Patients at high risk of death after lung-volume-reduction surgery

Alfred Fishman, Henry Eric Fessler, Fernando Martinez, Robert J. McKenna, Keith Naunheim, Steven Piantadosi, Gail Weinmann, Robert A Wise

Research output: Contribution to journalArticle

Abstract

Background: Lung-volume-reduction surgery is a proposed treatment for emphysema, but optimal selection criteria have not been defined. The National Emphysema Treatment Trial is a randomized, multicenter clinical trial comparing lung-volume-reduction surgery with medical treatment. Methods: After evaluation and pulmonary rehabilitation, we randomly assigned patients to undergo lung-volume-reduction surgery or receive medical treatment. Outcomes were monitored by an independent data and safety monitoring board. Results: A total of 1033 patients had been randomized by June 2001. For 69 patients who had a forced expiratory volume in one second (FEV 1) that was no more than 20 percent of their predicted value and either a homogeneous distribution of emphysema on computed tomography or a carbon monoxide diffusing capacity that was no more than 20 percent of their predicted value, the 30-day mortality rate after surgery was 16 percent (95 percent confidence interval, 8.2 to 26.7 percent), as compared with a rate of 0 percent among 70 medically treated patients (P1 (P1 and either homogeneous emphysema or a very low carbon monoxide diffusing capacity. These patients are at high risk for death after surgery and also are unlikely to benefit from the surgery.

Original languageEnglish (US)
Pages (from-to)1075-1083
Number of pages9
JournalNew England Journal of Medicine
Volume345
Issue number15
DOIs
StatePublished - Oct 11 2001

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Pneumonectomy
Emphysema
Carbon Monoxide
Clinical Trials Data Monitoring Committees
Forced Expiratory Volume
Therapeutics
Patient Selection
Multicenter Studies
Rehabilitation
Randomized Controlled Trials
Tomography
Confidence Intervals
Lung
Mortality

ASJC Scopus subject areas

  • Medicine(all)

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Patients at high risk of death after lung-volume-reduction surgery. / Fishman, Alfred; Fessler, Henry Eric; Martinez, Fernando; McKenna, Robert J.; Naunheim, Keith; Piantadosi, Steven; Weinmann, Gail; Wise, Robert A.

In: New England Journal of Medicine, Vol. 345, No. 15, 11.10.2001, p. 1075-1083.

Research output: Contribution to journalArticle

Fishman, A, Fessler, HE, Martinez, F, McKenna, RJ, Naunheim, K, Piantadosi, S, Weinmann, G & Wise, RA 2001, 'Patients at high risk of death after lung-volume-reduction surgery', New England Journal of Medicine, vol. 345, no. 15, pp. 1075-1083. https://doi.org/10.1056/NEJMoa11798
Fishman A, Fessler HE, Martinez F, McKenna RJ, Naunheim K, Piantadosi S et al. Patients at high risk of death after lung-volume-reduction surgery. New England Journal of Medicine. 2001 Oct 11;345(15):1075-1083. https://doi.org/10.1056/NEJMoa11798
Fishman, Alfred ; Fessler, Henry Eric ; Martinez, Fernando ; McKenna, Robert J. ; Naunheim, Keith ; Piantadosi, Steven ; Weinmann, Gail ; Wise, Robert A. / Patients at high risk of death after lung-volume-reduction surgery. In: New England Journal of Medicine. 2001 ; Vol. 345, No. 15. pp. 1075-1083.
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