本研究旨在评估肺癌手术后心肺功能（CPF）的纵向变化，并鉴定导致心肺康复失败的预测因素。数据来自潜在CATCH-LUNG队列研究，根据基线和手术后6个月的6分钟步行距离（6MWD）将患者分为两组。CPF康复失败被定义为6MWD从基线到手术后6个月下降超过50m的参与者。排除基线6MWD小于400m的患者。采用混合效应模型进行分析，并使用泊松回归计算预测因子的相对风险（RR）和95%的CI。在419名患者中，分别有24.1%和17.7%在手术后6个月和1年内心肺功能康复失败。多变量分析显示，基线步行次数[每1000次喂食减少1.05倍（95% CI，1.01-1.09）]，基线气短[每分上升10分=1.15（1.07-1.23）]，术后2周内从基线降低的预计值的FEV1 [%（% lower）每低10个单位，增加风险系数1.30倍（1.10-1.53）]和从基线到2周内减少的中等至剧烈体力活动（MVPA）[RR=1.95（1.22, 3.11）]或基线和术后2周内持续低MVPA [RR=1.63（1.04, 2.54）]是CPF丧失的显著因素。无法在手术后6个月恢复CPF与肺功能和MVPA减少以及基线体力活动（PA）和气短有关。这些结果暗示，术中术后体力活动的参与对于促进肺癌手术后CPF的恢复是必要的。© 2023亚太呼吸学会。

This study aimed to evaluate the longitudinal changes in cardiopulmonary function (CPF) and identify predictors of cardiopulmonary recovery failure after lung cancer surgery.Data was obtained from a prospective CATCH-LUNG cohort study, where patients were divided into two groups based on 6-min walk distance (6MWD) at baseline and 6 months after surgery. CPF recovery failure was defined as a participant whose 6MWD dropped over 50 m from baseline to 6 months after surgery. Patients with a baseline 6MWD less than 400 m were excluded. The analysis was investigated using mixed effects models, and the relative estimates for the predictors were expressed relative risk (RR) and 95% CI using a Poisson regression.Among 419 patients, 24.1% and 17.7% showed failure of CPF recovery at 6 months and 1 year after surgery, respectively. In the multivariable analysis, baseline step count [RR per 1000 steps lower = 1.05 (95% CI, 1.01-1.09)], baseline dyspnoea [RR per 10 points higher = 1.15(1.07-1.23)], decreased FEV1 % predicted from baseline to 2 weeks after surgery [RR per 10% lower = 1.30(1.10-1.53)] and decreased moderate-to-vigorous physical activity (MVPA) from baseline to 2 weeks [RR = 1.95(1.22, 3.11)] or persistent low MVPA at baseline and 2 weeks after surgery [RR = 1.63(1.04, 2.54)] were significant factors for loss of CPF.The inability to recover CPF at 6 months after surgery was linked to reduction of lung function and MVPA from baseline to 2 weeks as well as baseline physical activity (PA) and dyspnoea. These results imply that engagement of perioperative PA is necessary to facilitate recovery of CPF after lung cancer surgery.© 2023 Asian Pacific Society of Respirology.