Observational studyBMC pulmonary medicine2025
Surgical lung volume reduction eligibility in an emphysema patient pool referred for endoscopic treatment.
Observational study in BMC pulmonary medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04023409 (The Identification of Phenotypes in Patients With Severe Chronic Obstructive Pulmonary Disease), which is not on this map. Not yet cited in PubMed.
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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.
The trial behind it
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The Identification of Phenotypes in Patients With Severe Chronic Obstructive Pulmonary Disease (Groningen Severe COPD Cohort)
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Authors and funding
9 authors.
Funding
Abstract
purposeLung volume reduction surgery (LVRS) and bronchoscopic lung volume reduction (BLVR) are effective treatments for certain patients with severe emphysema. However, treatment access varies across centres, as not all provide both treatment options. We aimed to assess the proportion of severe COPD patients referred for BLVR that could also be eligible for LVRS.
methodsA retrospective observational study was performed of the Groningen severe COPD cohort. Strict LVRS criteria included: age ≤ 75 years, BMI between 18 and 32 kg/m2, modified Medical Research Council scale ≥ 2, amount of acute exacerbations ≤ 2, forced expiratory volume in 1 s between 20% and 45% of predicted, residual volume ≥ 150% of predicted, total lung capacity ≥ 100% of predicted, PaCO2 ≤ 8 kPa, PaO2 ≥ 6 kPa, %voxel density score in any lobe ≥ 20% and a heterogeneity index of ≥ 10% (-950HU). Chest CT of the remaining population was visually assessed to determine target zones for surgery and any parenchymal changes contraindicating surgery.
resultsIn this cohort of 1030 pre-selected patients, 193 (19%) patients met the strict LVRS criteria. Visual chest CT assessment of those patients, excluded 73 patients, resulting in 120 (62%) patients eligible for LVRS. Main factors for exclusion were the absence of approachable surgical targets (18%) and presence of bronchiectasis (10%). Among these eligible patients, 55 (46%) were treated with BLVR.
conclusionOur analysis indicates that providing LVRS in addition to endoscopic treatment can double therapeutic options for severe emphysema patients, highlighting the importance of offering both treatments to benefit more patients.
trial registrationPatients who visited the UMCG between August 2014 and July 2019 have been included in the Groningen Severe COPD cohort (retrospectively registered at clinicaltrials.gov: NCT04023409 (15/07/2019), an observational cross-sectional cohort with the main aim to identify clinical phenotypes and endotypes in patients with severe COPD.
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