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.

中文翻译：

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闭塞性细支气管炎综合征患者 FEV1 下降与死亡率的关系——系统文献综述

背景

闭塞性细支气管炎综合征 (BOS) 是肺移植 (LT) 和异基因造血干细胞移植 (allo-HSCT) 后最严重的并发症之一，也是导致晚期死亡率和发病率的主要原因。没有获得批准的 BOS 治疗方法。本综述旨在系统地识别和总结关于 FEV ₁下降与 LT 或 allo-HSCT 后发生 BOS 的患者死亡率之间关系的研究结果。

方法

在 Medline、Embase 和 Cochrane 评论数据库中进行了系统的文献检索。在 501 项潜在研究中，确定了 25 项符合纳入标准并进行了分析。

结果

_{总体而言，13 项研究报告了 FEV 1}与死亡率之间的关系，12 项研究报告了死亡率和 FEV ₁结果，但没有调查它们之间的关系。分析中存在异质性，该分析在肺功能水平、与对照组比较、治疗和统计方法方面调查了 FEV _{1下降与死亡率之间的关系；}尽管如此，在分析的研究中发现与 FEV ₁降低相关的死亡风险明显且持续增加。

结论

_{系统性文献综述确定了支持 FEV 1}与死亡率之间关系的研究和发现，FEV ₁的降低与死亡风险增加在统计学上相关。了解较低的 FEV ₁水平与较高的死亡率相关可能有助于评估 BOS 患者的状况并监测未来的治疗效果。然而，需要更多的证据来进一步研究这种关系并验证其临床实用性。