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Annals of Surgical Oncology
Erschienen in: Annals of Surgical Oncology 4/2019

07.01.2019 | Health Services Research and Global Oncology

Psychosocial Risks are Independently Associated with Cancer Surgery Outcomes in Medically Comorbid Patients

verfasst von: Ira L. Leeds, MD, MBA, ScM, Patrick M. Meyers, BA, Zachary O. Enumah, MD, Jin He, MD, PhD, FACS, Richard A. Burkhart, MD, FACS, Elliott R. Haut, MD, PhD, FACS, Jonathan E. Efron, MD, FACS, Fabian M. Johnston, MD, MHS, FACS

Erschienen in: Annals of Surgical Oncology | Ausgabe 4/2019

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Abstract

Background

The specific effect of psychosocial risk factors on surgical outcomes in cancer patients remains unexplored. The purpose of this prospective observational study was to assess the association of preoperative psychosocial risk factors and 30-day complications following cancer surgery.

Methods

Psychosocial risks among elective gastrointestinal cancer surgery patients were ascertained through structured interviews using well-established screening forms. We then collected postoperative course by chart review. Multivariable analysis of short-term surgical outcomes was performed in those with a low versus high number of psychosocial risks.

Results

Overall, 142 patients had a median age of 65 years (interquartile range 55–71), 55.9% were male, and 23.1% were non-White. More than half (58.2%) of the study population underwent a resection for a hepato-pancreato-biliary primary tumor, and 31.9% had a colorectal primary tumor. High-risk biomedical comorbidities were present in 43.5% of patients, and three-quarters of patients (73.4%) had at least one psychosocial risk. Complication rates in patients with at least one psychosocial risk were 28.0 absolute percentage points higher than those with no psychosocial risks (54.4% vs. 26.2%, p = 0.039). Multiple psychosocial risk factors in medically comorbid patients independently conferred an increase in the odds of a complication by 3.37-fold (95% CI 1.08–10.48, p = 0.036) compared with those who had one or no psychosocial risks.

Conclusions

We demonstrated a more than threefold odds of a complication in medically comorbid patients with multiple psychosocial risks. These findings support the use of psychosocial risks in preoperative assessment and consideration for inclusion in preoperative optimization efforts.
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Metadaten
Titel
Psychosocial Risks are Independently Associated with Cancer Surgery Outcomes in Medically Comorbid Patients
verfasst von
Ira L. Leeds, MD, MBA, ScM
Patrick M. Meyers, BA
Zachary O. Enumah, MD
Jin He, MD, PhD, FACS
Richard A. Burkhart, MD, FACS
Elliott R. Haut, MD, PhD, FACS
Jonathan E. Efron, MD, FACS
Fabian M. Johnston, MD, MHS, FACS
Publikationsdatum
07.01.2019
Verlag
Springer International Publishing
Erschienen in
Annals of Surgical Oncology / Ausgabe 4/2019
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-018-07136-3

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