Improved Health-Related Quality of Life After Lung Volume Reduction Surgery and Pulmonary Rehabilitation

Abstract

It has been hypothesized that lung volume reduction surgery (LVRS) and pulmonary rehabilitation improve health-related quality of life (HRQOL). The purpose of this study was to test the hypothesis by examining the long-term functional consequences and general health status of patients with emphysema who have undergone LVRS and pulmonary rehabilitation. Forty-nine subjects with severe emphysema, aged 51 to 84 years old, post-LVRS and pulmonary rehabilitation participated in this study. Subjects reported changes in physical and mental domains on the Medical Outcomes Study 36-Item Short Form Health Survey (MOS SF-36) over 3 time periods: prior to surgery, 6 months postsurgery, and 18 months postsurgery. The population as a whole was studied and both gender and age were analyzed as subsets. Subjects participated in an intensive 2-week (10 daily sessions) pulmonary rehabilitation program following LVRS. Subjects showed significant improvements in both the physical and mental component summaries at Time 2 (3 months post-LVRS through 6 months post-LVRS) and Time 3 (12 months post-LVRS through 18 months post-LVRS) when compared to Time 1 (pre-LVRS). On the mental component summary scale, subjects younger than 65 years old had significant improvement compared to subjects 65 years and older at Time 3 (P < .05). Women significantly improved more than men at Time 3 on the physical component summary scale (P < .05). Lung volume reduction surgery and 2 weeks (10 daily sessions) of intensive pulmonary rehabilitation appears to improve HRQOL in people with emphysema up to at least 18 months postsurgery. What these data further suggest is that even after declines in health, women can improve HRQOL later in life, and that greater focus should be given to the emotional needs of our older patients.