Pub Date : 2024-05-27eCollection Date: 2024-05-01DOI: 10.1183/23120541.50821-2023
[This corrects the article DOI: 10.1183/23120541.00821-2023.].
[This corrects the article DOI: 10.1183/23120541.00821-2023.].
{"title":"Erratum: \"Age-related changes in the neural gating of respiratory sensations in humans\". Wen-Pin Chang, Kai-Jie Liang, Chia-Hsiung Cheng, Chia-Yih Liu, Andreas von Leupoldt and Pei-Ying S. Chan. <i>ERJ Open Res</i> 2024; 10: 00821-2023.","authors":"","doi":"10.1183/23120541.50821-2023","DOIUrl":"https://doi.org/10.1183/23120541.50821-2023","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1183/23120541.00821-2023.].</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11129640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141157485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-16DOI: 10.1183/23120541.00096-2024
Mattia Nigro, Claudia Valenzuela, Francisco Arancibia, Mark Cohen, David CL Lam, Ryan C. Maves, Barbara Rath, Steven Q Simpson, Yuanlin Song, Sotirios Tsiodras, James D Chalmers, Stefano Aliberti
Long COVID is a heterogeneous clinical syndrome characterised by a variety of reported symptoms and signs. Its clinical management is expected to differ significantly worldwide.A survey-based study investigating Long COVID-related standard operating procedures (SOPs) has been conducted by the European Respiratory Society (ERS) END-COVID clinical research collaboration with the support of other international societies (ALAT, APSR, CHEST, ESCMID, PATS). A global analysis of the results is provided here, alongside with sub-population analysis based on continents, national income levels, type of involved healthcare professionals and inclusion or exclusion of paediatric patients.1015 healthcare professionals from 110 different countries worldwide participated in this study, the majority of them being respiratory physicians (60.6%). A dedicated Long COVID programme was present in 55.4% of the investigated institutions, with hospital admission during the acute infection being the main inclusion criteria to access them. Consistent differences in Long COVID-related procedures were identified among centres, mainly regarding the multidisciplinary approach, the availability of telemedicine and psychological support, the type of requested exams and the total amount of visits in the centre.Long COVID management shows important differences related to geographical areas and national income levels. SOPs were significantly different when centres were managed by a pulmonologist or when paediatric patients were included.ERS has received funding to conduct this study by AstraZeneca UK Limited, Novartis Pharma AG, F. Hoffmann-La Roche Ltd, and Boehringer Ingelheim International GmbH.
{"title":"A worldwide look into Long COVID-19 management: an END-COVID survey","authors":"Mattia Nigro, Claudia Valenzuela, Francisco Arancibia, Mark Cohen, David CL Lam, Ryan C. Maves, Barbara Rath, Steven Q Simpson, Yuanlin Song, Sotirios Tsiodras, James D Chalmers, Stefano Aliberti","doi":"10.1183/23120541.00096-2024","DOIUrl":"https://doi.org/10.1183/23120541.00096-2024","url":null,"abstract":"Long COVID is a heterogeneous clinical syndrome characterised by a variety of reported symptoms and signs. Its clinical management is expected to differ significantly worldwide.A survey-based study investigating Long COVID-related standard operating procedures (SOPs) has been conducted by the European Respiratory Society (ERS) END-COVID clinical research collaboration with the support of other international societies (ALAT, APSR, CHEST, ESCMID, PATS). A global analysis of the results is provided here, alongside with sub-population analysis based on continents, national income levels, type of involved healthcare professionals and inclusion or exclusion of paediatric patients.1015 healthcare professionals from 110 different countries worldwide participated in this study, the majority of them being respiratory physicians (60.6%). A dedicated Long COVID programme was present in 55.4% of the investigated institutions, with hospital admission during the acute infection being the main inclusion criteria to access them. Consistent differences in Long COVID-related procedures were identified among