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Comprehensive Pulmonary Rehabilitation is an Effective Way for Better Postoperative Outcomes in Surgical Lung Cancer Patients with Risk Factors: A Propensity Score-Matched Retrospective Cohort Study

BACKGROUND: To investigate the effectiveness and cost minimization of comprehensive pulmonary rehabilitation (CPR) in lung cancer patients who underwent surgery. PATIENTS AND METHODS: A retrospective observational study based on medical records was conducted, with 2410 lung cancer patients who under...

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Autores principales: Zhou, Kun, Lai, Yutian, Wang, Yan, Sun, Xin, Mo, Chunmei, Wang, Jiao, Wu, Yanming, Li, Jue, Chang, Shuai, Che, Guowei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7520117/
https://www.ncbi.nlm.nih.gov/pubmed/33061586
http://dx.doi.org/10.2147/CMAR.S267322
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author Zhou, Kun
Lai, Yutian
Wang, Yan
Sun, Xin
Mo, Chunmei
Wang, Jiao
Wu, Yanming
Li, Jue
Chang, Shuai
Che, Guowei
author_facet Zhou, Kun
Lai, Yutian
Wang, Yan
Sun, Xin
Mo, Chunmei
Wang, Jiao
Wu, Yanming
Li, Jue
Chang, Shuai
Che, Guowei
author_sort Zhou, Kun
collection PubMed
description BACKGROUND: To investigate the effectiveness and cost minimization of comprehensive pulmonary rehabilitation (CPR) in lung cancer patients who underwent surgery. PATIENTS AND METHODS: A retrospective observational study based on medical records was conducted, with 2410 lung cancer patients who underwent an operation with/without CPR during the peri-operative period. Variables including clinical characteristics, length of stay (LOS), postoperative pulmonary complications (PPCs), and hospitalization expenses were compared between the intervention group (IG) and control group (CG). The CPR regimen consists of inspiratory muscle training (IMT), aerobic endurance training, and pharmacotherapy. RESULTS: Propensity score matching analysis was performed between two groups, and the ratio of matched patients was 1:4. Finally, 205 cases of IG and 820 cases of CG in the matched cohort of our study were identified. The length of postoperative hospital stay [median: 5 interquartile (4–7) vs 7 (4–8) days, P < 0.001] and drug expenses [7146 (5411–8987) vs 8253 (6048–11,483) ¥, P < 0.001] in the IG were lower compared with the CG. Additionally, the overall incidence of PPCs in the IG was reduced compared with the CG (26.8% vs 36.7%, P = 0.008), including pneumonia (10.7% vs 16.8%, P = 0.035) and atelectasis (8.8% vs 14.0%, P = 0.046). Multivariable analysis showed that CPR intervention (OR = 0.655, 95% CI: 0.430–0.865, P = 0.006), age ≥70 yr (OR = 1.919, 95% CI: 1.342–2.744, P < 0.001), smoking (OR = 2.048, 95% CI: 1.552–2.704, P < 0.001) and COPD (OR = 1.158, 95% CI: 1.160–2.152, P = 0.004) were related to PPCs. CONCLUSION: The retrospective cohort study revealed a lower PPC rate and the shorter postoperative length of stay in the patients receiving CPR, demonstrating the clinical value of CRP as an effective strategy for surgical lung cancer patients with risk factors.
