Patient-reported walking difficulty predicting the post-discharge overall function in patients with lung cancer undergoing minimally invasive surgery

Abstract

Background Postoperative mobility of patients with lung cancer is crucial for their physical rehabilitation. This study aimed to identify severe walking difficulty and establish a threshold for predicting the functional recovery of patients with lung cancer undergoing minimally invasive surgery (MIS). Methods This prospective study enrolled patients with lung cancer who underwent MIS, divided into two cohorts. The 0–10-scale walking difficulty score was assessed daily during hospitalization following surgery and weekly for 4 weeks after discharge. Chi-square and receiver operating characteristic curve analyses were employed to establish the threshold, with the Timed Up and Go Test on postoperative day 2 as an anchor in cohort 1. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 was assessed biweekly for 1 month post-discharge. Post-discharge functional status trajectories were compared based on the threshold. Results Based on cohort 1, the threshold for walking difficulty was set to 4. Cohort 2 patients were categorized using the threshold: 71.26% exhibited no or mild, while 28.74% experienced severe walking difficulty upon discharge. Compliance rates for reporting walking difficulty post-discharge consistently exceeded 60%. Significant differences in post-discharge physical function (P < 0.001), emotional function (P = 0.008), role function (P < 0.001), and quality of life (P = 0.033) were observed among patients with differing walking difficulty severities. Conclusions A patient-reported walking difficulty score of ≥ 4 indicates severe walking difficulty. Significant differences in post-discharge functional status were observed among patients with different walking difficulty degrees. Intensive care for severe walking difficulty is crucial for post-discharge functional recovery. Trial registration number: ChiCTR2000033016