Published online Sep 9, 2021. doi: 10.5492/wjccm.v10.i5.232
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
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 (P < 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.
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.