Hiroshi Saito1, Atsushi Shiraishi2, Hiroaki Nomori3, Hiroki Matsui4,5, Kazuki Yoshida6, Yuya Matsue7,8, Tomoko Fujii9,10, Kennosuke Kawama11. 1. Departments of Rehabilitation, Kameda Medical Center, Chiba, Japan. 2. Emergency and Trauma Center, Kameda Medical Center, Chiba, Japan. 3. Department of Thoracic Surgery, Kashiwa Kousei General Hospital, 617 Shikoda, Kashiwa city, Chiba, 277-0862, Japan. hnomori@qk9.so-net.ne.jp. 4. Department of Clinical Epidemiology and Health Economics, School of Public Health, University of Tokyo, Tokyo, Japan. 5. Clinical Research Support Division, Kameda Institute for Health Science, Kameda College of Health Sciences, Kamogawa, Japan. 6. Division of Rheumatology, Immunology and Allergy, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA. 7. Department of Cardiovascular Medicine, Juntendo University, Tokyo, Japan. 8. Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan. 9. Department of Epidemiology and Preventive Service, Kyoto University Graduate School of Medicine, Kyoto, Japan. 10. Australian and New Zealand Intensive Care Research Centre, Monash University School of Public Health, Melbourne, Australia. 11. Faculty of Human Science, University of Tsukuba, Tokyo, Japan.
Abstract
PURPOSE: The aim was to investigate the relationship of age for recovery of six-minute walking distance (6MWD), pulmonary function, and health-related quality of life (HRQOL) after lung cancer surgery. METHODS: Primary outcome was the 6MWD recovery until 6 months after surgery. Secondary outcome was the recoveries of forced expiratory volume in 1 s (FEV1) and HRQOL until 6 months after surgery. Linear mixed-effects model was used to estimate the association of age to the outcomes. RESULTS: A total of 311 lung cancer patients were included. All the 6MWD, FEV1, and HRQOL decreased after surgery (- 32 m, - 0.39L, and - 2 scores, respectively, p = 0.027-p < 0.001). While 6MWD increased every month after surgery (5 m/month, 95% confidence interval (CI); 4-7, p < 0.001), the recovery decreased, as the age increased 1 standard deviation (SD) (i.e., 9 years) (- 2 m/month; 95% CI - 3 to - 1, p < 0.001). While FEV1 increased every month after surgery (0.03 L/month; 95% CI 0.02-0.03, p < 0.001), the recovery increased, as the age increased by 1 SD (0.01 L/month; 95% CI 0.00-0.01, p = 0.003), which was opposite to the 6MWD recovery. While the postoperative HRQOL recovered every month (2 score/month; 95% CI 1-2, p < 0.001), there was no significant association between the recovery and age (0 score/month; 95% CI - 1 to 0, p = 0.5). CONCLUSIONS: The 6MWD recovery delayed in elderly patients, which was not related to their FEV1-and HRQOL recoveries. Postoperative walking training would be important for the elderly lung cancer patients.
PURPOSE: The aim was to investigate the relationship of age for recovery of six-minute walking distance (6MWD), pulmonary function, and health-related quality of life (HRQOL) after lung cancer surgery. METHODS: Primary outcome was the 6MWD recovery until 6 months after surgery. Secondary outcome was the recoveries of forced expiratory volume in 1 s (FEV1) and HRQOL until 6 months after surgery. Linear mixed-effects model was used to estimate the association of age to the outcomes. RESULTS: A total of 311 lung cancerpatients were included. All the 6MWD, FEV1, and HRQOL decreased after surgery (- 32 m, - 0.39L, and - 2 scores, respectively, p = 0.027-p < 0.001). While 6MWD increased every month after surgery (5 m/month, 95% confidence interval (CI); 4-7, p < 0.001), the recovery decreased, as the age increased 1 standard deviation (SD) (i.e., 9 years) (- 2 m/month; 95% CI - 3 to - 1, p < 0.001). While FEV1 increased every month after surgery (0.03 L/month; 95% CI 0.02-0.03, p < 0.001), the recovery increased, as the age increased by 1 SD (0.01 L/month; 95% CI 0.00-0.01, p = 0.003), which was opposite to the 6MWD recovery. While the postoperative HRQOL recovered every month (2 score/month; 95% CI 1-2, p < 0.001), there was no significant association between the recovery and age (0 score/month; 95% CI - 1 to 0, p = 0.5). CONCLUSIONS: The 6MWD recovery delayed in elderly patients, which was not related to their FEV1-and HRQOL recoveries. Postoperative walking training would be important for the elderly lung cancerpatients.
Entities:
Keywords:
Age; Lung cancer; Recovery; Six-minute walking distance; Surgery
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