Reduced exercise capacity and self-perceived health status in high-risk patients undergoing lung resection

doi:10.5492/wjccm.v10.i5.232

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World Journal of Critical Care Medicine

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World J Crit Care Med. Sep 9, 2021; 10(5): 232-243
Published online Sep 9, 2021. doi: 10.5492/wjccm.v10.i5.232

Table 1 Baseline characteristics of the groups

		Low-risk group, n = 39	High-risk group, n = 44	Control group, n = 32	F
Age in yr		52.18 (13.91)	69.91 (7.97)	48.44 (13.57)	37.171^a^,^c
Sex, % males		31.88	42.03	26.09	0.704
BMI		27.08 (5.02)	26.50 (4.56)	26.08 (4.42)	0.405
Length of hospital stay		6.56 (1.82)	6.95 (2.03)	-	0.362
Charlson index		4.10 (2.38)	4.93 (2.43)	1.38 (1.60)	22.861^b^,^c
Operation duration in min		208.79 (86.34)	208.81 (52.29)	-	0.999
Surgical procedure, %VATS		74.5	72.4	-	0.722
Spirometric parameters	FEV₁	2.71 (0.83)	1.60 (0.50)	2.88 (0.86)	18.301^a^,^c
Spirometric parameters	FVC	3.57 (1.02)	2.5 (1.05)	3.59 (0.92)	8.605^a^,^c
HADS	Anxiety	3.95 (2.71)	4.64 (2.95)	2.38 (2.94)	5.866^b^,^c
	Depression	0.92 (1.49)	4.36 (3.84)	0.31 (0.78)	28.964^a^,^b^,^c
	Total	4.87 (3.34)	9 (5.65)	2.69 (3.59)	20.253^a^,^b^,^c

Variables are expressed as mean (SD) or percentage.

^aSignificant differences between low-risk and high-risk groups.

^bSignificant differences between low-risk group and control group.

^cSignificant differences between high-risk group and control group. BMI: Body mass index; FEV₁: Forced expiratory volume in 1 s; FVC: Forced vital capacity; HADS: Hospital Anxiety and Depression Scale; VATS: Video-assisted thoracic surgery.

Table 2 Exercise capacity and self-perceived health status before lung resection

		Low-risk group, n = 35	High-risk group, n = 40	Control group, n = 32	F
Exercise capacity
FSS		19.72 (12.99)	28 (19.49)	9.00	16.469 1^a^,^b^,^c^,¹
Lower limb assessment
Hand-held dynamometry		107.24 (51.59)	112.31 (47.99)	213.01 (60.58)	43.669 1^b^,^c^,¹
5STS	Dyspnea baseline	0.41 (1.33)	0.32 (1.12)	0	1.478
	LL fatigue baseline	0.36 (1.20)	1.23 (2.38)	0	5.829 1^a^,^c^,¹
	Time	12.43 (4.49)	18.23 (14.27)	9.87 (2.66)	8.202 1^a^,^b^,^c^,¹
	Dyspnea post-test	1.03 (1.98)	0.86 (1.79)	0	4.098^b^,^c
	LL fatigue post-test	0.72 (1.57)	1.77 (2.94)	0	7.297 1^a^,^b^,^c^,¹
Upper limb assessment
Handgrip dynamometry		329.46 (93.08)	291.57 (117.29)	380 (79.31)	7.178 1^b^,^c^,¹
UULEX test	Dyspnea baseline	0.44 (1.50)	0.38 (1.03)	0	1.64^c
	UL Fatigue baseline	1.00 (1.59)	1.13 (1.82)	0	6.322 1^b^,^c^,¹
	Time	442.50 (230.69)	187.50 (201.80)	555.00 (124.75)	23.245 1^a^,^b^,^c^,¹
	Dyspnea post-test	2.19 (2.54)	0.88 (1.59)	0.25 (0.98)	7.439 1^b^,¹
	UL Fatigue post-test	6.56 (2.19)	6.38 (2.19)	5.50 (2.66)	1.283
Self-perceived health status
EQ-5D-5L VAS		86.81 (16.99)	66.23 (22.94)	94.69 (4.91)	23.147 1^a^,^c^,¹
EQ-5D-5L index		1.00	0.76 (0.43)	1.00	11.238^a^,^b^,^c

Variables are expressed as mean (SD).

^aSignificant differences between low-risk and high-risk groups.

^bSignificant differences between low-risk group and control group.

^cSignificant differences between high-risk group and control group.

