Department of Rehabilitation, Teikyo University School of Medicine University Hospital, Mizonokuchi, Kawasaki, Japan.
Department of Rehabilitation Medicine, Teikyo University School of Medicine University Hospital, Mizonokuchi, 5-1-1 Futako, Takatsu-ku, Kawasaki, Kanagawa, 213-8507, Japan.
Support Care Cancer. 2020 May;28(5):2293-2297. doi: 10.1007/s00520-019-05061-z. Epub 2019 Aug 31.
We investigated the impact of preoperative short-term rehabilitation on activities of daily living among patients with colorectal cancer.
This retrospective cohort study utilized a hospital-based database containing Diagnosis Procedure Combination survey data from over 100 participating acute-care hospitals. We extracted data on consecutive inpatients hospitalized with stage 1 and 2 colorectal cancer. We compared characteristics and outcomes between patients who underwent short-term rehabilitation before surgery and those who did not. Primary outcomes measured were Barthel Index decline and number of complications during hospitalization.
Among of included inpatients (male, 57%; older individuals aged over 65 years, 79%; mean Barthel Index, 93.4), the number of patients who underwent preoperative rehabilitation was 760 (39.3%). Patients in the preoperative rehabilitation group were less likely to have a decline in the Barthel Index compared with the control group (5.9% vs 10.1%, P < 0.001) and after propensity score adjustment using inverse probability weighting (6.3% vs 9.8%, P = 0.024). The preoperative rehabilitation group had fewer complications during hospitalization compared with the control group (P < 0.001) and after inverse probability weighting (P = 0.001).
Our study showed that preoperative short-term rehabilitation was associated with maintenance and improvement of activities of daily living and fewer complications among patients with stage 1 and 2 colorectal cancer.
我们研究了术前短期康复对结直肠癌患者日常生活活动能力的影响。
本回顾性队列研究利用了一个基于医院的数据库,该数据库包含来自 100 多家参与急性护理医院的诊断程序组合调查数据。我们提取了连续因 1 期和 2 期结直肠癌住院的患者数据。我们比较了接受术前短期康复治疗和未接受该治疗的患者的特征和结局。主要结局指标为 Barthel 指数下降和住院期间并发症的数量。
在所纳入的住院患者中(男性占 57%;年龄超过 65 岁的老年人占 79%;平均 Barthel 指数为 93.4),接受术前康复治疗的患者有 760 例(占 39.3%)。与对照组相比,术前康复组的 Barthel 指数下降的患者比例较低(5.9%对 10.1%,P<0.001),且经逆概率加权调整后(6.3%对 9.8%,P=0.024)也是如此。与对照组相比,术前康复组患者在住院期间的并发症较少(P<0.001),且经逆概率加权调整后(P=0.001)也是如此。
我们的研究表明,术前短期康复与 1 期和 2 期结直肠癌患者的日常生活活动能力的维持和改善以及并发症的减少有关。