Abstract
BackgroundThe effectiveness of Incentive spirometry (IS) in patients undergoing video-assisted thoracic surgery (VATS) remains lacking. We conducted a population-based study to investigate the effectiveness of IS on patients with lung cancers following VATS.MethodsWe identified patients newly diagnosed with lung cancer who underwent surgical resection by VATS or thoracotomy from the years 2000 to 2008 in the Longitudinal Health Insurance Database. Exposure variable was the use of IS during admission for surgical resection by VATS or thoracotomy. Primary outcomes included hospitalization cost, incidence of pneumonia, and length of hospital stay. Secondary outcomes included the frequency of emergency department (ED) visits and hospitalizations at 3-month, 6-month, and 12-month follow-ups after thoracic surgery.ResultsWe analyzed 7549 patients with lung cancer undergoing surgical resection by VATS and thoracotomy. The proportion of patients who were subjected to IS was significantly higher in those who underwent thoracotomy than in those who underwent VATS (68.4% vs. 53.1%, P < 0.0001). After we controlled for potential covariates, the IS group significantly reduced hospitalization costs (− 524.5 USD, 95% confidence interval [CI] = − 982.6 USD – -66.4 USD) and the risk of pneumonia (odds ratio = 0.55, 95% CI = 0.32–0.95) compared to the non-IS group following VATS. No difference in ED visit frequency and hospitalization frequency at 3-month, 6-month, and 1-year follow-up was noted between the IS and the non-IS groups following VATS.ConclusionsThe use of IS in patients with lung cancers undergoing VATS may reduce hospitalization cost and the risk of pneumonia.
Highlights
The effectiveness of Incentive spirometry (IS) in patients undergoing video-assisted thoracic surgery (VATS) remains lacking
Outcome measures We evaluated the effect of IS in patients admitted with lung cancer receiving surgical resection by VATS or thoracotomy
The chest surgeons prescribed IS for 65.5% of patients with lung cancers undergoing surgical resection. 66.3% of the patients received neoadjuvant
Summary
The effectiveness of Incentive spirometry (IS) in patients undergoing video-assisted thoracic surgery (VATS) remains lacking. We conducted a population-based study to investigate the effectiveness of IS on patients with lung cancers following VATS. Lung cancer is one of the leading causes of cancer-related deaths in the world [1]. Non-small cell lung cancers (NSCLCs) are the most common types of lung cancers and have diverse pathological characteristics [2]. Survival from lung cancer is highly associated with lung resection surgery [3]. The most common postoperative complications following thoracic or abdominal surgery are pulmonary complications, such as atelectasis (alveolar collapse), pneumonia, and acute respiratory failure [12, 13]. Lung expansion therapy allows patients to maintain an effective cough mechanism to facilitate removal of secretions from the airways following surgery. An incentive spirometer is a medical device, which helps patients sustain
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