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spelling pubmed-75201172020-10-14 Comprehensive Pulmonary Rehabilitation is an Effective Way for Better Postoperative Outcomes in Surgical Lung Cancer Patients with Risk Factors: A Propensity Score-Matched Retrospective Cohort Study Zhou, Kun Lai, Yutian Wang, Yan Sun, Xin Mo, Chunmei Wang, Jiao Wu, Yanming Li, Jue Chang, Shuai Che, Guowei Cancer Manag Res Original Research BACKGROUND: To investigate the effectiveness and cost minimization of comprehensive pulmonary rehabilitation (CPR) in lung cancer patients who underwent surgery. PATIENTS AND METHODS: A retrospective observational study based on medical records was conducted, with 2410 lung cancer patients who underwent an operation with/without CPR during the peri-operative period. Variables including clinical characteristics, length of stay (LOS), postoperative pulmonary complications (PPCs), and hospitalization expenses were compared between the intervention group (IG) and control group (CG). The CPR regimen consists of inspiratory muscle training (IMT), aerobic endurance training, and pharmacotherapy. RESULTS: Propensity score matching analysis was performed between two groups, and the ratio of matched patients was 1:4. Finally, 205 cases of IG and 820 cases of CG in the matched cohort of our study were identified. The length of postoperative hospital stay [median: 5 interquartile (4–7) vs 7 (4–8) days, P < 0.001] and drug expenses [7146 (5411–8987) vs 8253 (6048–11,483) ¥, P < 0.001] in the IG were lower compared with the CG. Additionally, the overall incidence of PPCs in the IG was reduced compared with the CG (26.8% vs 36.7%, P = 0.008), including pneumonia (10.7% vs 16.8%, P = 0.035) and atelectasis (8.8% vs 14.0%, P = 0.046). Multivariable analysis showed that CPR intervention (OR = 0.655, 95% CI: 0.430–0.865, P = 0.006), age ≥70 yr (OR = 1.919, 95% CI: 1.342–2.744, P < 0.001), smoking (OR = 2.048, 95% CI: 1.552–2.704, P < 0.001) and COPD (OR = 1.158, 95% CI: 1.160–2.152, P = 0.004) were related to PPCs. CONCLUSION: The retrospective cohort study revealed a lower PPC rate and the shorter postoperative length of stay in the patients receiving CPR, demonstrating the clinical value of CRP as an effective strategy for surgical lung cancer patients with risk factors. Dove 2020-09-23 /pmc/articles/PMC7520117/ /pubmed/33061586 http://dx.doi.org/10.2147/CMAR.S267322 Text en © 2020 Zhou et al. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Zhou, Kun
Lai, Yutian
Wang, Yan
Sun, Xin
Mo, Chunmei
Wang, Jiao
Wu, Yanming
Li, Jue
Chang, Shuai
Che, Guowei
Comprehensive Pulmonary Rehabilitation is an Effective Way for Better Postoperative Outcomes in Surgical Lung Cancer Patients with Risk Factors: A Propensity Score-Matched Retrospective Cohort Study
title Comprehensive Pulmonary Rehabilitation is an Effective Way for Better Postoperative Outcomes in Surgical Lung Cancer Patients with Risk Factors: A Propensity Score-Matched Retrospective Cohort Study
title_full Comprehensive Pulmonary Rehabilitation is an Effective Way for Better Postoperative Outcomes in Surgical Lung Cancer Patients with Risk Factors: A Propensity Score-Matched Retrospective Cohort Study
title_fullStr Comprehensive Pulmonary Rehabilitation is an Effective Way for Better Postoperative Outcomes in Surgical Lung Cancer Patients with Risk Factors: A Propensity Score-Matched Retrospective Cohort Study
title_full_unstemmed Comprehensive Pulmonary Rehabilitation is an Effective Way for Better Postoperative Outcomes in Surgical Lung Cancer Patients with Risk Factors: A Propensity Score-Matched Retrospective Cohort Study
title_short Comprehensive Pulmonary Rehabilitation is an Effective Way for Better Postoperative Outcomes in Surgical Lung Cancer Patients with Risk Factors: A Propensity Score-Matched Retrospective Cohort Study
title_sort comprehensive pulmonary rehabilitation is an effective way for better postoperative outcomes in surgical lung cancer patients with risk factors: a propensity score-matched retrospective cohort study
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7520117/
https://www.ncbi.nlm.nih.gov/pubmed/33061586
http://dx.doi.org/10.2147/CMAR.S267322
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