Time course of symptomatic improvement following Lung Volume Reduction Surgery (LVRS) and comparison to improvement following Pulmonary Rehabilitation (PR)

Austin Bassett Thompson, Rudy P Lackner, T. Bohling, D. Kozeny, S. Waggoner, Craig Arnold Piquette

Research output: Contribution to journalReview article

Abstract

Purpose: To determine the time course of improvement in patients undergoing LVRS and to compare the extent of the improvements to the results of PR prior to surgery. Methods: Prior to LVRS, patients underwent a minimum of 6 weeks of PR, reaching a plateau in functional improvement. Subsequent to LVRS the patients were followed up at 1, 3, and 6 months. Dyspnea was quantitated by the Medical Research Council (MRC) scale and the Mahler Dyspnea Index (MDI). Functional status was measured by the Human Activity Profile, which is scored as the maximal activities score (MAS) and an adjusted score (AAS). Quality of Life was measured by the SF-36 Health Status Questionnaire (SF-36). The SF-36 provides scores in 9 domains as well as an aggregate score. Results: Functional status (AAS) trended towards improvement during PR (p=0.1), fell at 1 month (p=.03), and improved beyond the PR measurement at 3 and 6 months (p=.008, .0003, respectively). A similar pattern was seen for the MRC, MDI, and SF-36 with continuing improvement through 6 months. The domains of the SF-36 with most significant improvements following surgery were general health transition, vitality, and physical function. There was general worsening in the pain index. Conclusion: Patients undergoing LVRS symptomatically benefit beyond the improvements seen with pulmonary rehabilitation alone. One month following surgery, patient functioning, quality of life and functional status trend towards worsening, followed by significant improvements at 3 and 6 months. Clinical Implications: Evaluations of improvement following LVRS should be controlled by comparison to improvement with pulmonary rehabilitation alone and must take into account the time course of improvement following surgery.

Original languageEnglish (US)
Pages (from-to)176S
JournalChest
Volume110
Issue number4 SUPPL.
StatePublished - Oct 1 1996

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Pneumonectomy
Rehabilitation
Lung
Dyspnea
Biomedical Research
Health Transition
Quality of Life
Human Activities
Health Status
Pain

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Time course of symptomatic improvement following Lung Volume Reduction Surgery (LVRS) and comparison to improvement following Pulmonary Rehabilitation (PR). / Thompson, Austin Bassett; Lackner, Rudy P; Bohling, T.; Kozeny, D.; Waggoner, S.; Piquette, Craig Arnold.

In: Chest, Vol. 110, No. 4 SUPPL., 01.10.1996, p. 176S.

Research output: Contribution to journalReview article

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abstract = "Purpose: To determine the time course of improvement in patients undergoing LVRS and to compare the extent of the improvements to the results of PR prior to surgery. Methods: Prior to LVRS, patients underwent a minimum of 6 weeks of PR, reaching a plateau in functional improvement. Subsequent to LVRS the patients were followed up at 1, 3, and 6 months. Dyspnea was quantitated by the Medical Research Council (MRC) scale and the Mahler Dyspnea Index (MDI). Functional status was measured by the Human Activity Profile, which is scored as the maximal activities score (MAS) and an adjusted score (AAS). Quality of Life was measured by the SF-36 Health Status Questionnaire (SF-36). The SF-36 provides scores in 9 domains as well as an aggregate score. Results: Functional status (AAS) trended towards improvement during PR (p=0.1), fell at 1 month (p=.03), and improved beyond the PR measurement at 3 and 6 months (p=.008, .0003, respectively). A similar pattern was seen for the MRC, MDI, and SF-36 with continuing improvement through 6 months. The domains of the SF-36 with most significant improvements following surgery were general health transition, vitality, and physical function. There was general worsening in the pain index. Conclusion: Patients undergoing LVRS symptomatically benefit beyond the improvements seen with pulmonary rehabilitation alone. One month following surgery, patient functioning, quality of life and functional status trend towards worsening, followed by significant improvements at 3 and 6 months. Clinical Implications: Evaluations of improvement following LVRS should be controlled by comparison to improvement with pulmonary rehabilitation alone and must take into account the time course of improvement following surgery.",
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T1 - Time course of symptomatic improvement following Lung Volume Reduction Surgery (LVRS) and comparison to improvement following Pulmonary Rehabilitation (PR)

AU - Thompson, Austin Bassett

AU - Lackner, Rudy P

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AU - Kozeny, D.

AU - Waggoner, S.

AU - Piquette, Craig Arnold

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N2 - Purpose: To determine the time course of improvement in patients undergoing LVRS and to compare the extent of the improvements to the results of PR prior to surgery. Methods: Prior to LVRS, patients underwent a minimum of 6 weeks of PR, reaching a plateau in functional improvement. Subsequent to LVRS the patients were followed up at 1, 3, and 6 months. Dyspnea was quantitated by the Medical Research Council (MRC) scale and the Mahler Dyspnea Index (MDI). Functional status was measured by the Human Activity Profile, which is scored as the maximal activities score (MAS) and an adjusted score (AAS). Quality of Life was measured by the SF-36 Health Status Questionnaire (SF-36). The SF-36 provides scores in 9 domains as well as an aggregate score. Results: Functional status (AAS) trended towards improvement during PR (p=0.1), fell at 1 month (p=.03), and improved beyond the PR measurement at 3 and 6 months (p=.008, .0003, respectively). A similar pattern was seen for the MRC, MDI, and SF-36 with continuing improvement through 6 months. The domains of the SF-36 with most significant improvements following surgery were general health transition, vitality, and physical function. There was general worsening in the pain index. Conclusion: Patients undergoing LVRS symptomatically benefit beyond the improvements seen with pulmonary rehabilitation alone. One month following surgery, patient functioning, quality of life and functional status trend towards worsening, followed by significant improvements at 3 and 6 months. Clinical Implications: Evaluations of improvement following LVRS should be controlled by comparison to improvement with pulmonary rehabilitation alone and must take into account the time course of improvement following surgery.

AB - Purpose: To determine the time course of improvement in patients undergoing LVRS and to compare the extent of the improvements to the results of PR prior to surgery. Methods: Prior to LVRS, patients underwent a minimum of 6 weeks of PR, reaching a plateau in functional improvement. Subsequent to LVRS the patients were followed up at 1, 3, and 6 months. Dyspnea was quantitated by the Medical Research Council (MRC) scale and the Mahler Dyspnea Index (MDI). Functional status was measured by the Human Activity Profile, which is scored as the maximal activities score (MAS) and an adjusted score (AAS). Quality of Life was measured by the SF-36 Health Status Questionnaire (SF-36). The SF-36 provides scores in 9 domains as well as an aggregate score. Results: Functional status (AAS) trended towards improvement during PR (p=0.1), fell at 1 month (p=.03), and improved beyond the PR measurement at 3 and 6 months (p=.008, .0003, respectively). A similar pattern was seen for the MRC, MDI, and SF-36 with continuing improvement through 6 months. The domains of the SF-36 with most significant improvements following surgery were general health transition, vitality, and physical function. There was general worsening in the pain index. Conclusion: Patients undergoing LVRS symptomatically benefit beyond the improvements seen with pulmonary rehabilitation alone. One month following surgery, patient functioning, quality of life and functional status trend towards worsening, followed by significant improvements at 3 and 6 months. Clinical Implications: Evaluations of improvement following LVRS should be controlled by comparison to improvement with pulmonary rehabilitation alone and must take into account the time course of improvement following surgery.

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