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Examining the impact of physical function performance in predicting patient outcomes after lung-sparing surgery for
Simon Ho1, Melissa Culligan2,3, Joseph Friedberg2,3
1Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine, Baltimore, MD, USA.
Purpose:
The purpose of this study was to examine the impact of physical function performance and pulmonary function on patient outcomes after lung-sparing surgery for malignant pleural mesothelioma (MPM).
Materials And Methods:
A retrospective review of 54 patients with MPM from 2015 to 2020 was performed. The primary objective was to assess whether physical function, as measured by the Eastern Cooperative Oncology Group Performance Status (ECOG), and pulmonary function tests were predictive of postoperative patient outcomes (ventilator days, chest tube days, hospital length of stay). A secondary objective was to explore demographic and preoperative variables that best predict postoperative physical function and patient outcomes.
Results:
Data include 54 patients who underwent extended pleurectomy-decortication. Preoperative ECOG was a significant predictor of postoperative patient outcomes while preoperative lung function lacked predictive ability. Preoperative ECOG was also predictive of preoperative lung function. Age on the day of surgery was the best predictor of postoperative physical function, which was significantly reduced postoperatively.
Conclusions:
Preoperative physical function performance was a significant predictor of postoperative outcomes. The results of our study highlight the importance of physical function in patients with MPM and support the need for early rehabilitation and further research to determine optimal rehabilitation interventions.IMPLICATIONS FOR REHABILITATIONPreoperative physical function can predict outcomes after lung-sparing surgery for malignant pleural mesothelioma (MPM).Physical function in patients with MPM should be carefully examined.To accurately reflect patients' abilities, patient assessment should include both patient-reported outcomes and performance-based measures.Patients with MPM should receive rehabilitation early after diagnosis and throughout the continuum of care.
Insights
Preoperative physical function, not lung function, significantly predicts patient outcomes after lung-sparing surgery for malignant pleural mesothelioma (MPM). Early rehabilitation is crucial for these patients.
Area of Science:
- Thoracic Surgery
- Oncology
- Rehabilitation Medicine
Background:
- Malignant pleural mesothelioma (MPM) is a rare and aggressive cancer.
- Lung-sparing surgery offers a treatment option, but patient outcomes vary.
- Predictors of postoperative outcomes require further investigation.
Purpose of the Study:
- To evaluate the impact of physical and pulmonary function on patient outcomes post-lung-sparing surgery for MPM.
- To identify preoperative variables that predict postoperative physical function and outcomes.
Main Methods:
- Retrospective review of 54 MPM patients undergoing extended pleurectomy-decortication (2015-2020).
- Assessed Eastern Cooperative Oncology Group Performance Status (ECOG) and pulmonary function tests.
- Analyzed correlations between preoperative function and postoperative outcomes (ventilator days, chest tube days, hospital stay).
Main Results:
- Preoperative physical function (ECOG) significantly predicted postoperative outcomes.
- Preoperative pulmonary function did not predict postoperative outcomes.
- Age predicted postoperative physical function, which declined significantly after surgery.
Conclusions:
- Preoperative physical function is a key predictor of outcomes in MPM patients undergoing lung-sparing surgery.
- Emphasizes the need for careful assessment of physical function and early rehabilitation interventions.
- Rehabilitation should be integrated throughout the patient's care continuum.
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