centres, mainly regarding the multidisciplinary approach, the availability of telemedicine and psychological support, the type of requested exams and the total amount of visits in the centre.Long COVID management shows important differences related to geographical areas and national income levels. SOPs were significantly different when centres were managed by a pulmonologist or when paediatric patients were included.ERS has received funding to conduct this study by AstraZeneca UK Limited, Novartis Pharma AG, F. Hoffmann-La Roche Ltd, and Boehringer Ingelheim International GmbH.","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140968156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-16DOI: 10.1183/23120541.00404-2024
Kai Fricke, Noriane Andrina Sievi, Felix Peter Schmidt, Macé Matthew Schuurmans, Malcolm Kohler
{"title":"Efficacy of surveillance bronchoscopyversusclinically-indicated bronchoscopy for detection of acute lung transplant rejection: a systematic review and meta-analysis","authors":"Kai Fricke, Noriane Andrina Sievi, Felix Peter Schmidt, Macé Matthew Schuurmans, Malcolm Kohler","doi":"10.1183/23120541.00404-2024","DOIUrl":"https://doi.org/10.1183/23120541.00404-2024","url":null,"abstract":"","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140968625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-16DOI: 10.1183/23120541.00071-2024
Össur Ingi Emilsson, Henrik Johansson, A. Johannessen, Christer Janson, Andreas Palm, Karl A. Franklin, Anna Oudin, F. Gómez Real, M. Holm, Thorarinn Gíslason, Eva Lindberg, R. Jõgi, V. Schlünssen, Francisco Javier Callejas-González, Jingwen Zhang, Andrei Malinovschi, C. Svanes, Magnus Ekström
Heritability of cough has not yet been studied. We aimed to evaluate if individuals with cough are more likely to have offspring who develop cough, and if these associations differ by type of cough (productive/non-productive).The RHINESSA Generation Study (Respiratory Health In Northern Europe, Spain and Australia) includes 7155 parents (initially aged 30–54) answering detailed questionnaires in 2000 and 2 010, and 8176 offspring ≥20 years answering similar questionnaires in 2012–2019. Chronic cough was categorized as productive or non-productive (dry) cough. Associations between parental and offspring cough were analyzed using mixed-effects logistic regression, adjusting for offspring age, sex, body mass index, smoking history, education level, current asthma, rhinitis, nocturnal gastroesophageal reflux; parent sex and smoking history; center and family.Among parents with non-productive cough, 11% of their offspring reported non-productive cough, compared with 7% of offspring to parents without non-productive cough, adjusted odds ratio (aOR) 1.59 (95% confidence interval 1.20–2.10). Among parents with productive cough, 14% of their offspring reported productive cough, compared with 11% of offspring to parents without productive cough, aOR 1.34 (1.07–1.67). No associations were found between parent productive cough – offspring non-productive cough, nor between parent non-productive cough – offspring productive cough.Parents with chronic cough are more likely to have offspring with chronic cough independent of parental asthma, suggesting cough to be a separate heritable trait. The type of cough is important, as the non-productive cough in parent associates only with non-productive cough in offspring, and the same applied for productive cough.
{"title":"Heritability of cough across two generations: the RHINESSA study","authors":"Össur Ingi Emilsson, Henrik Johansson, A. Johannessen, Christer Janson, Andreas Palm, Karl A. Franklin, Anna Oudin, F. Gómez Real, M. Holm, Thorarinn Gíslason, Eva Lindberg, R. Jõgi, V. Schlünssen, Francisco Javier Callejas-González, Jingwen Zhang, Andrei Malinovschi, C. Svanes, Magnus Ekström","doi":"10.1183/23120541.00071-2024","DOIUrl":"https://doi.org/10.1183/23120541.00071-2024","url":null,"abstract":"Heritability of cough has not yet been studied. We aimed to evaluate if individuals with cough are more likely to have offspring who develop cough, and if these associations differ by type of cough (productive/non-productive).The RHINESSA Generation Study (Respiratory Health In Northern Europe, Spain