¹Global P value adjusted by multiplicity. 5STS: Five sit-to-stand test; EQ-5D-5L: Euroqol 5 dimensions 5 levels; FSS: Fatigue severity scale; LL: Lower limb; UL: Upper limb; UULEX: Unsupported upper-limb exercise; VAS: Visual analogue scale.

Table 3 Exercise capacity and self-perceived health status differences at discharge among and between groups

		Low-risk group, n = 29			High-risk group, n = 36			Control group, n = 32			F
		Mean change	95%CI	P value among groups	Mean change	95%CI	P value among groups	Mean change	95%CI	P value among groups	F
Exercise capacity
FSS		-4.17 (16.76)	(-10.02, 1.67)	0.156	-8.00 (18.56)	(-14.10, -1.90)	0.012	0	-	1	21.735 1^a^,^b^,^c^,¹
Lower limb assessment
Hand-held dynamometry		7.20 (24.49)	(2.11, 16.52)	< 0.001	22.94 (31.12)	(12.41, 33.47)	< 0.001	-0.05 (0.85)	(-0.35, 0.25)	0.729	15.8 1^b^,^c^,¹
5STS test	Dyspnea baseline	-0.64 (1.45)	(-1.15, -0.12)	0.017	-1.05 (2.14)	(-1.75, -0.35)	0.004	0	-	1	4.122 1^b^,^c^,¹
	LL fatigue baseline	-0.30 (1.28)	(-0.76, 0.15)	0.186	-0.42 (1.81)	(-1.02, 0.17)	0.160	0	-	1	8.735 1^a^,^b^,^c
	Time	-3.30 (7.28)	(-5.88, -0.72)	0.014	-7.84 (11.39)	(-11.58, -4.09)	< 0.001	-0.06 (0.50)	(-0.24, 0.13)	0.531	14.818 1^a^,^b^,^c^,¹
	Dyspnea post-test	-0.91 (2.02)	(-1.63, -0.19)	0.015¹	-2.74 (2.92)	(-3.69, -1.78)	< 0.001	0	-	1	20.128 1^a^,^b^,^c^,¹
	LL fatigue post-test	-0.42 (2.00)	(-1.13, -0.28)	0.008¹	-1.74 (2.77)	(-2.65, -0.83)	< 0.001	0	-	1	23.570 1^a^,^b^,^c^,¹
Upper limb assessment
Handgrip dynamometry		34.14 (46.47)	(16.46, 51.81)	0.124	28.05 (40.84)	(14.24, 41.87)	< 0.001	15.28 (64.29)	(-7.89, 38.46)	0.188	7.663 1^b^,^c^,¹
UULEX test	Dyspnea baseline	-1.62 (2.78)	(-3.10, -0.14)	0.034¹	-2.00 (2.15)	(-3.24, -0.76)	0.004	0	-	1	11.262 1^b^,^c^,¹
	UL fatigue baseline	-0.75 (2.74)	(-2.21, 0.71)	0.292	-4.29 (3.27)	(-6.17, -2.39)	< 0.001	0	-	1	37.713 1^a^,^b^,^c^,¹
	Time	202.50 (204.20)	(93.68, 311.31)	0.002	145.70 (232.63)	(11.39, 280.03)	0.036	-3.75 (40.14)	(-18.22, 10.72)	0.601	86.717 1^a^,^b^,^c^,¹
	Dyspnea post-test	-1.87 (3.44)	(-3.71, -0.04)	0.046	-2.29 (2.05)	(-3.47, -1.10)	0.001	0	-	1	17.854 1^b^,^c^,¹
	UL fatigue post-test	0 (3.40)	(-1.81, 1.81)	1	-1.71 (2.05)	(-2.90, -0.53)	0.008	0	-	1	9.688 1^a^,^c^,¹
Self-perceived health status
EQ-5D-5L VAS		14.35 (20.48)	(3.82, 24.88)	0.011	11.10 (22.07)	(0.77, 21.43)	0.037	-0.50 (2.64)	(-1.45, 0.45)	0.292	38.091 1^a^,^b^,^c^,¹
EQ-5D-5L index		0.14 (0.35)	(0.07,0.21)	< 0.001	0.28 (0.46)	(0.11, 0.46)	0.003	0	-	1	9.686 1^a^,^c^,¹

Variables are expressed as mean (SD).

^aSignificant differences between low-risk and high-risk groups.

^bSignificant differences between low-risk group and control group.

^cSignificant differences between high-risk group and control group.

