Comparison of lung volume reduction surgery and physical training on health status and physiologic outcomes - A randomized controlled clinical trial

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Bibtex

@article{0236abd161bd40818d70bb483511ab03,
title = "Comparison of lung volume reduction surgery and physical training on health status and physiologic outcomes - A randomized controlled clinical trial",
abstract = "Study objectives: In 1996, researchers in Sweden initiated a collaborative randomized study comparing lung volume reduction surgery (LVRS) and physical training with physical training alone. The primary end point was health status; secondary end points included survival and physiologic measurements. Design: After an initial 6-week physical training program, researchers' patients were randomized to either LVRS (surgical group [SG]) with continued training for 3 months, or to continued training alone (training group [TG]) for 1 year. Setting: All seven thoracic surgery centers in Sweden. Patients: All patients in Sweden with severe emphysema fulfilling inclusion criteria for LVRS. Interventions: Patients randomized to surgery underwent a median sternotomy, except for a few patients in whom thoracotomy or video-assisted thoracoscopy were performed. In the TG, supervised physical training continued for 1 year; in the SG, supervised physical training continued for 3 months postoperatively. Measurements and results: Fifty-three patients were included in each group. Six in-hospital deaths occurred after surgery (12{\%}), and one more death occurred during follow-up. Two deaths occurred in the TG. The difference in death rates between the groups was not statistically significant. Health status, as measured by St. George Respiratory Questionnaire (SGRQ) [total scale score mean difference at 1 year, 14.7; 95{\%} confidence interval (CI), 9.8 to 19.7] as well as by the Medical Outcomes Study Short-Form General Health Survey (physical function scale score mean difference at 1 year, 19.7; 95{\%} CI, 12.1 to 27.3) was improved from baseline in the SG compared with the TG. FEV1, residual volume, and shuttle walking test values also improved in the SG but not in the TG after 6 months and 12 months. Conclusions: In severe emphysema, LVES can improve health status in survivors but is associated with mortality risk. The effects are stable for at least I year. Physical training alone failed to achieve a similar improvement.",
keywords = "health status, emphysema, lung function, Short-Form General Health Survey, Medical Outcomes Study, St. George Respiratory Questionnaire",
author = "G Hillerdal and Claes-G{\"o}ran L{\"o}fdahl and K Strom and Skoogh, {B E} and L Jorfeldt and F Nilsson and D Forslund-Stiby and Jonas Ranstam and Erik Gyllstedt",
year = "2005",
doi = "10.1378/chest.128.5.3489",
language = "English",
volume = "128",
pages = "3489--3499",
journal = "Chest",
issn = "1931-3543",
publisher = "American College of Chest Physicians",
number = "5",

}