Rodríguez-Torres Janet, Cabrera-Martos Irene, López-López Laura, Quero-Valenzuela Florencio, Cahalin Lawrence Patrick, Valenza Marie Carmen
Fisioterapia, University of Granada, Granada 18016, Spain.
Physical Therapy, University of Miami, Miami, FL 33124, United States.
World J Crit Care Med. 2021 Sep 9;10(5):232-243. doi: 10.5492/wjccm.v10.i5.232.
Lung resection represents the main curative treatment modality of non-small cell lung cancer. Patients with high-risk to develop postoperative pulmonary complications have been classified as "high-risk patients." Characterizing this population could be important to improve their approach and rehabilitation.
To identify the differences between high and low-risk patients in exercise capacity and self-perceived health status after hospitalization.
A longitudinal observational prospective cohort study was carried out. Patients undergoing lung resection were recruited from the "Hospital Virgen de las Nieves" (Granada) and divided into two groups according to the risk profile criteria (age ≥ 70 years, forced expiratory volume in 1 s ≤ 70% predicted, carbon monoxide diffusion capacity ≤ 70% predicted or scheduled pneumonectomy). Outcomes included were exercise capacity (Fatigue Severity Scale, Unsupported Upper-Limb Exercise, handgrip dynamometry, Five Sit-to-stand test, and quadriceps hand-held dynamometry) and patient-reported outcome (Euroqol-5 dimensions 5 Levels Visual Analogue Scale).
In total, 115 participants were included in the study and divided into three groups: high-risk, low-risk and control group. At discharge high-risk patients presented a poorer exercise capacity and a worse self-perceived health status ( < 0.05). One month after discharge patients in the high-risk group maintained these differences compared to the other groups.
Our results show a poorer recovery in high-risk patients at discharge and 1 mo after surgery, with lower self-perceived health status and a poorer upper and lower limb exercise capacity. These results are important in the rehabilitation field.
肺切除术是非小细胞肺癌的主要根治性治疗方式。具有发生术后肺部并发症高风险的患者被归类为“高风险患者”。明确这一人群的特征对于改进其治疗方法和康复情况可能具有重要意义。
确定高风险和低风险患者在出院后运动能力和自我感知健康状况方面的差异。
开展了一项纵向观察性前瞻性队列研究。从“拉斯涅韦斯圣母医院”(格拉纳达)招募接受肺切除术的患者,并根据风险特征标准(年龄≥70岁、第1秒用力呼气量≤预测值的70%、一氧化碳弥散量≤预测值的70%或计划行肺切除术)分为两组。纳入的结果包括运动能力(疲劳严重程度量表、无支撑上肢运动、握力测量、五次坐立试验和股四头肌手持式测力计)和患者报告的结果(欧洲五维健康量表5级视觉模拟量表)。
该研究共纳入115名参与者,分为三组:高风险组、低风险组和对照组。出院时,高风险患者的运动能力较差,自我感知健康状况也较差(P<0.05)。出院后1个月,高风险组患者与其他组相比仍保持这些差异。
我们的结果显示,高风险患者在出院时和术后1个月恢复较差,自我感知健康状况较低,上下肢运动能力较差。这些结果在康复领域具有重要意义。