and Australia) includes 7155 parents (initially aged 30–54) answering detailed questionnaires in 2000 and 2 010, and 8176 offspring ≥20 years answering similar questionnaires in 2012–2019. Chronic cough was categorized as productive or non-productive (dry) cough. Associations between parental and offspring cough were analyzed using mixed-effects logistic regression, adjusting for offspring age, sex, body mass index, smoking history, education level, current asthma, rhinitis, nocturnal gastroesophageal reflux; parent sex and smoking history; center and family.Among parents with non-productive cough, 11% of their offspring reported non-productive cough, compared with 7% of offspring to parents without non-productive cough, adjusted odds ratio (aOR) 1.59 (95% confidence interval 1.20–2.10). Among parents with productive cough, 14% of their offspring reported productive cough, compared with 11% of offspring to parents without productive cough, aOR 1.34 (1.07–1.67). No associations were found between parent productive cough – offspring non-productive cough, nor between parent non-productive cough – offspring productive cough.Parents with chronic cough are more likely to have offspring with chronic cough independent of parental asthma, suggesting cough to be a separate heritable trait. The type of cough is important, as the non-productive cough in parent associates only with non-productive cough in offspring, and the same applied for productive cough.","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140967531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-16DOI: 10.1183/23120541.00857-2023
E. Kritikaki, G. Terzis, Meera Soundararajan, I. Vogiatzis, D. Simoes
Extracellular matrix proteins (ECM) are the major constituent of muscle cell microenvironment, imparting instructive signalling, steering cell behaviour, and controlling muscle regeneration. ECM remodelling is among the most affected signalling pathways in COPD and aged muscle. As a fraction of COPD patients present muscle atrophy, we questioned whether ECM composition would be altered in patients with peripheral muscle wasting (atrophic COPD) compared to those without muscle wasting (non-atrophic COPD).A set of ECM molecules with known impact on myogenesis were quantified in vastus lateralis muscle biopsies from 29 COPD patients (FEV1: 55±12% predicted) using ELISA and Realtime-PCR. COPD were grouped to atrophic or non-atrophic based on fat-free mass index (< or≥17 kg.m−2).Atrophic COPD patients presented a lower average vastus lateralis muscle fibre cross sectional area (3872±258 μm2) compared to non-atrophic COPD (4509±198 μm2). Gene expression of ECM molecules was found significantly lower in atrophic COPD compared to non-atrophic COPD for collagen type I chain (COL1A1), fibronectin (FN1), tenascin C (TNC),and biglycan (BGN).In terms of protein levels, there were no significant differences between the two COPD cohorts for any of the ECM molecules tested.Although atrophic COPD presented decreased contractile muscle tissue, the differences in ECM mRNA expression between atrophic and non-atrophic COPD were not translated at the protein level, potentially indicating an accumulation of long-lived ECM proteins and dysregulated proteostasis, as this is typically observed during deconditioning and ageing.
{"title":"Expression of intramuscular extracellular matrix (ECM) proteins in vastus lateralis muscle fibres between atrophic and non-atrophic COPD","authors":"E. Kritikaki, G. Terzis, Meera Soundararajan, I. Vogiatzis, D. Simoes","doi":"10.1183/23120541.00857-2023","DOIUrl":"https://doi.org/10.1183/23120541.00857-2023","url":null,"abstract":"Extracellular matrix proteins (ECM) are the major constituent of muscle cell microenvironment, imparting instructive signalling, steering cell behaviour, and controlling muscle regeneration. ECM remodelling is among the most affected signalling pathways in COPD and aged muscle. As a fraction of COPD patients present muscle atrophy, we questioned whether ECM composition would be altered in patients with peripheral muscle wasting (atrophic COPD) compared to those without muscle wasting (non-atrophic COPD).A set of ECM molecules with known impact on myogenesis were quantified in