Age-Related Effects of a Structured Postoperative Pulmonary Physiotherapy Program After Lung Cancer Surgery: An Ambispective Observational Cohort Study in Middle-aged and Older Patients
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- Bezmialem Vakif University
- Enrollment
- 60
- Locations
- 1
- Primary Endpoint
- Length of Hospital Stay
Study Overview
Brief Summary
This ambispective observational cohort study aims to evaluate age-related differences in clinical outcomes among patients undergoing lung cancer surgery who received a structured comprehensive in-patient physiotherapy (CIPT) program as part of standard postoperative care. The CIPT program includes patient education, chest physiotherapy, breathing exercises, airway clearance techniques, early mobilization, postural exercises, and upper- and lower-extremity range-of-motion exercises during the postoperative hospital stay.
The primary outcome is hospital length of stay. Secondary outcomes include clinical parameters (blood pressure, resting heart rate, oxygen saturation, and respiratory rate), symptom-related outcomes (dyspnea, fatigue, and incisional pain), and inflammatory biomarkers (C-reactive protein, neutrophil-to-lymphocyte ratio, and albumin). Outcomes are analyzed according to predefined age groups (45-64 years and 65-90 years) to evaluate potential age-related differences.
Detailed Description
This ambispective observational cohort study evaluates age-related differences in clinical outcomes among patients undergoing lung cancer surgery who received a structured comprehensive in-patient physiotherapy (CIPT) program as part of standard postoperative care. Patients aged 45-90 years were included and classified into two predefined age groups: middle-aged (45-64 years) and older (65-90 years).
The CIPT program was initiated on the first day after transfer from the intensive care unit to the thoracic surgery ward and continued until hospital discharge. The program included patient education, breathing exercises, incentive spirometry, airway clearance techniques, early mobilization, postural exercises, and upper- and lower-extremity range-of-motion exercises. One session per day was supervised by a physiotherapist, with additional sessions performed independently by the patient or with caregiver assistance during hospitalization.
The primary outcome was hospital length of stay. Secondary outcomes included clinical parameters (blood pressure, resting heart rate, oxygen saturation, and respiratory rate), symptom-related outcomes (dyspnea, fatigue, and incisional pain), and inflammatory biomarkers (C-reactive protein [CRP], neutrophil-to-lymphocyte ratio [NLR], and albumin).
Outcomes were assessed during the postoperative inpatient period and compared between the predefined age groups. No randomization or non-intervention control group was included, as all participants received the same structured CIPT program as part of standard postoperative care.
Study Design
- Study Type
- Observational
- Observational Model
- Cohort
- Time Perspective
- Other
Masking Description
No masking is applied in this study.
Eligibility Criteria
- Ages
- 45 Years to 90 Years (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Patients aged 45 to 90 years
- •Undergoing lung cancer surgery (lobectomy, segmentectomy, or pneumonectomy)
- •Medically stable in the early postoperative period
- •Able to participate in a structured pulmonary physiotherapy program
- •Provided written informed consent
Exclusion Criteria
- •Hemodynamic instability preventing mobilization
- •Severe cognitive impairment limiting cooperation
- •Neurological or orthopedic conditions restricting mobilization
- •Requirement for prolonged mechanical ventilation
- •Presence of another active malignancy
- •Any medical contraindication to physiotherapy as determined by the attending physician
Arms & Interventions
Middle-aged group (45-64 years)
Participants aged 45-64 years who underwent lung cancer surgery and received the comprehensive in-patient physiotherapy (CIPT) program as part of standard postoperative care during hospitalization. Outcomes were assessed during the postoperative inpatient period and compared with those of the older cohort.
Intervention: Comprehensive In-Patient Physiotherapy (CIPT) Program (Behavioral)
Older group (65-90 years)
Participants aged 65-90 years who underwent lung cancer surgery and received the comprehensive in-patient physiotherapy (CIPT) program as part of standard postoperative care during hospitalization. Outcomes were assessed during the postoperative inpatient period and compared with those of the middle-aged cohort.
Intervention: Comprehensive In-Patient Physiotherapy (CIPT) Program (Behavioral)
Outcomes
Primary Outcomes
Length of Hospital Stay
Time Frame: Postoperative period, from ward admission after surgery until hospital discharge (maximum 30 postoperative days)
Length of hospital stay is defined as the number of days from postoperative admission to the ward until hospital discharge following lung cancer surgery.
C-reactive protein (CRP)
Time Frame: Postoperative Day 1 and at hospital discharge (up to 30 days after surgery)
Serum CRP levels (mg/L) will be measured to evaluate postoperative systemic inflammatory response.
Peripheral Oxygen Saturation (SpO₂)
Time Frame: Postoperative Day 1 and at hospital discharge (up to 30 days after surgery)
Peripheral oxygen saturation (%) will be measured using pulse oximetry to assess postoperative oxygenation status.
Secondary Outcomes
- Neutrophil-to-Lymphocyte Ratio (NLR)(Postoperative Day 1 and at hospital discharge (up to 30 days after surgery))
- Serum Albumin(Postoperative Day 1 and at hospital discharge (up to 30 days after surgery))
- Systolic Blood Pressure(Postoperative Day 1 and at hospital discharge (up to 30 days after surgery))
- Diastolic Blood Pressure(Postoperative Day 1 and at hospital discharge (up to 30 days after surgery))
- Heart Rate(Postoperative Day 1 and at hospital discharge (up to 30 days after surgery))
- Dyspnea Severity(Postoperative Day 1 and at hospital discharge (up to 30 days after surgery))
- Fatigue Severity(Postoperative Day 1 and at hospital discharge (up to 30 days after surgery))
- Incisional Pain Intensity(Postoperative Day 1 and at hospital discharge (up to 30 days after surgery))
Investigators
Ayşe Sena Manzak
Assistant Professor
Bezmialem Vakif University