Lung-volume reduction surgery for pulmonary emphysema: Improvement in body mass index, airflow obstruction, dyspnea, and exercise capacity index after 1 year

David J. Lederer, Byron M. Thomashow, Mark E. Ginsburg, John H M Austin, Matthew N. Bartels, Chun K. Yip, Patricia A. Jellen, Frances L. Brogan, Steven M. Kawut, Roger A. Maxfield, Angela M. DiMango, Paul F. Simonelli, Lyall A. Gorenstein, Gregory D N Pearson, Joshua R. Sonett

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Objectives: We hypothesized that lung-volume reduction surgery for pulmonary emphysema would improve body mass index, airflow obstruction, dyspnea, and exercise capacity (BODE) index, a multidimensional predictor of survival in chronic obstructive pulmonary disease. We also aimed to identify preoperative predictors of improvement in the BODE index. Methods: In a prospective cohort study of patients undergoing lung-volume reduction surgery at our center, with the methodology of the National Emphysema Treatment Trial, we compared clinical characteristics before and 1 year after surgery with the Wilcoxon signed rank test. Changes in the BODE index were correlated with preoperative variables with the Spearman correlation coefficient. Results: Twenty-three patients with predominantly upper-lobe pulmonary emphysema underwent lung-volume reduction surgery (14 by video-assisted thoracoscopic surgery, 9 by median sternotomy). There were no postoperative or follow-up deaths. The BODE index improved from a median of 5 (interquartile range 4-5) before surgery to 3 (interquartile range 2-4) 1 year after surgery (P < .0001). Improvements were seen in the lung function and dyspnea components of the BODE index. Lower preoperative 6-minute walk distance and lower postwalk Borg fatigue scores were each associated with greater improvement in the BODE index after 1 year. Conclusion: Lung-volume reduction surgery for pulmonary emphysema improved the BODE index in patients with predominantly upper-lobe disease. Lower preoperative 6-minute walk distance correlated with greater improvement in the BODE index.

Original languageEnglish (US)
Pages (from-to)1434-1438
Number of pages5
JournalJournal of Thoracic and Cardiovascular Surgery
Volume133
Issue number6
DOIs
StatePublished - Jun 2007
Externally publishedYes

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Pulmonary Emphysema
Pneumonectomy
Dyspnea
Body Mass Index
Exercise
Video-Assisted Thoracic Surgery
Sternotomy
Emphysema
Nonparametric Statistics
Chronic Obstructive Pulmonary Disease
Fatigue
Cohort Studies
Clinical Trials
Prospective Studies
Lung
Survival

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Lung-volume reduction surgery for pulmonary emphysema : Improvement in body mass index, airflow obstruction, dyspnea, and exercise capacity index after 1 year. / Lederer, David J.; Thomashow, Byron M.; Ginsburg, Mark E.; Austin, John H M; Bartels, Matthew N.; Yip, Chun K.; Jellen, Patricia A.; Brogan, Frances L.; Kawut, Steven M.; Maxfield, Roger A.; DiMango, Angela M.; Simonelli, Paul F.; Gorenstein, Lyall A.; Pearson, Gregory D N; Sonett, Joshua R.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 133, No. 6, 06.2007, p. 1434-1438.

Research output: Contribution to journalArticle

Lederer, DJ, Thomashow, BM, Ginsburg, ME, Austin, JHM, Bartels, MN, Yip, CK, Jellen, PA, Brogan, FL, Kawut, SM, Maxfield, RA, DiMango, AM, Simonelli, PF, Gorenstein, LA, Pearson, GDN & Sonett, JR 2007, 'Lung-volume reduction surgery for pulmonary emphysema: Improvement in body mass index, airflow obstruction, dyspnea, and exercise capacity index after 1 year', Journal of Thoracic and Cardiovascular Surgery, vol. 133, no. 6, pp. 1434-1438. https://doi.org/10.1016/j.jtcvs.2006.12.062
Lederer, David J. ; Thomashow, Byron M. ; Ginsburg, Mark E. ; Austin, John H M ; Bartels, Matthew N. ; Yip, Chun K. ; Jellen, Patricia A. ; Brogan, Frances L. ; Kawut, Steven M. ; Maxfield, Roger A. ; DiMango, Angela M. ; Simonelli, Paul F. ; Gorenstein, Lyall A. ; Pearson, Gregory D N ; Sonett, Joshua R. / Lung-volume reduction surgery for pulmonary emphysema : Improvement in body mass index, airflow obstruction, dyspnea, and exercise capacity index after 1 year. In: Journal of Thoracic and Cardiovascular Surgery. 2007 ; Vol. 133, No. 6. pp. 1434-1438.
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abstract = "Objectives: We hypothesized that lung-volume reduction surgery for pulmonary emphysema would improve body mass index, airflow obstruction, dyspnea, and exercise capacity (BODE) index, a multidimensional predictor of survival in chronic obstructive pulmonary disease. We also aimed to identify preoperative predictors of improvement in the BODE index. Methods: In a prospective cohort study of patients undergoing lung-volume reduction surgery at our center, with the methodology of the National Emphysema Treatment Trial, we compared clinical characteristics before and 1 year after surgery with the Wilcoxon signed rank test. Changes in the BODE index were correlated with preoperative variables with the Spearman correlation coefficient. Results: Twenty-three patients with predominantly upper-lobe pulmonary emphysema underwent lung-volume reduction surgery (14 by video-assisted thoracoscopic surgery, 9 by median sternotomy). There were no postoperative or follow-up deaths. The BODE index improved from a median of 5 (interquartile range 4-5) before surgery to 3 (interquartile range 2-4) 1 year after surgery (P < .0001). Improvements were seen in the lung function and dyspnea components of the BODE index. Lower preoperative 6-minute walk distance and lower postwalk Borg fatigue scores were each associated with greater improvement in the BODE index after 1 year. Conclusion: Lung-volume reduction surgery for pulmonary emphysema improved the BODE index in patients with predominantly upper-lobe disease. Lower preoperative 6-minute walk distance correlated with greater improvement in the BODE index.",
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T1 - Lung-volume reduction surgery for pulmonary emphysema

