CAMPHOR score: patient-reported outcomes are improved by pulmonary endarterectomy in chronic thromboembolic pulmonary hypertension (CTEPH)

Research output: Contribution to journalArticle

Authors

  • Katherine Bunclark
  • Nisha Abraham
  • Samantha Ali
  • Liliana Amaral-Almeida
  • John E Cannon
  • Natalie Doughty
  • Choo Ng
  • Anie Ponnaberanam
  • Karen Sheares
  • Nicola Speed
  • Dolores Taboada
  • Mark Toshner
  • Steven Tsui
  • David P Jenkins
  • Joanna Pepke-Zaba

Colleges, School and Institutes

Abstract

Background Pulmonary endarterectomy (PEA) is the recommended treatment for eligible patients with chronic thromboembolic pulmonary hypertension (CTEPH). The Cambridge Pulmonary Hypertension Outcome Review (CAMPHOR) score is an internationally-validated patient-reported outcome (PRO) measure for CTEPH. It assesses 3 domains: activity, quality of life (QoL) and symptoms. We assessed PROs in patients with CTEPH undergoing PEA.
Methods This retrospective observational study of consecutive CTEPH patients undergoing PEA at the UK national PEA centre between 2006 and 2017 assessed change in CAMPHOR score from baseline (pre-PEA) until up to 5 years post-PEA. CAMPHOR scores were compared between (i) those with and without clinically significant residual PH and (ii) those undergoing PEA and propensity-matched CTEPH patients who were not operated on. The minimally clinically important difference (MCID) was calculated using an anchor-based method.
Results Of 1324 CTEPH patients who underwent PEA, 1053 (80%) had a CAMPHOR score recorded pre-PEA, 934 (71%) within a year of PEA and 784 (60%) had both. There were significant improvements between pre- and post-PEA in all three CAMPHOR domains (median ± interquartile range: activity, −5±7; QoL, −4±8; and symptoms, −7±8; p<0.0001, all). Improvements in CAMPHOR score were greater and more sustained in those without clinically significant residual PH. CTEPH patients undergoing PEA had better CAMPHOR scores than those not operated on. The MCID in CAMPHOR score was -3±5 for activity, -4±7 for QoL, and -6±7 for symptoms.
Conclusions PROs are markedly improved by PEA in patients with CTEPH, more so in those without clinically significant residual PH.

Details

Original languageEnglish
JournalThe European respiratory journal
Early online date8 Jun 2020
Publication statusE-pub ahead of print - 8 Jun 2020