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. 2010 Winter;62(1):66-74.
doi: 10.3138/physio.62.1.66. Epub 2010 Feb 22.

A pilot study of the incidence of post-thoracotomy pulmonary complications and the effectiveness of pre-thoracotomy physiotherapy patient education

Julie C Reid  1 , Anne Jamieson, Jennifer Bond, Bashir M Versi, Arpit Nagar, Bernard H K Ng, Julie D Moreland
Affiliations

A pilot study of the incidence of post-thoracotomy pulmonary complications and the effectiveness of pre-thoracotomy physiotherapy patient education

Julie C Reid et al. Physiother Can. 2010 Winter.

Abstract
in English, French

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=22) received physiotherapy education prior to surgery and the no preop group (n=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.

Objectif : Évaluer l'incidence et analyser le modèle des complications postopératoires pulmonaires (CPP) à la suite d'une thoracotomie dans les cas soumis à des traitements de physiothérapie; évaluer la valeur de l'effet d'une séance de physiothérapie éducative préopératoire comparativement à aucun traitement de physiothérapie visant à réduire les CPP avant l'intervention.

Méthodes : Quarante-deux patients subissant une thoracotomie ont formé la cohorte de cette étude rétrospective-prospective à deux groupes. Le groupe préopératoire (n=22) a reçu des traitements de physiothérapie éducative avant l'intervention, alors que le groupe non préopératoire (n=20) n'en a reçu aucun. Des radiographies thoraciques ont été examinées afin de détecter toute CPP dans les cinq jours suivant l'intervention. Les incidences de CPP ont été établies. La valeur de l'effet était basée sur un dénombrement total des CPP.

Résultats : Après cinq jours, les incidences d'atélectasie, de collapsus cardiovasculaire, de consolidation et d'autres complications étaient de 85,0 %, de 39,0 %, de 31,7 % et de 38,1 %, respectivement. Les modèles de CPP ont été marqués par des augmentations appréciables aux jours deux et trois. La valeur de l'effet de la physiothérapie en préthoracotomie était donc de zéro.

Conclusions : Dans notre échantillon, les incidences de CPP ont été élevées et ne différaient pas substantiellement en fonction du fait qu'une éducation préopératoire était offerte ou non.

Keywords: education; postoperative pulmonary complications; preoperative physiotherapy; thoracotomy.

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Figures

Figure 1
Figure 1
Incidence of any post-thoracotomy complication for each group on each postoperative day (includes atelectasis, consolidation, collapse, and “other”; 95% CI reported)
Figure 2
Figure 2
Incidence of post-thoracotomy atelectasis for each group on each postoperative day (95% CI reported)
Figure 3
Figure 3
Incidence of post-thoracotomy lung collapse for each group on each postoperative day (95% CI reported)
Figure 4
Figure 4
Incidence of post-thoracotomy consolidation for each group on each postoperative day (95% CI reported)
See this image and copyright information in PMC

References

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