Abstract Rationale Recent guidelines suggest tracheobronchial stenting for symptomatic central airway obstruction (CAO). Prior literature has shown high technical success in restoring airway patency and improving symptoms at a single time point; however, data on longitudinal patient-reported outcomes after stenting is limited. Methods We performed a prospective, longitudinal observational cohort study of a convenience sample of adults (≥18 years old) with malignant CAO receiving tracheobronchial stenting. Participants were followed for up to 90 days following tracheobronchial stenting. Symptoms and quality of life (QoL) were assessed every 3 days via electronic survey using visual analogue scales (VAS), where 0 was “best” and 100 was “worst” for dyspnea, cough, and overall health. Semi-structured phone interviews were conducted at 14, 30, 60, and 90 days following tracheobronchial stenting to assess symptoms, medication adherence to bronchodilators and mucolytics, and understand patient experiences following stenting. The primary outcomes were longitudinal patient-reported symptoms and medication adherence. Qualitative analysis of patient interviews was also performed. Results Among 9 patients who enrolled, median age was 64 years (IQR: 59-68), 67% were female, 78% had primary lung cancer, and 89% underwent stenting during inpatient hospitalization. Among 6 patients with complete follow-up, 50% spent over one-third of their time hospitalized and 50% died prior to 90 days. At baseline, patients were highly symptomatic with median VAS-dyspnea score of 50 (IQR: 28-72), VAS-cough score of 30 (IQR: 9-70), and overall health VAS of 64.5 (IQR: 45-75). There was heterogeneity in response to stenting, both day-to-day and overall, with some experiencing sustained improvement and others minimal to none (Figure 1). Patients spent a median 120 minutes on pulmonary clearance regimens with high adherence (71% adherent). Qualitatively, most patients reported improvement in dyspnea, though cough patterns and responses remained variable. While several patients described relief in cough and dyspnea following stenting, others experienced lingering symptoms with high treatment burden, or uncertainty about improvement in their symptoms from treatments. Conclusion In this longitudinal cohort of patients with malignant CAO, there was variable response to tracheobronchial stenting; treatment response varied over time and by patient. Future work is needed to identify which patients are most likely to benefit given the high morbidity and mortality of this population. This abstract is funded by: Internal funding from Division of Palliative Medicine, University of Michigan, Ann Arbor, United States.
Savsani et al. (Fri,) studied this question.