Shortness of breath on the day of discharge: an early alert for post-discharge complications in patients undergoing lung cancer surgery

作者全名：Kang, Dan; Lei, Cheng; Zhang, Yong; Wei, Xing; Dai, Wei; Xu, Wei; Zhang, Jingyu; Yu, Qingsong; Su, Xueyao; Huang, Yanyan; Shi, Qiuling

作者地址：[Kang, Dan; Lei, Cheng; Zhang, Yong; Xu, Wei; Su, Xueyao; Huang, Yanyan; Shi, Qiuling] Chongqing Med Univ, Sch Publ Hlth, Chongqing, Peoples R China; [Wei, Xing; Dai, Wei; Shi, Qiuling] Univ Elect Sci & Technol China, Sichuan Canc Hosp & Inst, Sichuan Clin Res Ctr Canc, Sichuan Canc Ctr,Affiliated Canc Hosp,Dept Thorac, Chengdu, Peoples R China; [Zhang, Jingyu; Shi, Qiuling] Chongqing Med Univ, Coll Biomed Engn, State Key Lab Ultrasound Med & Engn, Chongqing, Peoples R China; [Yu, Qingsong] Chengdu Ctr Dis Control & Prevent, Chengdu 610041, Sichuan, Peoples R China

通信作者：Shi, QL (通讯作者)，Chongqing Med Univ, Sch Publ Hlth, Chongqing, Peoples R China.; Shi, QL (通讯作者)，Univ Elect Sci & Technol China, Sichuan Canc Hosp & Inst, Sichuan Clin Res Ctr Canc, Sichuan Canc Ctr,Affiliated Canc Hosp,Dept Thorac, Chengdu, Peoples R China.; Shi, QL (通讯作者)，Chongqing Med Univ, Coll Biomed Engn, State Key Lab Ultrasound Med & Engn, Chongqing, Peoples R China.

来源：JOURNAL OF CARDIOTHORACIC SURGERY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001258112200008

JCR分区：Q3

影响因子：1.5

年份：2024

卷号：19

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：Lung cancer; Post-discharge complications; Patient-reported outcomes; Shortness of breath; Cutpoint

摘要：Purpose Symptom assessment based on patient-reported outcome (PRO) can correlate with disease severity, making it a potential tool for threshold alerts of postoperative complications. This study aimed to determine whether shortness of breath (SOB) scores on the day of discharge could predict the development of post-discharge complications in patients who underwent lung cancer surgery. Methods Patients were from a study of a dynamic perioperative rehabilitation cohort of lung cancer patients focusing on patient-reported outcomes. Patients were assessed using the Perioperative Symptom Assessment Scale for Lung surgery (PSA-Lung). Logistic regression model was used to examine the potential association between SOB on the day of discharge and complications within 3 months after discharge. The post-discharge complications were taken as the anchor variable to determine the optimal cutpoint for SOB on the day of discharge. Results Complications within 3 months post-discharge occurred in 71 (10.84%) of 655 patients. Logistic regression analysis revealed that being female (OR 1.764, 95% CI 1.006-3.092, P < 0.05) and having two chest tubes (OR 2.026, 95% CI 1.107-3.710, P < 0.05) were significantly associated with post-discharge complications. Additionally, the SOB score on the day of discharge (OR 1.125, 95% CI 1.012-1.250, P < 0.05) was a significant predictor. The optimal SOB cutpoint was 5 (on a scale of 0-10). Patients with an SOB score >= 5 at discharge experienced a lower quality of life 1 month later compared to those with SOB score<5 at discharge (73 [50-86] vs. 81 [65-91], P < 0.05). Conclusion SOB on the day of discharge may serve as an early warning sign for the timely detection of 3 month post-discharge complications.

基金机构：National Key R&D Plan for Intergovernmental Cooperation; Ministry of Science and Technology of China [2022YFE0133100]; Natural Science Foundation of Chongqing, China [CSTB2022NSCQ-MSX0118]; Beijing Xisike Clinical Oncology Research Foundation [Y-2019AZMS-0486]; Postdoctoral Fellowship Program of CPSF [GZC20233357]

基金资助正文：This research was funded by the National Key R&D Plan for Intergovernmental Cooperation, the Ministry of Science and Technology of China (Grant No: 2022YFE0133100), Sponsored by Natural Science Foundation of Chongqing, China (Grant No: CSTB2022NSCQ-MSX0118), Supported by Beijing Xisike Clinical Oncology Research Foundation (Grant No: Y-2019AZMS-0486) and Postdoctoral Fellowship Program of CPSF (GZC20233357).