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July 3, 2023CHEST PulmonaryOpen Access

Long-term Survival and Quality of Life

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Why the study?

CTEPH causes significant morbidity and mortality, but long-term survival and health-related quality-of-life outcomes from contemporary multicenter studies are lacking.

Does pulmonary thromboendarterectomy improve survival and quality of life in patients with CTEPH?

Comparison

Operated vs operable but no surgery vs inoperable CTEPH

Design

Multicenter prospective cohort study

Follow-up

Up to 4 years

Key result

Inoperable status and operable but no surgery status in patients with CTEPH were associated with higher mortality rates relative to undergoing pulmonary thromboendarterectomy (HR 2.10; 95% CI 1.17-3.77 and HR 2.19; 95% CI 1.20-3.99, respectively).

Authors

KCKelly ChinWAWilliam R. AugerRBRaymond L. Benza

Discussion

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Overview

Supports pulmonary thromboendarterectomy consideration in operable CTEPH; leaves open randomized confirmation of survival benefit.

Study Design

Type

Cohort (n=750)

Multicenter

Yes

Structured PICO

Does pulmonary thromboendarterectomy improve survival and quality of life in patients with CTEPH?

P
Population
750 patients with chronic thromboembolic pulmonary hypertension (median age 59 years) from 30 US sites, classified into operated, operable but no surgery, and inoperable groups, followed for up to 4 years.
E
Exposure
Pulmonary thromboendarterectomy (PTE) surgery (n=566)
C
Comparator
Patients classified as operable but who did not undergo surgery (n=88) and patients classified as inoperable (n=96)
O
Outcome
Survival and health-related quality of life (SF-36 and EmPHasis-10 scores) up to 2 years vs baseline

Main Result

Hazard Ratio: 2.1 (95% CI 1.17–3.77)

In patients with CTEPH, undergoing pulmonary thromboendarterectomy is associated with significantly better long-term survival and quality of life compared to those who are inoperable or operable but do not undergo surgery.

Cite This Study

Chin et al. (2023) conducted a cohort in Chronic thromboembolic pulmonary hypertension (CTEPH) (n=750). Inoperable or operable without surgery status vs. Pulmonary thromboendarterectomy (operated) was evaluated on Mortality (HR 2.10, 95% CI 1.17-3.77). Inoperable status and operable but no surgery status in patients with CTEPH were associated with higher mortality rates relative to undergoing pulmonary thromboendarterectomy (HR 2.10; 95% CI 1.17-3.77 and HR 2.19; 95% CI 1.20-3.99, respectively).

synapsesocial.com/papers/6a208c13fedcec2fd6301c32https://doi.org/10.1016/j.chpulm.2023.100008
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