A Pilot Study of the Incidence of Post-thoracotomy Pulmonary Complications and the Effectiveness of Pre-thoracotomy Physiotherapy Patient Education

Abstract

Purpose: To estimate the incidence and examine the pattern of post-thoracotomy pulmonary complications (PPC) that are amenable to physiotherapy treatment and to estimate the effect size of a pre-thoracotomy physiotherapy education session compared to no preoperative physiotherapy for reducing PPC. Methods: Forty-two patients undergoing thoracotomy participated in this two-group retrospective-prospective cohort study. The preop group (n ¼ 22) received physiotherapy education prior to surgery and the no preop group (n ¼ 20) did not receive preoperative physiotherapy education. Chest radiographs were examined for PPC for 5 days postoperatively. Incidences of PPC were determined. The effect size was based on a grand count of PPC. Results: The 5-day incidence of atelectasis, collapse, consolidation, and other complications was 85.0%, 39.0%, 31.7%, and 38.1%, respectively. Patterns of PPC showed large increases at days 2 and 3. The effect size for pre-thoracotomy physiotherapy education was zero. Conclusions: In our sample, incidence of PPC was high and did not substantially differ based on whether or not preoperative education was provided.Key Words: education, postoperative pulmonary complications, preoperative physiotherapy, thoracotomy Reid JC, Jamieson A, Bond J, Versi BM, Nagar A, Ng BHK, Moreland JD. A pilot study of the incidence of post-thoracotomy pulmonary complications and the effectiveness of pre-thoracotomy physiotherapy patient education. Physiother Can. 2010;62:66-74. RÉ SUMÉObjectif : É valuer l'incidence et analyser le modè le des complications postopé ratoires pulmonaires (CPP) à la suite d'une thoracotomie dans les cas soumis à des traitements de physiothé rapie; é valuer la valeur de l'effet d'une sé ance de physiothé rapie é ducative pré opé ratoire comparativement à aucun traitement de physiothé rapie visant à ré duire les CPP avant l'intervention. Mé thodes : Quarante-deux patients subissant une thoracotomie ont formé la cohorte de cette é tude ré trospective-prospective à deux groupes. Le groupe pré opé ratoire (n ¼ 22) a reç u des traitements de physiothé rapie é ducative avant l'intervention, alors que le groupe non pré opé ratoire (n ¼ 20) n'en a rec¸u aucun. Des radiographies thoraciques ont é té examiné es afin de dé tecter toute CPP dans les cinq jours suivant l'intervention. Les incidences de CPP ont é té é tablies. La valeur de l'effet é tait basé e sur un dé nombrement total des CPP. Ré sultats : Aprè s cinq jours, les incidences d'até lectasie, de collapsus cardiovasculaire, de consolidation et d'autres complications é taient de 85,0 %, de 39,0 %, de 31,7 % et de 38,1 %, respectivement. Les modè les de CPP ont é té marqué s par des augmentations appré ciables aux jours deux et trois. La valeur de l'effet de la physiothé rapie en pré thoracotomie é tait donc de zé ro. Conclusions : Dans notre é chantillon, les incidences de CPP ont é té é levé es et ne diffé raient pas substantiellement en fonction du fait qu'une é ducation pré opé ratoire é tait offerte ou non.Mots clé s : c...

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