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A service evaluation exploring time on physiotherapy caseload following lung lobectomy surgery

Chloe Tait

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Background

The number of lobectomy procedures performed in the United Kingdom (UK) continues to increase annually increasing pressure on thoracic surgical bed capacity. Physiotherapy following thoracic surgery can encourage earlier patient independence helping to reduce hospital length of stay and decrease pressure on hospital beds. The purpose of the service evaluation was to explore whether age, gender, type of surgical incision, day first mobilised and chest drain duration affected time on physiotherapy caseload following lobectomy surgery at one teaching hospital. The findings could support the identification of individuals at risk of longer times on physiotherapy caseloads and help direct physiotherapy rehabilitation provision towards these individuals.

Methods

A retrospective service evaluation was conducted in a UK teaching hospital. Data were retrospectively collected from 1st July 2015–30th June 2016 for all patients reviewed by the cardiothoracic physiotherapy team following lobectomy surgery. Data were collected from patients’ physiotherapy ward sheets, chest radiograph and an electronic patient database and included: date of surgery; day discharged from physiotherapy; age; gender; type of surgical incision; day first mobilised; day chest drains removed.

Results

135 individuals were treated by the physiotherapy team following lobectomy surgery within the data collection period. Time on physiotherapy caseload was longer for females and for those who had longer chest drain durations. Time on physiotherapy caseload was reduced by having a VATS incision and was not affected by the patient’s age. Day mobilised postoperatively was an independent predictor of time on physiotherapy caseload however after adjusting for other covariates it was not statistically significantly associated with time on physiotherapy caseload.

Conclusion

Reviewing chest drain removal practices and providing more intensive physiotherapy input following thoracotomy are worth greater exploration to ascertain whether these interventions could further reduce time on physiotherapy caseload following lobectomy surgery.



2021 Journal (Vol. 53 Issue 2)
Journal of the Association of Chartered Physiotherapists in Respiratory Care. Volume 53. Issue 2. 2021 Article on: p70-78
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