Impact of age on the recovery of six-minute walking distance after lung cancer surgery: a retrospective cohort study

Gen Thorac Cardiovasc Surg. 2020 Feb;68(2):150-157. doi: 10.1007/s11748-019-01191-7. Epub 2019 Sep 4.

Abstract

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.

Keywords: Age; Lung cancer; Recovery; Six-minute walking distance; Surgery.

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Female
  • Forced Expiratory Volume / physiology
  • Health Status
  • Humans
  • Lung / physiopathology
  • Lung Neoplasms / physiopathology
  • Lung Neoplasms / psychology
  • Lung Neoplasms / surgery*
  • Male
  • Middle Aged
  • Pneumonectomy*
  • Quality of Life / psychology
  • Recovery of Function / physiology*
  • Respiratory Function Tests
  • Retrospective Studies
  • Time Factors
  • Walking / physiology*