Preoperative short-term plus postoperative physical therapy versus postoperative physical therapy alone for patients undergoing lung cancer surgery: retrospective analysis of a nationwide inpatient database

Abstract

Objectives: The aim of this study is to determine whether physical therapy (PT) within 3 days before lung cancer surgery combined with postoperative PT reduces 30-day mortality and the incidence of postoperative pulmonary complications (PPCs) compared with postoperative PT alone.

Methods: This retrospective cohort study, using the Japanese Diagnosis Procedure Combination database, included patients aged ≥18 years who underwent non-small-cell lung cancer surgery and received PT on postoperative Day 1 or 2 between 2010 and 2015. Thirty-day mortality and incidence of PPCs (pneumonia, aspiration pneumonia and respiratory failure) were compared between patients who received preoperative PT within 3 days combined with postoperative PT and those who received postoperative PT alone using 1:1 propensity score matching.

Results: Of 21 259 eligible patients, 6374 matched pairs were analysed by propensity score matching. There was no significant difference in 30-day mortality between postoperative PT with and without preoperative PT (0.2% vs 0.2%, P = 0.55; risk difference -0.05%, 95% confidence interval -0.2% to 0.1%) and no difference in the incidence of PPCs (2.4% vs 2.0%, P = 0.15; risk difference -0.4%, 95% confidence interval -0.9% to 0.1%).

Conclusions: Preoperative short-term plus postoperative PT for lung cancer surgery did not significantly reduce 30-day mortality or incidence of PPCs compared with postoperative PT alone in patients undergoing lung cancer surgery.

Keywords: Lung cancer surgery; Physical therapy; Postoperative pulmonary complications.