Cost-Effectiveness of Lung Volume Reduction Surgery
Cost-Effectiveness of Lung Volume Reduction Surgery
Lung volume reduction surgery (LVRS) has been advanced as a therapy to significantly improve
 quality of life in patients with COPD, but to date no controlled studies have evaluated the
 impact of LVRS.
Background:

 Lung volume reduction surgery (LVRS) has been advanced as a therapy to significantly improve
 quality of life in patients with COPD, but to date no controlled studies have evaluated the
 impact of LVRS.

 Objectives:

 Evaluate cost-effectiveness of LVRS compared to current therapy for COPD.

 Methods:

 This is a case control study in which veterans undergoing LVRS at VA Puget Sound Health Care
 System (VAPSHCS) are compared to patients with a similar severity of disease at Boise VAMC
 who are not undergoing LVRS. Changes in health related quality of life are being evaluated
 using three instruments: the SF-36, the St. George�s Respiratory Questionnaire, and the
 Quality of Well-Being Scale, the latter to calculate utility associated with different health
 states. Costs will be determined using utilization data on outpatient visits, medications,
 oxygen use, inpatient days, radiology tests, laboratory tests, and emergency room visits are
 being collected for the twelve months before and after surgery. Costs will be calculated
 according to VA and community standards.

 Status:

 Complete.
Inclusion Criteria:

 Severe COPD as defined by FEV1 of 20-30% predicted; marked hyperinflation with a residual
 volume of >165% predicted; 6-min walk greater than 600 ft; abstinence from cigarette
 smoking for 3-mths; absence of co-morbid illnesses that would significantly increase
 surgical risk, such as severe coronary artery disease

 Exclusion Criteria: