【Abstract】Objective To analyze the correlation of postoperative physical fitness with mental health and quality of life in elderly patients with non-small cell lung cancer (NSCLC), and to analyze the influencing factors for poor physical fitness. Methods A questionnaire survey was conducted on 132 elderly NSCLC patients who underwent thoracoscopic lobectomy in our hospital from March 2021 to August 2023. All patients received routine rehabilitation interventions such as early activity and deep breathing training after surgery. The general demographic questionnaire, Karnofsky performance status (KPS), Edmonton frailty scale, self-rating anxiety scale (SAS), self-rating depression scale (SDS), Tampa scale of kinesiophobia (TSK) and functional assessment of cancer therapy-lung (FACT-L) were used to investigate the patients at three month after surgery. Totally 126 valid questionnaires were recovered, with an effective recovery rate of 95.45%. According to KPS score, the 126 patients were divided into good physical fitness group (KPS score ≥70 points) and poor physical fitness group (KPS score <70 points). SPSS statistics 24.0 was used for statistical analysis. Data comparison between two groups was performed using t test orχ² test depending on data type. Logistic regression analysis was applied to evaluate the influencing factors of postoperative poor physical fitness in elderly NSCLC patients. Pearson correlation coefficient was adopted to evaluate the correlation between postoperative physical fitness and mental health as well as quality of life. Results Logistic regression analysis showed that frailty (OR=3.040,95%CI 1.731-5.342), anxiety (OR=2.450,95%CI 1.263-4.751), depression (OR=2.713,95%CI 1.470-5.008), and kinesiophobia (OR=2.208,95%CI 1.058-4.606) were risk factors for poor postoperative physical fitness in the elderly NSCLC patients (P<0.05). The scores of SAS, SDS and TSK were significantly higher (P<0.05), while the FACT-L score was obviously lower in the poor physical fitness group than the good physical fitness group (P<0.05). Pearson correlation coefficient analysis indicated that the KPS score at three months after surgery was negatively correlated with the scores of SAS, SDS and TSK (r=-0.566, -0.630, -0.549; P<0.05), and was positively correlated with FACT-L score (r=0.607; P<0.05). Conclusion Poor postoperative physical fitness can lead to a decline in quality of life in elderly NSCLC patients. Frailty, anxiety, depression and kinesiophobia are the key factors causing poor postoperative physical fitness in them, so it is necessary to take targeted prevention and control measures in clinical practice.

This work was supported by the Youth Scientific Research Project of Fujian Provincial Health Commission (2019-1-53) and the Projectof Science and Technology Plan of Quanzhou (2021N165S).