Association Between Patient Physical Function and Length of Stay After Thoracoscopic Lung Cancer Surgery.

Autor: Valsangkar N; Section of General Thoracic Surgery, Emory University School of Medicine, Atlanta, Georgia., Wei JW; Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia., Binongo JN; Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia., Pickens A; Section of General Thoracic Surgery, Emory University School of Medicine, Atlanta, Georgia., Sancheti MS; Section of General Thoracic Surgery, Emory University School of Medicine, Atlanta, Georgia., Force SD; Section of General Thoracic Surgery, Emory University School of Medicine, Atlanta, Georgia., Gillespie TW; Department of Surgery, Emory University School of Medicine, Atlanta, Georgia., Fernandez FG; Section of General Thoracic Surgery, Emory University School of Medicine, Atlanta, Georgia., Khullar OV; Section of General Thoracic Surgery, Emory University School of Medicine, Atlanta, Georgia. Electronic address: onkar.vohra.khullar@emory.edu.
Jazyk: angličtina
Zdroj: Seminars in thoracic and cardiovascular surgery [Semin Thorac Cardiovasc Surg] 2021 Summer; Vol. 33 (2), pp. 559-566. Date of Electronic Publication: 2020 Nov 11.
DOI: 10.1053/j.semtcvs.2020.10.003
Abstrakt: Patient-reported outcomes (PRO) are an ideal method for measuring patient functional status. We sought to evaluate whether preoperative PRO were associated with resource utilization. We hypothesize that higher preoperative physical function PRO scores, measured via the NIH-sponsored Patient Reported Outcome Measurement Information System (PROMIS), are associated with shorter length of stay (LOS). Preoperative physical function scores were obtained using NIH PROMIS in a prospective observational study of patients undergoing minimally invasive surgery for lung cancer. Poisson regression models were constructed to estimate the association between the length of stay and PROMIS physical function T-score, adjusting for extent of resection, age, gender, and race. Due to the significant interaction between postoperative complications and physical function T-score, the relationship between physical function and LOS was described separately for each complication status. A total of 123 patients were included; 88 lobectomy, 35 sublobar resections. Mean age was 67 years, 35% were male, 65% were Caucasian. Among patients who had a postoperative complication, a lower preoperative physical function T-score was associated with progressively increasing LOS (P  value = 0.006). In particular, LOS decreased by 18% for every 10-point increase in physical function T-score. Among patients without complications, T-score was not associated with LOS (P = 0.86). Preoperative physical function measured via PRO identifies patients who are at risk for longer LOS following thoracoscopic lung cancer surgery. In addition to its utility for preoperative counseling and planning, these data may be useful in identifying patients who may benefit from risk-reduction measures.
(Copyright © 2020 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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