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Title: Individualised risk in patients undergoing lung volume reduction surgery (LVRS): The Glenfield BFG Score
Authors: Greening, Neil J.
Vaughn, Paul
Oey, Inger
Steiner, Michael C.
Morgan, Mike D.
Rathinam, Sridhar
Waller, David A.
First Published: 1-Jun-2017
Publisher: European Respiratory Society: ERJ
Citation: European Respiratory Journal, 2017, 49(6)
Abstract: Introduction: LVRS has been shown to be beneficial in patients with COPD but there is low uptake, partly due to perceived concerns of high operative mortality. We aimed to develop an individualised risk score after LVRS. Methods: This was a cohort study of patients undergoing LVRS. Factors independently predicting 90 day mortality and a risk prediction score were identified. Reliability of the score was tested using area under receiver operator characteristic curve (AUROC). Results: 237 LVRS procedures were performed. The multivariate analysis factors associated independently with death were; BMI <18.5 kg/m2(OR 2.83, p=0.059), FEV1<0.71L (OR 5.47, p=0.011) and TLCO<20% (OR 5.56, p=0.031). A risk score was calculated and a total score assigned. AUROC for the risk score was 0.80 and a better predictor than individual components (p<0.01). The score was stratified into three risk groups. 46% of patients were classified as low risk. Similar improvements in lung function and health status were seen in all groups. The score was introduced and tested in a further 71 patients. AUROC for 90 day mortality in this cohort was 0.84. Conclusion: It is possible to provide an individualised predictive risk score for LVRS, which may aid decision making for both clinicians and patients.
DOI Link: 10.1183/13993003.01766-2016
ISSN: 0903-1936
eISSN: 1399-3003
Embargo on file until: 1-Dec-2018
Version: Post-print
Status: Peer-reviewed
Type: Journal Article
Rights: Copyright © European Respiratory Society: ERJ 2017. After an embargo period this version of the paper will be an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License (, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
Description: The file associated with this record is under embargo until 18 months after publication, in accordance with the publisher's self-archiving policy. The full text may be available through the publisher links provided above.
Appears in Collections:Published Articles, Dept. of Infection, Immunity and Inflammation

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