Patient-reported walking difficulty predicting the post-discharge overall function in patients with lung cancer undergoing minimally invasive surgery

Postoperative mobility of patients with lung cancer is crucial for their physical rehabilitation. This study aimed to identify severe walking difficulty by a threshold and predicting the functional recovery of patients with lung cancer undergoing minimally invasive surgery (MIS).

This prospective study enrolled patients with lung cancer who underwent MIS, divided into two cohorts. The 0-10 scale walking difficulty score was assessed regularly during hospitalization and post-discharge. Chi-square and receiver operating characteristic curve analyses guided to define the threshold, with the Timed Up and Go Test on postoperative day 2 as an anchor in cohort 1. Cohort 2 included patients assessed for walking difficulty at discharge. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 was assessed biweekly for 1 month post-discharge. Post-discharge functional status trajectories were compared based on the threshold.

Based on cohort 1, the threshold for walking difficulty was set to 4. Cohort 2 patients were categorized using the threshold: 71.26% exhibited no or mild, while 28.74% experienced severe walking difficulty upon discharge. Compliance rates for reporting walking difficulty post-discharge consistently exceeded 60%. Walking difficulty severity significantly impacted post-discharge physical function (P < 0.001), emotional function (P = 0.008), role function (P < 0.001), and quality of life (P = 0.033).

A patient-reported walking difficulty score of ≥ 4 indicates severe walking difficulty. Significant differences in post-discharge functional status were observed among patients with different walking difficulty degrees.

Continuous rehabilitation care of severe walking difficulty demonstrates significant prognostic value for post-discharge functional recovery.

gov Identifier: ChiCTR2000033016.