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Results of bilateral LVRS compared to medical therapy in patients with severe emphysema.

Patients	90-day mortality		P-value	Total mortality		Risk ratio*	P-value
Patients	LVRS	Medical therapy	P-value	LVRS	Medical therapy	Risk ratio*	P-value
Group A	20/70 (28.6)	0/70 (0)	<0.001	42/70	30/70	1.82	0.06
Group B	4/139 (2.9)	5/151 (3.3)	1.00	26/139	51/151	0.47	0.005
Group C	6/206 (2.9)	2/213 (0.9)	0.17	34/206	39/213	0.98	0.7
Group D	7/84 (8.3)	0/65 (0)	0.02	28/84	26/65	0.81	0.49
Group E	11/109 (10.1)	1/111 (0.9)	0.003	27/109	14/111	2.06	0.02
Patients	Improvement in exercise capacity^¶				Improvement in health-related quality of life^Δ
Patients	LVRS	Medical therapy	Odds ratio	P-value	LVRS	Medical therapy	Odds ratio	P-value
Group A	4/58 (7)	1/48 (2)	3.48	0.37	6/58 (10)	0/48 (0)	---	0.03
Group B	25/84 (30)	0/92 (0)	---	<0.001	40/84 (48)	9/92 (10)	8.38	<0.001
Group C	17/115 (15)	4/138 (3)	5.81	0.001	47/115 (41)	15/138 (11)	5.67	<0.001
Group D	6/49 (12)	3/41 (7)	1.77	0.5	18/49 (37)	3/41 (7)	7.35	0.001
Group E	2/65 (3)	2/59 (3)	0.9	1	10/65 (15)	7/59 (12)	1.35	0.61

Groups A-E are defined in the text.
Values in parentheses indicate percentage.

LVRS: lung volume reduction surgery.
* Risk ratio for total mortality in surgically versus medically treated patients during a mean follow-up of 29.2 months.
¶ Increase in the maximal workload of more than 10W from the patient's postrehabilitation base-line value (24 months after randomization).
Δ Improvement in the health-related quality of life was defined as a decrease in the score on the St. George's Respiratory Questionnaire of more than 8 points (on a 100-point scale) from the patient's postrehabilitation baseline score (24 months after randomization).

Adapted with permission from: Martinez FJ, Chang A. Surgical therapy for chronic obstructive pulmonary disease. Semin Respir Crit Care Med 2005; 26:167. Copyright © 2005 Thieme Medical Publishers, Inc.

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