vastus lateralis muscle biopsies from 29 COPD patients (FEV1: 55±12% predicted) using ELISA and Realtime-PCR. COPD were grouped to atrophic or non-atrophic based on fat-free mass index (< or≥17 kg.m−2).Atrophic COPD patients presented a lower average vastus lateralis muscle fibre cross sectional area (3872±258 μm2) compared to non-atrophic COPD (4509±198 μm2). Gene expression of ECM molecules was found significantly lower in atrophic COPD compared to non-atrophic COPD for collagen type I chain (COL1A1), fibronectin (FN1), tenascin C (TNC),and biglycan (BGN).In terms of protein levels, there were no significant differences between the two COPD cohorts for any of the ECM molecules tested.Although atrophic COPD presented decreased contractile muscle tissue, the differences in ECM mRNA expression between atrophic and non-atrophic COPD were not translated at the protein level, potentially indicating an accumulation of long-lived ECM proteins and dysregulated proteostasis, as this is typically observed during deconditioning and ageing.","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140967169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-16DOI: 10.1183/23120541.00985-2023
Julian Pott, Dora Csengeri, Jonna Ostermann, Hans Klose, Christoph Sinning, Lars Harbaum
{"title":"Right ventricular strain to systolic pulmonary artery pressure ratio in response to treatment of pulmonary arterial hypertension","authors":"Julian Pott, Dora Csengeri, Jonna Ostermann, Hans Klose, Christoph Sinning, Lars Harbaum","doi":"10.1183/23120541.00985-2023","DOIUrl":"https://doi.org/10.1183/23120541.00985-2023","url":null,"abstract":"","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140968469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-16DOI: 10.1183/23120541.00320-2024
Jin Young Park, Haesung Jun, Seung-Eun Lee, Ha-Kyeong Won, Sung-Yoon Kang, N. Kang, Ji-Yoon Oh, Young-Chan Kim, So-Young Park, Jin An, Y. Yoo, Mi-Yeong Kim, Hwa Young Lee, J.-S. Shim, Min-Hye Kim, Sae-Hoon Kim, Sang-Heon Kim, Yoon-Seok Chang, Sang-Hoon Kim, Byung Jae Lee, S. Birring, Woo-Jung Song
Disease control in chronic diseases is an overarching concept that reflects the degree to which the goals of therapy are met. However, to date, there is no consensus on the definition of disease control in chronic cough. This study aimed to provide a conceptual exploration of patient-reported cough control in chronic cough.This research is comprised of two sub-analyses. First, patients with chronic cough receiving care at referral clinics were evaluated. Correlation analyses were performed between patient-reported cough control (a 5-point Likert scale), cough-specific patient-reported outcomes (PROs), and generic health PRO scores. Second, a survey was conducted among patients with refractory chronic cough and physicians to identify factors pertinent to cough control.The analysis of 341 patients (mean age: 55.5±15.1 years; and female: 66.6%) revealed that cough control rating was moderately correlated with cough severity visual analogue scale and Leicester Cough Questionnaire scores, while demonstrating weaker correlations with cough-associated throat symptoms, cough-related complications, or general health-related quality of life (QoL). In the survey of patients and physicians, both groups considered certain factors, such as cough frequency, severity, and impact on QoL, to be relevant to the concept of cough control. However, patients rated “needs for cough rescue drug’ notably higher than physicians.Patient-reported cough control was associated with cough severity or impact on QoL, however, cough control may not be fully captured by conventional cough PRO measurement tools. Further studies are warranted to define the consensus and tools to measure disease control in chronic cough.
慢性疾病的疾病控制是一个总体概念，反映了治疗目标的实现程度。然而，迄今为止，关于慢性咳嗽疾病控制的定义尚未达成共识。本研究旨在对慢性咳嗽患者报告的咳嗽控制情况进行概念性探讨。首先，对在转诊诊所接受治疗的慢性咳嗽患者进行评估。在患者报告的咳嗽控制情况（5 点李克特量表）、咳嗽特异性患者报告结果（PROs）和一般健康 PRO 评分之间进行了相关性分析。对 341 名患者（平均年龄：55.5±15.1 岁；女性：66.6%）的分析表明，咳嗽控制评分与咳嗽严重程度视觉模拟量表和莱斯特咳嗽问卷评分呈中度相关，而与咳嗽相关咽喉症状、咳嗽相关并发症或一般健康相关生活质量（QoL）的相关性较弱。在对患者和医生的调查中，双方都认为咳嗽频率、严重程度和对 QoL 的影响等因素与咳嗽控制的概念相关。患者报告的咳嗽控制情况与咳嗽严重程度或对 QoL 的影响有关，但传统的咳嗽 PRO 测量工具可能无法完全反映咳嗽控制情况。还需要进一步的研究来确定慢性咳嗽疾病控制的共识和测量工具。
