Lung Cancer, Postoperative Pulmonary Complications
Conditions
Keywords
pulmonary physiotherapy, pulmonary rehabilitation, lung cancer, early rehabilitation, thoracic surgery, lung cancer surgery, age-related outcomes
Brief summary
This ambispective observational cohort study aims to evaluate age-related differences in clinical outcomes among patients undergoing lung cancer surgery who received a structured comprehensive in-patient physiotherapy (CIPT) program as part of standard postoperative care. The CIPT program includes patient education, chest physiotherapy, breathing exercises, airway clearance techniques, early mobilization, postural exercises, and upper- and lower-extremity range-of-motion exercises during the postoperative hospital stay. The primary outcome is hospital length of stay. Secondary outcomes include clinical parameters (blood pressure, resting heart rate, oxygen saturation, and respiratory rate), symptom-related outcomes (dyspnea, fatigue, and incisional pain), and inflammatory biomarkers (C-reactive protein, neutrophil-to-lymphocyte ratio, and albumin). Outcomes are analyzed according to predefined age groups (45-64 years and 65-90 years) to evaluate potential age-related differences.
Detailed description
This ambispective observational cohort study evaluates age-related differences in clinical outcomes among patients undergoing lung cancer surgery who received a structured comprehensive in-patient physiotherapy (CIPT) program as part of standard postoperative care. Patients aged 45-90 years were included and classified into two predefined age groups: middle-aged (45-64 years) and older (65-90 years). The CIPT program was initiated on the first day after transfer from the intensive care unit to the thoracic surgery ward and continued until hospital discharge. The program included patient education, breathing exercises, incentive spirometry, airway clearance techniques, early mobilization, postural exercises, and upper- and lower-extremity range-of-motion exercises. One session per day was supervised by a physiotherapist, with additional sessions performed independently by the patient or with caregiver assistance during hospitalization. The primary outcome was hospital length of stay. Secondary outcomes included clinical parameters (blood pressure, resting heart rate, oxygen saturation, and respiratory rate), symptom-related outcomes (dyspnea, fatigue, and incisional pain), and inflammatory biomarkers (C-reactive protein \[CRP\], neutrophil-to-lymphocyte ratio \[NLR\], and albumin). Outcomes were assessed during the postoperative inpatient period and compared between the predefined age groups. No randomization or non-intervention control group was included, as all participants received the same structured CIPT program as part of standard postoperative care.
Interventions
BEHAVIORALComprehensive In-Patient Physiotherapy (CIPT) Program
The comprehensive in-patient physiotherapy (CIPT) program was provided as part of standard postoperative care following lung cancer surgery. The program included patient education, breathing exercises, incentive spirometry, airway clearance techniques, early mobilization, postural exercises, and upper- and lower-extremity range-of-motion exercises. It was initiated on the first day after transfer to the thoracic surgery ward and continued until hospital discharge. One session per day was supervised by a physiotherapist, with two additional sessions performed independently by the patient or with caregiver assistance
Sponsors
Bezmialem Vakif University
Study design
Observational model
COHORT
Time perspective
OTHER
Eligibility
Sex/Gender
ALL
Age
45 Years to 90 Years
Healthy volunteers
No
Inclusion criteria
* Patients aged 45 to 90 years * Undergoing lung cancer surgery (lobectomy, segmentectomy, or pneumonectomy) * Medically stable in the early postoperative period * Able to participate in a structured pulmonary physiotherapy program * Provided written informed consent
Exclusion criteria
* Hemodynamic instability preventing mobilization * Severe cognitive impairment limiting cooperation * Neurological or orthopedic conditions restricting mobilization * Requirement for prolonged mechanical ventilation * Presence of another active malignancy * Any medical contraindication to physiotherapy as determined by the attending physician
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Length of Hospital Stay | Postoperative period, from ward admission after surgery until hospital discharge (maximum 30 postoperative days) | Length of hospital stay is defined as the number of days from postoperative admission to the ward until hospital discharge following lung cancer surgery. |
| C-reactive protein (CRP) | Postoperative Day 1 and at hospital discharge (up to 30 days after surgery) | Serum CRP levels (mg/L) will be measured to evaluate postoperative systemic inflammatory response. |
| Peripheral Oxygen Saturation (SpO₂) | Postoperative Day 1 and at hospital discharge (up to 30 days after surgery) | Peripheral oxygen saturation (%) will be measured using pulse oximetry to assess postoperative oxygenation status. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Neutrophil-to-Lymphocyte Ratio (NLR) | Postoperative Day 1 and at hospital discharge (up to 30 days after surgery) | NLR will be calculated from complete blood count parameters to assess systemic inflammatory status. |
| Serum Albumin | Postoperative Day 1 and at hospital discharge (up to 30 days after surgery) | Serum albumin levels (g/dL) will be measured to assess nutritional status. |
| Systolic Blood Pressure | Postoperative Day 1 and at hospital discharge (up to 30 days after surgery) | Systolic blood pressure (mmHg) will be recorded to assess postoperative hemodynamic response. |
| Diastolic Blood Pressure | Postoperative Day 1 and at hospital discharge (up to 30 days after surgery) | Diastolic blood pressure (mmHg) will be recorded to assess postoperative hemodynamic response. |
| Heart Rate | Postoperative Day 1 and at hospital discharge (up to 30 days after surgery) | Heart rate (beats per minute) will be measured to evaluate cardiovascular response during the postoperative period. |
| Dyspnea Severity | Postoperative Day 1 and at hospital discharge (up to 30 days after surgery) | Dyspnea severity will be assessed using the Modified Borg Dyspnea Scale (0-10), where 0 indicates "no breathlessness" and 10 indicates "maximal breathlessness." |
| Fatigue Severity | Postoperative Day 1 and at hospital discharge (up to 30 days after surgery) | Fatigue will be assessed using the Borg Rating of Perceived Exertion (0-10), where higher scores indicate greater perceived fatigue. |
| Incisional Pain Intensity | Postoperative Day 1 and at hospital discharge (up to 30 days after surgery) | Incisional pain will be evaluated using the Numeric Rating Scale (NRS, 0-10), where 0 represents "no pain" and 10 represents "worst imaginable pain." |
Countries
Turkey (Türkiye)
Contacts
PRINCIPAL_INVESTIGATORAyşe Sena Manzak Dursun, Assistant Professor
Bezmialem Vakif University
Outcome results
None listed