Rodríguez-Torres J, Cabrera-Martos I, López-López L, Quero-Valenzuela F, Cahalin LP, Valenza MC. Reduced exercise capacity and self-perceived health status in high-risk patients undergoing lung resection. World J Crit Care Med 2021; 10(5): 232-243 [PMID: 34616659 DOI: 10.5492/wjccm.v10.i5.232]
Corresponding Author of This Article
Marie Carmen Valenza, PhD, Full Professor, Fisioterapia, University of Granada, Avda. de la Ilustración, 60, Granada 18016, Spain. cvalenza@ugr.es
Research Domain of This Article
Critical Care Medicine
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Crit Care Med. Sep 9, 2021; 10(5): 232-243 Published online Sep 9, 2021. doi: 10.5492/wjccm.v10.i5.232
Reduced exercise capacity and self-perceived health status in high-risk patients undergoing lung resection
Janet Rodríguez-Torres, Irene Cabrera-Martos, Laura López-López, Florencio Quero-Valenzuela, Lawrence Patrick Cahalin, Marie Carmen Valenza
Janet Rodríguez-Torres, Irene Cabrera-Martos, Laura López-López, Florencio Quero-Valenzuela, Marie Carmen Valenza, Fisioterapia, University of Granada, Granada 18016, Spain
Florencio Quero-Valenzuela, Cardiothoracic Surgery Department, Virgen de las Nieves Hospital, Granada 18016, Spain
Lawrence Patrick Cahalin, Physical Therapy, University of Miami, Miami, FL 33124, United States
Author contributions: Valenza MC was the guarantor and designed the study; Cabrera-Martos I, Rodríguez-Torres J and López-López L participated in the acquisition, analysis and interpretation of the data and drafted the initial manuscript; Quero-Valenzuela F and Cahalin LP revised the article critically for important intellectual content.
Institutional review board statement: The study protocol was reviewed and approved by the University of Granada Ethics Committee.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: None of the authors presented conflict of interest.
Data sharing statement: The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to their containing information could compromise the privacy of research participants.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Marie Carmen Valenza, PhD, Full Professor, Fisioterapia, University of Granada, Avda. de la Ilustración, 60, Granada 18016, Spain. cvalenza@ugr.es
Received: December 17, 2020 Peer-review started: December 17, 2020 First decision: May 6, 2021 Revised: May 10, 2021 Accepted: July 6, 2021 Article in press: July 6, 2021 Published online: September 9, 2021 Processing time: 265 Days and 21.2 Hours
Abstract
BACKGROUND
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.
AIM
To identify the differences between high and low-risk patients in exercise capacity and self-perceived health status after hospitalization.
METHODS
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).
RESULTS
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 (P < 0.05). One month after discharge patients in the high-risk group maintained these differences compared to the other groups.
CONCLUSION
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.
Core Tip: Lung cancer is the leading cause of cancer death among men and the second among women worldwide. A revolutionary change in this approach is being witnessed with less invasive techniques. However, it is still associated with a high incidence of postoperative pulmonary complications, which could lead to a reduced exercise capacity. Patients with higher risk to develop postoperative pulmonary complications have been classified as “high-risk patients,” and they could present a lower exercise capacity and self-perceived health status.
