Skip to main content
Top
Published in: Orphanet Journal of Rare Diseases 1/2024

Open Access 01-12-2024 | Bronchoscopy | Research

Risk factors associated with severe adverse events in patients with relapsing polychondritis undergoing flexible bronchoscopy

Authors: Shao-Ting Wang, Jinglan Wang, Xiaoxing Gao, Keqi Chen, Kai-Feng Xu, Xinlun Tian

Published in: Orphanet Journal of Rare Diseases | Issue 1/2024

Login to get access

Abstract

Background

Patients with relapsing polychondritis (RP) sometimes experience upper airway collapse or lower airway stenosis, and bronchoscopy may provide a valuable typical image to confirm the diagnosis. This study aimed to identify potential risk factors associated with severe adverse effects during bronchoscopy.

Methods

We performed a retrospective cohort study of 82 consecutive patients with RP hospitalized at Peking Union Medical College Hospital between January 1, 2012 and December 31, 2022. Clinical features and disease patterns were compared among patients with RP undergoing bronchoscopy with or without severe adverse effects. Binary logistic regression analysis was performed to identify the associated risk factors.

Results

For patients with RP undergoing bronchoscopy with severe adverse effects, the forced vital capacity (FVC), forced vital capacity percent predicted values (FVC%), and peak expiratory flow were significantly lower (P = 0.001, P = 0.001, and P = 0.021, respectively) than those in the non-severe adverse effect subgroup. Binary logistic regression analysis revealed that low FVC% (odds ratio, 0.930; 95% confidence interval, 0.880–0.982; P = 0.009) was an independent risk factor for severe adverse events in patients undergoing bronchoscopy.

