Background: Over 10% of people over 65 are classified as frail, which is a state of increased vulnerability resulting from aging- and/or illness associated decline in physiologic reserve and function which compromises the ability to cope with everyday/acute stressors. Frailty is associated with an increased mortality and non-home discharge in patients undergoing lung lobectomy surgery for cancer. This underscores the need for proactive measures and interventions to decrease postoperative frailty and improve patient outcomes.
Ground-breaking work has been carried out in University of Galway to identify a panel of microRNAs (miR-1, miR-206 and miR-24) that are highly expressed in skeletal muscle, associated with frailty in post-critically ill COVID-19 patients.
Pre-habilitation is an exercise programme designed to increase physiologic reserve in patients undergoing major surgical procedures.
Objectives and Hypotheses
The objective is to determine whether pre-habilitation can improve frailty outcomes in patients undergoing lung lobectomy for lung cancer.
We hypothesise that pre-habilitation programme will improve markers for frailty, both biochemically and functionally, and reduce the postoperative increase in frailty markers, in these patients.
Methods
20 patients will participate in this observational study. At baseline assessment, patients will undergo; a 6 minute walk test, grip strength test, blood sample for microRNA analysis, and ultrasound of the diaphragm and gastrocnemius. These tests will be repeated at the end of the pre-habilitation programme prior to surgery, at discharge from hospital and at follow up clinic. Questionnaires of clinical frailty and quality of life will be administered at baseline and at follow up clinic. The control group will consist of a historic cohort of age- and procedure- matched patients undergoing lobectomy who did not receive pre-habilitation.
Conclusions
This project will determine whether pre-habilitation can improve frailty outcomes in patients undergoing lung lobectomy for lung cancer.