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1 Division of Thoracic Surgery, and 2 Division of Internal Medicine, Tor Vergata University, Rome, Italy
CORRESPONDENCE: T.C. Mineo, Thoracic Surgery, Tor Vergata University, Policlinico Tor Vergata, Via Oxford 81, Rome, 00133, Italy. Fax: 39 0620902881. E-mail: ambrogi@med.uniroma2.it
Keywords: emphysema, lung function, lung volume reduction surgery, quality of life
Received: March 6, 2003
Accepted October 19, 2003
This study has been carried out within the Research Fellowship Programme "Dottorato di Ricerca in Tecnologie e Terapie avanzate in Chirurgia", awarded by Tor Vergata University. This research was supported by the MURST COFIN 2001 prot.2001061191-001 and partially by CNR single project 2002 CNR CU0100935CT26.
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.
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