Study objectives: To evaluate changes in health-related quality of life (HRQL) as assessed by the Medical Outcomes Study Short Form 36-item questionnaire (SF-36) after pulmonary rehabilitation and lung volume reduction surgery (LVRS).
Design: Prospective cohort study.
Patients: Nineteen patients with severe emphysema who underwent pulmonary rehabilitation in preparation for LVRS.
Interventions: Pulmonary rehabilitation followed by bilateral sequential LVRS.
Measurements and results: HRQL assessed by the SF-36 was measured at baseline, after pulmonary rehabilitation, and 6 months after LVRS. One-way analysis of variance with repeated measures demonstrated no significant change from baseline in any of the eight domains after pulmonary rehabilitation. Scores for only one domain, vitality, improved significantly after LVRS compared with scores after pulmonary rehabilitation. However, significant improvements over baseline scores were demonstrated after combined preoperative pulmonary rehabilitation and LVRS in the domains of physical functioning, role limitations due to physical problems, social functioning, and vitality. Pulmonary rehabilitation contributed most to the overall improvements in role limitations due to physical problems, whereas LVRS contributed mainly to the overall improvements in physical functioning, social functioning, and vitality.
Conclusions: Patients with severe emphysema experience significant improvements in both physical and social health status as assessed by the SF-36 after combined pulmonary rehabilitation and LVRS. Each intervention makes unique and complementary contributions to the overall improvements in HRQL.