T2 - Improvement in body mass index, airflow obstruction, dyspnea, and exercise capacity index after 1 year

AU - Lederer, David J.

AU - Thomashow, Byron M.

AU - Ginsburg, Mark E.

AU - Austin, John H M

AU - Bartels, Matthew N.

AU - Yip, Chun K.

AU - Jellen, Patricia A.

AU - Brogan, Frances L.

AU - Kawut, Steven M.

AU - Maxfield, Roger A.

AU - DiMango, Angela M.

AU - Simonelli, Paul F.

AU - Gorenstein, Lyall A.

AU - Pearson, Gregory D N

AU - Sonett, Joshua R.

PY - 2007/6

Y1 - 2007/6

N2 - Objectives: We hypothesized that lung-volume reduction surgery for pulmonary emphysema would improve body mass index, airflow obstruction, dyspnea, and exercise capacity (BODE) index, a multidimensional predictor of survival in chronic obstructive pulmonary disease. We also aimed to identify preoperative predictors of improvement in the BODE index. Methods: In a prospective cohort study of patients undergoing lung-volume reduction surgery at our center, with the methodology of the National Emphysema Treatment Trial, we compared clinical characteristics before and 1 year after surgery with the Wilcoxon signed rank test. Changes in the BODE index were correlated with preoperative variables with the Spearman correlation coefficient. Results: Twenty-three patients with predominantly upper-lobe pulmonary emphysema underwent lung-volume reduction surgery (14 by video-assisted thoracoscopic surgery, 9 by median sternotomy). There were no postoperative or follow-up deaths. The BODE index improved from a median of 5 (interquartile range 4-5) before surgery to 3 (interquartile range 2-4) 1 year after surgery (P < .0001). Improvements were seen in the lung function and dyspnea components of the BODE index. Lower preoperative 6-minute walk distance and lower postwalk Borg fatigue scores were each associated with greater improvement in the BODE index after 1 year. Conclusion: Lung-volume reduction surgery for pulmonary emphysema improved the BODE index in patients with predominantly upper-lobe disease. Lower preoperative 6-minute walk distance correlated with greater improvement in the BODE index.

AB - Objectives: We hypothesized that lung-volume reduction surgery for pulmonary emphysema would improve body mass index, airflow obstruction, dyspnea, and exercise capacity (BODE) index, a multidimensional predictor of survival in chronic obstructive pulmonary disease. We also aimed to identify preoperative predictors of improvement in the BODE index. Methods: In a prospective cohort study of patients undergoing lung-volume reduction surgery at our center, with the methodology of the National Emphysema Treatment Trial, we compared clinical characteristics before and 1 year after surgery with the Wilcoxon signed rank test. Changes in the BODE index were correlated with preoperative variables with the Spearman correlation coefficient. Results: Twenty-three patients with predominantly upper-lobe pulmonary emphysema underwent lung-volume reduction surgery (14 by video-assisted thoracoscopic surgery, 9 by median sternotomy). There were no postoperative or follow-up deaths. The BODE index improved from a median of 5 (interquartile range 4-5) before surgery to 3 (interquartile range 2-4) 1 year after surgery (P < .0001). Improvements were seen in the lung function and dyspnea components of the BODE index. Lower preoperative 6-minute walk distance and lower postwalk Borg fatigue scores were each associated with greater improvement in the BODE index after 1 year. Conclusion: Lung-volume reduction surgery for pulmonary emphysema improved the BODE index in patients with predominantly upper-lobe disease. Lower preoperative 6-minute walk distance correlated with greater improvement in the BODE index.

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