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Clinical Trial
. 2015 Mar;136(3):440-5.
doi: 10.1016/j.ygyno.2015.01.547. Epub 2015 Jan 31.

Perioperative trajectory of patient reported symptoms: a pilot study in gynecologic oncology patients

Larissa A Meyer  1 , Alpa M Nick  2 , Qiuling Shi  3 , Xin Shelley Wang  3 , Loretta Williams  3 , Tremaine Brock  2 , Maria D Iniesta  2 , Kelly Rangel  2 , Karen H Lu  2 , Pedro T Ramirez  2
Affiliations
Clinical Trial

Perioperative trajectory of patient reported symptoms: a pilot study in gynecologic oncology patients

Larissa A Meyer et al. Gynecol Oncol. 2015 Mar.

Abstract

Objective: With the growing focus on patient-centered care, patient reported outcomes (PROs) are becoming an important component to clinical trials and quality metrics. The objective of this study was to pilot the collection of patient reported symptom burden in women undergoing surgery in a gynecologic oncology practice.

Methods: Perioperative patient reported symptom burden was measured for women undergoing laparotomy on the gynecologic oncology service at the University of Texas MD Anderson Cancer Center. Symptoms were assessed using the M.D. Anderson Symptom Inventory (MDASI-OC), a 27 item tool validated for use in patients with ovarian cancer. The MDASI-OC was administered as a preoperative baseline, daily while admitted to the hospital after surgery, twice a week on the first week after discharge and then weekly until 8 weeks postoperatively.

Results: 29 patients were evaluable. Seventy-five percent of patients had a diagnosis of ovarian cancer. Of those patients, half underwent a primary debulking surgery and the other half had neoadjuvant chemotherapy prior to interval cytoreductive surgery. In the postoperative inpatient setting, the five symptoms with the highest overall burden were fatigue, pain, abdominal pain, dry mouth and drowsiness. Longitudinal change of the top 5 symptoms during hospitalization did not show any significant difference between those who had neoadjuvant chemotherapy and those who did not.

Conclusion: The collection of longitudinal PROs to assess symptom burden is feasible in patients undergoing gynecologic oncology surgery. Patient reported outcomes are a crucial component of patient-centered research and the longitudinal collection and analysis of symptom burden can allow for more meaningful comparisons of surgical technique and perioperative care.

Keywords: Patient reported outcomes; Surgery; Symptom burden.

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Conflict of interest statement

Conflict of Interest: The authors have no relevant conflicts of interest to report.

Figures

Figure 1
Figure 1
Symptom curve of the most highly ranked symptoms by postoperative patients during their hospitalization.
Figure 2
Figure 2
Comparison of the top 5 ranked postoperative symptoms by women discharged before or after the mean length of stay.
Figure 3
Figure 3
Trajectory of patient report of abdominal pain and correlation with significant clinical events.
Figure 4
Figure 4
Trajectory of top 5 postoperative symptom composite score after hospital discharge.
See this image and copyright information in PMC

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