TY - JOUR
T1 - Predictors of nursing home admission, severe functional impairment, or death one year after surgery for non-small cell lung cancer
AU - Billmeier, Sarah E.
AU - Ayanian, John Z.
AU - He, Yulei
AU - Jaklitsch, Michael T.
AU - Rogers, Selwyn O.
PY - 2013/3
Y1 - 2013/3
N2 - 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:: PatientsE' risk of long-term disability should be incorporated in preoperative counseling.
AB - 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:: PatientsE' risk of long-term disability should be incorporated in preoperative counseling.
KW - functional impairment
KW - functional outcomes
KW - non-small cell lung cancer
KW - nursing home admission
KW - surgery in the elderly
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U2 - 10.1097/SLA.0b013e31828353af
DO - 10.1097/SLA.0b013e31828353af
M3 - Article
C2 - 23386241
AN - SCOPUS:84873914652
SN - 0003-4932
VL - 257
SP - 555
EP - 563
JO - Annals of surgery
JF - Annals of surgery
IS - 3
ER -