¹Global P value adjusted by multiplicity. 5STS: Five sit to stand test; CI: Confidence interval; EQ-5D-5L: Euroqol 5 dimensions 5 levels; FSS: Fatigue severity scale; LL: Lower limb; UL: Upper limb; UULEX: Unsupported upper-limb exercise; VAS: Visual analogue scale.

Table 4 Exercise capacity and self-perceived health status differences, 1 mo after discharge, among and between groups

		Low-risk group, n = 29			High-risk group, n = 36			Control group, n = 32			F
		Mean change	95%CI	P value, among groups	Mean change	95%CI	P value among groups	Mean change	95%CI	P value among groups	F
Exercise capacity
FSS		2.84 (16.33)	(-3.90, 9.58)	0.393	2.50 (14.78)	(-3.74, 8.74)	0.416	0	-	1	18.606 1^b^,^c^,¹
Lower limb assessment
Hand-held dynamometry		-15.56 (31.54)	(-32.37, 1.24)	0.067	-18.57 (27.73)	(-34.58, -2.56)	0.026	0.01 (9.61)	(-2.29, 4.64)	0.494	23.129 1^b^,^c^,¹
5STS test	Dyspnea baseline	0.69 (1.98)	(-0.00, 1.39)	0.051	0.37 (2.26)	(-0.37, 1.11)	0.321	0	-	1	4.152^c
	LL fatigue baseline	0 (2.15)	(-0.76, 0.76)	1	0.21 (1.49)	(-0.28, 0.70)	0.390	0	-	1	7.650 1^b^,^c^,¹
	Time	1.75 (8.08)	(-1.10, 4.62)	0.221	3.95 (14.58)	(-0.84, 8.74)	0.104	-0.01 (0.57)	(-0.21, 0.20)	0.931	18.333 1^a^,^b^,^c^,¹
	Dyspnea post-test	1.12 (1.87)	(0.46, 1.78)	0.002	0.68 (1.47)	(0.20, 1.17)	0.007¹	0	-	1	26.453 1^a^,^b^,^c^,¹
	LL fatigue post-test	0.39 (1.54)	(-0.15, 0.94)	0.151	0.11 (2.27)	(-0.64, 0.85)	0.777	0	-	1	47.483 1^a^,^b^,^c^,¹
Upper limb assessment
Handgrip dynamometry		3.80 (58.47)	(-28.58, 36.18)	0.805	3.21 (69.72)	(-37.04, 43.47)	0.866	-16.24 (64.27)	(-39.42, 6.93)	0.163	15.494 1^b^,^c^,¹
UULEX test	Dyspnea baseline	1.06 (3.29)	(-0.69, 2.82)	0.217	-0.60 (2.87)	(-2.66, 1.46)	0.526	0	-	1	54.082 1^a^,^b^,^c^,¹
	UL fatigue baseline	0.94 (3.02)	(-0.67, 2.55)	0.234	0 (3.27)	(-2.34, 2.34)	1	0	-	1	194.932 1^a^,^b^,^c^,¹
	Time	-225.00 (191.62)	(-327.11, -122.89)	< 0.001	-240.00 (187.62)	(-374.00, -105.00)	0.003	7.50 (80.28)	(-21.44, 36.44)	0.601	19.744 1^a^,^b^,^c^,¹
	Dyspnea post-test	2.18 (2.61)	(0.79, 3.58)	0.004	-2.40 (2.79)	(-4.40, -0.39)	0.024	0.13 (0.49)	(-0.05, 0.30)	0.161	133.723 1^a^,^b^,^c^,¹
	UL fatigue post-test	0.94 (2.32)	-0.30 (2.17)	0.127	0 (1.76)	(-1.26, 1.26)	1	-0.19 (0.90)	(-0.51, 0.14)	0.245	8.777 1^a^,^c^,¹
Self-perceived health status
EQ-5D-5L VAS		-19.58 (23.59)	(-34.57, -4.59)	0.015	-3.33 (14.03)	(-12.25, 5.58)	0.428	-2.81 (13.68)	(-7.74, 2.12)	0.254	42.089 1^a^,^c^,¹
EQ-5D-5L index		-0.07 (0.35)	(-0.15, 0.01)	0.057	-0.22 (0.65)	(-0.54, 0.99)	0.163	0	-	1	0.789

Variables are expressed as mean (SD).

^aSignificant differences between low-risk and high-risk groups.

^bSignificant differences between low-risk group and control group.

^cSignificant differences between high-risk group and control group.

Citation: 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
URL: https://www.wjgnet.com/2220-3141/full/v10/i5/232.htm
DOI: https://dx.doi.org/10.5492/wjccm.v10.i5.232