The degree of pulmonary fissure completeness can predict the PCCs and the length of hospital stay following video-assisted thoracoscopic surgery lobectomy for early-stage non-small-cell lung cancer.
Background: Cough is a common respiratory complication in non-small cell lung cancer (NSCLC) patients after surgery. Previous studies have proposed a number of risk factors for postoperative cough; however, these studies are mainly based on traditional thoracotomies and tend to lack adequate objective assessment methods. The purpose of this study was to identify the risk factors of cough in NSCLC patients after video-assisted thoracoscopic surgery (VATS) using the Leicester Cough Questionnaire in Mandarin Chinese (LCQ-MC) to evaluate postoperative cough. Methods: A total of 198 NSCLC patients were enrolled. Overall, 91 patients (46.0%) developed cough after VATS, and 73 patients remained cough after 1 month. Univariate and multivariate logistic regression analyses were performed to identify the independent risk factors of postoperative cough. Results: The independent factors of postoperative cough included female sex [odds ratio (OR) 2.399, 95% confidence interval (CI): 1.260-4.565, P=0.008], duration of anesthesia (over 164 minutes; OR 2.810, 95% CI: 1.368-5.771, P=0.005), resection of the lower paratracheal nodes (OR 3.697, 95% CI: 1.439-9.499, P=0.007), and resection of the subcarinal nodes (OR 4.175, 95% CI: 1.203-14.495, P=0.024). The follow-up LCQ-MC total score after 1 month (18.00±1.80) was significantly higher than the postoperative total score (16.35±2.26; P=0.004). Conclusions: Female sex, duration of anesthesia over 164 minutes, lower paratracheal node resection and subcarinal node resection were independent risk factors related to cough in NSCLC patients after VATS. In addition, the LCQ-MC performed satisfactorily in describing the longitudinal changes in cough symptoms.
BackgroundThere are no validated and reliable cough‐specific instruments to assess health‐related quality of life with respect to postoperative cough in non‐small cell lung cancer (NSCLC) patients. We used the Leicester Cough Questionnaire in Mandarin‐Chinese (LCQ‐MC) and investigated the validity, reliability, and repeatability of this instrument.MethodsA total of 130 NSCLC patients (average age 58.75 ± 9.43 years, 65 men, 65 women) completed the LCQ‐MC, cough Visual Analogue Scale (VAS), Cough Symptom Score (CSS), Hospital Anxiety and Depression Scale (HADS), and Medical Outcomes Study 36‐item Short‐Form Health Survey (SF‐36). Forty patients completed the LCQ‐MC again one week later. Concurrent validity, internal consistency, and repeatability were assessed.ResultsAnalyses of concurrent validity showed significant correlations between the LCQ‐MC and the cough VAS (r = −0.488 to −0.660) and CSS (r = −0.495 to −0.601). The corresponding domains of the LCQ‐MC and the SF‐36 exhibited moderate correlations (r = 0.421–0.432). However, there was no significant correlation between the LCQ‐MC and the HADS (P > 0.05). Internal consistency was acceptable (Cronbach's α of 0.74–0.90). Test‐retest reliability was high (intraclass correlation coefficients of 0.89–0.95).ConclusionThe LCQ‐MC is a reliable, valid instrument for assessing postoperative cough in NSCLC patients.
Background
Cough is a common complication after pulmonary surgery. Previous studies lacked a standard measure to assess postoperative cough-related quality of life and recovery. The purpose of this study is to compare postoperative cough regarding changes in health-related quality of life (HRQOL) and recovery trajectory between video-assisted thoracic surgery (VATS) lobectomy and sublobectomy (segmentectomy or wedge resection) for early-stage non-small cell lung cancer (NSCLC) patients via the Leicester Cough Questionnaire in Mandarin Chinese (LCQ-MC).
Methods
Overall, 156 patients with NSCLC underwent either VATS lobectomy or VATS sublobectomy; LCQ-MC was used to report the impact of postoperative cough on HRQOL for 6 months after surgery. The total scores of LCQ-MC range from 3 to 21, with a higher score indicating better health. Recovery from postoperative cough was defined as LCQ-MC scores returning to preoperative levels. The sensitivity of LCQ-MC to changes in postoperative cough recovery over time was evaluated via its ability to distinguish between surgery types.
Results
The VATS sublobectomy group reported significantly higher mean LCQ-MC scores at 1 month after surgery, but no significant difference postoperatively at 3 and 6 months after surgery, and returned to preoperative physical (69 vs. 99 days), psychological (67 vs. 99 days), social (50 vs. 98 days) and total (69 vs. 99 days) scores faster than the VATS lobectomy group (all p < 0.05).
Conclusion
VATS sublobectomy had generally better HRQOL and faster recovery of postoperative cough than VATS lobectomy. In addition, the LCQ-MC performed satisfactorily in describing the longitudinal changes in postoperative cough.
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