Effectiveness of an Interdisciplinary Integrated Care Model on Perioperative Outcomes in Patients Undergoing Lung Cancer Surgery: A Randomized Controlled Trial
In brief
Integrated care shortens stay by 1.5 days and halves lung complications
In a single-center RCT of 240 lung-cancer surgery patients, a multidisciplinary program that combined pulmonary rehab, psychological support, nutrition, and enhanced recovery cut average hospital stay by about 1.5 days and reduced postoperative pulmonary complications from 26% to 12%. The same regimen also improved walking distance, anxiety, depression and quality of life, suggesting broad perioperative benefits.
- Journal
- ANZ journal of surgery (Q2)
- Published
- 26 July 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Xingu Chen, Nili Zhang, Xiaohong Zhang, Shuping Liang, Shuting Liu, Ying Liu, et al.
- PMID
- 42503044
- DOI
- 10.1111/ans.70841
Why clinicians should know about it
- Picked for Pulmonary and Respiratory Medicine (paper of the day, 27 July 2026).
Abstract
BACKGROUND: Lung cancer surgery is associated with significant perioperative morbidity, including pulmonary complications and psychological distress. The effectiveness of comprehensive interdisciplinary care models in improving outcomes remains insufficiently studied. METHODS: This single-center randomized controlled trial enrolled 240 patients undergoing lung cancer surgery between March 2021 and December 2023. Patients were randomized 1:1 to receive either an interdisciplinary integrated care intervention (n = 120) or standard care (n = 120). The intervention included preoperative pulmonary rehabilitation, psychological support, nutritional optimization, and enhanced postoperative recovery protocols. The primary outcome was postoperative length of hospital stay (LOS). Secondary outcomes included postoperative pulmonary complications (PPCs), pain scores, functional recovery (6-min walk distance), psychological status (HADS), and quality of life (QLQ-C30). Intention-to-treat analysis was performed as the primary analysis. RESULTS: In the ITT analysis, the intervention group had significantly shorter LOS compared to control (7.43 ± 1.94 vs. 9.02 ± 2.30 days; mean difference 1.59 days, 95% CI: 1.07-2.12; p < 0.001; Cohen's d = 0.75). After adjusting for baseline FEV1 imbalance, the difference remained significant (adjusted mean difference 1.54 days, 95% CI: 1.02-2.06; p < 0.001). PPCs were significantly lower in the intervention group (12.0% vs. 26.1%; RR = 0.46, 95% CI: 0.26-0.81; p = 0.008). The intervention group demonstrated superior functional recovery, with 6-min walk distance differences of 57.77 m at 1 month and 61.97 m at 3 months, both exceeding the minimal clinically important difference of 22-42 m. Psychological outcomes (HADS-anxiety: 4.19 ± 2.55 vs. 6.48 ± 3.22; HADS-Depression: 3.57 ± 1.97 vs. 5.19 ± 2.89 at 3 months; both p < 0.001) and quality of life were significantly improved. CONCLUSIONS: An interdisciplinary integrated care model significantly reduces hospital stay, decreases pulmonary complications, and improves functional and psychological outcomes in patients undergoing lung cancer surgery. These findings support the implementation of comprehensive perioperative care programs.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.