, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. 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

6 authors.

Judith Maria BrockDepartment for Pneumology and Critical Care Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany; Translational Lung Research Center Heidelberg, German Center for Lung Research (DZL), Heidelberg, Germany. Electronic address: Judith.Brock@med.uni-heidelberg.de.
Susanne Annemarie DittrichDepartment for Pneumology and Critical Care Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany; Translational Lung Research Center Heidelberg, German Center for Lung Research (DZL), Heidelberg, Germany.
Florian EichhornDepartment of Thoracic Surgery, Thoraxklinik at University of Heidelberg, Heidelberg, Germany; Translational Lung Research Center Heidelberg, German Center for Lung Research (DZL), Heidelberg, Germany.
Kai SchlampDepartment of Radiology, Thoraxklinik at University of Heidelberg, Heidelberg, Germany; Translational Lung Research Center Heidelberg, German Center for Lung Research (DZL), Heidelberg, Germany.
Konstantina KontogianniDepartment for Pneumology and Critical Care Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany; Translational Lung Research Center Heidelberg, German Center for Lung Research (DZL), Heidelberg, Germany.
Felix J F HerthDepartment for Pneumology and Critical Care Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany; Translational Lung Research Center Heidelberg, German Center for Lung Research (DZL), Heidelberg, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPneumothorax is a major complication after endoscopic lung volume reduction with valves, with a prevalence of up to 34%. Although some patients benefit from valve implantation despite pneumothorax, others are significantly impaired after lung collapse. RESEARCH QUESTION: What are the differences in the severity grades of pneumothorax and how do these affect clinical practice? STUDY DESIGN AND

methodsThis single-center retrospective study analyzed patients undergoing endoscopic valve implantation with and without pneumothorax after intervention. Emphysema characteristics, collateral ventilation, management, and outcome of patients with pneumothorax 3 months after valve implantation were assessed. Pneumothorax was categorized as severe (chest tube insertion, prolonged air leak requiring valve removal), moderate (chest tube, no valve removal), and mild (no chest tube).

resultsPneumothorax occurred in 102 of 532 patients (19%) and was significantly more common after valve placement in the upper lobes (31.3%) compared with the lower lobes (11.3%; P < .001). Fissure integrity was significantly higher in patients with pneumothorax (mean, 96.6 ± 6.3% vs 93.4 ± 10.3%; P = .002). Of all pneumothoraces, 30.4% were mild, 30.4% were moderate, and 39.2% were severe. Severe pneumothorax caused multiple complications and prolonged hospitalization. Valve placement in the left upper lobe and a larger size of the target lobe were identified as risk factors for severe pneumothorax. Patients with pneumothorax demonstrated complete lobar atelectasis in > 60% as a sign of therapeutic success, but obviously only when valves could be left in place or reimplanted. However, valve reimplantation resulted in repeat pneumothorax in 42.9%.

interpretationPatients could be informed more individually about their risk of pneumothorax, which varies with target lobe location, fissure integrity, and reimplantation. The poor outcome and high complication rate of severe pneumothorax calls for future research into the prediction of severe pneumothorax.

Indexed as

BronchoscopyPneumonectomyPneumothoraxPostoperative ComplicationsPulmonary EmphysemaAgedChest TubesFemaleHumansMaleMiddle AgedProstheses and ImplantsRetrospective StudiesRisk FactorsSeverity of Illness IndexCOPDendobronchial valvesendoscopic lung volume reductionpneumothoraxsevere pneumothoraxvalve removal

Identifiers

PMID39521377
PMCPMC12001813

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LicenceCC BY-NC-ND
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Registered trials

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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.