For Release: February 10, 1999
Contact:
Kimberly Lynch, ACCP
(847) 498-8341
REHABILITATION PLUS SURGERY IMPROVES QUALITY
OF LIFE FOR PATIENTS WITH SEVERE EMPHYSEMA
Patients with severe emphysema who undergo both pulmonary rehabilitation and bilateral lung volume reduction surgery (LVRS) can improve their quality of life in such areas as social functioning, vitality, role limitations, and physical functioning, according to a new study reported today in the February issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.
Emphysema is an incurable disease, usually caused by smoking, which is characterized by damaged tiny air sacs"¢alveoli"¢in the lungs. In its mildest form, it contributes to shortness of breath. In its severe form, it can lead to respiratory or heart failure and death.
Drs. Marilyn Moy, John Reily, Jr., and other researchers at Brigham and Women"¢s Hospital in Boston decided to determine whether and what kinds of quality of life improvements might take place in the lives of patients with severe emphysema after they undergo pulmonary rehabilitation and bilateral lung volume reduction surgery (LVRS). They noted that pulmonary rehabilitation has been shown to improve quality of life in patients with chronic obstructive pulmonary disease (COPD) even when there was no evidence of improvements in pulmonary function. On the other side of the coin, they observed that while LVRS has often resulted in improvements in lung function and exercise capacity, the impact of surgery on health-related quality of life still needed to be measured.
Nineteen patients with severe emphysema who were scheduled for pulmonary rehabilitation prior to LVRS were recruited into the study. They were administered a health-related quality of life medical outcomes questionnaire at three points during the study"¢once three months prior to the rehabilitation phase to establish baseline data; the second following "rehab" and prior to surgery on one lung; and the third, six months after surgery on the second lung. The measurements focused on such quality of life areas as physical functioning, role limitations, bodypain, general health, vitality, social functioning, emotional role, and mental health.
The study showed that a combination of pulmonary rehabilitation and LVRS resulted instatistically significant progress in four of the eight areas measured, including physicalfunctioning, role limitations due to physical problems, social functioning, and vitality. Investigators said that both pulmonary rehabilitation and LVRS contributed to the overall advances, each in a distinct manner. For example, they noted that pulmonary rehabilitation accounted for more than 90% of the improvement in role limitation due to physical problems. LVRS, on the other hand, accounted for virtually all of the progress in physical functioning and vitality and for most of the gains in social functioning.
Investigators concluded that health-related quality of life (HRQL) measurements provide outcome information that is independent from and complementary to pulmonary function measures. Increases in lung function, they said, explain only part of the improvement inHRQL after LVRS. They added that HRQL should be measured directly in patients withemphysema at baseline and after therapeutic interventions. HRQL, they concluded, improvesafter combined preoperative pulmonary rehabilitation and LVRS in patients with severe emphysema.
CHEST is published by the American College of Chest Physicians (ACCP) which represents15,000 members who provide clinical, respiratory, and cardiothoracic patient care in the U.S.and throughout the world.
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Reporters may wish to call Kimberly Lynch of the ACCP at (847) 498-8341 for a full copy of the article. She can also be reached by fax at (847) 498-5460. The table of contents and the abstracts of all articles appearing in the February issue of CHEST are available on the ACCP web site at Dr. John Reilly of Brigham and Women"¢s Hospital can be reached by phone at (617) 732-7420.
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