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

Sarah E. Billmeier, John Z. Ayanian, Yulei He, Michael T. Jaklitsch, Selwyn O. Rogers

Research output: Contribution to journalArticle

7 Citations (Scopus)

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

Original languageEnglish (US)
Pages (from-to)555-563
Number of pages9
JournalAnnals of Surgery
Volume257
Issue number3
DOIs
StatePublished - Mar 2013
Externally publishedYes

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Nursing Homes
Non-Small Cell Lung Carcinoma
Comorbidity
Survivors
Counseling
Lung Neoplasms
Logistic Models

Keywords

  • functional impairment
  • functional outcomes
  • non-small cell lung cancer
  • nursing home admission
  • surgery in the elderly

ASJC Scopus subject areas

  • Surgery

Cite this

Predictors of nursing home admission, severe functional impairment, or death one year after surgery for non-small cell lung cancer. / Billmeier, Sarah E.; Ayanian, John Z.; He, Yulei; Jaklitsch, Michael T.; Rogers, Selwyn O.

In: Annals of Surgery, Vol. 257, No. 3, 03.2013, p. 555-563.

Research output: Contribution to journalArticle

Billmeier, Sarah E. ; Ayanian, John Z. ; He, Yulei ; Jaklitsch, Michael T. ; Rogers, Selwyn O. / Predictors of nursing home admission, severe functional impairment, or death one year after surgery for non-small cell lung cancer. In: Annals of Surgery. 2013 ; Vol. 257, No. 3. pp. 555-563.
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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:: PatientsE' risk of long-term disability should be incorporated in preoperative counseling.",
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