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肺癌手术患者出院时症状负担及其影响因素分析:横断面研究。

Profiling symptom burden and its influencing factors at discharge for patients undergoing lung cancer surgery: a cross-sectional analysis.

机构信息

Department of Thoracic Surgery, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, People's Republic of China.

State Key Laboratory of Biomedical Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, People's Republic of China.

出版信息

J Cardiothorac Surg. 2022 Sep 3;17(1):229. doi: 10.1186/s13019-022-01974-9.

Abstract

BACKGROUND

Following lung cancer surgery, patients often experience severe symptoms which are not properly assessed at discharge. The aim of this study was to identify the clinical presentation at discharge and the influencing factors of postoperative symptoms in patients who have undergone lung cancer surgery.

METHODS

This cross-sectional study analysed data from patients who participated in a prospective cohort study that enrolled patients who underwent lung cancer surgery at six tertiary hospitals in the People's Republic of China, from November 2017 to January 2020. Patient symptoms at discharge were measured using the MD Anderson Symptom Inventory Lung Cancer module. The five core symptoms were defined according to ratings of moderate to severe symptoms (≥ 4 on a 0-10 scale). A multivariate linear regression model was used to identify the influencing factors of each symptom at discharge.

RESULTS

Among the 366 participants, 51.9% were male and the mean (SD) age was 55.81 (10.43) years. At discharge, the core symptoms were cough (36.4%), pain (28.2%), disturbed sleep (26.3%), shortness of breath (25.8%), and fatigue (24.3%), and more than half of the participants (54.6%) had one to five of the core symptoms, with moderate to severe severity. A low annual income and the use of two chest tubes were significantly associated (P = 0.030 and 0.014, respectively) with higher mean scores of the core symptoms.

CONCLUSION

Though clinically eligible for discharge, more than half of the participants had severe symptoms at discharge after lung cancer surgery. Special attention should be given to patients who have two chest tubes after surgery and those who have a low annual income.

摘要

背景

肺癌手术后,患者常出现严重症状,但在出院时未得到充分评估。本研究旨在确定肺癌手术后患者出院时的临床表现及术后症状的影响因素。

方法

本横断面研究分析了参加中国六家三级医院前瞻性队列研究的患者数据,研究对象为 2017 年 11 月至 2020 年 1 月期间接受肺癌手术的患者。采用 MD Anderson 症状评估量表肺癌模块评估患者出院时的症状。根据中度至重度症状(评分≥4 分)定义了 5 种核心症状。采用多元线性回归模型确定出院时各症状的影响因素。

结果

366 名参与者中,51.9%为男性,平均(SD)年龄为 55.81(10.43)岁。出院时,核心症状为咳嗽(36.4%)、疼痛(28.2%)、睡眠障碍(26.3%)、呼吸困难(25.8%)和疲劳(24.3%),超过一半的参与者(54.6%)有 1 至 5 种核心症状,且症状严重程度为中度至重度。低年收入和使用两根胸腔引流管与核心症状的平均评分较高显著相关(P=0.030 和 0.014)。

结论

尽管临床适合出院,但超过一半的肺癌手术后患者在出院时仍存在严重症状。术后使用两根胸腔引流管和低年收入的患者应给予特别关注。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8aa5/9441056/d60dcf10cc6f/13019_2022_1974_Fig1_HTML.jpg

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