PMID- 34309022 OWN - NLM STAT- MEDLINE DCOM- 20211124 LR - 20221202 IS - 1531-4995 (Electronic) IS - 0023-852X (Print) IS - 0023-852X (Linking) VI - 131 IP - 12 DP - 2021 Dec TI - Modeling Recurrence in Idiopathic Subglottic Stenosis With Mobile Peak Expiratory Flow. PG - E2841-E2848 LID - 10.1002/lary.29760 [doi] AB - OBJECTIVES/HYPOTHESIS: We sought to establish normative peak expiratory flow (PEF) data for patients with idiopathic subglottic stenosis (iSGS), evaluate whether immediate changes in PEF after a procedure predict long-term treatment response, and test if a decline in longitudinal PEF is associated with disease recurrence. STUDY DESIGN: International, prospective, 3-year multicenter cohort study of 810 patients with untreated, newly diagnosed, or previously treated iSGS. METHODS: iSGS patients consented and enrolled in the North American Airway Collaborative (NoAAC) iSGS(1000) cohort recorded PEF data on a mobile smartphone app. Cox regression tested the associations between the magnitude of postoperative PEF improvement and longitudinal 90-day PEF decline with the risk of disease recurrence. RESULTS: Within the NoAAC iSGS(1000) cohort, 810 patients participated in a 3-year prospective study comparing surgical treatment efficacy and 385 had appropriate PEF measurements and follow-up data. Of those patients, 42% (161/385) required at least one operation during study follow-up. The mean PEF preceding operative intervention was 241 L/min (95% confidence interval [CI]: 120-380) corresponding to a predicted PEF of 52%. The mean increase in PEF following a procedure was 111 L/min (95% CI: 96-125 L/min). Interestingly, the magnitude of immediate PEF improvement was not predictive of disease recurrence (hazard ratio [HR] for 100 L/min increase = 0.90, 95% CI: 0.60-1.00). However, recurrence was associated with the magnitude of PEF decline over 90 days (30% vs. 10% decline, HR = 2.2, 95% CI: 1.5-3.0). CONCLUSIONS: We provide normative PEF data on a large iSGS patient cohort. The degree of PEF improvement immediately after surgery was not associated with a longer procedure-free interval. However, a 30% decline in PEF over 90 days was associated with elevated risk of disease recurrence. LEVEL OF EVIDENCE: 2 Laryngoscope, 131:E2841-E2848, 2021. CI - (c) 2021 The American Laryngological, Rhinological and Otological Society, Inc. FAU - Kimura, Kyle AU - Kimura K AUID- ORCID: 0000-0002-9947-9626 AD - Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, U.S.A. FAU - Du, Liping AU - Du L AD - Vanderbilt Center for Quantitative Sciences, Vanderbilt-Ingram Cancer Center, Nashville, Tennessee, U.S.A. FAU - Berry, Lynn D AU - Berry LD AD - Vanderbilt Center for Quantitative Sciences, Vanderbilt-Ingram Cancer Center, Nashville, Tennessee, U.S.A. FAU - Huang, Li-Ching AU - Huang LC AD - Vanderbilt Center for Quantitative Sciences, Vanderbilt-Ingram Cancer Center, Nashville, Tennessee, U.S.A. FAU - Chen, Sheau-Chiann AU - Chen SC AD - Vanderbilt Center for Quantitative Sciences, Vanderbilt-Ingram Cancer Center, Nashville, Tennessee, U.S.A. FAU - Francis, David O AU - Francis DO AD - Division of Otolaryngology-Head and Neck Surgery, University of Wisconsin-Madison, Madison, Wisconsin, U.S.A. FAU - Gelbard, Alexander AU - Gelbard A AUID- ORCID: 0000-0003-0078-1305 AD - Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, U.S.A. CN - North American Airway Collaborative (NoAAC) LA - eng GR - R01 HL146401/HL/NHLBI NIH HHS/United States GR - 1409-22214/Patient Centered Outcomes Research Institute/ GR - R01HL146401-01/National Heart, Lung, and Blood Institute, NIH/ PT - Journal Article PT - Multicenter Study PT - Observational Study PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't DEP - 20210726 PL - United States TA - Laryngoscope JT - The Laryngoscope JID - 8607378 