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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...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Dove
2020
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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. |
format | Online Article Text |
id | pubmed-7520117 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Dove |
record_format | MEDLINE/PubMed |
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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