{"title":"Exploring the Concept of Disease Control in Chronic Cough","authors":"Jin Young Park, Haesung Jun, Seung-Eun Lee, Ha-Kyeong Won, Sung-Yoon Kang, N. Kang, Ji-Yoon Oh, Young-Chan Kim, So-Young Park, Jin An, Y. Yoo, Mi-Yeong Kim, Hwa Young Lee, J.-S. Shim, Min-Hye Kim, Sae-Hoon Kim, Sang-Heon Kim, Yoon-Seok Chang, Sang-Hoon Kim, Byung Jae Lee, S. Birring, Woo-Jung Song","doi":"10.1183/23120541.00320-2024","DOIUrl":"https://doi.org/10.1183/23120541.00320-2024","url":null,"abstract":"Disease control in chronic diseases is an overarching concept that reflects the degree to which the goals of therapy are met. However, to date, there is no consensus on the definition of disease control in chronic cough. This study aimed to provide a conceptual exploration of patient-reported cough control in chronic cough.This research is comprised of two sub-analyses. First, patients with chronic cough receiving care at referral clinics were evaluated. Correlation analyses were performed between patient-reported cough control (a 5-point Likert scale), cough-specific patient-reported outcomes (PROs), and generic health PRO scores. Second, a survey was conducted among patients with refractory chronic cough and physicians to identify factors pertinent to cough control.The analysis of 341 patients (mean age: 55.5±15.1 years; and female: 66.6%) revealed that cough control rating was moderately correlated with cough severity visual analogue scale and Leicester Cough Questionnaire scores, while demonstrating weaker correlations with cough-associated throat symptoms, cough-related complications, or general health-related quality of life (QoL). In the survey of patients and physicians, both groups considered certain factors, such as cough frequency, severity, and impact on QoL, to be relevant to the concept of cough control. However, patients rated “needs for cough rescue drug’ notably higher than physicians.Patient-reported cough control was associated with cough severity or impact on QoL, however, cough control may not be fully captured by conventional cough PRO measurement tools. Further studies are warranted to define the consensus and tools to measure disease control in chronic cough.","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140968169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-16DOI: 10.1183/23120541.00109-2024
Clément Jambon-Barbara, Alex Hlavaty, Claire Bernardeau, Hélène Bouvaist, M. Chaumais, Marc Humbert, D. Montani, J. Cracowski, C. Khouri
Pulmonary arterial hypertension (PAH) is a rare and severe disease for which most of the evidence about prognostic factors, evolution and treatment efficacy comes from cohorts, registries and clinical trials. We therefore aimed to develop and validate a new PAH identification algorithm that can be used in the French healthcare database (SNDS).We developed and validated the algorithm using the Grenoble Alpes University Hospital medical charts. We first identified PAH patients following a previously validated algorithm (Gillmeyeret al. algorithm), using in hospital ICD-10 codes, right heart catheterisation procedure and PAH specific treatment dispensing. Then, we refined the latter with the exclusion of chronic thromboembolic pulmonary hypertension procedures and treatment, the main misclassification factor. Secondly, we validated this algorithm using a gold standard review of in-hospital medical charts and calculated sensitivity, specificity, positive and negative predictive value (PPV and NPV) and accuracy. Finally, we applied this algorithm in the French healthcare database and described the characteristics of the identified patients.In the Grenoble University Hospital, we identified 252 unique patients meeting all the algorithm's criteria between 01/01/2010 and 30/06/2022, and reviewed all medical records. The sensitivity, specificity, PPV, NPV and accuracy were 91.0%, 74.3%, 67.9%, 93.3% and 80.6% respectively. Application of this algorithm to the SNDS yielded the identification of 9931 patients with consistent characteristics compared to PAH registries.Overall, we propose a new PAH identification algorithm developed and adapted to the French specificities, that can be used in future studies using the French healthcare database.
