医学
萧条(经济学)
焦虑
内科学
胰腺癌
前瞻性队列研究
癌症
胰腺切除术
逻辑回归
糖尿病
物理疗法
胰腺
精神科
内分泌学
宏观经济学
经济
作者
Massimiliano Tuveri,Giampaolo Perri,Veronica Marinelli,Gabriella Lionetto,Laura Addari,Chiara Cova,Lidia Del Piccolo,Roberto Salvia,Claudio Bassi
出处
期刊:Pancreatology
[Elsevier]
日期:2022-11-01
卷期号:22 (7): 1035-1040
被引量:2
标识
DOI:10.1016/j.pan.2022.10.001
摘要
This study aims to assess the prevalence of preoperative fatigue, depression and anxiety among patients undergoing pancreatic surgery for pancreatic cancer (PC), and possible relationship with postoperative outcomes.Prospective data from 162 consecutive patients undergoing pancreatectomy for PC at a third-level referral centers for pancreatic surgery were collected. All patients preoperatively completed four questionnaires assessing depression (PHQ-9), anxiety (STAI-Y2), chronic illness fatigue (FACIT-F) and cancer therapy fatigue (FACT-G).Forty patients (25%) where in the first quartile for chronic illness (FACIT-F ≤34) and/or cancer therapy (FACT-G ≤78) fatigue, 26 patients (16%) met the criteria for major depression (PHQ-9 ≥10) and 34 patients (21%) had anxiety symptoms (STAI-Y2 ≥40). Cancer therapy fatigue was significantly associated with higher rates of morbidity (70% vs 49%), major morbidity (Clavien-Dindo ≥3) (28% vs 11%), post-pancreatectomy hemorrhage (18% vs 4%), pulmonary complications (20% vs 9%) and mortality (8% vs null) (all P ≤ 0.01). Major depression was associated with higher rates of post-pancreatectomy hemorrhage and readmission (23% vs 5%). Multivariable logistic regression analysis of preoperative factors confirmed diabetes (OR 2.71, 95%CI 1.01-7.20; P = 0.04), ASA score ≥3 (OR 4.12, 95%CI 1.52-11.21; P < 0.01) and cancer therapy fatigue (OR 2.95, 95%CI 1.01-8.74; P = 0.04) to be independent predictors of major morbidity.Higher levels of fatigue (in particular cancer therapy fatigue) strongly correlates with worse postoperative outcomes.
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