Abstract

We need to understand the living quality in our population, so we review performance status focus on ECOG 3,4,5 that includes a concept of capable of limited self-care, because this increases expenses at families and health system. We need to understand the variables that increase risk of higher ECOG values. Between January 2004 and December 2013, all patients diagnosed with pathology of SCLC and NSCLC at National Institute of Oncology at Paraguay were analyzed retrospectively. ECOG performance status was recorded and SPSS 20 was used to analyze with logistic Binary regression. We studied 478 subjects. At age mean 60,40 [95% CI 59,45 to 61,34 ] years and ECOG performance status mean 2,13 [95% CI 2,06 to 2,20] points. Bivariate correlations show no relation with age, gender, living place, work, smoking, alcohol consumption, histopathology of lung cancer only with motive of consultation and clinical severity. In our model of predicting a ECOG 3 to 5 adding first motive of consultation show a Nagelkerke R2: 0.14, Hosmer y Lemeshow P: 0.95. Adding to the model clinical severity Nagelkerke R2: 0.07 Hosmer y Lemeshow P: 1.0. Variables in our predicting model show at clinical severity IIB stage OR: 6,62 [95% CI 1,13 to 38,52 P=0.035], clinical severity IIIA stage OR: 3.85 [95% CI 1,18 to 12.51 P=0.025], clinical severity IIIB stage OR:4,49 [95% CI 1,87 to 10,78 P=0.001]. At limited-stage SCLC clinical severity OR: 10,12 [95% CI 1,88 to 54,34 P=0.007]. At first motive of consultation chest paint OR: 3,13 [95% CI 1,38 to 7,11 P=0.006]. Cough OR: 2,30 [95% CI 1,11 to 4,76 P=0.024]. Palpable Tumoral mass OR: 8,35 [95% CI 1,65 to 42,07 P=0.010]. Regardless our expectations about relation of disability of patient with lung cancer about place of living, work, gender, age this variables show no relation with ECOG at 3 to 5. In Our review we found a prediction model with clinical severity adding 7% to prognostic of limited self-care and by adding to the model first motive of consultation a 14% of prognostic of worst ECOG status. If first consultation motive is chest pain, cough or palpable tumoral mass, this are strongly related with worst ECOG values. As a conclusion most of our patients are diagnostic in advance clinical stages with a bad performance status which will limit our options to treatment. All of these can be related with a late consultation or a late detection of the disease.

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