Department of Thoracic Surgery, Hitachi General Hospital, Hitachi, Ibaraki, 317-0077, Japan.
Department of Thoracic Surgery, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan.
Gen Thorac Cardiovasc Surg. 2021 Aug;69(8):1204-1213. doi: 10.1007/s11748-021-01607-3. Epub 2021 Feb 19.
To clarify the trajectory and profile of quality of life (QOL) in lung cancer patients undergoing surgery during hospitalization.
Among prospectively enrolled 279 patients between 2015 and 2018, we used the EQ-5D-5 levels (EQ-5D-5L), which consist of a descriptive system of five dimensions and a visual analog scale (VAS) (from 0 to 100). The five dimensions are mobility, self-care, usual activities, pain/discomfort, and anxiety/depression, which are rated according to a 5-grade evaluation. QOL assessments were performed preoperatively (Pre) and on postoperative day 1/3/5/7 (D1/D3/D5/D7). To observe the trajectory of QOL, the EQ-5D VAS was used. To define the profile of QOL, we applied univariate linear regression analysis to predict EQ-5D VAS based on the five dimensions of EQ-5D as explanatory variables and to determine the rank of absolute values of the standardized coefficient of each dimension that represented strength of the effect on the EQ-5D VAS.
The means of VAS scores were as follows: Pre/D1/D3/D5/D7 = 79/45/58/64/71. Younger age, fewer comorbidities, and surgical indications decreased the VAS at D1. More comorbidities, advanced cancer stage, postoperative adverse events, and chest tube placements hampered restoration of the VAS. Regarding QOL profiles, anxiety/depression was the highest rank preoperatively while usual activity, but not pain/discomfort, was the highest postoperatively.
This is the first study to visualize the trajectory of QOL in surgical patients with lung cancer during hospitalization. This information may help improve perioperative patient care.
明确住院期间接受手术的肺癌患者的生活质量(QOL)轨迹和特征。
在 2015 年至 2018 年间前瞻性纳入的 279 例患者中,我们使用了 EQ-5D-5 水平(EQ-5D-5L),它由五个维度的描述性系统和视觉模拟量表(VAS)(0 至 100)组成。五个维度分别为移动性、自我护理、日常活动、疼痛/不适和焦虑/抑郁,根据 5 级评估进行评分。QOL 评估在术前(Pre)和术后第 1/3/5/7 天(D1/D3/D5/D7)进行。为了观察 QOL 的轨迹,使用了 EQ-5D VAS。为了定义 QOL 的特征,我们应用单变量线性回归分析,根据 EQ-5D 的五个维度作为解释变量预测 EQ-5D VAS,并确定每个维度的标准化系数绝对值的等级,代表其对 EQ-5D VAS 的影响强度。
VAS 评分的平均值如下:Pre/D1/D3/D5/D7=79/45/58/64/71。年龄较小、合并症较少和手术适应证会降低 D1 的 VAS。合并症较多、癌症分期较晚、术后不良事件和胸腔引流管放置会阻碍 VAS 的恢复。关于 QOL 特征,焦虑/抑郁在术前排名最高,而术后是日常活动,而不是疼痛/不适,排名最高。
这是第一项研究,旨在可视化住院期间接受肺癌手术患者的 QOL 轨迹。这些信息可能有助于改善围手术期患者护理。