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Original Articles: General Thoracic

Quality of Life and Mood in Older Patients After Major Lung Resection

Department of Surgery, The University of Chicago, Chicago, Illinois

Accepted for publication December 26, 2008.

^_* Address correspondence to Dr Ferguson, Department of Surgery, 5841 S Maryland Ave, MC 5035, Chicago, IL 60637 (Email: mferguso{at}surgery.bsd.uchicago.edu).

Presented at the Fifty-fifth Annual Meeting of the Southern Thoracic Surgical Association, Austin, TX, Nov 5–8, 2008.

Background: The increasing percentage of older patients undergoing lung resection for cancer necessitates a better understanding of long-term outcomes in this population. We studied the associations among quality of life, mood, clinical factors, and age after major lung resection.

Methods: Outcomes for quality of life and mood questionnaires were compared with clinical factors for older (70 years) and younger (<70 years) patients who recovered from major lung resection for stage I or II lung cancer from 1996 to 2006 and were without evidence of recurrence.

Results: Of 221 eligible patients, 124 completed questionnaires; 55 (44%) were older (age 76 ± 4 years). The time from resection was 2.6 ± 1.6 years. Despite similar comorbidities, older patients were more likely to experience pulmonary (11% versus 3%; p = 0.14), cardiovascular (9% versus 1%; p = 0.087), or any complications (25% versus 12%; p = 0.045). Quality of life function, mood, and symptom scores were similar between the two groups except older patients experienced worse physical function (p = 0.067), fatigue (p = 0.068), and dyspnea (p = 0.094). Postoperative pulmonary complications were related to physical function and dyspnea scores. Covariates for worst quartile scores were percent predicted forced expiratory volume in the first second (physical function, role function, fatigue, pain, and dyspnea) and pulmonary complications (physical function).

Conclusions: Quality of life after recovery from lung resection is similar for older and younger patients despite an increased frequency of postoperative complications among older patients. Important quality of life and symptom score differences are related to percent predicted forced expiratory volume in the first second. This information may help with patient selection and preoperative counseling.