{"title":"Development and validation of a code-based algorithm using in-hospital medical records to identify patients with pulmonary arterial hypertension in the French Healthcare Database","authors":"Clément Jambon-Barbara, Alex Hlavaty, Claire Bernardeau, Hélène Bouvaist, M. Chaumais, Marc Humbert, D. Montani, J. Cracowski, C. Khouri","doi":"10.1183/23120541.00109-2024","DOIUrl":"https://doi.org/10.1183/23120541.00109-2024","url":null,"abstract":"Pulmonary arterial hypertension (PAH) is a rare and severe disease for which most of the evidence about prognostic factors, evolution and treatment efficacy comes from cohorts, registries and clinical trials. We therefore aimed to develop and validate a new PAH identification algorithm that can be used in the French healthcare database (SNDS).We developed and validated the algorithm using the Grenoble Alpes University Hospital medical charts. We first identified PAH patients following a previously validated algorithm (Gillmeyeret al. algorithm), using in hospital ICD-10 codes, right heart catheterisation procedure and PAH specific treatment dispensing. Then, we refined the latter with the exclusion of chronic thromboembolic pulmonary hypertension procedures and treatment, the main misclassification factor. Secondly, we validated this algorithm using a gold standard review of in-hospital medical charts and calculated sensitivity, specificity, positive and negative predictive value (PPV and NPV) and accuracy. Finally, we applied this algorithm in the French healthcare database and described the characteristics of the identified patients.In the Grenoble University Hospital, we identified 252 unique patients meeting all the algorithm's criteria between 01/01/2010 and 30/06/2022, and reviewed all medical records. The sensitivity, specificity, PPV, NPV and accuracy were 91.0%, 74.3%, 67.9%, 93.3% and 80.6% respectively. Application of this algorithm to the SNDS yielded the identification of 9931 patients with consistent characteristics compared to PAH registries.Overall, we propose a new PAH identification algorithm developed and adapted to the French specificities, that can be used in future studies using the French healthcare database.","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140967334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-16DOI: 10.1183/23120541.00978-2023
Michal Svoboda, I. Čundrle, M. Plutinský, Pavel Homolka, L. Mitas, Z. Chovanec, L. Olson, K. Brat
In recent years, ventilatory efficiency (VE/VCO2slope) and partial pressure of end-tidal carbon dioxide (PETCO2) emerged as independent predictors of post-operative pulmonary complications (PPC). Single parameters may give only partial information regarding peri-procedural hazards. Accordingly, our aim was to create prediction models with improved ability to stratify PPC risk in patients scheduled for elective lung resection surgery.Thispost-hocanalysis was comprised of consecutive lung resection candidates from two prior prospective trials. All individuals completed pulmonary function tests and cardiopulmonary exercise testing (CPET). Logistic regression analyses were used for identification of risk factors for PPC that were entered into the final risk prediction models. Two risk models were developed; the first used rest PETCO2(for patients with no available CPET data), the second used VE/VCO2slope (for patients with available CPET data). ROC analysis with the De-Long test and area under the curve (AUC) were used for comparison of models.The dataset from 423 patients was randomly split into the derivation (n=310) and validation (n=113) cohorts. Two final models were developed, both including sex, thoracotomy, „atypical“ resection and FEV1/FVC ratio as risk factors. In addition, the first model also included rest PETCO2, while the second model used VE/VCO2slope from CPET. AUCs of risk scores were 0.795 (95% CI: 0.739–0.851) and 0.793 (95% CI: 0.737–0.849); both p<0.001. No differences in AUCs were found between the derivation and validation cohorts.We created two multicomponental models for PPC risk prediction, both having excellent predictive properties.
{"title":"New Models for Prediction of Post-Operative Pulmonary Complications in Lung Resection Candidates","authors":"Michal Svoboda, I. Čundrle, M. Plutinský, Pavel Homolka, L. Mitas, Z. Chovanec, L. Olson, K. Brat","doi":"10.1183/23120541.00978-2023","DOIUrl":"https://doi.org/10.1183/23120541.00978-2023","url":null,"abstract":"In recent years, ventilatory efficiency (VE/VCO2slope) and partial pressure of end-tidal carbon dioxide (PETCO2) emerged as independent predictors of post-operative pulmonary complications (PPC). Single parameters may give only partial information regarding peri-procedural hazards. Accordingly, our aim was to create prediction models with improved ability to stratify PPC risk in patients scheduled for elective lung resection surgery.Thispost-hocanalysis was comprised of consecutive lung resection candidates from two prior prospective trials. All individuals completed pulmonary function tests and cardiopulmonary exercise testing (CPET). Logistic regression analyses were used for identification of risk factors for PPC that were entered into the final risk prediction models. Two risk models were developed; the first used rest PETCO2(for