The Association of Different Levels of Physical Activity on Postoperative Pulmonary Complications in Patients Undergoing Thoracoscopic Lung Resection Surgery

Qianfoshan Hospital245 enrolled

Overview

This study aimed to predict different physical activity (PA) levels in patients undergoing thoracoscopic lung resection surgery (LRS) using the International Physical Activity Questionnaire (IPAQ) and investigate the association between the PA levels and the incidence of postoperative pulmonary complications (PPCs). The patients were classified into the high-level and low-level PA groups based on the IPAQ scores. The incidence of PPCs within postoperative 5 days, number of PPCs, the incidence of postoperative adverse events (PAEs) within postoperative 5 days, extubation time, length of hospital stay (LOS), unplanned admission to the intensive care unit (ICU), and the mortality 1-month postoperatively were recorded. Arterial blood samples were collected before induction of anesthesia and 1 hour postoperatively, and the supernatants were centrifuged for cytokine analysis. Binomial logistic analysis was performed to determine the relationship between predefined variables and PPCs. Receiver operating characteristic (ROC) curve analysis was performed to identify independent risk factors, and the area under the curve (AUC) was calculated.

Study Type

OBSERVATIONAL

Enrollment

245

Conditions

Postoperative Pulmonary Complications

Eligibility

Sex: ALLMin age: 18 YearsMax age: 80 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. Patients older than 18 years and younger than 80 years; 2. Patients scheduled to accept elective thoracic surgery under general anesthesia; 3. Patients of American Society of Anesthesiologists (ASA) Ⅱ～Ⅲ level grade; 4. Patients signed the informed consent form for the clinical study. Exclusion Criteria: 1. Patients with moderate or severe chronic obstructive pulmonary disease (GOLD Grade III or IV level grade)； 2. Patients with severe or uncontrolled bronchial asthma； 3. Patients with severe neuromuscular disease or thoracic malformation； 4. Patients with severe heart disease (New York Heart Association Class III or IV level grade or acute coronary syndrome or persistent ventricular arrhythmia)； 5. Patients with cognitive dysfunction； 6. Patients who have participated in other clinical trials within the previous 30 days； 7. Patients with coagulation dysfunction； 8. Patients who received radiotherapy or chemotherapy within 2 months before surgery.

Outcomes

Primary Outcomes

Incidence of pulmonary complications

1. Respiratory Infection 2. Respiratory Failure 3. Pleural Effusion 4. Atelectasis 5. Pneumothorax 6. Bronchospasm 7. Aspiration pneumonitis

Time frame: Within five days after surgery

Secondary Outcomes

The arterial levels of inflammatory markers

interleukin-6(IL-6), interleukin-8(IL-8), tumor necrosis factor-α(TNF-α)

Time frame: before induction of anesthesia(T0),1.5 hours after the beginning of surgery(T2),3 hours after the beginning of surgery(T3)and 1 hour after the end of surgery(T4).

The number of postoperative pulmonary complications

Time frame: Within five days after the surgery

Extubation time

Time frame: The time from the end of surgery to the removal of the endotracheal intubation.

Postoperative length of stay

Time frame: During the study procedure

Incidence of postoperative adverse events

1. arrhythmia 2. acute cardiovascular disease (myocardial infarction, heart failure) 3. acute cerebrovascular disease (cerebral infarction, cerebral hemorrhage, TIA) 4. acute postoperative psychiatric disorder (delirium,somnolence,coma) 5. shock

Time frame: Within five days after operation

Unplanned admission to the ICU