A simple patient-reported score, an unexpected recovery indicator

Jingyu Zhang¹, Qiuling Shi^{1, 2, 3}

¹State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China.
²School of Public Health and Management, Chongqing Medical University, Chongqing, China.
³Department of Thoracic Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China.

Recovery after lung cancer surgery is a complex process that means different things to different stakeholders. Clinicians and researchers have been most interested in early and in-hospital recovery; however, patients define recovery as a return to normal life, which occurs after discharge.

Post-surgical cough is the most common complaint of patients undergoing lung cancer surgery. Approximately 25–50% of patients experience cough after surgery, which may last for a long time, including post-discharge. Thus, cough after discharge becomes a major obstacle to patients’ recovery and return to normal life, since it is difficult for patients to cope with this troublesome symptom without any guide from clinicians, who are well informed on how patients’ cough develops after discharge.

Is there any possibility to use a simple method during the patients’ hospitalization to predict the patients’ cough trajectories and their functional recovery after discharge? Yes, the answer is a simple patient-reported cough score at discharge. We analyzed cough trajectories and related recovery status within one month after discharge in 392 patients with lung cancer surgery. We found:

1. The higher the discharge cough of the patient, the worse the post-discharge recovery status.
2. Compared to patients who suffered a mild cough or none at all on the day of discharge, patients who experienced a moderate or severe cough did not have a satisfactory recovery.

This is significant as it means that these patients may require extensive medical care and frequent monitoring after discharge.

Our study established a discharge cut-off point on a single patient-reported cough score that will be validated in an external patient set. For medical staff in the busy clinic, this simple predictor would enable an efficient procedure at discharge to identify target populations who require post-discharge cough management.

Study Details

The symptom severity was rated in a 0-10 points numerical scale (0=absent, 10=as bad as you can imagine) using MDASI-LC. Using the enjoyment of life score at 1 month after discharge as an anchor, we categorized discharge cough severity as none/mild (0≤none/mild < 3 points), moderate (3 points ≤moderate < 6 points), and severe (6 points≤severe≤10 points). On the day of discharge, 45.66% of patients suffered a none/mild cough, 41.82% suffered a moderate cough, and 12.5% suffered a severe cough.

Abstract will be presented virtually in the Thursday Afternoon Poster Presentations: Slot 8 on 20 October, 4:05 pm – 4:20 pm. 

This newsletter editorial represents the views of the author and does not necessarily reflect the views of ISOQOL. 

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