Physical function and health-related quality of life after surgery for nontuberculous mycobacterium pulmonary disease: a prospective cohort study

Abstract

\n Background: Nontuberculous mycobacterium pulmonary disease (NTM-PD) is a progressive condition characterized by exercise intolerance and impaired health-related quality of life (HRQOL). NTM-PD is sometimes treated with surgery in combination with medication, but little is known about the postoperative physical function and HRQOL. This study aimed to investigate the exercise capacity and HRQOL of patients with NTM-PD preoperatively and 6 months postoperatively.Methods: This prospective observational study included patients with NTM-PD and was conducted at Fukujuji Hospital. The intervention was surgical resection plus perioperative and post-discharge physical therapy. The physical function was assessed preoperatively and 6 months postoperatively using the 6-minute walk test (6MWT). HRQOL was assessed preoperatively and 6 months postoperatively using the Short-Form 36 Health Survey (SF-36) and St. George’s Respiratory Questionnaire. The postoperative HRQOL was compared between patients with and without preoperative clinical symptoms.Results: In total, 35 patients were analyzed. Preoperative clinical symptoms were present in 20 of 35 patients (57%), and the preoperatively symptomatic group had significantly lower preoperative HRQOL than the preoperatively asymptomatic group (p < 0.05). Thirty-two patients completed the 6-month follow-up. Compared with preoperatively, there were significant improvements at 6 months postoperatively in the 6MWT (p < 0.01) and HRQOL, mainly in the SF-36 mental component summary (p < 0.01). The SF-36 mental component summary in the preoperatively symptomatic group was very significantly improved from preoperatively to 6 months postoperatively (p < 0.05).Conclusions: The combination of surgical treatment and physical therapy for NTM-PD contributes to improvements in physical function and HRQOL.