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评估体力功能表现对预测恶性胸膜间皮瘤肺保护手术后患者结局的影响。

Examining the impact of physical function performance in predicting patient outcomes after lung-sparing surgery for malignant pleural mesothelioma.

机构信息

Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine, Baltimore, MD, USA.

Division of Thoracic Surgery, University of Maryland School of Medicine, Baltimore, MD, USA.

出版信息

Disabil Rehabil. 2022 Nov;44(22):6676-6683. doi: 10.1080/09638288.2021.1970256. Epub 2021 Aug 29.

Abstract

PURPOSE

The purpose of this study was to examine the impact of physical function performance and pulmonary function on patient outcomes after lung-sparing surgery for malignant pleural mesothelioma (MPM).

MATERIALS AND METHODS

A retrospective review of 54 patients with MPM from 2015 to 2020 was performed. The primary objective was to assess whether physical function, as measured by the Eastern Cooperative Oncology Group Performance Status (ECOG), and pulmonary function tests were predictive of postoperative patient outcomes (ventilator days, chest tube days, hospital length of stay). A secondary objective was to explore demographic and preoperative variables that best predict postoperative physical function and patient outcomes.

RESULTS

Data include 54 patients who underwent extended pleurectomy-decortication. Preoperative ECOG was a significant predictor of postoperative patient outcomes while preoperative lung function lacked predictive ability. Preoperative ECOG was also predictive of preoperative lung function. Age on the day of surgery was the best predictor of postoperative physical function, which was significantly reduced postoperatively.

CONCLUSIONS

Preoperative physical function performance was a significant predictor of postoperative outcomes. The results of our study highlight the importance of physical function in patients with MPM and support the need for early rehabilitation and further research to determine optimal rehabilitation interventions.IMPLICATIONS FOR REHABILITATIONPreoperative physical function can predict outcomes after lung-sparing surgery for malignant pleural mesothelioma (MPM).Physical function in patients with MPM should be carefully examined.To accurately reflect patients' abilities, patient assessment should include both patient-reported outcomes and performance-based measures.Patients with MPM should receive rehabilitation early after diagnosis and throughout the continuum of care.

摘要

目的

本研究旨在探讨体力功能表现和肺功能对恶性胸膜间皮瘤(MPM)患者肺保留手术后结局的影响。

材料与方法

对 2015 年至 2020 年间的 54 例 MPM 患者进行回顾性研究。主要目的是评估体力功能(Eastern Cooperative Oncology Group 体力状态评分[ECOG])和肺功能测试是否可预测术后患者结局(呼吸机使用天数、胸腔引流管留置天数、住院时间)。次要目的是探讨预测术后体力功能和患者结局的最佳人口统计学和术前变量。

结果

数据包括 54 例行扩大性胸膜剥脱术的患者。术前 ECOG 是术后患者结局的显著预测因素,而术前肺功能缺乏预测能力。术前 ECOG 还可预测术前肺功能。手术当天的年龄是术后体力功能的最佳预测因素,术后体力功能显著降低。

结论

术前体力功能表现是术后结局的显著预测因素。我们的研究结果强调了体力功能在 MPM 患者中的重要性,并支持需要早期康复以及进一步研究来确定最佳康复干预措施。

康复意义

术前体力功能可预测恶性胸膜间皮瘤(MPM)患者肺保留手术后的结局。MPM 患者的体力功能应仔细检查。为了准确反映患者的能力,患者评估应同时包括患者报告的结局和基于表现的测量。MPM 患者应在诊断后及早开始康复治疗,并贯穿整个治疗过程。

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