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  P3.04 - Poster Session with Presenters Present (ID 474)

  • Event: WCLC 2016
  • Type: Poster Presenters Present
  • Track: Surgery
  • Presentations: 1
  • Moderators:
  • Coordinates: 12/07/2016, 14:30 - 15:45, Hall B (Poster Area)

  • 18676

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    P3.04-006 - The Effect of Preoperative Multi-Disciplinary Support Commenced at Outpatient Clinic on Lung Cancer Patients (ID 4477)

    14:30 - 14:30  |  Author(s): D. Okutani
    • Abstract
    • Slides

    Background:
    We assessed the effect of preoperative multi-disciplinary support, commenced at the outpatient clinic of our hospital, on patients with lung cancer.
    
    Methods:
    Since 2013, coaching on respiratory rehabilitation is being provided to the lung cancer patients at our outpatient clinic. In 2014, preoperative multi-disciplinary support was introduced in addition to rehabilitation support. Multi-disciplinary team consisted of an anesthesiologist, a nutritionist, pharmacist, medical social worker, and nurse. We examined 54 cases of primary lung cancer patients, undergoing video-assisted lobectomy. Patients were classified into three groups: ‘no support’; ‘rehabilitation alone’, and ‘preope rative support’. The ‘no support’ group received no preoperative support and included the last consecutive 18 cases before the introduction of preoperative support.The ‘rehabilitation alone’ group included 18 consecutive cases, when no other support was available. The ‘preoperative support’ group included 18 consecutive cases, starting from the first patient receiving multi-disciplinary preoperative support.
    
    Results:
    Data are presented in the following order: ‘no support’, ‘rehabilitation alone’, and ‘preoperative support’. Morbidity rates were 27.8%, 16.6%, and 0%, respectively. The number of days of postoperative hospital stay were 11.3/10, 8.7/8, and 6.9/7 (average/median), respectively and there was a significant difference among the groups (p=0.000266). Univariate and multivariate analysis were performed according to the following parameters: age, sex, stage, operation time, blood loss, days of raised body temperature, postoperative complications, days of antibiotic treatment, days with a chest drain, day of first walk postoperatively, clinical path, and preoperative support. In univariate analysis, the number of days with a chest drain, the day of first walk postoperatively, clinical path, and preoperative support correlated with the postoperative stay in hospital. In multivariate analysis, preoperative support was most strongly associated with a shorter postoperative stay according to logistic regression analysis with backward stepwise deletion. Moreover, there was a reduction in the overall medical expenses per patient, in the preoperative support group (p=0.0405). A postoperative questionnaire was administered to patients and their families. Results showed that patients recognized the effect of preoperative interventions on outcome and a shift in patient attitude, from a passive to an active mindset, was observed.
    
    Conclusion:
    Preoperative rehabilitation and nutritional support improve physiological function; anesthesiologist and pharmacist review identify problems and improve strategy; and hearing and explanation by nursing staff increase problem-solving capacity and coping mechanisms of patients. These effects may result in a shorter hospital stay.
    
    

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