An audit of current physiotherapy management and patient outcomes in one thoracic surgical unit
Reeve, JC; Nicol, K,; Denehy, L,
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Limited data are published which consider the physiotherapy management of patients undergoing thoracic surgery. This study prospectively audited patients undergoing open thoracic surgery in one surgical unit, investigating physiotherapy management, postoperative pulmonary complication rate and length of postoperative stay. Fifty four patients with a mean age of 61.9 years (SD 12.9, range 18–85 years) were studied. The majority of patients underwent lung resection (n = 45, 81.8%). No patient received preoperative physiotherapy. The mean physiotherapy time spent with patients postoperatively in total was 12.6 units (SD 7.1, range 4–39 units), with each unit representing a 15-minute time period. On postoperative day one the majority of patients used forced expiratory manoeuvres (n = 41, 74.5%) with lung expansion manoeuvres used in 25 (45.5%) patients. Ten (18.5%) patients developed a postoperative pulmonary complication. Six (10.9%) patients received early ambulation only and none of these developed a postoperative pulmonary complication. The median (IQR) postoperative length of stay was 7 (3) days. Twenty-one (38.2%) patients had a length of stay over nine days. Most common reasons for an increased postoperative length of stay were persistent air leak from the chest drains (n = 9, 16.7%) and respiratory complications (n = 4, 7.3%). The median (IQR) length of postoperative stay in patients developing a pulmonary complication was 10 (2.3) days which was significantly higher than those not developing a pulmonary complication (p = 0.003). Despite limited supporting evidence, this patient group utilises considerable physiotherapy resources. Future studies should consider the efficacy of these interventions.