Chen Anna, Dusza Stephen, Bromberg Jacqueline, Goldfarb Shari, Sanford Rachel, Markova Alina
Memorial Sloan Kettering Cancer Center.
Res Sq. 2024 Sep 2:rs.3.rs-4797536. doi: 10.21203/rs.3.rs-4797536/v1.
Malignant wounds can present in up to 14.5% of patients with advanced cancer, significantly reducing quality of life (QoL). Management of malignant wounds is generally palliative, with the goal of improving or maintaining QoL. There is a lack of data on the impact of wound care clinics on QoL in patients with malignant wounds.
We sought to assess the QoL in patients with malignant wounds attending a wound care clinic. We also aimed to describe the baseline QoL, trends in QoL, physical symptoms, and treatment modalities that affect QoL in patients with malignant wounds over time.
This retrospective observational study included 36 patients attending a wound care clinic at an oncologic hospital from 1/1/2016-4/1/2023. As part of the standard of care, these patients complete a Skindex-16 QoL survey at each visit. The Skindex-16 is a validated instrument to measure the effects of skin diseases on QoL. Data were extracted from the electronic medical record. Descriptive statistics, graphical methods, and random effects models for change were used to describe the patient population and the QoL measures over time.
Of the 36 patients who completed at least one Skindex-16 questionnaire, 69.4% were female, and 50.0% developed malignant wounds from breast cancer, 30.5% from nonmelanoma skin cancer, and 8.3% from sarcoma. At the initial visit, 86.1% of patients had exudate associated with their malignant wound, 52.7% of patients had malodor, 63.9% had bleeding, 69.4% had pain, and 50% had pruritus. The mean baseline Skindex-16 score was 54.5, falling into the "extremely severe" category, with a mean score of 15.4, 18.8, and 20.3 for the symptoms, emotions, and functioning domains, respectively. Nineteen patients completed at least one additional Skindex-16 questionnaire at follow-up visits (visit two 52.8%, visit three 33.3%, visit four 19.4%, visit five or greater 13.9%). Compared to the mean Skindex-16 score at baseline, there was an 18.5 point improvement at visit 2 (95% CI: 3.3-33.7, p = 0.018).
Malignant wounds severely adversely affect patients' quality of life. However, patients experienced improved quality of life after being treated at a dedicated wound clinic.
晚期癌症患者中高达14.5%会出现恶性伤口，这显著降低了生活质量（QoL）。恶性伤口的管理通常是姑息性的，目标是改善或维持生活质量。关于伤口护理诊所对恶性伤口患者生活质量影响的数据匮乏。
我们试图评估在伤口护理诊所就诊的恶性伤口患者的生活质量。我们还旨在描述恶性伤口患者的基线生活质量、生活质量趋势、身体症状以及随着时间推移影响生活质量的治疗方式。
这项回顾性观察研究纳入了2016年1月1日至2023年4月1日在一家肿瘤医院伤口护理诊所就诊的36例患者。作为护理标准的一部分，这些患者每次就诊时都要完成一份Skindex-16生活质量调查问卷。Skindex-16是一种经过验证的工具，用于测量皮肤疾病对生活质量的影响。数据从电子病历中提取。使用描述性统计、图形方法和变化的随机效应模型来描述患者群体和随时间变化的生活质量指标。
在完成至少一份Skindex-16问卷的36例患者中，69.4%为女性，50.0%的恶性伤口由乳腺癌引起，30.5%由非黑色素瘤皮肤癌引起，8.3%由肉瘤引起。在初次就诊时，86.1%的患者的恶性伤口有渗出液，52.7%的患者有恶臭，63.9%有出血，69.4%有疼痛，50%有瘙痒。Skindex-16的平均基线评分为54.5，属于“极其严重”类别，症状、情绪和功能领域的平均评分分别为15.4、18.8和20.3。19例患者在随访就诊时至少又完成了一份Skindex-16问卷（第二次就诊时为52.8%，第三次就诊时为33.3%，第四次就诊时为19.4%, 第五次或更多次就诊时为13.9%）。与基线时的Skindex-16平均评分相比，第二次就诊时提高了18.5分（95%可信区间：3.3 - 33.�，p = 0.018）。
恶性伤口严重地对患者的生活质量产生不利影响。然而，患者在专门的伤口诊所接受治疗后生活质量得到了改善。