Conclusions

Low FVC or FVC% suggests a high risk of severe adverse effects in patients with RP undergoing bronchoscopy. Patients with such risk factors should be carefully evaluated before bronchoscopy and adequately prepared for emergency tracheal intubation or tracheostomy.
Appendix
Available only for authorised users
Literature
1.
go back to reference Ernst A, Rafeq S, Boiselle P, Sung A, Reddy C, Michaud G, et al. Relapsing polychondritis and airway involvement. Chest. 2009;135(4):1024–30.CrossRefPubMed Ernst A, Rafeq S, Boiselle P, Sung A, Reddy C, Michaud G, et al. Relapsing polychondritis and airway involvement. Chest. 2009;135(4):1024–30.CrossRefPubMed
2.
go back to reference McAdam LP, O’Hanlan MA, Bluestone R, Pearson CM. Relapsing polychondritis: prospective study of 23 patients and a review of the literature. Med (Baltim). 1976;55(3):193.CrossRef McAdam LP, O’Hanlan MA, Bluestone R, Pearson CM. Relapsing polychondritis: prospective study of 23 patients and a review of the literature. Med (Baltim). 1976;55(3):193.CrossRef
3.
go back to reference Dion J, Costedoat-Chalumeau N, Sène D, Cohen-Bittan J, Leroux G, Dion C, et al. Relapsing Polychondritis can be characterized by three different clinical phenotypes: analysis of a recent series of 142 patients. Arthritis Rheumatol. 2016;68(12):2992–3001.CrossRefPubMed Dion J, Costedoat-Chalumeau N, Sène D, Cohen-Bittan J, Leroux G, Dion C, et al. Relapsing Polychondritis can be characterized by three different clinical phenotypes: analysis of a recent series of 142 patients. Arthritis Rheumatol. 2016;68(12):2992–3001.CrossRefPubMed
4.
go back to reference Lin DF, Yang WQ, Zhang PP, Lv Q, Jin O, Gu JR. Clinical and prognostic characteristics of 158 cases of relapsing polychondritis in China and review of the literature. Rheumatol Int. 2016;36(7):1003–9.CrossRefPubMed Lin DF, Yang WQ, Zhang PP, Lv Q, Jin O, Gu JR. Clinical and prognostic characteristics of 158 cases of relapsing polychondritis in China and review of the literature. Rheumatol Int. 2016;36(7):1003–9.CrossRefPubMed
5.
go back to reference Ahn HJ, Kim JA, Yang M, Lee EK. Respiratory insufficiency and dynamic hyperinflation after rigid bronchoscopy in a patient with relapsing polychondritis -a case report. Korean J Anesthesiol. 2013;65(6):569–73.CrossRefPubMedPubMedCentral Ahn HJ, Kim JA, Yang M, Lee EK. Respiratory insufficiency and dynamic hyperinflation after rigid bronchoscopy in a patient with relapsing polychondritis -a case report. Korean J Anesthesiol. 2013;65(6):569–73.CrossRefPubMedPubMedCentral
6.
go back to reference Burgess FW, Whitlock W, Davis MJ, Patane PS. Anesthetic implications of relapsing polychondritis: a case report. Anesthesiology. 1990;73(3):570–2.CrossRefPubMed Burgess FW, Whitlock W, Davis MJ, Patane PS. Anesthetic implications of relapsing polychondritis: a case report. Anesthesiology. 1990;73(3):570–2.CrossRefPubMed
7.
go back to reference Rafeq S, Trentham D, Ernst A. Pulmonary manifestations of relapsing polychondritis. Clin Chest Med. 2010;31(3):513–8.CrossRefPubMed Rafeq S, Trentham D, Ernst A. Pulmonary manifestations of relapsing polychondritis. Clin Chest Med. 2010;31(3):513–8.CrossRefPubMed
8.
go back to reference Healy F, Wilson AF, Fairshter RD. Physiologic correlates of airway collapse in chronic airflow obstruction. Chest. 1984;85(4):476–81.CrossRefPubMed Healy F, Wilson AF, Fairshter RD. Physiologic correlates of airway collapse in chronic airflow obstruction. Chest. 1984;85(4):476–81.CrossRefPubMed
10.
go back to reference Christina RB, Irtaza K, Arjun BC, Edward FH. Bronchoscopy safety in patients with chronic obstructive lung disease. J Bronchol Interv Pulmonol. 2017;24(2):98–10310.CrossRef Christina RB, Irtaza K, Arjun BC, Edward FH. Bronchoscopy safety in patients with chronic obstructive lung disease. J Bronchol Interv Pulmonol. 2017;24(2):98–10310.CrossRef
11.
go back to reference Li C, Zhu T, Ma D, Chen Y. Complications and safety analysis of diagnostic bronchoscopy in COPD: a systematic review and meta-analysis. Expert Rev Respir Med. 2022;16(5):555–65.CrossRefPubMed Li C, Zhu T, Ma D, Chen Y. Complications and safety analysis of diagnostic bronchoscopy in COPD: a systematic review and meta-analysis. Expert Rev Respir Med. 2022;16(5):555–65.CrossRefPubMed
12.
go back to reference Elston WJ, Whittaker AJ, Khan LN, Flood-Page P, Ramsay C, Jeffery PK, et al. Safety of research bronchoscopy, biopsy and bronchoalveolar lavage in asthma. Eur Respir J. 2004;24(3):375–7.CrossRefPubMed Elston WJ, Whittaker AJ, Khan LN, Flood-Page P, Ramsay C, Jeffery PK, et al. Safety of research bronchoscopy, biopsy and bronchoalveolar lavage in asthma. Eur Respir J. 2004;24(3):375–7.CrossRefPubMed
13.
go back to reference Moore WC, Evans MD, Bleecker ER, Busse WW, Calhoun WJ, Castro M, et al. Safety of investigative bronchoscopy in the Severe Asthma Research Program. J Allergy Clin Immunol. 2011;128(2):328–336e3.CrossRefPubMedPubMedCentral Moore WC, Evans MD, Bleecker ER, Busse WW, Calhoun WJ, Castro M, et al. Safety of investigative bronchoscopy in the Severe Asthma Research Program. J Allergy Clin Immunol. 2011;128(2):328–336e3.CrossRefPubMedPubMedCentral
14.
go back to reference Staats BA, Utz JP, Michet CJ Jr. Relapsing polychondritis. Semin Respir Crit Care Med. 2002;23(2):145–54.CrossRefPubMed Staats BA, Utz JP, Michet CJ Jr. Relapsing polychondritis. Semin Respir Crit Care Med. 2002;23(2):145–54.CrossRefPubMed
Metadata
Title
Risk factors associated with severe adverse events in patients with relapsing polychondritis undergoing flexible bronchoscopy
Authors
Shao-Ting Wang
Jinglan Wang
Xiaoxing Gao
Keqi Chen
Kai-Feng Xu
Xinlun Tian
Publication date
01-12-2024
Publisher
BioMed Central
Published in
Orphanet Journal of Rare Diseases / Issue 1/2024
Electronic ISSN: 1750-1172
DOI
https://doi.org/10.1186/s13023-024-03061-9

Other articles of this Issue 1/2024

Orphanet Journal of Rare Diseases 1/2024 Go to the issue