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Relationship between FEV1 decline and mortality in patients with bronchiolitis obliterans syndrome—a systematic literature review

Authors :
Clément François
Emilie Hofstetter
Yuliya Sabeva
Gerhard Boerner
Iwona Pustulka
Beata Smela
Robert Kemp
Source :
Respiratory Medicine. 188:106608
Publication Year :
2021
Publisher :
Elsevier BV, 2021.

Abstract

Background Bronchiolitis obliterans syndrome (BOS) is one of the most severe complications and the leading cause of late mortality and morbidity after lung transplantation (LT) and allogeneic hematopoietic stem cell transplantation (allo-HSCT). No approved treatment for BOS is available. This review aimed to systematically identify and summarise the findings regarding the relationship between FEV1 decline and mortality in patients who developed BOS following LT or allo-HSCT. Methods A systematic literature search was performed in the Medline, Embase and Cochrane reviews databases. Of the 501 potential studies identified 25 met inclusion criteria and were analysed. Results Overall, 13 studies reported a relationship between FEV1 and mortality, and 12 studies reported both mortality and FEV1 results but did not investigate the relationship between them. There was heterogeneity in the analyses, which investigated the relationship between FEV1 decline and mortality across the studies in terms of levels of lung functioning, comparison to a control group, treatment, and statistical methodology; nevertheless, a clear and consistent increase in the risk of death associated with FEV1 decrease was seen in the analysed studies. Conclusions The systematic literature review identified studies and findings that support a relationship between FEV1 and mortality, with a decrease in FEV1 being statistically associated with increased risk of death. Knowing that lower FEV1 levels are associated with higher mortality rates may help assess the condition of a patient with BOS and monitor future treatment effectiveness. However, more evidence is needed to further investigate this relationship and to verify its clinical usefulness.

Details

ISSN :
09546111
Volume :
188
Database :
OpenAIRE
Journal :
Respiratory Medicine
Accession number :
edsair.doi...........c80fa01fb93e0e8060b5dcb03c64c9c2
Full Text :
https://doi.org/10.1016/j.rmed.2021.106608