Reduced exercise capacity and self-perceived health status in highrisk patients undergoing lung resection

BACKGROUND Lung resection represents the main curative treatment modality of non-small cell lung cancer.Patients with high-risk to develop postoperative pulmonary complications have been classified as“high-risk patients.”Characterizing this population could be important to improve their approach and rehabilitation.AIM To identify the differences between high and low-risk patients in exercise capacity and self-perceived health status after hospitalization.METHODS A longitudinal observational prospective cohort study was carried out.Patients undergoing lung resection were recruited from the“Hospital Virgen de las Nieves”(Granada)and divided into two groups according to the risk profile criteria(age≥70 years,forced expiratory volume in 1 s≤70%predicted,carbon monoxide diffusion capacity≤70%predicted or scheduled pneumonectomy).Outcomes included were exercise capacity(Fatigue Severity Scale,Unsupported Upper-Limb Exercise,handgrip dynamometry,Five Sit-to-stand test,and quadriceps hand-held dynamometry)and patient-reported outcome(Euroqol-5 dimensions 5 Levels Visual Analogue Scale).RESULTS In total,115 participants were included in the study and divided into three groups:high-risk,low-risk and control group.At discharge high-risk patients presented a poorer exercise capacity and a worse self-perceived health status(P<0.05).One month after discharge patients in the high-risk group maintained these differences compared to the other groups.CONCLUSION Our results show a poorer recovery in high-risk patients at discharge and 1 mo after surgery,with lower self-perceived health status and a poorer upper and lower limb exercise capacity.These results are important in the rehabilitation field.