Associations between postoperative pulmonary interventions based on enhanced recovery programs and outcomes in patients with lung cancer: A retrospective propensity score matching study

Purpose: The purpose of the study was to assess the impact of postoperative pulmonary interventions based on enhanced recovery programs (PPIE) on patients undergoing lung cancer surgery using a retrospective propensity score matching (PSM). Methods: The non-PPIE group only received the enhanced recovery programs, while the PPIE group received additional postoperative pulmonary interventions, including the active cycle of breathing techniques, oscillatory positive expiratory pressure therapy, incentive spirometry training, and early mobilization, conducted by nurses. Results: 656 patients with lung cancer were identified from January 2020 to December 2022. PSM resulted in 253 patients in each group. The PPIE group showed significant improvements in the presence of postoperative pulmonary complications within the first 30-day (4.7% vs. 11.9%, OR 0.37, 95% CI 0.19-0.74, p = 0.004) and in- hospital postoperative pulmonary complications (3.2% vs. 11.1%, OR 0.26, 95% CI 0.12-0.59, p = 0.001). PPIE was associated with an estimated median reduction in the postoperative hospital length of stay by 1 day (P < 0.001). Moreover, the duration of chest tube indwelling didn't significantly differ between groups (p = 0.394). Conclusion: PPIE is beneficial to the outcomes of patients after lung cancer surgery, except for the duration of postoperative chest tube indwelling. Postoperative pulmonary interventions could be integrated into the ERPs to enhance rehabilitation. Moreover, nurses play a role in facilitating the recovery of patients who have undergone lung cancer surgery.