Impact of lung volume reduction surgery versus rehabilitation on quality of life.
This study aims at evaluating the effects of lung volume reduction versus respiratory rehabilitation on quality of life, assessed by three different questionnaires. Sixty emphysematous patients were randomised by computer to receive either surgery (n = 30) or rehabilitation (n = 30). Life quality was evaluated by the Nottingham Health Profile, the Short Form (SF)-36 item and the St George's questionnaires. As reported previously, dyspnoea index, forced expiratory volume in one second, residual volume, 6-min walk test and arterial oxygen tension improved after surgery more than after rehabilitation. Quality of life was significantly improved after surgery as follows Nottingham Health Profile physical mobility; SF-36 physical and social functioning, mental and general health, emotional role; St George's general, activity. At multivariate analysis 6- and 12-month changes after surgery of Short Form-36 physical functioning, general health, and St George's activity domains were significantly correlated with forced expiratory volume in one second, while Short Form-36 social functioning and Nottingham Health Profile isolation correlated with residual volume. Functional and especially symptomatic improvements persisted: dyspnoea index, residual volume, and Short Form-36 and St Georges's physical scores were still significant at 4 yrs. Surgery produces greater and longer effects than rehabilitation on quality of life by improving both physical and psychosocial domains. Symptomatic improvements persisted at 4 yrs.
Division of Thoracic Surgery, Tor Vergata University, Rome, Italy.
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TC
Mineo
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V
Ambrogi
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E
Pompeo
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S
Elia
D
D
Mineo
P
P
Bollero
I
I
Nofroni
D000203:Activities of Daily Living / Q000145:classification / Q000523:psychology; D000368:Aged; D001945:Breathing Exercises; D004417:Dyspnea / Q000209:etiology / Q000523:psychology; D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D011013:Pneumonectomy / Q000523:psychology; D011183:Postoperative Complications / Q000209:etiology / Q000523:psychology; D011656:Pulmonary Emphysema / Q000523:psychology / Q000534:rehabilitation* / Q000601:surgery*; D011788:Quality of Life / Q000523:psychology; D012129:Respiratory Function Tests; D012384:Rome; D020775:Thoracic Surgery, Video-Assisted