Intensive rehabilitation as an independent determinant of better outcome in patients with lung tumors treated by thoracic surgery
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Submission date: 2015-06-24
Final revision date: 2015-08-31
Acceptance date: 2015-09-17
Online publication date: 2016-06-20
Publication date: 2017-10-30
Arch Med Sci 2017;13(6):1442–1448
Introduction: The frequency of postoperative complications after thoracic surgery remains high. Rehabilitation may become a procedure characterized by a high cost-effectiveness ratio. The aim of the study was to determine the independent importance of intensive rehabilitation in patients with lung tumors treated by thoracic surgery.
Material and methods: The prospective observational study included two groups of patients: 187 patients treated according to the historical scheme including thoracic surgery without specific exercises improving cardio-pulmonary capacity, and 215 patients treated in agreement with the innovative algorithm of perioperative intensive physiotherapy until discharge from hospital. The evaluated clinical endpoints comprised bronchoscopy for pulmonary toilet and all other possible postoperative complications.
Results: The use of intensive physiotherapy significantly shortened the duration of hospitalization through reducing the frequencies of different postoperative complications. The specific clinical benefit was associated with a significantly lower rate of bronchoscopy performance for pulmonary toilet (16% vs. 5.6%, p = 0.0006). Multivariate regression analyses revealed intensive physiotherapy as a significant independent predictor for all postoperative complications (OR = 0.57; 95% CI: 0.323–0.988; p = 0.045) and need to perform bronchoscopy for pulmonary toilet (OR = 0.24; 95% CI: 0.11–0.51; p = 0.0002).
Conclusions: The study showed the strong independent positive effect of intensive rehabilitation in patients with lung tumors treated by thoracic surgery.