Predictive relationship in perioperative symptoms and step count for lung cancer patients

Lung cancer patients' recovery is hindered by persistent symptoms, but the relationship between symptoms and physical activity is not well understood.

The objective of this study is to examine changes in symptoms and physical activity among lung cancer patients and their short-term predictive relationship.

Ninety-six lung cancer patients (average age 59.70) were selected. Symptoms (pain, fatigue, distress, cough, dyspnea, and sleepiness) were monitored three times daily from preoperative to postoperative day 6 using the Ecological Momentary Assessment. Step count was continuously monitored via a smartwatch. Short-term trends in symptoms and step count were analyzed. A hierarchical linear model was used to examine the immediate and lagged correlations between symptoms and step count, with confounders controlled.

Symptoms and step counts showed fluctuation with a jagged changing trajectory. Step count decreased significantly when symptoms were worse than the individual average (P < 0.001), except for cough. Symptoms were significantly reduced when step count significantly increased (P < 0.001). Pain (β =  - 73.384, P < 0.001) had a negative predictive effect on step count at the next moment, after controlling for step count. Step count at the same time had a significant effect on alleviating pain (β =  - 0.0002, P < 0.05), fatigue (β =  - 0.0003, P < 0.05), and sleepiness (β =  - 0.0003, P < 0.001), next moment, after controlling for symptoms. There was a significant intrinsic predictive effect between symptoms and step count (P < 0.001).

Lung cancer patients experience fluctuations in symptoms and step count during the perioperative period. There is a significant relationship between symptoms and step count on the same day. Future studies could explore interventions to improve symptoms and mobility.