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- Brocki, Barbara Cristina, et al.
(författare)
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Can the Melbourne Scoring Scale be used to assess postoperative pulmonary complications in high-risk patients following lung resection?
- 2018
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Ingår i: European Respiratory Journal. - : European Respiratory Society. - 0903-1936 .- 1399-3003. ; 52:Suppl. 62
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Objectives: Postoperative pulmonary complications (PPC) are common following lung resections, but there is no consensus in the literature on the definition of a clinically relevant PPC. This study aimed to use the Melbourne Scoring Scale (MGS) to determine the frequency and predictors of PPC in patients scheduled for lung resection on suspicion of or due to cancer.Methods: In a prospective observational design, we assessed 87 consecutive patients following lung resections in Aalborg University Hospital, Denmark. Patients were preoperatively classified as being at high PPC-risk (n= 68) or low PPC-risk (n=19), based on the presence of one or more of the items: FEV1 or carbon monoxide diffusion capacity (DLCO) ≤70%, age ≥70 years or scheduled pneumonectomy. Data on PPC was collected daily and re-evaluated two weeks postoperatively. Multivariate regression analysis was used to evaluate variables associated with PPC.Results: The actual frequency of PPC according to the MGS was 11% (n=10), all cases within the predefined high-risk group, with pneumonia accounting for 10% of the cases. We found that preoperative FEV1 and DLCO ≤60% were significantly associated with a higher PPC risk (area under the ROC curve 0.851), 95% CI 2.2-56.6 and 1.1-36.8 for FEV1 and DLCO, respectively.Conclusions: The MGS can be used to identify patients at high risk of postoperative clinically relevant PPC after lung resections, in particular in patients with preoperative values of FEV1 ≤ 60% or DLCO ≤ 60%. More research is needed to evaluate the effect of preventable interventions targeting patients at high-risk of developing PPC.
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| 2. |
- Brocki, Barbara Cristina, 1957-, et al.
(författare)
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Short and long-term effects of supervised versus unsupervised exercise training on health-related quality of life and functional outcomes following lung cancer surgery : a randomized controlled trial
- 2014
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Ingår i: Lung Cancer. - : Elsevier. - 0169-5002 .- 1872-8332. ; 83:1, s. 102-108
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE:Surgical resection enhances long-term survival after lung cancer, but survivors face functional deficits and report on poor quality of life long time after surgery. This study evaluated short and long-term effects of supervised group exercise training on health-related quality of life and physical performance in patients, who were radically operated for lung cancer.METHODS:A randomized, assessor-blinded, controlled trial was performed on 78 patients undergoing lung cancer surgery. The intervention group (IG, n=41) participated in supervised out-patient exercise training sessions, one hour once a week for ten weeks. The sessions were based on aerobic exercises with target intensity of 60-80% of work capacity, resistance training and dyspnoea management. The control group (CG, n=37) received one individual instruction in exercise training. Measurements consisted of: health-related quality of life (SF36), six minute walk test (6MWT) and lung function (spirometry), assessed three weeks after surgery and after four and twelve months.RESULTS:Both groups were comparable at baseline on demographic characteristic and outcome values. We found a statistically significant effect after four months in the bodily pain domain of SF36, with an estimated mean difference (EMD) of 15.3 (95% CI:4 to 26.6, p=0.01) and a trend in favour of the intervention for role physical functioning (EMD 12.04, 95% CI: -1 to 25.1, p=0.07) and physical component summary (EMD 3.76, 95% CI:-0.1 to 7.6, p=0.06). At 12 months, the tendency was reversed, with the CG presenting overall slightly better measures. We found no effect of the intervention on 6MWT or lung volumes at any time-point.CONCLUSION:Supervised compared to unsupervised exercise training resulted in no improvement in health-related quality of life, except for the bodily pain domain, four months after lung cancer surgery. No effects of the intervention were found for any outcome after one year.
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