Health-related quality of life and its determinants among cancer patients: evidence from 12,148 patients of Indian database

BACKGROUND

Cancer survivors experience a decrement in health-related quality of life (HRQoL) resulting from the disease as well as adverse effects of therapy. We evaluated the HRQoL of cancer patients, stratified by primary cancer site, stage, treatment response and associated adverse events, along with its determinants.

METHODS

Data were collected from 12,148 patients, sampled from seven purposively chosen leading cancer hospitals in India, to elicit HRQoL using the EuroQol questionnaire comprising of 5-dimensions and 5-levels (EQ-5D-5L). Multiple linear regression was used to determine the association between HRQoL and various socio-demographic as well as clinical characteristics.

RESULTS

Majority outpatients (78.4%) and inpatients (81.2%) had solid cancers. The disease was found to be more prevalent among outpatients (37.5%) and inpatients (40.5%) aged 45-60 years and females (49.3-58.3%). Most patients were found to be in stage III (40-40.6%) or stage IV (29.4-37.3%) at the time of recruitment. The mean EQ-5D-5 L utility score was significantly higher among outpatients [0.630 (95% CI: 0.623, 0.637)] as compared to inpatients [0.553 (95% CI: 0.539, 0.567)]. The HRQoL decreased with advancing cancer stage among both inpatients and outpatients, respectively [stage IV: (0.516 & 0.557); stage III (0.609 & 0.689); stage II (0.677 & 0.713); stage I (0.638 & 0.748), p value < 0.001]. The outpatients on hormone therapy (B = 0.076) showed significantly better HRQoL in comparison to patients on chemotherapy. However, palliative care (B=-0.137) and surgery (B=-0.110) were found to be associated with significantly with poorer HRQoL paralleled to chemotherapy. The utility scores among outpatients ranged from 0.305 (bone cancer) to 0.782 (Leukemia). Among hospitalized cases, the utility score was lowest for multiple myeloma (0.255) and highest for testicular cancer (0.771).

CONCLUSION

Older age, lower educational status, chemotherapy, palliative care and surgery, advanced cancer stage and progressive disease were associated with poor HRQoL. Our study findings will be useful in optimising patient care, formulating individualized treatment plan, improving compliance and follow-up.

Oral surgical procedures under local anaesthesia in day surgery

Background

The objective of this study was to analyze gender-stratified data of patients who underwent day surgery in a hospital based on the type of treatment, type of local anaesthesia, and local anaesthesia complications. By learning all these parameters, it is our main goal to find answers to questions such as what we can do in hospital conditions, what we can win, and what operations we can treat.

Methods

A retrospective review was performed to assess hospital records of 10,750 dental patients who received oral surgery under local anaesthesia at the Istanbul University Department of Oral and Maxillofacial Surgery from August 2013 through June 2016.

Results

Patients mostly received surgery for wisdom teeth, dental implants, or odontogenic cysts or tumours. Men aged 31–40 years (23.66%) and women aged 21–30 years (30.73%) were the largest groups undergoing operations. Surgery for an impacted tooth was the most common ambulatory procedure, accounting for 54.2% of operations. The second most common ambulatory procedure was dental implant surgery (10.2%), followed by root (7.4%), odontogenic cyst (7.2%), and impacted canine surgeries (6.4%). The most common age group receiving surgery was 21–30 years old (3304 patients, 60.75%). Twice as many women as men underwent surgery.

Conclusions

Day case surgery is an expanding area of health care and a valuable method of treating patients in many aspects of oral surgical practice. Different medical and dental specialties can benefit from this ambulatory approach to treatment, which also reduces treatment costs.