Centre for Shared Decision Making and Collaborative Care Research, Oslo University Hospital, Rikshospitalet, Oslo, Norway; Department of Respiratory Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
Lung Cancer. 2013 Oct;82(1):156-61. doi: 10.1016/j.lungcan.2013.06.016. Epub 2013 Aug 3.
Older patients with lung cancer are less likely to be offered surgery then younger patients. Although higher preoperative symptom burden is associated with poorer postoperative outcomes, few studies have examined age-related differences in symptom experience of lung cancer patients prior to surgery. This study evaluated for differences in symptom occurrence, severity, and distress between older (≥65 years) and younger (<65 years) patients prior to surgery.
Data were collected through chart review and a symptom assessment scale (i.e., Memorial Symptom Assessment Scale (MSAS)) that evaluated multiple dimensions of 32 symptoms. Descriptive statistics were used to present demographic and clinical characteristics of the sample. Logistic regression analyses were used to evaluate for age-related differences in each dimension of the symptom experience.
A total of 270 patients completed the MSAS prior to surgery (113 younger and 157 older patients). Few age-related differences were found. When age differences were identified, older patients reported lower occurrence rates and lower severity and distress ratings. Cough, lack of energy, feeling drowsy and worrying was the four most common symptoms in both age groups. In the younger patients, feeling nervous was ranked fourth. Shortness of breath was ranked third by the older patients. The study confirmed the high occurrence rates for cough, pain, fatigue, shortness of breath, and sleep disturbance found in previous studies. However, "new" symptoms were identified including feeling nervous, worrying, sweats, feeling bloated, and problems with sexual interest. These "new" symptoms were reported by over 40% of the patients.
Measurement of symptoms in lung cancer patients before surgery is important, because patients reported an average of 10 symptoms. Few age-related differences in the patients' symptom experience were identified. Psychological symptoms were common and warrant consideration.
相较于年轻患者，老年肺癌患者接受手术治疗的可能性较低。尽管术前较高的症状负担与较差的术后结果相关，但很少有研究检查术前肺癌患者的年龄相关症状体验差异。本研究评估了手术前老年（≥65 岁）和年轻（<65 岁）患者在症状发生、严重程度和困扰方面的差异。
数据通过病历回顾和症状评估量表（即纪念症状评估量表（MSAS））收集，该量表评估了 32 种症状的多个维度。描述性统计用于呈现样本的人口统计学和临床特征。逻辑回归分析用于评估症状体验各维度的年龄相关性差异。
共有 270 名患者在手术前完成了 MSAS（113 名年轻患者和 157 名老年患者）。发现年龄相关差异较少。当发现年龄差异时，老年患者报告的发生率较低，严重程度和困扰评分较低。咳嗽、缺乏能量、嗜睡和担忧是两个年龄组中最常见的四种症状。在年轻患者中，紧张感排名第四。对于老年患者，呼吸急促排名第三。该研究证实了先前研究中发现的咳嗽、疼痛、疲劳、呼吸急促和睡眠障碍的高发生率。然而，还确定了一些“新”症状，包括紧张、担忧、出汗、腹胀和性兴趣问题。这些“新”症状被超过 40%的患者报告。
在手术前测量肺癌患者的症状很重要，因为患者报告了平均 10 种症状。患者症状体验中很少有年龄相关差异。常见的心理症状值得考虑。
