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Sandra Dixon



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    MA17 - New Methods to Improve Lung Cancer Patients Outcomes (ID 918)

    • Event: WCLC 2018
    • Type: Mini Oral Abstract Session
    • Track: Nursing and Allied Professionals
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/25/2018, 13:30 - 15:00, Room 205 AC
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      MA17.11 - Multi-Centred, Prospective, Audit to Identify Readmission Causes and Complications Within 30 of Primary Lung Cancer Surgery (ID 11916)

      14:40 - 14:45  |  Author(s): Sandra Dixon

      • Abstract
      • Presentation
      • Slides

      Background

      Surgery remains the first choice of curative treatment, for patients with non-small lung cancer, the proportion of patients undergoing surgery has risen in recent years. Post-operative complications are well recognised following curative lung cancer surgery but there is limited data on readmission rates and causes . The UK Thoracic Surgery Group (TSG), a subgroup of the National Lung Cancer Forum (NLCNF) conducted a multicentre audit to assess readmission potential causes and patient experience.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      The audit involved 6 UK thoracic surgical centres with prospective data collection over 3 months from primary lung cancer resection patients. Patients were contacted 1 month post discharge by telephone. Data collection included demographics, socioeconomic, smoking status, comorbidities, surgery, postoperative recovery, discharge satisfaction and readmission details.

      4c3880bb027f159e801041b1021e88e8 Result

      268 patients underwent thoracic surgery, the overall readmission rate was 11% (30), with variable readmission rate across the centres (range 3-24%), most readmission occurred within 7 days of discharge 47% (14) with patients being readmitted to a hospital that did not performed the procedure 43%(17). The most common cause of readmission was mainly pulmonary related with chest infections being largest cause, pain, wound infection and pneumothorax were also common. Length of stay following readmission was longer than initial surgical stay median 8 (range 0-94) vs 5 (range 2-27).Type of surgical approach had no impact on readmission. However readmission was associated with smoking, post-operative complications, discharge with drain, length of stay post-surgery and the patient’s readiness for discharge (see table 1).

      table 1.png

      8eea62084ca7e541d918e823422bd82e Conclusion

      This audit provides a broad overview of the pattern and trend of readmissions rates within 30 days post discharge following lung cancer resection. Whilst not every readmission can be avoided, there is opportunity to identify and prevent patient readmission. Listening to patient’s assessment of their readiness for discharge is crucial to facilitating patient compliance with discharge and confidence in community carers.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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    P3.16 - Treatment of Early Stage/Localized Disease (Not CME Accredited Session) (ID 982)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/26/2018, 12:00 - 13:30, Exhibit Hall
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      P3.16-08 - Baseline Quality of Life is Influenced by the Duration of Abstinence from Smoking in Candidates to Lung Cancer Surgery (ID 12350)

      12:00 - 13:30  |  Author(s): Sandra Dixon

      • Abstract
      • Slides

      Background

      The optimal interval of smoking cessation before Non-Small Cell Lung Cancer (NSCLC) surgery is still unknown. The objective of this study is to evaluate the influence of smoking cessation on the preoperative quality of life (QoL) of surgical NSCLC patients.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      266 consecutive ever smokers (133 females) with a pack year history >=20 undergoing lung resections for NSCLC and with complete preoperative QoL data were analysed. The EORTC QoL summary score was calculated (SumS) as the average of the individual functional and reversed symptom scales (excluding Global-Health and Financial-Impact scales). The following smoking-related variables were tested for a possible association with SumS: age when the patient quit smoking and months elapsed from smoking cessation (for current smokers a value of 0 was used). These variables were entered as independent predictors in a stepwise multivariable regression analysis along with several patient-related baseline factors.

      4c3880bb027f159e801041b1021e88e8 Result

      108 patients were current smokers, 158 were ex smokers (quit at least 1month before surgery). We found no difference of preoperative QoL SumS between current smokers and ex smokers (81.5 vs. 83.0, p=0.66). Amongst the 158 ex-smokers, 69 quit smoking before the age of 60. Their SumS was similar to the one of those who quit older (84.2 vs. 82.0, p=0.30). A linear regression showed a significant association between the duration of abstinence from smoke and their QoL SumS (coefficient 0.02, SE 0.009, p=0.03). When the analysis was adjusted for other confounders using a multivariable regression analysis, the duration of abstinence from smoking (p<0.0001-longer time better QoL)(Fig1) and the age at which the patient quit smoking (p=0.001-older age better QoL)remained independently associated with SumS along with performance score.

      Figure 1: Lowess Curve plotting SumS against the months elapsed from the time quit smoking.

      fig 1.tif

      8eea62084ca7e541d918e823422bd82e Conclusion

      Patients should be counselled to stop smoking prior surgery independently as the QoL has expected to increase.

      6f8b794f3246b0c1e1780bb4d4d5dc53

      Only Active Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login or select "Add to Cart" and proceed to checkout.