Chronic obstructive pulmonary disease (COPD) is characterized by progressive airflow limitation leading to disability. Patients with severe COPD suffer from dyspnea, which can subsequently cause a difficulty in performing routine activities of daily living and affect their quality of life (QOL). Lung volume reduction surgery (LVRS) has been reported to be an effective treatment modality for selected patients with advanced COPD to improve pulmonary function, lung mechanics, exercise tolerance, and dyspnea. However, the long-term effects of LVRS on QOL and psychological states such as anxiety and depression have not been fully elucidated. We evaluated QOL and psychological state before and after LVRS in patients with severe COPD for 5 years.
Eleven patients with severe COPD (Age: 66.1±5.9, VC: 2.3±0.7L, FEV1: 0.75±0.21L, RV:4.5±1.0L) who underwent LVRS were studied. QOL was assessed by Sickness Impact Profile (SIP). Psychological states (anxiety, depression) were measured by using the State Trait Anxiety (STAI) and the Self-Rating Questionnaire for Depression (SRQ-D). Serial measurements of QOL and psychological state were done before and 3, 12, 24, 36 and 60 months after LVRS.
The best scores in SIP were obtained at 36 months after LVRS. Especially, physical-SIP scores at 12, 24, 36 months reached to normal range. However, psychosocial-SIP score at 60 months was worse than pre-LVRS. As for psychological state scores, STAI scores did not show significant changes during 36 months, and indicated in the range of high anxiety at 60 months after LVRS. The SRQ-D scores have been in the suspected level of depression for 60 months.
It is difficult to maintain the beneficial effect of LVRS on psychosocial QOL and psychological states up to 5 years.
It is important to evaluate not only physiological functions but also psychological changes, when the total outcome should be assessed to determine the long-term benefit of LVRS.
Yoko Goto, None.