Perioperative rehabilitation approaches in those over 75 years with respiratory dysfunction from chronic obstructive pulmonary disease undergoing abdominal tumor surgery

Kii, Yoshitaka; Mizuma, Masazumi; Kawate, Nobuyuki

doi:10.3109/09638288.2011.591890

Cited by 4 publications

(2 citation statements)

References 3 publications

(4 reference statements)

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“…However, we emphasize that we found that respiratory complications were more common among non-survivors overall and therefore agree with others that predicting postoperative pulmonary complications can facilitate the selection of those patients that could benefit from specific evaluation and preparation for surgery [26] as well as increased vigilance on the ward [12]. Preoperative physical therapy has been found useful in preventing respiratory complications [27]. …”

Section: Discussionsupporting

confidence: 88%

Risk factors and mortality after elective and emergent laparatomies for oncological procedures in 899 patients in the intensive care unit: a retrospective observational cohort study

et al. 2013

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BackgroundAbdominal surgeries for cancer are associated with postoperative complications and mortality. A view of the success of anaesthetic, surgical and critical care can be gained by analyzing factors associated with mortality in patients admitted to intensive care units (ICUs). The objective of this study was to identify the postoperative mortality rate and the causes of perioperative death in high-risk patients after abdominal surgery for cancer. A secondary objective was to explore possible risk factors for death in scheduled and emergency surgeries, with a view to finding guidance on preventable risk factors.MethodsAn observational study, in a 12-bed surgical ICU of a tertiary hospital. Patients admitted after abdominal surgery for cancer to the ICU for more than 24 hours’ care were included from January 1, 2008–December 31, 2009. Data were extracted from the minimum basic dataset. The main outcome considered was 90-day mortality.ResultsOf 899 patients included, 80 (8.9%) died. Seven died within 48 hours of surgery, 18 died between 2 and 7 days, and 55 died after 7 days. Non-survivors were older and had more respiratory comorbidity, chronic liver disease, metastasis, and underwent more palliative procedures. 112 patients underwent emergency surgery; mortality in these patients for resection surgery was 32.5%; in the 787 patients who underwent scheduled surgery, mortality was 4.7% for resection procedures. The estimated odds ratios (95% confidence interval) of preoperative patient factors in emergency surgery confirmed a negative association between survival and older age 0.96 (0.91–1), the presence of respiratory comorbidity 0.14 (0.02–0.77) and metastasis 0.18 (0.05–0.6). After scheduled surgery, survival was negatively associated with age 0.93 (0.90–0.96) and chronic liver disease 0.40 (0.17–0.91). Analysis of complications after emergency surgery also indicated a negative association with sepsis 0.03 (0.003–0.32), respiratory events 0.043 (0.011–0.17) and cardiac events 0.11 (0.027–0.45); after scheduled surgery, respiratory 0.03 (0.01–0.08) and cardiac 0.11 (0.02–0.45) events, renal failure 0.02 (0.006–0.14) and neurological events 0.06 (0.007–0.5).ConclusionsAs most deaths occurred after discharge from the ICU, postoperative sepsis, respiratory and cardiac events should be watched carefully on the ward.

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Section: Discussionsupporting

confidence: 88%

Risk factors and mortality after elective and emergent laparatomies for oncological procedures in 899 patients in the intensive care unit: a retrospective observational cohort study

et al. 2013

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“…These programs have been used mainly before orthopedic surgery with improvement of health outcomes (18). In oncologic patients, prehabilitation has been used as a useful tool to improve patient's evolution, but mainly before surgical intervention (19), and its positive effects on the quality of life (QoL) as well as general outcomes have been also described in elderly cancer survivors (20). Reports on the bene ts of prehabilitation in non-surgical cancer patients are scarce.…”

Section: Discussionmentioning

confidence: 99%

Multimodal Prehabilitation in Radioactive Iodine-refractory Differentiated Thyroid Cancer Treated With Lenvatinib.

APd¹,

Joaquín²,

Vázquez³

et al. 2021

Preprint

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Purpose This study describes our clinical experience with lenvatinib for the treatment of radioactive iodine refractory differentiated thyroid cancer (RR-DTC) using a multimodal patient-centered prehabilitation multidisciplinary approach assessing its effectiveness and patient outcomes. Methods and design This is a retrospective observational real-life study of a consecutive series of RR-DTC patients treated with lenvatinib as first-line treatment at Germans Trias i Pujol University Hospital. Results Partial response was observed in 6 patients (46.1%), stable disease in 5 patients (38.5%) and disease progression in 2 patients (15.4%). PFS and OS were 16.3 and 17.9 months respectively. AEs occurred in all patients. The most common adverse event (AE) was fatigue (69%), followed by diarrhea (46%), hypertension (46%) and anorexia (38.3%). Weight loss was present in 30.7% of the patients and only 7.7% was grade 3. Conclusion In our experience, prehabilitation can be useful to decrease not only the incidence but the severity of important side effects such as weight loss, anorexia and hypertension. For these complex patients, a multidisciplinary team is useful for follow-up, treatment and prevention of possible AEs.

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Cancer Prehabilitation

Silver

Baima

2013

American Journal of Physical Medicine &Amp; Rehabilitation

470

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Cancer prehabilitation, a process on the continuum of care that occurs between the time of cancer diagnosis and the beginning of acute treatment, includes physical and psychological assessments that establish a baseline functional level, identifies impairments, and provides targeted interventions that improve a patient's health to reduce the incidence and the severity of current and future impairments. There is a growing body of scientific evidence that supports preparing newly diagnosed cancer patients for and optimizing their health before starting acute treatments. This is the first review of cancer prehabilitation, and the purpose was to describe early studies in the noncancer population and then the historical focus in cancer patients on aerobic conditioning and building strength and stamina through an appropriate exercise regimen. More recent research shows that opportunities exist to use other unimodal or multimodal prehabilitation interventions to decrease morbidity, improve physical and psychological health outcomes, increase the number of potential treatment options, decrease hospital readmissions, and reduce both direct and indirect healthcare costs attributed to cancer. Future research may demonstrate increased compliance with acute cancer treatment protocols and, therefore, improved survival outcomes. New studies suggest that a multimodal approach that incorporates both physical and psychological prehabilitation interventions may be more effective than a unimodal approach that addresses just one or the other. In an impairment-driven cancer rehabilitation model, identifying current and anticipating future impairments are the critical first steps in improving healthcare outcomes and decreasing costs. More research is urgently needed to evaluate the most effective prehabilitation interventions, and combinations thereof, for survivors of all types of cancer.

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Perioperative rehabilitation approaches in those over 75 years with respiratory dysfunction from chronic obstructive pulmonary disease undergoing abdominal tumor surgery

Abstract: Comprehensive perioperative rehabilitation appears to be effective in high-risk patients with severe COPD who need surgery for abdominal cancer.

Cited by 4 publications

References 3 publications

Risk factors and mortality after elective and emergent laparatomies for oncological procedures in 899 patients in the intensive care unit: a retrospective observational cohort study

Risk factors and mortality after elective and emergent laparatomies for oncological procedures in 899 patients in the intensive care unit: a retrospective observational cohort study

Multimodal Prehabilitation in Radioactive Iodine-refractory Differentiated Thyroid Cancer Treated With Lenvatinib.

Cancer Prehabilitation

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