Impact of age on the recovery of six-minute walking distance after lung cancer surgery: a retrospective cohort study
Impact of age on the recovery of six-minute walking distance after lung cancer surgery: a retrospective cohort study
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DOI：
10.1007/s11748-019-01191-7
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发表时间：
2020-02-01
影响因子：
1.2
通讯作者：
Kawama, Kennosuke
中科院分区：
文献类型：
--
作者：
Saito, Hiroshi;Shiraishi, Atsushi;Kawama, Kennosuke
目的：探讨肺癌手术后年龄与6分钟步行距离（6MWD）恢复、肺功能以及健康相关生活质量（HRQOL）之间的关系。
方法：主要观察指标是手术后6个月内6MWD的恢复情况。次要观察指标是手术后6个月内第1秒用力呼气量（FEV1）和HRQOL的恢复情况。采用线性混合效应模型评估年龄与各项观察指标之间的关联。
结果：共纳入311例肺癌患者。手术后所有患者的6MWD、FEV1和HRQOL均下降（分别为 - 32米、 - 0.39升和 - 2分，p值介于0.027 - p < 0.001）。虽然手术后6MWD每月都有所增加（5米/月，95%置信区间（CI）为4 - 7，p < 0.001），但随着年龄增加1个标准差（SD）（即9年），其恢复程度降低（ - 2米/月；95%CI为 - 3至 - 1，p < 0.001）。虽然手术后FEV1每月都有所增加（0.03升/月；95%CI为0.02 - 0.03，p < 0.001），但随着年龄增加1个SD，其恢复程度增加（0.01升/月；95%CI为0.00 - 0.01，p = 0.003），这与6MWD的恢复情况相反。虽然术后HRQOL每月都有所恢复（2分/月；95%CI为1 - 2，p < 0.001），但其恢复程度与年龄之间无显著关联（0分/月；95%CI为 - 1至0，p = 0.5）。
结论：老年患者6MWD恢复延迟，这与其FEV1和HRQOL的恢复无关。术后步行训练对老年肺癌患者很重要。
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.