SB - IM MH - Adult MH - Female MH - Humans MH - Laryngoscopy/*statistics & numerical data MH - Laryngostenosis/*diagnosis/surgery MH - Longitudinal Studies MH - Male MH - Middle Aged MH - *Peak Expiratory Flow Rate MH - Prognosis MH - Prospective Studies MH - Recurrence MH - Reoperation/*statistics & numerical data MH - Risk Assessment/methods/statistics & numerical data MH - Surveys and Questionnaires MH - Treatment Outcome PMC - PMC8595545 MID - NIHMS1724035 OTO - NOTNLM OT - Idiopathic subglottic stenosis OT - disease-free interval OT - expiratory flow OT - peak expiratory flow COIS- Conflicts of Interest: None. FIR - Anderson, Catherine IR - Anderson C FIR - Amin, Milan R IR - Amin MR FIR - Benninger, Michael S IR - Benninger MS FIR - Blumin, Joel H IR - Blumin JH FIR - Bock, Jonathan M IR - Bock JM FIR - Bryson, Paul C IR - Bryson PC FIR - Castellanos, Paul F IR - Castellanos PF FIR - Chen, Sheau-Chiann IR - Chen SC FIR - Clary, Matthew S IR - Clary MS FIR - Cohen, Seth M IR - Cohen SM FIR - Crawley, Brianna K IR - Crawley BK FIR - Dailey, Seth H IR - Dailey SH FIR - Daniero, James J IR - Daniero JJ FIR - de Alarcon, Alessandro IR - de Alarcon A FIR - Donovan, Donald T IR - Donovan DT FIR - Edell, Eric S IR - Edell ES FIR - Ekbom, Dale C IR - Ekbom DC FIR - Fink, Daniel S IR - Fink DS FIR - Franco, Ramon A IR - Franco RA FIR - Garrett, C Gaelyn IR - Garrett CG FIR - Guardiani, Elizabeth A IR - Guardiani EA FIR - Hillel, Alexander T IR - Hillel AT FIR - Hoffman, Henry T IR - Hoffman HT FIR - Hogikyan, Norman D IR - Hogikyan ND FIR - Howell, Rebecca J IR - Howell RJ FIR - Hussain, Lena K IR - Hussain LK FIR - Johns, Michael M IR - Johns MM FIR - Kasperbauer, Jan L IR - Kasperbauer JL FIR - Khosla, Sid M IR - Khosla SM FIR - Kinnard, Cheryl IR - Kinnard C FIR - Kupfer, Robbi A IR - Kupfer RA FIR - Langerman, Alexander J IR - Langerman AJ FIR - Lee, Jaclyn IR - Lee J FIR - Lentz, Robert J IR - Lentz RJ FIR - Lorenz, Robert R IR - Lorenz RR FIR - Lott, David G IR - Lott DG FIR - Makani, Samir S IR - Makani SS FIR - Maldonado, Fabien IR - Maldonado F FIR - Mannion, Kyle IR - Mannion K FIR - Matrka, Laura IR - Matrka L FIR - McWhorter, Andrew J IR - McWhorter AJ FIR - Merati, Albert L IR - Merati AL FIR - Mori, Matthew IR - Mori M FIR - Netterville, James L IR - Netterville JL FIR - O'Dell, Karla IR - O'Dell K FIR - Ongkasuwan, Julina IR - Ongkasuwan J FIR - Patel, Siddharth A IR - Patel SA FIR - Postma, Gregory N IR - Postma GN FIR - Reder, Lindsay S IR - Reder LS FIR - Rohde, Sarah L IR - Rohde SL FIR - Richardson, Brent E IR - Richardson BE FIR - Rickman, Otis B IR - Rickman OB FIR - Rosen, Clark A IR - Rosen CA FIR - Rutter, Michael J IR - Rutter MJ FIR - Sandhu, Guri S IR - Sandhu GS FIR - Schindler, Joshua S IR - Schindler JS FIR - Schneider, G Todd IR - Schneider GT FIR - Shah, Rupali N IR - Shah RN FIR - Sikora, Andrew G IR - Sikora AG FIR - Sinard, Robert J IR - Sinard RJ FIR - Smith, Marshall E IR - Smith ME FIR - Smith, Libby J IR - Smith LJ FIR - Soliman, Ahmed Ms IR - Soliman AM FIR - Sveinsdottir, Sigriethur IR - Sveinsdottir S FIR - Van Daele, Douglas J IR - Van Daele DJ FIR - Veivers, David IR - Veivers D FIR - Verma, Sunil P IR - Verma SP FIR - Weinberger, Paul M IR - Weinberger PM FIR - Weissbrod, Philip A IR - Weissbrod PA FIR - Wootten, Christopher T IR - Wootten CT FIR - Shyr, Yu IR - Shyr Y EDAT- 2021/07/27 06:00 MHDA- 2021/11/25 06:00 PMCR- 2022/12/01 CRDT- 2021/07/26 08:58 PHST- 2021/07/05 00:00 [revised] PHST- 2021/03/01 00:00 [received] PHST- 2021/07/09 00:00 [accepted] PHST- 2021/07/27 06:00 [pubmed] PHST- 2021/11/25 06:00 [medline] PHST- 2021/07/26 08:58 [entrez] PHST- 2022/12/01 00:00 [pmc-release] AID - 10.1002/lary.29760 [doi] PST - ppublish SO - Laryngoscope. 2021 Dec;131(12):E2841-E2848. doi: 10.1002/lary.29760. Epub 2021 Jul 26.