Chest
Clinical InvestigationsSURGERYPatient Preferences Regarding Possible Outcomes of Lung Resection
Section snippets
Materials and Methods
The methods used in this report are described in detail elsewhere.14 Sixty-four patients aged 50 to 75 years were interviewed between September 1996 and April 1997 while awaiting appointments at three sites: the general internal medicine clinic of a community teaching hospital (n = 15), a private internal medicine practice (n = 20), and a pulmonary medicine practice (n = 29). Consecutive patients aged 50 to 75 years, regardless of current health or medical diagnoses, were recruited at the
Results
Demographic data are reported in Table 1 . Notably, 60% of participants were women, 20% were African Americans, and the average age was 60 years. Forty-four percent of the patients regarded themselves to be in good health compared with 36% who considered their health to be poor. As previously mentioned, all 29 pulmonary clinic patients had to report lung-related functional limitation or past mechanical ventilation to be enrolled in the study.
Utility scores with 95% confidence intervals (CIs)
Discussion
Individuals who require lung resection are often long-term smokers who at baseline suffer from respiratory debility because of chronic lung disease. Many attempts have been made to identify patients in this group who are likely to encounter postoperative complications.1, 23, 45, 67, 89, 1011, 1213, 1617, 1821, 2223, 2425, 26 Death is certainly an important complication, and past reports suggest that patients with advanced lung disease identified by a predicted postoperative FEV1 < 40% and
Patient Questionnaire Scenarios (all scenarios have the intermediate outcome in italics)
1. You have been diagnosed as having a small lung cancer in the middle of your right lung. To cure the cancer and restore your normal life expectancy, a treatment is available. However, with the treatment, there is a chance of dying immediately. If you did not have the treatment, the cancer would progress, you would be dead in 18 months, and the last 6 months would be marked by physical deterioration, such as an inability to walk more than a few steps, and pain that requires narcotic
ACKNOWLEDGMENT
The authors thank the Internal Medicine Program, the Moses Cone Health System, and the Greensboro Area Health Education Center of the University of North Carolina for their financial and logistical support of this project. We also thank Drs. Patrick Wright and Hal Stoneking for their contributions to this project.
References (31)
- et al.
Early and late morbidity in patients undergoing pulmonary resection with low diffusion capacity
Ann Thorac Surg
(1996) - et al.
Assessment of pulmonary complications after lung resection
Ann Thorac Surg
(1999) - et al.
Assessment of operative risk in patients undergoing lung resection: importance of predicted pulmonary function
Chest
(1994) - et al.
Prediction of postoperative respiratory failure in patients undergoing lung resection for lung cancer
Ann Thorac Surg
(1988) - et al.
Assessment of exercise oxygen consumption as preoperative criterion for lung resection
Ann Thorac Surg
(1987) - et al.
Exercise testing in the evaluation of patients at high risk for complications from lung resection
Chest
(1992) - et al.
Inability to perform bicycle ergometry predicts increased morbidity and mortality after lung resection
Chest
(1995) - et al.
Predicting complications after pulmonary resection: preoperative exercise testing vs a multifactorial cardiopulmonary risk index
Chest
(1993) - et al.
Lung scanning and exercise testing for the prediction of postoperative performance in lung resection candidates at increased risk for complications
Chest
(1995) - et al.
Pulmonary complications in patients undergoing thoracotomy for lung carcinoma
Chest
(1994)
Preoperative smoking habits and postoperative pulmonary complications
Chest
Methods for quality adjustment of life years
Soc Sci Med
Lung resection in patients with compromised pulmonary function
Ann Thorac Surg
Random versus predictable risks of mortality after thoracotomy for lung cancer
J Thorac Cardiovasc Surg
Elective pulmonary lobectomy: factors associated with morbidity and operative mortality
Ann Thorac Surg
Cited by (96)
SABR for Early Non-Small Cell Lung Cancer: Changes in Pulmonary Function, Dyspnea, and Quality of Life
2023, International Journal of Radiation Oncology Biology PhysicsShared Decision Making in Early-Stage Non-small Cell Lung Cancer: A Systematic Review
2022, Annals of Thoracic SurgeryHealth-Related Quality of Life After Lobectomy for Lung Cancer: Conceptual Framework and Measurement
2020, Annals of Thoracic SurgeryEvaluation of Risk for Thoracic Surgery
2020, Surgical Oncology Clinics of North AmericaCitation Excerpt :Indeed, 20% of patients who participate in SDM choose less invasive surgical options and more conservative treatment than do patients who do not use decision aids.48 Patients with lung cancer have expressed their aversion to risk acceptance: however, facing the cancer progression and no alternatives for cure, patients are willing to take extremely high risks of postoperative complications and surgery-related death.49 On the other hand, they are always more demanding about the risks of a permanent and long-lasting disability: the interference of cancer treatment in their daily lifestyle is one of the main treatment outcomes for the patient.
Understanding patients’ values and preferences regarding early stage lung cancer treatment decision making
2019, Lung CancerCitation Excerpt :Participants were asked to rate each statement using an elicitation procedure called prioritization [32]. Values presented were informed by those suggested for measuring value in cancer care [33] along with those reported among lung cancer patients [34–36]. In the next set of questions, we examined the extent to which participants’ valued length of life versus the potential for periprocedural death.
Presented, in part, at the national meeting of the Society of General Internal Medicine, Washington, DC, May 3, 1997.
Supported by the Education Committee of the Moses Cone Health System.