How clinical symptoms affect treatment & prognosis in patients with Congenital Pulmonary Airway Malformation (CPAM)? | CPAM diagnosis | Retrospective review | 2015-2020 | 110 patients underwent VATS | Symptomatic (n=53) | Asymptomatic (n=57) | Asymptomatic group had better periop results vs. symptomatic group | shorter operating times | (119.39 ± 49.42 min vs 100.73 ± 23.09 min, P = 0.031) | shorter post-op mechanical ventilation | (2 h [0.5-46] vs 1 h [0.5-5], P = 0.002) | shorter chest tube durations | (4d [2-29] vs 3d [2-10], P = 0.007) | shorter post-op hospital stays | (10d [6-36] vs 8d [6-16], P < 0.001) | Conclusion: Patients with CPAM tend to have better perioperative outcomes with diagnosis before the onset of symptoms. Symptomatic pulmonary lesions are associated with age, postnatal diagnosis, and maximum cyst diameter. | https://doi.org/10.1016/j.jpedsurg.2022.11.013 | Source: Zeng G et.al. | Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, China | @EmGooteeMD | @StayCurrentMD | Cincinnati Children's | Journal of Pediatric Surgery
Clinical Symptoms Affect Treatment and Prognosis in Pediatric Patients with Congenital Pulmonary Airway Malformation
Infographic · Nov 2023 · 1 min read
In brief
In brief
Propensity-matched cohort study of 200+ CPAM patients found asymptomatic cases had significantly better perioperative outcomes than symptomatic patients, with shorter operative times, ventilation duration, and hospital stays. Age at surgery, postnatal diagnosis, and cyst size independently predicted symptom development, supporting early elective resection.
- Asymptomatic CPAM patients have significantly better surgical outcomes: shorter operative time, ventilation, chest tube duration, and hospital stay.
- Early surgery before symptom onset is associated with improved perioperative results compared to waiting until symptoms develop.
- Older age at surgery, postnatal diagnosis, and larger maximum cyst diameter independently predict symptomatic CPAM lesions.
- Complication rates and conversion to thoracotomy were similar between symptomatic and asymptomatic groups after propensity matching.
- Prophylactic resection of asymptomatic CPAM may be safer and more effective than delayed intervention after symptoms appear.
Written by the GCMD Library team from the infographic.
The infographic uses a teal and yellow color scheme with hospital and fetus illustrations. The top section presents study design with a hospital icon on the left and patient flow diagram on the right. The middle section lists four key outcomes in bullet points with an illustration of a patient with chest tube. The bottom contains a yellow conclusion banner.
New infographic by Dr. Em Gootee
"Clinical Symptoms Affect Treatment and Prognosis in Pediatric Patients with Congenital Pulmonary Airway Malformation: A Propensity Score Matching Retrospective Cohort Study"
Authors: Guowei Zeng, Qi Zhang, Binqian Song, Xinghui Feng, Jian Sun, Xuming Mo, Kai-Hong Wu
Full article: https://gcmd.co/3QWkNW1
Objectives
Surgery for asymptomatic congenital pulmonary airway malformation patients is still debatable at this time. This study aims to investigate the safety and efficacy of surgery for asymptomatic patients, as well as the factors influencing the symptoms of this group of patients.
Methods
An institutional database was sampled for congenital pulmonary airway malformation patients. Patients were divided into the symptomatic group and the asymptomatic group. Propensity score matching (PSM) analysis selected patients in each group to compare perioperative outcomes. A multivariable logistic regression analysis was performed to investigate the potential influences on symptomatic lesions.
Results
The asymptomatic group had better perioperative results than the symptomatic group, including shorter operating times (119.39 ± 49.42 min vs 100.73 ± 23.09 min, P = 0.031), shorter postoperative mechanical ventilation (2 h [0.5–46] vs 1 h [0.5–5], P = 0.002), shorter chest tube durations (4d [2-29] vs 3d [2-10], P = 0.007), and shorter postoperative hospital stays (10d [6–36] vs 8d [6-16], P < 0.001). With the conversion to thoracotomy and postoperative complications, there was no statistically significant difference between the two PSM-matched groups (P > 0.05). Age (p = 0.037), postnatal diagnosis (p = 0.018), and maximum cyst diameter (p = 0.032) were found to be independent variables associated with symptomatic lesions by multivariable logistic regression.
Conclusions
Patients with congenital pulmonary airway malformation appear to have better perioperative outcomes before the beginning of symptoms. Symptomatic pulmonary lesions were associated with age, postnatal diagnosis, and maximum cyst diameter.