Comparison of lung volume reduction surgery and physical training on health status and physiologic outcomes - A randomized controlled clinical trial
(2005) In Chest 128(5). p.3489-3499- 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... (More)
- 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. (Less)
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https://lup.lub.lu.se/record/211860
- author
- Hillerdal, G ; Löfdahl, Claes-Göran LU ; Strom, K ; Skoogh, B E ; Jorfeldt, L ; Nilsson, F ; Forslund-Stiby, D ; Ranstam, Jonas LU and Gyllstedt, Erik LU
- organization
- publishing date
- 2005
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- health status, emphysema, lung function, Short-Form General Health Survey, Medical Outcomes Study, St. George Respiratory Questionnaire
- in
- Chest
- volume
- 128
- issue
- 5
- pages
- 3489 - 3499
- publisher
- American College of Chest Physicians
- external identifiers
-
- pmid:16304304
- wos:000233508400060
- scopus:28144446423
- ISSN
- 1931-3543
- DOI
- 10.1378/chest.128.5.3489
- language
- English
- LU publication?
- yes
- id
- 0236abd1-61bd-4081-8d70-bb483511ab03 (old id 211860)
- date added to LUP
- 2016-04-01 17:07:24
- date last changed
- 2022-01-29 00:33:44
@article{0236abd1-61bd-4081-8d70-bb483511ab03,
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.}},
author = {{Hillerdal, G and Löfdahl, Claes-Göran and Strom, K and Skoogh, B E and Jorfeldt, L and Nilsson, F and Forslund-Stiby, D and Ranstam, Jonas and Gyllstedt, Erik}},
issn = {{1931-3543}},
keywords = {{health status; emphysema; lung function; Short-Form General Health Survey; Medical Outcomes Study; St. George Respiratory Questionnaire}},
language = {{eng}},
number = {{5}},
pages = {{3489--3499}},
publisher = {{American College of Chest Physicians}},
series = {{Chest}},
title = {{Comparison of lung volume reduction surgery and physical training on health status and physiologic outcomes - A randomized controlled clinical trial}},
url = {{http://dx.doi.org/10.1378/chest.128.5.3489}},
doi = {{10.1378/chest.128.5.3489}},
volume = {{128}},
year = {{2005}},
}