Mortality Lower With Lung Volume Reduction Surgery in Emphysema
TUESDAY, Jan. 28, 2025 -- For patients with advanced emphysema, endobronchial valve placement (EBV) is associated with higher mortality and morbidity compared with lung volume reduction surgery (LVRS), according to a study presented at the annual meeting of The Society of Thoracic Surgeons, held from Jan. 24 to 26 in Los Angeles.
J.W. Awori Hayanga, M.D., M.P.H., from West Virginia University in Morgantown, and colleagues examined data from the U.S. Centers for Medicare and Medicaid Services inpatient claims database for all beneficiaries with severe emphysema undergoing either LVRS or EBV between Jan. 1, 2019, and Dec. 31, 2022, to compare outcomes.
Overall, 3,219 patients underwent lung volume reduction therapy: LVRS in 2,378 and EBV in 841. The researchers found that compared with those who underwent LVRS, EBV patients had lower Elixhauser comorbidity scores, shorter length of stay, and lower hospital charges prior to risk adjustment. Most of the LVRS procedures were minimally invasive (1,897 video-assisted thoracoscopic/robotic surgeries versus 481 open surgeries). EBV was associated with higher 30-day mortality, 30-day readmission rate, reintervention rate, and 30-day readmission with pneumothorax, higher supplementary oxygen requirement, and higher all-cause mortality at one year compared with LVRS after doubly robust risk adjustment including frailty (adjusted odds ratios, 2.68, 1.4, 17.2, 2.09, 3.49, and 1.75, respectively).
"Patients undergoing EBV placement have higher occurrences of various complications over time, often need a greater number of interventions, and even suffer higher mortality compared to those undergoing LVRS in contemporary surgical practice, where techniques have become much less invasive than they were 20 years ago when surgical options were first evaluated," Hayanga said in a statement.
Disclaimer: Statistical data in medical articles provide general trends and do not pertain to individuals. Individual factors can vary greatly. Always seek personalized medical advice for individual healthcare decisions.
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