10.3389/fpsyg.2012.00132

Vollständiger Abstract

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<h4>Background</h4>Frail elderly patients undergoing hepatobiliary-pancreatic (HBP) surgery face a substantially elevated risk of postoperative pulmonary complications (PPCs), which are associated with increased mortality, extended morbidity, and greater healthcare costs. Although the "I Cough" pulmonary rehabilitation program is a well-established preventive strategy for PPCs, its clinical effectiveness is often limited by suboptimal patient adherence. This randomized controlled trial was therefore conducted to determine whether a nurse-led intensive pulmonary rehabilitation exercises (IPREs) program could improve compliance and reduce the occurrence of PPCs in this highly susceptible population.<h4>Methods</h4>A total of 160 participants were randomly assigned to two groups. Eighty patients in the intervention (IPREs) group received IPREs, whereas 80 patients in the control group underwent conventional self-pulmonary rehabilitation training. The incidences of PPCs and other postoperative outcomes were compared between the two groups.<h4>Results</h4>The median compliance rate with pulmonary rehabilitation exercises was significantly higher in the IPREs group than in the control group (100.00% [IQR 83.33-100.00%] vs. 33.33% [IQR 33.33-66.67%]; <i>P</i> < 0.001). The incidence of PPCs was significantly lower in the IPREs group (22.50% vs. 38.75%; OR 0.459, 95% CI 0.230-0.926; P = 0.026), with notably reduced rates of pneumonia and atelectasis (<i>P</i> < 0.05). The overall rate of major complications was also reduced in the IPREs group (12.50% vs. 25.00%; OR 0.429, 95% CI 0.186-0.989; P = 0.043). Additionally, the median postoperative hospital stay was shorter in the IPREs group (6 days [IQR 5-8] vs. 8 days [IQR 6-9]; <i>P</i> = 0.035).<h4>Conclusions</h4>The nurse-led intensive pulmonary rehabilitation program significantly improved compliance with pulmonary rehabilitation exercises, reduced the incidence of PPCs, and shortened postoperative hospitalization in frail elderly patients undergoing HBP surgery.<h4>Clinical trial registration</h4>https://www.chictr.org.cn, identifier ChiCTR2000040021.

Abstract: PubMed · Datensatz