胸腔镜肺癌手术患者报告疲劳的纵向轨迹。

IF 3.4 2区 医学 Q2 ONCOLOGY
Annals of Surgical Oncology Pub Date : 2025-08-01 Epub Date: 2025-05-17 DOI:10.1245/s10434-025-17444-0
Zijie Li, Junhan Wu, Chaojian Chen, Chaofan Liu, Rixin Chen, Shujie Huang, Cheng Deng, Qiuling Shi, Guibin Qiao
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引用次数: 0

摘要

背景:术后疲劳被广泛认为是手术最普遍的不良反应之一,是功能恢复和生活质量的关键决定因素。然而,疲劳通常是在单个时间点测量的,无法捕捉到它的动态特性。本研究旨在描述术后疲劳的纵向轨迹,并确定潜在的因素。方法:这项回顾性研究纳入了2021年3月至2023年10月期间接受胸腔镜手术的肺癌患者。患者术后7天每天完成肺手术围手术期症状评估量表(PSA-Lung)。潜在类别混合模型用于分析纵向患者报告的数据,并根据轨迹特征确定亚组。结果:共纳入1096例患者。三聚类轨迹模型拟合最佳,分别为恶化疲劳组(17.7%)、恢复疲劳组(31.4%)和轻度疲劳组(50.9%)。与轻度疲劳组相比,合并合并症的患者进入恢复疲劳组的风险更高(优势比1.44,95%可信区间1.02-2.04;P = 0.040)。恢复性疲劳的存在与术前血红蛋白水平降低相关(p = 0.025)。此外,较低的术前体重指数和白蛋白水平增加了归为恶化-疲劳组的可能性(p = 0.022和p = 0.026)。结论:本研究阐明了疲劳轨迹的异质性,有一半的患者经历了恢复疲劳或恶化疲劳。有合并症或营养状况不佳的患者术后疲劳的严重程度更严重。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Longitudinal Trajectory of Patient-Reported Fatigue in Patients Undergoing Thoracoscopic Lung Cancer Surgery.

Background: Postoperative fatigue is widely recognized as one of the most prevalent adverse effects of surgery, representing a critical determinant of functional recovery and quality of life. However, fatigue is commonly measured at a single time point, failing to capture its dynamic nature. This study aimed to characterize the longitudinal trajectories of postoperative fatigue and identify the potential factors.

Methods: This retrospective study included patients with lung cancer who underwent thoracoscopic surgery between March 2021 and October 2023. Patients completed the Perioperative Symptom Assessment for Lung Surgery Scale (PSA-Lung) daily for 7 days after surgery. Latent class mixed modeling was used to analyze the longitudinal patient-reported data and identify subgroups based on trajectory features.

Results: A total of 1,096 patients were included. Three-cluster trajectory model provided the best fit, consisting of deterioration-fatigue group (17.7%), recovery-fatigue group (31.4%) and mild-fatigue group (50.9%). Compared with the mild-fatigue group, patients with comorbidities had a higher risk of being categorized into the recovery-fatigue group (odds ratio 1.44, 95% confidence interval 1.02-2.04; p = 0.040). The presence of recovery-fatigue was associated with lower preoperative hemoglobin level (p = 0.025). Moreover, lower preoperative body mass index and albumin level increased the likelihood of being classified as the deterioration-fatigue group (p = 0.022 and p = 0.026, respectively).

Conclusions: This study elucidated the heterogeneity of fatigue trajectories, with half of the patients experiencing either recovery-fatigue or deterioration-fatigue. The severity of postoperative fatigue was found to be worse in patients with comorbidities or poor nutritional status.

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来源期刊
CiteScore
5.90
自引率
10.80%
发文量
1698
审稿时长
2.8 months
期刊介绍: The Annals of Surgical Oncology is the official journal of The Society of Surgical Oncology and is published for the Society by Springer. The Annals publishes original and educational manuscripts about oncology for surgeons from all specialities in academic and community settings.
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