P-150RISK FACTORS FOR QUALITY OF LIFE FOLLOWING LUNG RESECTION SURGERY

Abstract

Objectives: The number of patients undergoing curative surgery for lung cancer is increasing. Whilst it is important to look at crude measures such as mortality, a quality of life questionnaire provides a holistic comparison of a patient's global and physical functioning measures. Therefore, a quality of life tool may identify preventable risk factors to predict and reduce complication and comorbidity rates from pulmonary resection. Method(s): A prospective study of 235 patients, undergoing lung resection, was conducted over a period of 5 years at a regional thoracic surgery unit. Demographic data was collected as well as preoperative and postoperative clinical outcomes such as length of stay, mortality, pulmonary complications and readmission to hospital. The EORTC QLQ-C30 quality of life (QOL) tool was used in this study and questionnaires were administered preoperatively (n=235), postoperatively at 5 weeks (n = 122) and then at 5 months (n=90). Result(s): Mean age was 68 (+/-9.4), mean preoperative FEV1 was 83 (+/-21) % predicted and predicted postoperative FEV1 was 66 (+/-18) %. Thoracotomy, pneumonectomy, preoperative QOL, age over 80, current/recent smoking, not attending preop rehabilitation classes and poor exercise capacity were all associated with poorer QOL within specific domains. Only thoracotomy, pneumonectomy and preoperative QOL score were significantly associated with a drop in global QOL after surgery. There was a significant drop in global QOL from 69 (+/-22) preoperatively to 60 (+/-23) 5 weeks following surgery with a partial recovery to 65 (+/-22) 5 months postop. Conclusion(s): The EORTC QLQ-C30 QOL tool in this study seems to capture the dynamic changes in patient-focused outcomes after lung surgery and picks up expected differences based on well-established risk factors. The poor response rate of postoperative questionnaires could be a barrier for clinical use as an audit tool of quality. Further work is required to understand how we can improve this and determine modifiable risk factors which could affect QOL.