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Ann Surg. 2013 Mar;257(3):555-63. doi: 10.1097/SLA.0b013e31828353af.

Predictors of nursing home admission, severe functional impairment, or death one year after surgery for non-small cell lung cancer.

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1
Department of Surgery, Brigham and Women's Hospital, Boston, MA 02115, USA. sbillmeier@partners.org

Abstract

OBJECTIVE:

To assess factors associated with nursing home admission, severe functional impairment, or death 1 year after surgery for stage I-IIIa non-small cell lung cancer.

BACKGROUND:

Patients perceive long-term disability to be one of the most undesirable complications of lung cancer treatment.

METHODS:

A multiregional cohort was surveyed 12 months after surgery. Logistic regression was used to determine adjusted predictors of long-term disability. Recursive partitioning was used to create a risk index based on preoperative factors.

RESULTS:

Of the 1007 patients, 146 (15%) were admitted to a nursing home or died by 1 year after surgery, with higher risk among patients 80 years or older, those with severe comorbidities, and those with stage II-IIIa disease (all Ps ≤ 0.01). Among 759 survivors who completed the follow-up survey, 51 (7%) were admitted to a nursing home or reported inability to get out of bed, dress or wash themselves, or perform usual activities. Patients with moderate comorbidities (P < 0.001) or lack of high school diploma (P = 0.03) were more likely to experience nursing home admission or severe functional impairment. The risk of nursing home admission, severe functional impairment, or death was low (16%) for patients younger than 75 years and for those 75 years or older with stage I disease, intermediate (33%) for patients 75 years or older with stage II-IIIa disease and no or mild comorbidities, and high (60%) for those 75 years or older with stage II-IIIa disease and moderate or severe comorbidities.

CONCLUSIONS:

Patients' risk of long-term disability should be incorporated in preoperative counseling.

PMID:
23386241
DOI:
10.1097/SLA.0b013e31828353af
[Indexed for MEDLINE]
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