patients with no available CPET data), the second used VE/VCO2slope (for patients with available CPET data). ROC analysis with the De-Long test and area under the curve (AUC) were used for comparison of models.The dataset from 423 patients was randomly split into the derivation (n=310) and validation (n=113) cohorts. Two final models were developed, both including sex, thoracotomy, „atypical“ resection and FEV1/FVC ratio as risk factors. In addition, the first model also included rest PETCO2, while the second model used VE/VCO2slope from CPET. AUCs of risk scores were 0.795 (95% CI: 0.739–0.851) and 0.793 (95% CI: 0.737–0.849); both p<0.001. No differences in AUCs were found between the derivation and validation cohorts.We created two multicomponental models for PPC risk prediction, both having excellent predictive properties.","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140968938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-16DOI: 10.1183/23120541.00654-2023
Pierre Mouillot, N. Favrolt, C. Khouri, Aurélie Grandvuillemin, M. Chaumais, D. Schenesse, A. Seferian, X. Jais, L. Savale, G. Beltramo, Olivier Sitbon, J. Cracowski, Marc Humbert, Marjolaine Georges, Philippe Bonniaud, D. Montani
Despite its known cardiac and lung toxicities, the chemotherapy drug gemcitabine has only rarely been associated with pulmonary hypertension (PH), and the underlying mechanism remains unclear.To assess the association between gemcitabine and PH.We identified incident cases of precapillary PH confirmed by right heart catheterisation in patients treated with gemcitabine from the French PH Registry between January 2007 to December 2022. The etiology, clinical, functional, radiologic, and hemodynamic characteristics of PH were reviewed at baseline and during follow-up. A pharmacovigilance disproportionality analysis was conducted using the WHO pharmacovigilance database.We identified nine cases of PAH, either induced (in eight patients) or exacerbated (in one patient) by gemcitabine. Patients exhibited severe precapillary PH, with a median mean pulmonary arterial pressure of 40 (min-max 26–47) mmHg, a cardiac index of 2.4 (1.6–3.9) L·min−1·m−2, and pulmonary vascular resistance of 6.3 (3.1–12.6) WU. The median time from the initiation of gemcitabine to the onset of PH was 7 (4–50) months, with patients receiving a median of 16 (6–24) gemcitabine injections. Six patients showed clinical improvement upon discontinuation of gemcitabine. In the WHO pharmacovigilance database, we identified a significant signal with 109 cases reporting at least one adverse event related to PH with gemcitabine.Both clinical cases and pharmacovigilance data substantiate a significant association between gemcitabine use and the onset or worsening of precapillary PH. The observed improvement following the discontinuation of treatment underscores the importance of PH screening in gemcitabine-exposed patients experiencing unexplained dyspnea.
{"title":"Characteristics and outcomes of gemcitabine-associated pulmonary hypertension","authors":"Pierre Mouillot, N. Favrolt, C. Khouri, Aurélie Grandvuillemin, M. Chaumais, D. Schenesse, A. Seferian, X. Jais, L. Savale, G. Beltramo, Olivier Sitbon, J. Cracowski, Marc Humbert, Marjolaine Georges, Philippe Bonniaud, D. Montani","doi":"10.1183/23120541.00654-2023","DOIUrl":"https://doi.org/10.1183/23120541.00654-2023","url":null,"abstract":"Despite its known cardiac and lung toxicities, the chemotherapy drug gemcitabine has only rarely been associated with pulmonary hypertension (PH), and the underlying mechanism remains unclear.To assess the association between gemcitabine and PH.We identified incident cases of precapillary PH confirmed by right heart catheterisation in patients treated with gemcitabine from the French PH Registry between January 2007 to December 2022. The etiology, clinical, functional, radiologic, and hemodynamic characteristics of PH were reviewed at baseline and during follow-up. A pharmacovigilance disproportionality analysis was conducted using the WHO pharmacovigilance database.We identified nine cases of PAH, either induced (in eight patients) or exacerbated (in one patient) by gemcitabine. Patients exhibited severe precapillary PH, with a median mean pulmonary arterial pressure of 40 (min-max 26–47) mmHg, a cardiac index of 2.4 (1.6–3.9) L·min−1·m−2, and pulmonary vascular resistance of 6.3 (3.1–12.6) WU. The median time from the initiation of gemcitabine to the onset of PH was 7 (4–50) months, with patients receiving a median of 16 (6–24) gemcitabine injections. Six patients showed clinical improvement upon discontinuation of gemcitabine. In the WHO pharmacovigilance database, we identified a significant signal with 109 cases reporting at least one adverse event related to PH with gemcitabine.Both clinical cases and pharmacovigilance data substantiate a significant association between gemcitabine use and the onset or worsening of precapillary PH. The observed improvement following the discontinuation of treatment underscores the importance of PH screening in gemcitabine-exposed patients experiencing unexplained dyspnea.","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140969139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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