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Multimodal Prehabilitation in Thoracic Surgery

Not Applicable
Conditions
Lung Cancer
Interventions
Other: Usual care
Other: Multimodal prehabilitation
Registration Number
NCT04052100
Lead Sponsor
Hospital Clinic of Barcelona
Brief Summary

This trial aims to assess the impact of a multimodal prehabilitation program in high-risk patients undergoing lung resection surgery.

Detailed Description

This trial aims to assess the cost-effectiveness of a multimodal prehabilitation program in high-risk patients undergoing lung resection surgery. Secondary objectives are to evaluate the impact of the intervention on: i) Healthcare resuorces use; ii) clinical outcomes; and, iii) patient's and professionals experience with the program.

The program includes X main interventions: i) A motivational interview; ii) A high-intensity exercise training program; iii) A plan for physical activity incentivation; iv) A nutritional optimization program; v) A psicologichal support program; and, vi) A smoking cessation program.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
158
Inclusion Criteria
  1. Forced espiratory volume in the first second (FEV1) and/or estimated postoperative lung diffusion capacity for carbon monoxide < 60%; and/or,
  2. American Society of Anesthesiologist (ASA) index 3-4; and/or,
  3. Peak oxygen uptake among 10-20 mL/kg/min.
Exclusion Criteria
  1. Non-elective surgery;
  2. Metastasic disease;
  3. Unestable cardiac or respiratory condition; 4) Cognitive or locomotor limitations precluding the adherence to the program.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Usual careUsual carePatients following the standard preoperative policies of opur institution
PrehabilitationMultimodal prehabilitationPatients following the standard preoperative policies of opur institution and the multimodal prehabilitation program
Primary Outcome Measures
NameTimeMethod
Hospital length of stayDuring initial hospitalization

Hospital days of stay

Secondary Outcome Measures
NameTimeMethod
TNF-αBaseline and pre-surgery

Blood levels of TNF-α

IL-10Baseline and pre-surgery

Blood levels of IL-10

8-isoprostaneBaseline and pre-surgery

Blood levels of 8-isoprostane

Self-perceived physical statusBaseline and pre-surgery

Physical status measured by the physical domain of the SF-36 questionnaire (range 0-100 points (the higher, the better))

Psychological statusBaseline and pre-surgery

Anxiety and depression levels measured by the Hospital Anxiety and Depression (HAD) questionnaire (range 0-42 points (the lower, the better))

Fat free mass indexBaseline and pre-surgery

Fat free mass index measured by bioimpedance

PCRBaseline and pre-surgery

Blood levels of PCR

ultrasensible PCRBaseline and pre-surgery

Blood levels of ultrasensible PCR

IL-8Baseline and pre-surgery

Blood levels of IL-8

fibrinogenBaseline and pre-surgery

Blood levels of fibrinogen

white cellsBaseline and pre-surgery

Blood levels of white cells

Postoperative complicationsDuring initial hospitalization

Number and severity of postoperative complications

30-day hospital readmissionsTo 30 days after surgery

Hospital readmissions during the first 30 days after surgery

30-day emergency room visitsTo 30 days after surgery

Emergency room visits during the first 30 days after surgery

Physical activityBaseline and pre-surgery

Physical activity measured by the Yale Physical Activity Survey (YPAS) (range 0-126 points (the higher, the better))

Aerobic capacityBaseline and pre-surgery

Exercise endurance time achieved in a constant work-rate exercise test in cycle-ergometer

Self-perceived mental statusBaseline and pre-surgery

Mental status measured by the mental domain of the SF-36 questionnaire (range 0-100 points (the higher, the better))

IL-6Baseline and pre-surgery

Blood levels of IL-6

leptinBaseline and pre-surgery

Blood levels of leptin

adiponectinBaseline and pre-surgery

Blood levels of adiponectin

Trial Locations

Locations (1)

Hospital Clínic de Barcelona

🇪🇸

Barcelona, Catalonia, Spain

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